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Parameds_complete
P53 med list
| General(Trade) | MOA or PCOL | Onset/duration | Indications | Contraindications | Adverse Effects | Dose | Notes |
|---|---|---|---|---|---|---|---|
| Adenosine (Adenocard) | Atypical AntiArrythmic/edogenous nucleoside/prevents or term reentry/dec. automaticity | imm 10-30sec | PSVT/WPW/WCTach | KnownVtach/hypersens/Afib/Aflut/av blocks | flush/metalic tst/hypotens/asystole/dizzi/cp | rapid 6mg q2 repeat 12mg q2 12mg PED: 0.1-0.2mg/kg repeat double | Methylxanthines antagonize actions of adenosine |
| Lidocaine (Xylocaine) | Class1 antiarry/k+ channel block/neg dromo/dec auto/prev or term reentry/local anesthetic | 30-90s/10-20m | PVCs/Vfib/plvtach/vent_tach/wctach/prophyl | Hypersens/adv_av_blk/brady/wpw | Myocard depress/cns depres (seizure/tinni/drowsi) | IV-vfib 1.5mg/kg q3 repeat half/other 1-1.5mg/kg repeat half q5-10 max 3mg/kg inf: 1g in 250cc at 2-4mg/min PED:1mg/kg inf:20-50mcg/kg/mn | Beta blck increase effect/flush between drug lido changes pH |
| Procainamide (Pronestyl/Procard) | Na+ channel block/works to depress excitability/neg dromo/ dec automaticity/inc fibrill thres | 30-90s | PVC/Vtach/Vfib/plvtach all refract lido/WPW/Afib/wctach | hypersens/torsades/adv_av_blk/brady | myocard depress/av blk/ekg change | IVP 20-30mg/min until 17m or arryth gone or hypotension or widened qrs/ inf 1g in 250ml @1-4mg/min PED: IV 3-6mg/kg inf: 20-80 mcg/kg/min | add to lido |
| Bretylium Tosylate (Bretylol) | Class 3 antiarryth/inc fibr thres/ slight bp increase at first/prev or term reentry | 2-3m for Anit Fib/20min for anti-arryth/last 6-24hr | Vfib/plvtach/wctach refract to classI | adv_av_blk/brady/digoxin toxicity/ | hypotens/brady/bp & hr increase/N/volatile vomiting | IVP 5mg/kg (very slow IVP 8 min) repeat 10mg/kg q5-15 MAX 30 infuse: 1-2mg/mn 1g in 100ml | |
| Amiodarone (Cordarone) | K+channelblock/antidisrythmic/relax vascular smooth muscle/alpha β blockade | 5-15min/var | Vfib/plvtach/Afib/unstableVtach | Adv_av_blk/brady/hypotens/torsades/iodine or shellfish allergy/TCA use | PEA/Hypotens/Brady/CHG/Naus/Abnormal Liver/Fever/Thrombocytopenia | Vfib 300mg/Vtach 150-300mg over 5-10min/max 2.2g in 24hr/INF: 300mg in 250ml D5W @1mg/min for 6min | Nabicarb precipitate/increase digoxin/enhance other antiarryth |
| Verapamil (Isoptin/Calan) | Class 4 antiarry/Ca+channelblk/neg dromo/prev & end rentry/dec automat/decreas02/dilate coronary art/inhibit vasospasm | 5-10m | Stable PSVT/decrease ventricular rate n Afib or Aflutter | CHF/Adv_av_blk/Hypotens/wctach/vtach/WPW/Brady | Hypotens/brady/av_blk/dizzi/headach/OD:Ca+ | 2.5-5mg (slow IV 2min)/repeat 5-10mg q15-30 MAX 20mg PED: 0.1-0.3mg/kg | beta blck increase effect lower dose |
| Diltiazem (Cardizem/Lyoject) | Ca+channelblk/prev vasospasm/dilate cor art/dec automat/neg dromo/dec O2 | 2-5m for 1-3hr | PSVT/Afib/Aflut | Hypersens/Adv_av_blk/Brady/Hypo/CHF/wctach | Brady/Hypotens/CHF/AV_blk/dizzi/PVC OD:Ca+ | 0.25mg/kg over 2m repeat 0.35mg/kg over 15min/ Inf: 125mg in 100ml @ 5-15mg/hr supplied 25or 50mg bottle | Beta blockers increas effect |
