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2009 REMSA Paramedic
Paramedic Drugs
| Question | Answer |
|---|---|
| Adenosine- Action | Decreases conduction throught the AV Node |
| Adenosine- Indication | Symptomatic Supraventricular Tachycardia, Effective in terminating re-entyr arrhythmias due to AV or Sinus node |
| Adenosine- Contraindications | 2nd or 3rd degree heart block, Sick Sinus Syndrome, Drug/Poison Tachycardia |
| Adenosine- Side Effects | Paroxysmal dysrhythmias, Facial Flushing, SOB, Dizziness, Syncope. frequently cause brief periods of asystole. |
| Adenosine- Precautions | Does not convert A-fib/Flutter or V-Tach |
| Adenosine- Supplied | 6mg/2ml flip-top Vial (typical), 6mg and 12mg prefilled syringe |
| Adenosine- Dose and route | Adult: 6mg RIVP, maybe repeated (X2) in 1-2min by 12mg RIVP if needed.Pedi: 0.1mg/kg IV/IO, followed in 1-2min with 0.2mg/kg IV/IO; Max 6mg then 12mg |
| Atropine Sulfate- Contraindications | Tachycardias, Glaucoma |
| Atropine Sulfate- Side Effects | Tachycardia, Dysrhythmias, exacerbation of glaucoma, pupil dilation, dry mouth, urine retention. Atropine can cause tachycardia, thus increasing myocardial oxygen demand which exacerbates myocardial infarction. |
| Atropine Sulfate- Supplied | Prefilled Syringe 1mg/10ml (typical); Vial 1mg/ml |
| Atropine Sulfate- Dose and route | Symptomatic Bradycardia, or vagally mediated bradycardia: Adult: 0.5mg IV may be repeated q 3min, max dose is 3 mg Pedi: 0.02mg/kg IV/IO (Minimum single dose 0.1mg Maximum single dose 0.5mg)Asystole or PEA:Adult: 1mg every 3 to 5 min, maximum dose i |
| Amiodrone- Action | Prolongs the refactory period and action potential duration, decreases ventricular conduction, automaticity, and excitability. Class III antidysrythmic |
| Amiodrone- Indication | V-Fib, V-Tach, Wide complex Tach of unknown origin, Atrial Dyshrythmias. |
| Amiodrone- Contraindications | 2nd or 3rd degree heartblock, Ventricular escape rhythms. |
| Amiodrone- Side effects | Cause profound hypotension, decreases myocardial contractility, prolong the QT interval |
| Amiodrone-Supplied | 150mg in 3ml ampule or vial |
| Amiodrone- Precautions | Terminal elimination is extremely long (half life of 40 days), has negative intropic and chronotropic effects, will foam up if shaken, be cautious with other drugs the prolong the QT interval (ie Procainamide) |
| Amiodrone-Dose and route | Adult: 300mg IV bolus in cardiac arrest, may repeat once at 150mg (VF/VT)150mg IV Drip over 10 min in VT with pulses or Atrial DysrhythmiasPedi: 5mg/kg IV/IO bolusin cardiac arrest5mg/kg IV/IO drip over 20-60 minutes in rhythms with pulsesnot reco |
| Dopamine Action | Stimulates alpha, beta 1, and dopaminergic receptors. Renal doses (2-4 mcg/kg/min): Vasodilation of renal. mesentric, and cerebal arteriesbeta doses (5-10mcg/kg/min): Increase cardiac outputAlpha doses (10-20mcg/kg/min): Vasoconstriction of periphal |
| Dopamine Indications | Imporves cardiac output and BP in cardiogenic or neurogenic shock |
| Dopamine Contraindications | Hypovolemic shock, tachydysrhymthias, HTN |
| Dopamine Side Effects | HTN, dysrhythmias, headache, N/V, may increase myocardial ischemia, infilitration may cause necrosis |
