20 terms

Paramedic Drug Cards

Generic Name: Albuterol
Trade Name: Ventolin, Proventil
Class/MOA: Beta 2 Agonist (Bronchodilator)

Indications: Reversible bronchoconstriction

Contraindications: None in emergency setting

Side Effects: Increased heart rate; Headache;
N/V; Palpitations; Tremors; Restlessness; Hypertension

Dose/Route: Adult: 2.5 mg in 3ccs NS via nebulizer

Dose/Route: Ped: 1.25 mg in 3ccs NS via nebulizer

May repeat every 20 minutes 3 times
Generic Name: Diphenhydramine
Trade Name: Benadryl

Class: Antihistamine

MOA: Blocks cellular histamine receptors; Decreases vasodilation; Decreases motion sickness; Reverses Extrapyramidal reactions

Indications: Anaphylaxis; Allergic reactions; Dystonic reactions

Contraindications: Asthma & other lower respiratory diseases

Side Effects: Hypotension; Headache; Palpitations; Tachycardia; Sedation; Drowsiness; Disturbed coordination; Dry mouth/throat

Dose/Route Adult: 25-50 mg IV/IO/IM

Dose/Route Ped: 1-2 mg/kg IV/IO slowly or IM
Generic Name: Nalbuphine
Trade Name: Nubain
Class: Narcotic Agonist/Antagonist (Analgesic)

Indications: Moderate to severe pain

Contraindications: Undiagnosed head or abdominal injury

Side Effects: Hypotension; Bradycardia; Facial flushing; Respiratory depression; CNS depression; Euphoria; Paradoxical CNS stimulation; Blurred vision

Dose/Route: Adult: 5 mg IV/IO/IM/SC repeat as 2 mg doses as needed up to 20 mg

Dose/Route Ped: 0.1 to 0.15 mg/kg IV/IO/IM/SC
Generic Name: Ipratropium
Trade Name: Atrovent
Class/MOA Anticholinergic

Indications: Bronchospasm associated with asthma, COPD, inhaled irritants

Contraindications: Hypersensitivity to atropine or use as a primary treatment for acute bronchospasm

Side Effects: Palpitations; Headache; Nervousness; Dizziness

Dose/Route Adult: 500 mcg in 2.5-3 mL NS via nebulizer

Dose/Route Ped: 125-250 mcg in 2.5-3 ml NS via nebulizer
Epinephrine 1:1000
Generic Name: Epinephrine 1:1000
Trade Name: Adrenalin
Class/MOA: Sympathomimetic

Indications: Acute bronchial asthma; Ped cardiac arrest; Exacerbated COPD, anaphylaxis

Contraindications: Hypertension; Cardiovascular disease; Pulmonary embolism

Side Effects: Palpitations; Anxiety; Tremors; Headache; DIzziness; N/V

Dose/Route Adult: 0.3 - 0.5 mg SC/IM

Dose/Route Ped: 0.01 mg/kg SC/IM
Dose/Route Ped Cardiac Arrest: 0.01 mg/kg IV/IO

Dose/Route Ped Croup: Nebulize, mix 2 mg / 1 mL NS
Generic Name: Aspirin
Trade Name: Bayer, Excedrin, St Josephs Childrens, Alka Seltzer

Class/MOA: Analgesic; Antipyretic; Platelet inhibitor

Indications: Chest pain suggestive of MI

Contraindications: Active ulcer disease; Asthma

Side Effects: Heartburn; Prolonged bleeding; GI bleeding; N/V

Dose/Route: Adult: 81 - 324 Chewable tablets

Dose/Route: Ped: None
Generic Name: Naloxone

Trade Name: Narcan

Class/MOA: Narcotic Antagonist

Indications: Narcotic & Synthetic narcotic overdose; Coma of unknown origin

Contraindications: Non-narcotic induced respiratory depression

Side Effects: Withdrawal symptoms; tachycardia; hypertension; arrhythmias; N/V; diaphoresis

Dose/Route Adult: 0.4 to 2 mg IV/IO/IM/SC/Intra-nasally
2 times the dose ET
Repeated 2 - 3 min as needed up to 10 mg