| Nifedipine (Procardia/Adalat) | Ca+channelblk/prev vasospasm/decr after and preload/decr platelet aggr/dec O2/no effect on conduction | 15-30m fro 6-8h | Hypotensive Emerg/Angina | Hypersens/Hypotension | Hypotens/Flush/dizzi/Hedache OD:Ca+ | 10-20mg capsule puncture and squeeze under tng/bite capsule swallow NOPEDI | Beta blockers increas effect/ CNS depress increas eff |
| Calcium Chloride (CaCl) | Electrolyte/pos inotropic/import blood and nerve and muscle funct | 5-15min/var | Hyperkalemia/Hypocalcemia/Ca+channelblk OD/MagSulf OD | Vfig/suspect digoxin toxicity (bradycardia/halo effect vision) | metal tst/hypotension/tissue necrosis on infiltration | 2-4mg/kg q10 PED: 20mg/kg | Sodium Bicarb precipit |
| Atropine Sulfate (Atropine) | Anticholergenic (comp blk of Ach)/+ chrono/+drom/+ automat/+ elect act/+afterload/inc O2 demand | Immidiate for 3-5min | Symptomatic Brady/some AV_blk/Asystole/PEA/Organophosphate poison | none in cardiac arrest/tachycardia | decrease bodily fluid/inc O2 demand/tachycardia/blurred vision/OD: Cholergenic (physostigmine) | dead 1mg q3 MAX 3mg/Brady: 0.5-1mg q3 titrate to HR>60/Organic: 2-5mg IV or IM or both q5-15 PEDI 0.02mg/kg q3 Max 0.5mg | none |
| Magnesium Sulfate | Electrolyte/cofactor of enzyme/cns depressant/block neuromuscular/periph & coron dilation/bronchodilation/dec plate agr/dec fatal MI | Immediate | Eclamptic toxemia/Refract Vfib/plvtach/torsades/mi/asthma | AV Block OD: can kill due to Hypovol | Brady/Hypotens/flush/cns depress/sweating/ OD:Ca+ | Toxemia 1-4mg over 3min (watch BP)/Other: 1-2mg in 10-100mls over 1to2 min | CNS Depress increas effect |
| Isoproterenol (Isuprel) | Synth catecholamine/sympathomimetic/beta agonist (b1 most)/inc chrono ino dromo/bronchodil/periph dilation/significant O2 increase | Immediate | Symptomatic Brady/some AV_blk/Torsades refract other | Hypersens/tachycardia/cardiac arrest/vtach | rapid massive incr O2 demand/sweats/flush/tachycardia OD: beta blockers | Infusion only 1mg in 250ml @2-10mcg/min titrate to HR>60 or PVC occur | Beta blockers decrease effect/ Bretylium inc effect/TCA incr effect |
| Epinephrine (Adrenaline) | Alpha & Beta catecholamine/beta1 +inotropic and beta2 bronchodilation/alpha makes vasoconstriction afterload inc/inc elect act | Immediate (1-2min CPR)/5-10min SC lasts 3-10min | Vfib/plvtach/asystole/pea/anaphalaxys or severe allergenic/asthma or severe croup/symptomatic bradycardia | none in cardiac arrest or anaphylaxis/hypersens to sulfite/unresolved hypovolemia/angina/hypertension/CHF | Increase O2 dem/Hypertension/Tremors/ OD: alpha and beta blok/sulfites | Standard 1mg q3/Intermediate 2-5mg q3/Escalating 1-3-5mg q3/Severe Croup 5mg 1:1000 in 5ml NS via nebulizer every 30min/Other 0.1-0.5mg 1:1000 SC or 0.1-1mg (1:10000)IVP/Inf: 1mg of 1:1000 in 250ml | Bretylium and TCA increase/Beta block decrease |