| Dopamine Precautions | Do not use concurrently with Sodium Bicarbonate |
| Dopamine Supplied | 400mg/5ml vial to be mix for infusion400mg in 250ml (1600mcg/ml)premixed IV solution |
| Dopamine Dose and route | 2-20mcg/kg/min IV infusionstart at 5mcg/kg/min to improve cardiac output |
| Epinephrine Action | Stimulates Alpha receptors: which stimulates periphal vasoconstrictionStimulates Beta 1 receptors: whichcause increased heart rate, contactility and conductionStimulates Beta 2 receptors: which causes bronchdilations |
| Epinephrine Indications | Asystole, VF, Pulseless VT, PEA, Symptomatic bradycardia,acute bronchospasm associated with asthma or anaphylaxis |
| Epinephrine Contra Indications | None in cardiac arrest, tachyarrhythmias, Increase myocadrial o2 consumption |
| Epinephrine Side Effects | Tachycardia, HTN, Angina, AMI. |
| Epinephrine Precaution | Protect from light, precipitates in alkaline solution(ie sodium bicarbonate), pink or bron colorindicates impotent, expired drug |
| Epinephrine Supplied | Ampule: 1mg/ml 1:1000Multidose vial: 30mg/30ml 1:1000Prefilled syringe: 1mg/10ml 1:10,000 |
| Epinephrine Dose and route | Anaphylaxis/allergic reaction/acute broncho spasm:Adult: 0.3-0.5mg, 1:1000 SQ,or 0.1mg 1:10,000Iv if severePedi: 0.01mg/kg, 1:1000 SQ (0.5mg max)Cardiac ArrestAdults: 1 mg IV q 3-5 minutes2.5mg, 1:1000 Et q 3-5 minutesPedi: o.01mg/kg (equivale |
| Furosemide (Lasix) Action | Loop diuretic, Venodilation |
| Furosemide (Lasix) Indications | Pulmonary edema, Hypertension |
| Furosemide (Lasix) ContraIndications | hypovolemia, Hypotension, renal insufficiency,Pregancy, Anuria |
| Furosemide (Lasix)Side effects | Hypovolemia, Hypotension, Hypokalemia, Electrolyte imbalance |
| Furosemide (Lasix)Precautions | Rapid administration can cause permanet hearing damage |
| Furosemide (Lasix) Supplied | 40mg/2ml vial |
| Furosemide (Lasix)Dose and route | 20-40mg SIVP or double the Home RX dose up to 80mg |
| Heparin Action | Prevents conversion of fibrinogen to fibrin and prothrombin to thrombin by enhancing the inhibitory effects of antithrombin III. slows the clotting process, and inhibits reactions that lead to the clotting of blood |
| Heparin Indications | DVT, PE, AMI, Post heart surgery, DIC, A-Fib with embolization |
| Heparin Contra Indications | Hypersensitivity, hemophelia, leukemia with bleeding, peptic ulcer, sever hepatic disease, thrombocytopenia, active bleeding. |
| Heparin Side Effects | Bleeding gums, petecchiae, eccymoisis, GI bleeding, epistaxis |
| Heparin Precautions | Heparin mey increase action of diazepam, a baseline PT and PTT must be drawn before administration |
| Heparin Supplied | usually 25,000 units in 500ml (50units/ml) |
| Heparin Dose and route | Initial IV bolus of 80 units/kg Heparin rate is adjusted to maintain a PTT of 51-75 seconds |
| Lidocaine (Xylocaine) Action | Sodium channel blocker, decreases ventricular conduction, automaticity, and excitability. Class I antidysrhythmic |
| Lidocaine (Xylocaine)Indications | V-fib, V-tach, R on T PVC's |
| Lidocaine (Xylocaine) Contra Indications | 2nd or 3rd degree heart block, hypotension |
