Summary NREMT Paramedic Drugs (Verified)

Summary NREMT Paramedic Drugs (Verified) ACETAMINOPHEN Class: Anti-pyretic Indications: Fever Contraindications: Liver failure; hypersensitivity; exceed max dose Side effects: Liver toxicity Adult Dose: 1 g q 6 hours; max 4 g in 24 hours Pediatric Dose: 15 mg/kg q 6 hours Special info: Tylenol ADENOSINE TRADE NAME: Adenocard CLASS: Antiarrhythmic ACTIONS: Slows (decreases) AV conduction INDICATIONS: Symptomatic PSVT, including Wolff-Parkinson-White Syndrome (WPW) PHARMACOKINETICS: Onset: 20 - 35 seconds Peak Effect: 20 - 35 seconds Duration: 30 - 120 seconds Half Life: 10 seconds CONTRAINDICATIONS: Second or third degree heart block, sick-sinus syndrome, known hypersensitivity to the drug, dysrhythmias other than PSVT, reactive airway diseases like asthmea. PRECAUTIONS: Arrhythmias, including blocks, are common at the time of cardioversion. Use with caution in patients with asthma. SIDE EFFECTS: CNS: Dizziness, near syncope, syncope CV: PVCs, PACs, sinus tachycardia, sinus bradycardia, AV blocks, chest pain, facial flushing, headache Resp: SOB, bronchoconstriction GI/GU: Nausea DOSAGE: ADULT: 6 mg rapid IV bolus over 1-2s; after 1-2 minutes, 12-mg dose over 1-2 seconds. PEDIATRIC: Initial dose: 0.1mg/kg; max 1st does = 6mg; Rapid IV bolus w/5cc flush ROUTES: IV with 20cc flush ALBUTEROL TRADE NAME: Proventil, Ventolin CLASS: Sympathetic Agonist DESCRIPTION: Sympathomimetic bronchodilator selective for β2 adrenergic receptors ACTIONS: Selective direct acting β2 agonist INDICATIONS: Bronchial asthma, emphysema, chronic bronchitis, allergic bronchospasm, or other reversible bronchospasm PHARMACOKINETICS: Onset: 5 - 15 minutes Peak Effect: 1 - 1.5 hours Duration: 3 - 6 hours Half Life: 3 hours CONTRAINDICATIONS: Know hypersensitivity to Albuterol. SIDE EFFECTS: CNS: Tremor, anxiety, dizziness, seizure CV: Headache, palpations, HTN, tachycardia, chest pain Resp: Bronchospasm (paradoxical effect) GI/GU: Nausea, vomiting, dry mouth DOSAGE For patients in emergency setting: ADULT: Nebulizer: 2.5mg in 3cc normal saline or 5mg in 6cc normal saline via HHN over 5 - 15 min. Repeat 10-20 min. prn, maximum 10mg/hr (4 treatments) MDI- 1-2 inhalations (90mcg each) many repeat every 15 minutes prn. PEDIATRIC: 0.15 mg/kg in 2.5-3.0 ml NS via HHN. Repeat prn. ROUTES: Nebulizer, metered-dose inhaler (MDI) PACKAGED: Premixed unit dose of 2.5mg in 2.5ml NS. AMIODARONE TRADE NAME: Cordarone, Pacerone CLASS: Antiarrhythmic ACTIONS: Prolongs action potential and refractory period. Slows the sinus rate; Increases PR and QT intervals. Decreases Peripheral vascular resistance. INDICATIONS: Life-threatening cardiac arrhythmias such as ventriculartachycardia and ventricular fibrillation. PHARMACOKINETICS: Onset: 2 minutes IV. Oral: 2-3 days Peak Effect: 6 - 20 minutes Duration: Varies Half Life: Varies, 30 - 100 days post oral administration CONTRAINDICATIONS: Hypersensitivity to Amiodarone, heart failure, severe sinus node dysfunction (sinus bradycardia, 2nd Œ 3rd degree blocks), cardiogenic shock SIDE EFFECTS: CNS: dizziness CV: Headache, bradycardia, hypotension, sinus arrest, prolonged PR, QRS, QT intervals, CHF, AV block, cardiogenic shock, palpations, chest pain Resp: Dyspnea, pulmonary fibrosis GI/GU: Nausea, vomiting DOSAGE: ADULT: V-Fib / V-Tach without pulses: 300 mg IV (max is 2.2g IV/24 hrs) Ventricular arrhythmias with a pulse: 150 mg over 10 minute. rpt every 10 min. Maintenance Infusion: 540mg IV over 18 hours (0.5mg/min) PEDIATRIC: Pulseless arrest: 5mg/kg rapid IV bolus, Perfusing tachycardia: 5mg/kg IV over 20-60 min. ROUTE: IV ASPRIN TRADE NAME: ASA, Bufferin, Ecotrin, Empirin, etc. CLASS: Platelet aggregate inhibitor, analgesic, non-steroidal anti-inflammatory (NSAID), antipyretic