| Dopamine (Intropin) | Sympathomimetic/catecholamine/vassopressor/stimulates release of NE/Alpha beta dopaminergic effects/ mod dose: most beta +inotropic some alpha/high dose 10-20mcg/kg more alpha +vasoconstr | <5m for 5-10min | Cardiogenic shock/neurogenic shock/hemodynamic signifi hypotension w/o hypovolemia | Hypersens/tachycardia/unresolved hypovolemia/phenochromocytoma (adrenal gland tumor) | Tachycardia/Palpation/Hypertension/Increase O2/Tissue necrosis | Infusion only 400mg in 250ml @2-20mcg/min titrate to HR>90 PEDI 2-20mcg/kg/min titrate to bp90 | Beta blockers decrease effect/Bretylium increases |
| Dobutamine (Dobutrex) | Sympathomimetic/synth catecholamine/vassopressor/Alpha beta effects/ inotropic/some renal dilation/minimal impact on HR/increase cardiac output coronary blood flow | 1-2m 2-10m peak | cardiogenic shock/hypotension after return of spontaneous circulation/hemodynamic signifi hypotension w/o hypovolemia/left heart failure | Hypersens/unresolved hypovolemia/tachydisrythmia | Hypotens/Tachycardia (dose related) | Infusion only 250mg in 250cc @2-20mcg/kg/min titrate to 90bpm PEDI: 2-20mcg/kg/min titrate to BP | Beta blockers decrease effect |
| Norepinephrine (Levophed) | Sympathomimetic/Catecholamine/vassopressor/mostly Alpha with beta effects/vaso renal constriction/increase O2/ +chrono +ino | immediate | Cardiogenic shock/neurogenic shock/hemodynamic signifi hypotension w/o hypovolemia | Hypersens/unresolved hypovolemia | Hypertension/reflex brady/inc 02/tissue necrosis | Infusion only 4mg in 250cc @0.5-30mcg titrate to BP 90 | Beta blockers decrease effect/ Bretylium inc effect |
| Nitroglycerin (nitrostat/nitroliqual spray) | vasodilator/relax smooth muscle(vaso)/inc coron blood flow/stop vasospam/dec pulm vasc res/dec pre & afterload/decrease O2 dem/inhibit platelet aggr/decrease bp | SL-1-3m/TD 15-30m/IV immed lasts SL-30/TD 2-12h | Ischemic Hrt Fail/Left Hrt Fail/MI/?hypertens? | Hypersens/Hypotension/Head trauma (ICP increase) | hedach/flush/hypotens/dizzi/reflex tachycardia/postural syncope | SL:0.3mg /0.4mg/0.6mg q5 x 3/ TD 1/2 to 2in (15mg/in)/Infusion: 5mcg/min and increas 5-10mcg q5 titrate for effect | CNS Depress increas effect |
| Amyl Nitrate | Same as Nitro/causes oxidation of hemoglobin for methemoglobin/Methemoglobin reacts with cyanide and creates a molecule with less affinity than oxygen lowering toxicity | 30s for 3-20m | Cyanide poisoning | none | hedach/hypertension/dizzi | crush 3ml ampule breath in for 30sec of each minute/ repeat as needed | none |
| Aspirin (Acetacylic Acid ACA) | Platelet inhibitor/decrease inflamation/inhibit prostaglandins | 30-45m lasts 4hr | New onset CP or AMI no signs or symptons of CVA | GI Bleeding/Hypersensitive to Aspirin not coating | GI Bleed/nausea/Increase PT & PTT | Oral only chew 2-4 (81mg each) tablets 324mg/ use 2 if patient already on anticoagualants | Increased effects with other anti-coagualants |