| Lidocaine (Xylocaine)Side effects | CNS abnormalities (Sz, altered LOC, irritability), Hypotension, Heart block, N/V |
| Lidocaine (Xylocaine)Supplied | 100mg/5mg Prefilled syringe2g/500ml infusion (4mg/ml) |
| Lidocaine (Xylocaine) Dose and route | Cardiac Arrest (VF/VT):1-1.5mg/kg IVP or ET q 3-5 minutes, 3mg/kg max total dose.post conversionmaintenance infusion; IV drip 1-4mg/minWide complex Tachycardia, Ventricular Ectopy, stable VT (with Pulses) .5-.75 mg/kg IV loading bolus. total maximum dose |
| Nitroglycerin (Nitrolingual) Actions | VAscular Smooth muscle relaxant, decreases preload and periphera vascular resistance(afterload), Dilates cornary arteries |
| Nitroglycerin (Nitrolingual)Indications | Acutse Cornary Syndrome (ACS), Pulmonary edema 2nd to CHF, HTN |
| Nitroglycerin (Nitrolingual) Contra Indications | Hypotension, cerebral hemorrhage |
| Nitroglycerin (Nitrolingual) Side effects | Hypotension, Headache, Reflex tachycardia |
| Nitroglycerin (Nitrolingual) Precautions | To insure potency, protect from light, air, heat, replace every q 4-6 months. May have to prime nitrolingual to ensure accurate delievery |
| Nitroglycerin (Nitrolingual) Supplied | Tablets Nitrostat:.4mgTopical Paste Nitro-bid: 1cm=6mgPump Spray Nitrolingual: .4mg/spray |
| Nitroglycerin (Nitrolingual)Dose and Route | Tablets Nitrostat:.4mg SL, q 3-5 minTopical Paste Nitro-bid: 1-2cm paste 1cm/6mg topicallyPump Spray Nitrolingual: 1 spray SL (.4mg)q 3-5min |
| Vasopressin (Pitressin) Action | Stimulates smooth muscle receptors causing smooth muscle contraction |
| Vasopressin (Pitressin)Indications | Cardaic Arrest(VF/VT only) 2nd line to Epinephrine |
| Vasopressin (Pitressin) Contra Indications | PVC's |
| Vasopressin (Pitressin)Side Effects | N/V, headaches |
| Vasopressin (Pitressin) Dose and Route | 40 units(U) IV/IO one time only (not recommended for pedis) |
| Albuterol Sulfate (Proventil, Ventolin)Action | Stimulates Beta2 receptors causing bronchial smooth muscle relaxation, reducing bronchospasm |
| Albuterol Sulfate (Proventil, Ventolin)Indications | Bronchospasm 2nd to COPD, asthma, Reactive airway disease |
| Albuterol Sulfate (Proventil, Ventolin)Contra Indications | Tachydysrhythmias |
| Albuterol Sulfate (Proventil, Ventolin)Side Effects | Tachycardia, anxiety, N/V |
| Albuterol Sulfate (Proventil, Ventolin)Precautions | My increase Myocardial O2 demand through tachycardia |
| Albuterol Sulfate (Proventil, Ventolin) Supplied | MDI 1 spray=90-100mcgNebulizer 2.5mg/3ml bullet |
| Albuterol Sulfate (Proventil, Ventolin)Dose and Route | Aerosol nebulizer: 2.5mg/3ml bullet nebulized @6lpm |
| Ipratropium Bromide (Atrovent) Action | Blocks parasympathetic stimulation, allowing sympathetic system to open airways by causing bronchial smooth muscle relaxiation, reducing bronchospasm. |
| Ipratropium Bromide (Atrovent) Indications | Bronchospasm 2nd to COPD, asthma, Reactive airway disease |
| Ipratropium Bromide (Atrovent) Contra Indications | Pt's w? Hx of sensitivity to Soyalecithin or related food producta such as soy beans and peanuts |
| Ipratropium Bromide (Atrovent) Side effects | Tachycardia, Anxiety, N/V |
| Ipratropium Bromide (Atrovent) Precautions | May cause increased myocardial O2 demand through tachycardia |