Dose/Route Ped: 0.01 mg IV/IO/IM/SC/Intra-nasally
2 times the dose ET
Repeated 2 - 3 min as needed up to 0.8 mg
Generic Name: Dopamine
Trade Name: Intropin

Class/MOA: Cardiac Inotropic agent

Indications: Cardiogenic, septic, anaphylactic, or spinal shock; Hypotension with low cardiac output states; distributive shock

Contraindications: Pheochromocytoma; Tachyarrhythmias; V-Fib; Hypertension; Tachycardia

Side Effects: Cardiac arrhythmias; Hypertension; Increased myocardial oxygen demand; Extravasation may cause tissue necrosis

Dose/Route Adult: 2 - 20 mcg/kg/min titrated to patient response
1-5 mcg Renal
5-10 mcg Myocardial
10-20 mcg Vascular

Dose/Route Ped: 2 - 20 mcg/kg/min titrated to patient response

Note: Only 3 adrenergic receptors effected; Vasopressor
Morphine Sulfate
Generic Name: Morphine Sulfate
Trade Name: Morphine
Class/MOA Narcotic Analgesic

Indications: Moderate to severe pain

Contraindications: Undiagnosed head or abdominal injury

Side Effects: Respiratory depression; Hypotension; Decreased LOC; N/V; Bradycardia; Tachycardia; Syncope; Facial flushing; Euphoria; Bronchospasm; Dry mouth

Dose/Route Adult: 2 - 5 mg IV/IO (over 1-5 min) Repeat dose 2 - 8 mg at 5 - 15 minute intervals max 15 mg;
5 - 20 mg IM/SC repeat as 2 mg doses as needed up to 20 mg

Dose/Route Ped: 0.1 - 0.2 mg/kg IV/IO/IM/SC max 5 mg
Generic Name: Amiodarone
Trade Name: Cordarone

Class/MOA: Antiarrythmic/Antidysrhythmic

Indications: V-Fib; Pulseless V-Tach; Unstable V-Tach with a pulse; Wide complex tach with pulse in patients not refractory to other therapy

Contraindications: Cardiogenic shock; Sinus bradycardia; 2nd & 3rd degree AV block; Hypotension

Side Effects: Hypotension; Bradycardia; Prolongation of the P-R, QRS & QT intervals; VF; VT

Dose/Route Adult: V-Tach without a pulse: 300 mg IV/IO Slow Diluted in 100 ccs D5W. May repeat dose once in 10 minutes at 150 mg

Dose/Route Adult: V-Tach with a pulse: 150 mg IV/IO Slow Diluted 100 ccs D5W. May repeat dose (once) in 10 minutes at 150 mg)

Ped: 5 mg/kg Slow IV/IO Max 15 mg/kg per 24 hours. Max single dose 300 mg

Maintenance Dose: 1 mg/min

Notes: Works on the Ventricles (Left) Suppresses Sodium, Calcium & POTASSIUM
Prolongs duration of the action potential and refractory period and relaxes smooth muscles, reducing peripheral vascular resistance and increasing coronary blood flow
*A Fib*
40 day half life, so push slow
Generic Name: Adenosine
Trade Name: Adenocard

Class/MOA Antidysrhythmic (Chemical defibrillator) (Endogenous nucleotide)

Indications: SVT; Narrow complex tachycardia; Recurrent PSVT

Contraindications: Bradycardia; 2nd & 3rd degree heart block; Sinus node disease; Asthma; COPD; Poisoned induced tachycardia; V-Tach; A-Fib; A-Flutter

Side Effects: Facial flushing; Diaphoresis; HA; N/V; Hypotension; Asystole; Parathesia; Shortness of breath; Chest pain; Palpitations; Metallic taste

Dose/Route Adult: 6 mg rapidly (over 1-2 seconds) IV/IO followed by 20 ccs rapid saline flushing; May be repeated (in 1 - 2 minutes) twice at 12 mg doses

Note: Works on the SA node. Slows conduction time through the AV node. Acts directly on sinus pace maker cells. Slows heart rate. Drug of choice for re-entry SVT

10 second half life
Onset - Seconds
Duration - 12 seconds
Generic Name: Fentanyl
Trade Name: Sublimaze
Class/MOA: Narcotic analgesic