| Heparin Sodium | anti-coagulant/prevents conversion of fibrogen into clot/affect active clotting process IX/XI/XII | immediate | Acute Myocardial infarction (Integrillin the super aspirin) | Hypersens/Active bleed/recent surgery | bleeding/chills/fever/backpain due to allergic reaction | IV: loading 70u/kg ma 14-17u/kg/hr/ PEDI: 50u/kg then 7.5u/kg/hr can be used IV/Infursion/SC | Beta blockers increas effect |
| Morphine Sulfate | Schedule 2 narcotic opiod/analgesic/decrease pulmon edema via pooling/vasodilation/decr pre & afterload/anti-anxiety/decr O2/depress resp center | immediate for 10-60m | ischemic Chest Pain/Lft Hrt fail/?maybe single system trauma (anxiety) | Hypersens/hypotens/resp depr/alter LOC/asthma/COPD/abd pain/head inj/hypovolemia | resp Depr/NV/Altered LOC/CNS Depr/Flushin/Hypotens/OD: Naloxone | IVP/IM/SC/IO/ 1-3mg q5 (give over 2min) PEDI: 0.1mg/kg | increased effect wih other CNS depress |
| Naxolone (Narcan/Vitamin N) | Narcotic antagonist/comp inhibition of opiod rec/prevents some opiod effect/no effect if opiod not present | 1-2m IVP/3-5m IM or SC last 30-60m IV or 3-6hrs IM/SC | Narcotics OD/coma of unknown origin/?use in alcohol coma? | Hypersensitive | NV/Acute Abstinence Syndrome/sweats/arrythmia | IVP/IM/SC/ET/IO 0.4 - 2mg q5 titrated to response/ Pedi <5yr 0.1mg/kg q5 titrate | Beta blockers increas effect |
| Furosemide (Lasix) | Loop Diuretic/inhibits reabsorb of fluid in loop of Henley/peripheral vasodilation | 5m vaso 10-20 diuretic for 2-4hrs | Lft Hrt Fail/Cerebral Edema/?hypertensive crisis? | Hypersens/Hypovolemia/Dehydration/Hypotensive | NVD/Tinnitus/Hypotension/ loss of electrolytes OD: Fluids | IVP/IM/IO 20-100mg over 2m/ PEDI : 1mg/kg | increased effect wih other CNS depress |
| Diazepam (Valium) | Sched 4 controlled/CNSdepressant/anticonvulsant(block spread)/sedative effects/muscle relax/induce retrograde amnesia/anti-anxiety | imm(IV)/ 5-15(IM) for 15-60m | Status Epilectipus/seizure/pre-cardiovert/pre-transcutaneous pacing/induction agents | Hypersensitive/Hypotension/Respiratory Depress/Altered LOC | CNS Depression/Hypotension OD: Romazicon (awaken RSI patient) | /IV IM IO ET Rectal/2-10mg q 5-10m MAX 30mg PEDI: 0.25mg/kg (IV) 0.5mg/kg (PR) | CNS Depress increas effect |
| Lorazepam (Ativan) | Sched 4 controlled/CNSdepressant/anticonvulsant(block spread)/sedative effects/muscle relax/induce retrograde amnesia/anti-anxiety | 1-5m | Status Epilectipus/seizure/pre-cardiovert/pre-transcutaneous pacing/induction agents | Hypersensitive/Hypotension/Respiratory Depress/Altered LOC | CNS Depression/Hypotension OD: Romazicon (awaken RSI patient) | IVB IM IO Rectal/2-4mg q15 to MAX 8mg PEDI: 0.05mg/kg - 0.2mg/kg q15m MAX 0.2mg/kg | CNS Depress increas effect |
| Midazolam (Versed) | Sched 4 controlled/CNSdepressant/anticonvulsant(block spread)/sedative effects/muscle relax/induce retrograde amnesia/anti-anxiety | 1-3m for 2-6hr | Status Epilectipus/seizure/pre-cardiovert/pre-transcutaneous pacing/induction agents | Hypersensitive/Hypotension/Respiratory Depress/Altered LOC | CNS Depression/Hypotension OD: Romazicon (awaken RSI patient) | 2-2.5mg slowly may repeat to MAX 0.1mg/kg (IV only) | CNS Depress increas effect |