| Ipratropium Bromide (Atrovent) Supplied | .5mg/2.5ml bullet |
| Ipratropium Bromide (Atrovent) Dose and Route | Aerosol Nebulizer, .5mg/2.5ml bullet, nebulized @ 6lpm |
| Methylprednisone (Solu-Medrol) Action | Decrease inflammation by suppresing imune system response, binds with intracellular corticosteriod receptors |
| Methylprednisone (Solu-Medrol)Indications | Status asthmaticus, anaphylaxis, spinal cord swelling,exacerbated COPD |
| Methylprednisone (Solu-Medrol)Contra Indications | Hypersensitivity |
| Methylprednisone (Solu-Medrol) Side Effects | Headache, HTN, CNS Depression |
| Methylprednisone (Solu-Medrol) Precautions | Pregancy, Glaucoma, renal Disease, CHF,HTN, Diabetes, Myasthenia Gravis |
| Methylprednisone (Solu-Medrol) Dose and route | Adult 125-250mg IV/IMPedis 30mg/kg IV/IM |
| Diazepam (Valium) Action | Anticonvulsant, Sedative |
| Diazepam (Valium) Indications | Status epliepticus, sedation |
| Diazepam (Valium) Contra Indications | Shock, Coma, Respiratory Distress |
| Diazepam (Valium) Side Effects | CNS and Respiratory Depression, Hypotension |
| Diazepam (Valium) Precautions | Oil based slower absorption |
| Diazepam (Valium) Supplied | 10mg/2ml vial |
| Diazepam (Valium) Dose and Route | Adults 0.1mg/kg IV maybe repeated Q 5-10min, 30mg max dosePedi .5mg/kg rectally, may repeat Q 5 min |
| Diphenydramine (Benadryl) ACtions | Antihistamine, sedation, motion sickness |
| Diphenydramine (Benadryl) Indications | Moderate to sever allergic ractions, anaphylaxis, acute extrapyramidal reactions |
| Diphenydramine (Benadryl) Contra Indications | asthma, gluacoma, CNS Depression |
| Diphenydramine (Benadryl) Precautions | Safety for use during pregancy has not been estblished |
| Diphenydramine (Benadryl) Supplied | 50mg vials |
| Diphenydramine (Benadryl) Dose and route | Adults 25-50mg IV/IMPedis 1mg/kg IV/IM |
| Haloperidol (Haldol) Action | 1st generation anti-psychotic, belived to block dopamine receptors in the brain |
| Haloperidol (Haldol) Indications | Acute psychotic episodes, Schizophrenia, Tourette Syndrome |
| Haloperidol (Haldol) Conta Indications | CNS depression, Coma, Pregancy, Parkingson's disease |
| Haloperidol (Haldol) Side Effects | Orthostatic hypotension,N/V, Allergic reaction, Prolonged QT interval. |
| Haloperidol (Haldol) Precautions | Pts on anticonvulsants or anticoagulants |
| Haloperidol (Haldol) Supplied | 5mg/1ml ampule |
| Haloperidol (Haldol) Dose and route | 5mg IM/IV, repeat as necessary |
| Meperidine (Demerol) Actions | Synthetic Opiod analgesic, CNS depressant |
| Meperidine (Demerol) Indications | Moderate to sever pain |
| Meperidine (Demerol) Contra Indications | Undiagnosed abdominal pain, ALOC |
| Meperidine (Demerol) Side Effects | N/V, Hypotension, Tachycardia, Respiratory depression |
| Meperidine (Demerol) Precautions | Monitor closely for repiratory depression and reverse with Narcan |
| Meperidine (Demerol) Supplied | 50mg/1ml vial |
| Meperidine (Demerol) Dose and Route | 25-50mg IV 50-100MG IM |
| Fentanyl (Sublimaze, Duragesic) Actions | Synthetic opioid analgesic, Rapid onset short acting analgesic CNS depression |