Description: Anti-inflammatory, inhibits platelet function ACTIONS: Blocks platelet aggregation. INDICATIONS: New-onset chest pain suggestive of MI signs and symptoms suggestive or recent CVA. PHARMACOKINETICS: Onset: 5 - 30 minutes Peak Effect: 15 - 120 minutes Duration: 1 - 4 hours Half Life: 15 - 20 minutes CONTRAINDICATIONS: GI bleed, ulcer, hemorrhagic stroke, bleeding disorders, kids with flu symptoms. Hypersensitivity to salicylates, relatively contraindicated in active ulcer disease & asthma. May cause GI upset/bleeding. Administer cautiously to patients with bleeding disorders and those who report allergies to non-steroidal anti-inflammatory (NSAID) drugs. Contraindicated in children 16 - 19 years of age with flu or chickenpox symptoms due to incidence of Reye's syndrome. SIDE EFFECTS: CV: Prolonged bleeding Resp: Wheezing, bronchspasm GI/GU: Nausea, vomiting, heartburn, GI bleeding DOSAGE: ADULT:324 mg PO (4 x 81 mg chewable preferred) as soon as possible after onset of chest pain. PEDIATRIC: Not recommended for use in the field with children. ROUTE: PO ATROPINE TRADE NAME: Atropine, Atropa CLASS: Anticholingeric Description: Anticholingeric, antimuscarinic, parasympatholytic ACTIONS: Decreases vagal tone resulting in positive chronotropic effect & increases AV conduction. Competitive antagonist for acetylcholine at muscarinic receptors. Atropine bronchodilates via parasympatholytic mechanism. INDICATIONS: Hemodynamically significant bradycardia and asystole. Cholinergic poisoning by certain mushrooms (Amanita spp.), insecticides (carbamates, acetycholinesterase inhibitors), and nerve gas. PHARMACOKINETICS: Onset: 2 minutes Peak Effect: 2 - 4 min. IV (20 - 60 min. IM) Duration: 4 hours Half Life: 2 - 3 hours CONTRAINDICATIONS: No significant contraindications, however, may worsen bradycardia associated with Mobitz-Type 2 and complete heart block. Use transcutaneous pacing if available. Use with extra caution in patients with symptoms of myocardial ischemia. SIDE EFFECTS: CNS: Pupillary dilation, confusion, restlessness, drowsiness, seizure CV: Tachycardia, paradoxical bradycardia Resp: Can cause mucus plugs due to drying of secretions GI/GU: Dry Mouth INTERACTIONS: Additive anticholinergic effects with antihistamines, phenothiazines, antipsychotics, tricyclic antidepressants, procainamide, other anticholinergics drugs. Caution with SSRIs. DOSAGE: ADULT: Symptomatic Bradycardias 0.5 - 1.0mg IV push; may be repeated q 3-5 minutes to a maximum of 0.04mg/kg; (2.5 - 3mg adults) results in full vagal blockage. Doses of less than 0.5mg may cause further slowing of the heart rate. Asystole & PEA initially 1.0mg IV; may be repeated q 3-5 minutes for total of 3mg. ETT-2.0mg Poisoning initially 1mg rapid IV, 2nd 1mg slow IV; larger doses may be required. Dosage exceeding 4mg by physician order only. PEDIATRIC: 0.05mg/kg IV, IM, IO every 10-15 min. ROUTE: IV, IO, ET (May be administered via *ABT in some cases of bronchospasm. Smaller doses of atropine are indicated for the elderly.) NOTES: Monitor vital signs carefully. BENADRYL Packaged: 1cc (50mg/1ml) Ampoule or Vial. Dose: 25-50mg IV or 50mg IM max is 400mg per day Actions: An antihistamine with anticholinergic (drying) and sedative side effects. Prevents but does not reverse histamine mediated responses, particularly on the smooth muscles of the airway, GI tract, uterus, and blood vessels. CALCIUM CHLORIDE Packaged: 10 grams in 10ML Dose: 4mg/kg IV slow Actions: Increases the force of myocardial contraction; calcium may either increase or decrease systemic vascular resistance CARDIZEM Packaged: 25mg in 5cc Dose: .25mg/kg for first dose, .35mg/kg in second dose Actions: Calcium channel blocker that slows AV nodal conduction time and prolong AV refractoriness.