Indications: Induce sedation for ET tube

Contraindications: Myasthenia gravis; MAOI inhibitors within 14 days

Side Effects: Hypotension; N/V; Drowsiness

Dose/Route Adult: 50 - 100 mcg Slowly IV/IO

Dose/Route Ped: 2 mcg/kg Slow IV/IO/IM
Lidocaine *
Generic Name: Lidocaine
Trade Name: Xylocaine
Class/MOA Antidysrhythmic

Indications: Pulseless V-Tach; V-Fib; V-Tach with a pulse

Contraindications: Supraventricular dysrhythmias; Stokres-Adams syndrome; 2nd & 3rd degree heart blocks; Bradycardias

Side Effects: Slurred speech; Seizures (with high doses); Altered mental status; Confusion; Lightheadedness; Blurred vision; Bradycardia

Dose/Route: Adult: Cardiac Arrest: 1 - 1.5 mg/kg IV repeated every 3 - 5 minutes at 0.5-.075 mg/kg up to 3 mg/kg, follow conversion with a drip of 2 - 4 mg/min

Dose/Route Adult: V-Tach with a pulse: 1 - 1.5 mg/kg Slow IV. May repeat at one-half dose every 5 - 10 min until conversion up to 3 mg/kg. Follow conversion with an infusion of 2 - 4 mg/min May dilute in NS or D5W

Dose/Route Ped: Cardiac arrest: 1 mg/kg IV, repeat 3-5 min up to 3 mg
Epinephrine 1:10000
Generic Name: Epinephrine 1:10000
Trade Name: Adrenalin
Class/MOA: Sympathomimetic

Indications: Cardiac arrest; Anaphylaxis; Asthma; Exacerbated COPD

Contraindications: Hypertension; Hypothermia; Pulmonary edema; Myocardial ischemia; Hypovolemic shock

Side Effects: Tachycardia; Headache; Hypertension; Arrythmias; Pulmonary Edema: Anxiety: Restlessness; Psychomotor agitation; Nausea; Headache; Angina; Tremors

Dose/Route: Adult: 1 mg every 5 minutes IV/IO
ET - 2 mg
Dose/Route Adult Asthma/COPD: 0.3 - 0.5 mg IV/IO
ET double the dose

Dose/Route Ped: 0.01 mg every 5 minutes IV/IO
ET - 0.02 mg

Dose/Route Ped Asthma: 0.01 mg/kg IV/IO

No max dose
Generic Name: Metoprolol
Trade Name: Lopressor
Class/MOA: Beta-Blocker

Indications: AMI, A-Fib

Contraindications: Cardiogenic shock; Sinus bradycardia < 45; 2nd or 3rd degree heart block; PR interval > 0.24; Cor pulmonale; Asthma; COPD; CHF

Side Effects: Dizziness; Depression; Tiredness; N/V; Dry mouth; Stomach pain; Heartburn; Rash; Itching

Dose/Route: Adult: 5 mg slow IV/ 5 min up to 3 times

No ped
Generic Name: Atropine

Class/MOA: Anticholinergic; Parasympatholytic; Vagolytic

Indications: Sinus bradycardia; PEA; Asystole; Organophosphate poisoning

Contraindications: None in the emergency setting

Side Effects: HA; Dizziness; Palpitations; N/V; Tachcyardia; Arrhythmias; Anticholinergic effects; Flushed, hot, dry skin; Hypertension

Dose/Route: Adult: Asystole: 1 mg IV or 2 mg ET, may repeat 3 - 5 minutes up to 0.04 mg/kg

Dose/Route Adult Symptomatic bradycardia: 0.5 - 1 mg IV/ 2 mg ET. Repeat 3 - 5 minutes to 0.04 mg/kg

Dose/Route Ped Symptomatic bradycardia: 0.02 mg/kg IV, 0.04 mg/kg ET, may repeat i 5 min up to 1 mg
Generic Name: Lorazepam
Trade Name: Ativan

Class/MOA: Benzodiazepine; Sedative; Anticonvulsant

Indications: Sedation for cardioversion and status epilepticus; Severe anxiety

Contraindications: Sensitivity to Benzodiazepines; Coma; Shock; Acute Narrow Glaucoma