| Fentanyl (Sublimaze, Duragesic) Indications | Moderate to sever pain |
| Fentanyl (Sublimaze, Duragesic) Contra Indications | Undiagnose abdominal pain, ALOC |
| Fentanyl (Sublimaze, Duragesic) Side effects | N/V, hypotension, respiratory depression |
| Fentanyl (Sublimaze, Duragesic) Precautions | Monitor closely for respiratory depression reverse with Narcan PRN, rapid administration has been shown to cause chest wall ridigity. |
| Fentanyl (Sublimaze, Duragesic) Supplied | 100mcg/2ml ampule |
| Fentanyl (Sublimaze, Duragesic) | Adults and Pedi's:1mcg/kg SIVP (adult max dose 100mcg, pedi max dose 2.5mcg/kg)Pedi's intranasal: .5-2mcg/kg divided into each nostril |
| Flumazenil (Romazicon) Action | Benzodiazepine anatagonist that competitively inhibits the actions of Benzodiapines |
| Flumazenil (Romazicon) Indications | Reversal of sedative effects after benzodiazepines after administration, suspected Benzodiazepine OD with respiratory arrest |
| Flumazenil (Romazicon) Contra Indications | Hypersensitivity, Serious TCA OD |
| Flumazenil (Romazicon) Side effects | Whatch for resedation that may occur after reversal of benzodiazepine may out last Flumazenil. |
| Flumazenil (Romazicon) Precautions | Caution in Pt's with seizure disorders, ETOH, or benzodiazepine dependence |
| Flumazenil (Romazicon) Supplied | .5mg/5ml vial |
| Flumazenil (Romazicon) Dose and Route | Initally .2mg IV over 30 seconds, May repeat .3mg IV over 30 IV seconds, may then consider .5mg IV over 30 seconds PRN @ 1 minute intervals MAX of 3mg |
| Nalbuphine (Nubain) Action | synthetic analgesic, Opioid agonist/antagonist |
| Nalbuphine (Nubain) Indications | Moderate to sever pain |
| Nalbuphine (Nubain) Contra Indications | Undiagnosed Abdominal pain, ALOC |
| Nalbuphine (Nubain) Side Effects | N/V, hypotension, Tachycardia, Respiratory depression, Narcotic withdrawl |
| Nalbuphine (Nubain) Precautions | May antagonize fentanyl and morphine |
| Nalbuphine (Nubain) Supplied | 10mg/1ml ampule |
| Nalbuphine (Nubain) Dose and Route | 2-5mg IVP, titrate to effect, maximum singe dose 20mg |
| Midazolam (Versed) Action | Rapid onset/short acting Benzodiazepine with CNS depressant and antiseizure actions. |
| Midazolam (Versed) Indications | Status epilepticus, sedation prior to Cardio version, sedation prior to intubation |
| Midazolam (Versed) Contra Indications | Use caution in pts with respiratory compromise/ distress or decreased mental status. Versed should not be used with pts with known hypersensitivity to benzodiasepine or pts with glaucoma. |
| Midazolam (Versed) Side effects | CNS and respiratory depression, hypotension |
| Midazolam (Versed) Precautions | monitor cardiopulmonary status constantly |
| Midazolam (Versed) Supplied | 10mg/2ml vial |
| Midazolam (Versed) Dose and Route | Adults: Titrate 2mg SIVP w/additional 1mg dose q 2min. Until desired sedative effect is achieved. 0.07-0.08 mg/kg deep IM (avg 3-5mg dose)Pedi: .1mg-.2mg/kg IV/IM Intranasal to maximum of 7 mg. |
| Morphine Sulfate (MS, Duramorph, Astramorph) Action | Opioid analgesic, CNS depressant, Periphal Vasodilation |
| Morphine Sulfate (MS, Duramorph, Astramorph) Indications | Moderate to severe pain, ACS, Pulmonary Edema |