| Diphenhydramine (Benadryl) | Antihistamine/comp antagaonist fo hist/ block rec not release/prevent initiation and tranof sensory nerve impulse/sedative/antichlinergic/antiemetic | immediate(IV) 5-10m(IM) for 1-2hrs | Allergic reaction/anaphylaxis/phentothiazine OD | Hypersens/Asthma/Alterd LOC/Cardiac History | Drowsi/Dizzi/Hedache/Excitable(child)/wheez/thick secretion bronchial/chest tight/palpation/hypotens/blurred vision/dry mout/NVD | IVP IO IM/ 10-100mg or 1mg/kg PEDI(2-12) 1-1.25mg/kg | Beta blockers increas effect |
| Dexamethasone Sodium Phosphate (Decadron) | Adrenal Corticosteroid (glucocoticoid type)/ Decreases Inflammation by decreasing leukocyte concetration (leukocyte fight infect) | 4-8hrs | Allergic Reaction/Anaphylaxis/Asthma (inc. status)/ Spinal cord inj/cerebral edema/?use in shock? | Hypertension/ None in single dose | Hypertension | IVP/IM/IO 10-100mg or 1mg/kg PEDI: 0.25 - 1 mg/kg | not |
| Sodium BiCarb | Electrolyte/ Increase free buffer to decrease acidosis/Increase pH/ Reverses metabolic acidosis | onset : 5-10m durat: 30-60m | metabolic acidosis/ Barbituate OD(helps eliminate drup faster in urine)/TCA OD/Hyperkalemia | Alkalosis/Hypocalcemia/Hypokalemia | Alkalosis/Hypokalemia/Hypoxemia/Tissue Necr/Tetany - cramps/conv/muscle twitch/joint flexion | IVP IO 1meq/kg repeat 0.5meq/kg q10 PEDI: 1meq/kg | |
| Thiamine | Vitamin B1/water soluble vitamin/needed for conversion of glucose to energy/ required for metabolism | coma of unk etiology/delerium tremens/beriberi- B1 vitamin def/wernicke's encephalopathy/korsakoff's syndrome | Hypersensitivity | Hypotension | IVP IM 50-100mg PEDI: none | none | |
| Dextrose 50% | Nutrient/Carbohydrate/Increases circulating available glucose | Hypoglycemia/coma of unk etiology/status epilepticus/diabetic code | relative in CVA/hyperglycemia | Tissue Necrosis | IVP 25-50g PEDI: <2yr: D25 125-250mg/kg | ||
| Glucagon HCL | Hormone prodcd by alpha cells of pancreas/ insulin antagonist/inc liver glycogenolysis/Increase brkdwn of glycogen to glucose/inhbt glycogen synthetase/rlx smoth muscle of gi tract/may incr cardiac contratility | onset : 5m | Hypoglycemia/Beta Blocker OD | Hypersense | N/V OD: support | IVP IM SC IO 0.5-1mg q15m PEDI same | INT none |
| Activated Charcoal | Absorbent/binds & adsorbs toxins present in gi tract/once bound toxin excreted thru bowel | Ingested Poison | Hypersensitivity | N/V Abdominal cramping/Constipation | ORAL NG tube: bottles of 25g & 50g | INT Don't administer w/ Syrup of Ipecac / Don't adminster to Pt with Alt LOC (use NG tube inst) | |
| Oxygen | Facilitates cellular energy metabolism | Hypoxia/Ischemic Chest Pain/Respiratory Dist/Suspect CO poison/Trauma/Shock | Known paraquat Poisoning | non but CO2 | 1- 6L low/15L high | ||