Side Effects: Respiratory depression; Apnea; N/V; Drowsiness; Sedation; Ataxia; Psycho-motor impairment; Confusion; Restlessness; Delirium; Hypotension; Bradycardia

Dose/Route: Adult: Sedation: 2 - 4 mg IM; 0.5 - 2 mg IV

Dose/Route Adult Status Epilepticus: 2 mg slow IV/PR (2mg/min).
May repeat dose in 15-20 minutes to a max of 8 mg

Dose/Route Ped Sedation: 0.03 - 0.5 mg/kg IV/IM/PR up to 4 mg

Dose/Route Ped Status epilepticus: 0.1 mg/kg slow IV/PR (2 - 5 min)
May repeat in 15-20 minutes to a max of 0.2 mg/kg

Note: IV must be diluted equal volume sterile water, sterile saline or D5W

Description: Most potent benzo available. Relatively short half-life.
Sodium Bicarbonate
Generic Name: Sodium Bicarbonate

Class/MOA: Alkalizing Agent; Electrolyte

Indications: Tricyclic antidepressant and barbiturate overdose; Refractory acidosis; Hyperkalemia; PEA; Cardiac arrest with good ventilations

Contraindications: None when used in severe hypoxia or late cardiac arrest

Side Effects: Metabolic alkalosis; Fluid overload; N/V; HA; Hypokalemia

Dose/Route: Adult: 1 mEq/kg IV, then 0.5 mEq/kg/10 min

Dose/Route Adult Tricyclic OD: 50 mEq then 100 mEq over an hour in 1 liter NS

Dose/Route Ped: Same as adult

Description: Provides vascular bicarbonate to assist the buffer system in reducing the effects of metabolic acidosis and in the treatment of some overdoses
Generic Name: Diltiazem
Trade Name: Cardizem

Class/MOA: Calcium Channel Blocker

Indications: Supraventricular tachydysrhythias (atrial flutter, atrial fibrillation); Angina pectoris

Contraindications: Hypotension (Systolic BP < 90, diastolic BP < 60); Sick sinus syndrome; 2nd & 3rd degree AV block; Cardiogenic shock; Wide-complex tachycardias; Poison/drug-induced tachcyardia

Side Effects: Bradycardia; 2nd or 3rd degree AV blocks; Chest pain; CHF; Syncope; V-Fib; V-tach; N/V; Dizziness/syncope; Dry mouth; Dyspnea; Headache; Hypotension; weakness; dyspnea

Dose/Route Adult: Initial bolus: 0.25 mg/kg IV over 5 minutes. May rebolus in 15 minutes: 0.35 mg/kg IV over 5 minutes
Maintenance infusion of 5-15 mg/h

Dose/Route Ped: Not recommended

Note: If a quarter doesn't work use a dime

Description: Works on the atria Slow calcium channel blocker. Dilates coronary and peripheral arteries and arterioles, thus increasing circulation to the heart and reducing peripheral vascular resistance. (Reduces preload and afterload) Reduces myocardial oxygen demand

Indications: Control of rapid ventricular rates due to atrial flutter, atrial fibrillation, and re-entry SVT refractory to adenosine; To increase coronary artery perfusion in angina

Onset: 2 - 5 minutes
Duration: 1 - 3 hours
Generic Name; Procainamide
Trade Name: Pronestyl

Class/MOA: Antiarrythmic

Indications: SVT; V-arrythmias; V-Fib; Pulseless V-Tach refractory to lidocaine; Monomorphic V-Tach

Contraindications: Myesthenia gravis; 2nd & 3rd degree heart block; Tricyclic overdose

Side Effects: Chest pain; Hypotension; Reflex tachycardia; Arrhythmias; Palpitations; Hypotension; Headache; N/V; Bradycardia; Widening of PR, QRS, & QT intervals; AV heart block

Dose/Route Adult: 20 - 30 mg IV/IO
17 mg/kg max
IV drip to effect, then 1-4 mg/min diluted in D5W or NS

Dose/Route Ped: 15 mg/kg/IV/IO over 30 - 60 minutes

Stop if: QRS widens by 50%
Fix it

Note: Slows intraventricular conduction, prolongs ventricular repolarization, and decreases myocardial excitability

Onset: 10 - 30 minutes
Duration: 3-6 hours