| Morphine Sulfate (MS, Duramorph, Astramorph) Contra Indications | Undiagnosed Abdominal pain, ALOC |
| Morphine Sulfate (MS, Duramorph, Astramorph) Side Effects | N/V, Hypotension, Tachycardia, respiratory depression |
| Morphine Sulfate (MS, Duramorph, Astramorph) Precautions | Monitor closely for respiratory depression, reverse with Narcan |
| Morphine Sulfate (MS, Duramorph, Astramorph) Supplied | 10mg/1ml typical |
| Morphine Sulfate (MS, Duramorph, Astramorph) Dose and Route | 2-5mg IV q 5 minute, titrate to effect5-15mg IM |
| Naloxone (Narcan) Action | Opioid anatagonist, blocks opioid receptor sites |
| Naloxone (Narcan) Indications | ALOC 2nd to narcotic or herion OD or of UNK etiology |
| Naloxone (Narcan) Contra Indications | Hypersensitivity |
| Naloxone (Narcan) Side Effects | Acute withdrawl symptoms |
| Naloxone (Narcan) Supplied | .4mg/ml (1ml,10ml vials) 2mg/2ml vial |
| Naloxone (Narcan) Dose and Route | Adult: 2mg IV,IM,SQ,ETPedi:.1mg/kg max 2mg IV,IM,SQ,ET, Intranasal |
| Nitrous Oxide (Nitronox) Action | Gaseous Analgesic, CNS Depresent |
| Nitrous Oxide (Nitronox) Indications | Moderate to Severe pain, Anxiety |
| Nitrous Oxide (Nitronox) Contra Indications | decreased LOC, head injury, undiagnosed abdonmial pain, alcohol or drug intoxication |
| Nitrous Oxide (Nitronox) Side Effects | Dizziness, N/V, Hypotension, decreased LOC |
| Nitrous Oxide (Nitronox) Supplied | D and E cylinders, mixed with 50% O2 |
| Nitrous Oxide (Nitronox) Dose and Route | Self administered, Pt must hold mask to their face, effects go away quickly |
| Zofran (Odansetron) Action | Prevents nausea and Vomiting bl blocking serotonin peripherally, centerally and in the small intestine |
| Zofran (Odansetron) Indication | N/V |
| Zofran (Odansetron) Contra Indications | Hypersensitivity |
| Zofran (Odansetron) Precautions | Pts w/ liver failure, pregancy, lactation, and children |
| Zofran (Odansetron) Dose and route | Adult: 4mg SIVPPedi: .15mg.kg SIVP (max 4mg) |
| Promethazine (Phenergan) Action | Antiemetic, antihistamine, phenothiazine drivative causing sedation |
| Promethazine (Phenergan) Indications | N/V |
| Promethazine (Phenergan) Contra Indications | Decreased LOC hypersensitivity |
| Promethazine (Phenergan) Side Effects | May impair mental and physical abilities, may potentiate other CNS depressants, may cause extra pyramidal reactions |
| Promethazine (Phenergan) Precautions | Dilute in 10ml NaCL to prevent phlebis |
| Promethazine (Phenergan) Supplied | 25mg/1ml ampule, 50mg/1ml ampule |
| Promethazine (Phenergan) Dose and Route | Adult: 12.5-25mg SIVP or 25-50mg IMPedi: 6.25-12.5mg IV 12.5-25mg IM |
| Calcium Chloride Action | Positive inotrope which increase contractility, stabilizes myocardial tissue in the setting of hyperkalemia |
| Calcium Chloride Indication | Hyperkalemic cardiac arrest, calcium channel blocker OD, respiratory depression, hypotension or bradycardia that may be encounter after the administradion of MgSO4 |
| Calcium Chloride Contra Indication | hyperkalemiadue to digitalis toxicity, know hypercalcemia |
| Calcium Chloride Side Effects | None |
| Calcium Chloride Supplied | 10ml vial (100mg/ml) |
