EMT Pharmacology

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Glucose: Indication

Change of mental status and a history of diabetes

Glucose: Contra-indication

Unconscious, unable to swallow; suspected stroke

Glucose: Medical Control Type

Standing order; obtain blood glucose level and on-line medical control if suspected stroke

Glucose: Action

Raises blood sugar

Glucose: Form

Gel, tablet

Glucose: Dosage

"1 Tube" or dose until patient regains mental status (2 tubes max dose)

Epinephrine: Indication

Severe allergic reaction: Stridor, Bronchospasm, severe abdominal pain, respiratory distress, tachycardia, shock (systolic<90), observe for edema of lips, face, tongue, generalized urticaria

Epinephrine: Contra-indication

None

Epinephrine: Medical Control Type

Standing order unless patient is older than 65 or younger than 5 yrs old

Epinephrine: Action

Bronchodilator, vasoconstrictor

Epinephrine: Form

Liquid

Epinephrine: Dosage

0.3 mg adult; 0.15 mg child (max dose of 2 five min. apart)

Activated Charcoal: Indication

Poisoning

Activated Charcoal: Contra-indication

Unconscious; unable to swallow; ingestion of hydrocarbon, petroleum distillate, corrosive substances, or heavy metals

Activated Charcoal: Medical Control Type

On-line

Activated Charcoal: Action

Adsorbs and binds poisons (Sorbitol = laxative)

Activated Charcoal: Form

Suspension

Activated Charcoal: Dosage

Adult 25-50 g; Child 12.5-25 g (1g per kg)

Pralidoxime (Mark I): Indication

Severe organophosphate poisoning characterized by muscle twitching, respiratory depression, and paralysis; Cholinergic syndrome symptoms

Pralidoxime (Mark I): Contra-indication

Non-organophosphate poisoning source

Pralidoxime (Mark I): Medical Control Type

Standing Order

Pralidoxime (Mark I): Action

Cholinesterate reactivator, deactivates acetylcholine

Pralidoxime (Mark I): Form

Liquid

Pralidoxime (Mark I): Dosage

One to Three kits (each kit = 1 dose), depnending on severity; 600 mg; less for peds.

Atropine (Mark I): Indication

Severe organophosphate poisoning characterized by muscle twitching, respiratory depression, and paralysis; Cholinergic syndrome symptoms

Atropine (Mark I): Contra-indication

Non-organophosphate poisoning source

Atropine (Mark I): Medical Control Type

Standing Order

Atropine (Mark I): Action

Blocks acetylcholine receptors, increases HR

Atropine (Mark I): Form

Liquid

Atropine (Mark 1): Dosage

One to Three kits depending on severity; 2 mg; less for peds

Nasal Naloxone: Indication

Significant respiratory depression and indications of opiate use such as AMS, pinpoint pupils, admission of heroin or methodone use by patient or bystanders, drug paraphernalia, or needle track marks

Nasal Naloxone: contra-indication

Allergy, Age less than 14 yrs old, patient is breathing adequately, recent seizures or trauma, cardiac arrest, nasal trauma or obstruction. Use caution with narcotic-dependent patients who may experience withdrawal.

Nasal Naloxone: Medical Control Type

Standing Order

Nasal Naloxone: Form

Mist

Nasal Naloxone: Dosage

2.0 mg

Nasal Naloxone: action

opiod receptor competitive agonist

Inhalers (albuterol): indications

slight wheezing and/or mild cough, able to move air without difficulty, prescription

Inhalers (albuterol): contraindications

Unconscious; unable to physically use device, maximum dose reached prior to arrival, device not prescribed to patient

Inhalers (albuterol): medical control

standing order

Inhalers (albuterol): action

bronchodilator

Inhalers (albuterol): form

powder/mist

Inhalers (albuterol): dosage

as prescribed (patient's medication)

Nebulizer (albuterol): indication

signs of respiratory compromise, diagnosis of reactive airway disease (RAD), current prescription for a rescue inhaler or nebulizer

Nebulizer (albuterol): contraindication

Younger than six months, known history of cardiac disease (past MI or angina)

Nebulizer (albuterol): Medical Control

standing order

Nebulizer (albuterol): action

bronchodilator

Nebulizer (albuterol): form

mist

Nebulizer (albuterol): dosage

Adult: 2.5mg in 3ml saline; Ped: 2.5 mg in 5ml saline; over 5 to 15 min.

Acetylsalicylic acid (aspirin): indications

chest pain

Acetylsalicylic acid (aspirin): contra- indications

unconscious, unable to swallow, allergic to aspirin, GI bleeding

Acetylsalicylic acid (aspirin): medical control

standing order

Acetylsalicylic acid (aspirin): action

anticoagulant; analgesic

Acetylsalicylic acid (aspirin): form

tablet

Acetylsalicylic acid (aspirin): dosage

162-325 mg

nitroglycerin: indications

chest pain, prescription

nitroglycerin: contraindications

systolic blood press under 10-0, intracranial bleeding or head injury

nitroglycerin: medical control

standing order, unless patient has taken Viagra or similar drug (online medical control if within past 48 hours)

nitroglycerin: action

vasodilator

nitroglycerin: form

tablet, spray

nitroglycerin: dosage

1 tablet or 1 spray (0.4 mg) up to three times 4 min apart

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