| Calcium Chloride Dose and Route | Adults: 5-10ml 10% solution SIVPPedis: .15-3ml/kg (.2-.4mg/kg) 10% solution SIVP |
| Magnesium Sulfate Action | CNS Depressant, Anticonvulsant, smooth muscle relaxant, decrease neuronal excitability. |
| Magnesium Sulfate Indication | Torsades des Pointes, Siezure 2nd to eclampsia, refactory VF/VT |
| Magnesium Sulfate Contra Indication | Heart block, renal insufficiency |
| Magnesium Sulfate Side Effects | Hypotension, CNS and Respiratory depression, muscular paralysis |
| Magnesium Sulfate Suppied | 1gm/2ml vial |
| Magnesium Sulfate Dose and route | Torsades de Pointes: (adult)2gm SIVP over 1-2min, (pedi) 25-50mg/kgRefactory VF/VT: Adult 2 gm IVP, Pedi25-50mg/kgseizure 2nd to eclampsia: 4gm SIVP |
| Pottasiun Chloride (KCl, K DUR) Action | electrolyte vital for normal nerve conduction, muscles, and kidney function |
| Pottasiun Chloride (KCl, K DUR) Indication | Tx/ prevention of hypokalemia, sever diarrhea, vomiting |
| Pottasiun Chloride (KCl, K DUR) Contra Indications | Hyperkalemia, severl renal failure |
| Pottasiun Chloride (KCl, K DUR) Side effects | Respiratory depression, apena, cardiac arrrest/ dysrhythmias, N/V, hyperkalemia |
| Pottasiun Chloride (KCl, K DUR) Precautions | Monitor ECG for changes |
| Pottasiun Chloride (KCl, K DUR) Dose and Route | Adult: 10-40 meq/hr IVPedi: .02meq/kg/min max 3meg/kg/day IV |
| Sodium Bicarbonate Action | Allalinizing agent, increase serum PH |
| Sodium Bicarbonate Indications | Metobolic acidosis, post resuscitation (after long down time), Tricyclic antidepressant OD, hyperkalemia |
| Sodium Bicarbonate Contra Indication | metobolic alkalosis |
| Sodium Bicarbonate Side Effect | Metobolic alkalosis, electrolyte imbalance |
| Sodium Bicarbonate Supplied | 50meq/50cc prefilled syringe |
| Sodium Bicarbonate Dose and Route | 1meq/kg IV repeated by .5meq/kg IV |
| Dextrose (D50, D25, D10) Actions | Increase blood glucose level (BGL) |
| Dextrose (D50, D25, D10) Indications | Adults BGL<60mg/dl; infants BGL<40mg/dl, hypoglycemia with decrease LOC or Seizrue of unknown etiology |
| Dextrose (D50, D25, D10) Contra Indication | Suspected intracranial hemorrhage, CVA |
| Dextrose (D50, D25, D10) Side effects | Infilteration can cause neucrosis, cerebral hemorrhage in neonates |
| Dextrose (D50, D25, D10) Supplied | 25gm/50cc prefilled syringe |
| Dextrose (D50, D25, D10) Dose and Route | Adults: 50% dextrose (D50) 25gm SIVPPedis: > 6 months 25 % dextrose (D25) 1-2ml/kg IV/IO< 6 months 10 % dextrose (D10) 1-2,ml/kg IV/IO |
| Glucagon Action | Panceratic hormonic which stimultes the breakdown of heptic glycogen to glucose |
| Glucagon Indication | decreased LOC 2nd to hypoglycemia (BGL<60)with out IV access. |
| Glucagon Contra Indication | Hyper sensitivity (protiens), ability to administer oral glucose |
| Glucagon Side Effects | Tachycardia, N/V |
| Glucagon Supplied | Glucagon must be reconstituted with provided dilutent. Dilute 1mg powder in 1 ml of diluting solution |
| Glucagon Dose and Route | >20kg 1mg IM<20kg .5mg IM |
| Thiamine (Betaxin) Action | Vitamin B1, essential for the normal metabolism of glucose |
| Thiamine (Betaxin) Indication | Hypoglycemia (BGL <60 mg/dl) with alcohol abuse, or malnutrition (prior to the administration of D50) wernicks encephalopathy |
| Thiamine (Betaxin) Contra Indication | None |
| Thiamine (Betaxin) Side Effects | Anxietry, N/V, allergic reaction |
| Thiamine (Betaxin) Supplied | 100mg.ml in 1ml vial |
| Thiamine (Betaxin) Dose and Route | 100mg SIVP or SIMP |
| Oxytocin (Pitocin) Action | Stimulates uterine muscle tone and contractions after placental delivery |
| Oxytocin (Pitocin) Indications | To control postpartium hemorrhage |
| Oxytocin (Pitocin) Contra indications | Hypersensitivity |
| Oxytocin (Pitocin)Side Effects | Hypertonicity of uterus, uterine rupture, N/V, dysrhythmias |
| Oxytocin (Pitocin)Supplied | 10 units/ml, 1 ml Vial |
| Oxytocin (Pitocin) Dose and Router | Place 20 unit ampule in 1000cc of NaCL, administer 500ml over 10-20 minutes the reduce infusion to 125ml/hr. |
| Acetaminophen (Tylenol) Action | Exact action is unknown, is thought o reduce fever by centeral action on the hypothalamic heat regulating cener. thought to produce analgesia by blocking generation of pain impulses |
| Acetaminophen (Tylenol) Indication | Mild pain or fever |
| Acetaminophen (Tylenol)Contra Indication | Hypersensitivity |
| Acetaminophen (Tylenol) Side Effects | May produce false positive decrease in blood glucose levels in home monitoring systems |
| Acetaminophen (Tylenol)Precautions | Use cautiously in Pts with pre existing liver disease, chronic alcohol use or chronic hepatitis/ jaundice |
| Acetaminophen (Tylenol)Supplied | 325mg and 120mg rectal suppository/OTC Liquid form 160mg/various concentration levels |
| Acetaminophen (Tylenol) Dose and Route | Adults: 325-650mg PO/PR q 4hrsPedis: 15 mg/kg PO/PR q 4hrs |
| Aspirin Action | Inhibits platelet aggergation and therby reduces thrombus formation |
| Aspirin Indication | ACS |
| Aspirin Contra Indications | GI Bleeding, Multi system tramua, hypersensitivity |
| Aspirin Side Effects | None |
| Aspirin Supplied | 81 mg Tablets |
| Aspirin Dose and Route | 162mg PO |
| Activated Charcoal Actions | An absorbent that adheres to many drugs and chemicals, inhibiting their absorotion from the GI tract |
| Activated Charcoal Indications | Poisoning/ OD |
| Activated Charcoal Contra Indications | Semi consciuos/ Unconsciuos |
| Activated Charcoal Side Effects | N/V, Black stools |
| Activated Charcoal Precautions | Contains 48 gm of sorbitol which has osmotic qualities promoting GI evacuation. |
| Activated Charcoal Supplied | 25gm Tube |
| Activated Charcoal Dose and Route | 1-2gm/kg PO |
| Proparacaine (Alcaine) Action | Provides anesthesia prior to ophthalmic procedures |
| Proparacaine (Alcaine) Indications | Anesthesia prior to irrigation, foreign body in eye |
| Proparacaine (Alcaine) Contra Indications | Hypersensitivity |
| Proparacaine (Alcaine) Side Effects | None |
| Proparacaine (Alcaine) Precautions | Not for long term use, warn Pt not to rub or touch eye while it is anesthetized, do not use if solution is discolored |
| Proparacaine (Alcaine) Supplied | 5% solu 15 ml |
| Proparacaine (Alcaine) Dose and route | 1-2 drops in eyes 2-3 minutes prior to procedure |
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