| Bronchodilators (broad for all bronchodilator) | Beta2 Agonist/ Sympathomimetic/Bronchodilation/smooth muscle relax of bronchiole/inhibit histamine release/mild vasodilation | on 5-15m dur: 3-4hr | Asthma/COPD/Pulmonary Edema | Hypersens/relative in tachycard or MI | Tachycardia/Palpation/Tremors/N/V/Arrythmia OD: Beta Blockers/Supportive | dependent on specific | Increased effect wih TCA/ Decrease effect with Beta blocker |
| Albuterol Sulfate (Proventil/Ventulin) | Beta2 Agonist/ Sympathomimetic/Bronchodilation/smooth muscle relax of bronchiole/inhibit histamine release/mild vasodilation | on 5-15m dur: 3-4hr | Asthma/COPD/Pulmonary Edema | Hypersens/relative in tachycard or MI | Tachycardia/Palpation/Tremors/N/V/Arrythmia OD: Beta Blockers/Supportive | 2.5-5mg PEDI: 1.25-2.5mg | |
| Metaproterenol Sulfate (Alupent) | Beta2 Agonist/ Sympathomimetic/Bronchodilation/smooth muscle relax of bronchiole/inhibit histamine release/mild vasodilation | on 5-15m dur: 3-4hr | Asthma/COPD/Pulmonary Edema | Hypersens/relative in tachycard or MI | Tachycardia/Palpation/Tremors/N/V/Arrythmia OD: Beta Blockers/Supportive | 15mg PEDI: 7.5mg | |
| Terbutaline Sulfate (Brethine/Brethaire) | Beta2 Agonist/ Sympathomimetic/Bronchodilation/smooth muscle relax of bronchiole/inhibit histamine release/mild vasodilation | on 5m dur: 1-4hr | Asthma/COPD/Pulmonary Edema | Hypersense/relative in Tachy/ MI | Tachycardia/Tremors/N/V/Palpitations/Arrythmia | SC 0.25mg q15-30/Inhaler 0.2-0.4mg (1-2 sprays) | Increased effects TCA/Decreased effect Beta Blocker |
| Methylpredisolone Sodium Succinate (Solu-Medrol) | Corticosteroid-type Glucocorticoid/Decrease inflammation/Alters airway hyperactivity | on 1-2hrs | Anaphylaxis/Severe Allergic Reaction/Asthma/Spinal Cord Trauma/Cerebral Edema/?use in shock? | NONE | Hypertens/CHF OD: supportive | 40-125mg Asthma: 1-2mg/kg Spinal Cord Inj: 30mg/kg over 30min PEDI: same | Furosimide could increase K loss/ |
| Ipratropium Bromide (Atrovent) | Anticholergenic/Parasympatholytic/Dries respiratory tract secretions/Block Acetylcholine Receptors (inhibit parasympathetic) | peak 1.5-2hr / duration: 4-6hrs | Asthma/COPD | Hypersense | Palpitation/Anxiety/Dizzi/N/V/Headache | 500mcg in 2.5ml saline usually deliver w/ Beta agonist | |
| Hydrocortisone | Short acting synth steroid/inhibits formation of histamine/increases response to circulating catecholamines | on immediat/ peak 4-8hr dur 1-1.5 days | Reduce Inflamation due to allergic reaction/severe anaphylaxis/asthma/COPD | Cushings Synd/ Benzyl Alcohol sensitive | Leukocytosis/hyperglycemia/incrased infection/decreased wound healing/Increase rat of death in sepsis | Anaph shk: IV IO IM 100-500mg PEDI: 2-4mg/kg/day (MAX: 500mg)/Adrenal Insuff: same PEDI: 1-2mg/kg/ Asthma: same PEDI 1mg/kg | |
| Fentanyl Citrate (Sublimaze) | Narcotic analgesic/chemically unrelated to morphin but similar reaction/50 to 100 times more potent than Morphine/ less emetic effect/duration of action | Immediate(IV) Peak 5-15m(IV) Duration: 30-60m halflife 6-8hr | Pain Mgmt/RSI Adjunct/Maintenace of Analgesia | Severe Hemorrhage/Shock/Hypersense | CNS: sedation/euphoria/dizzi/diaphoresis/delirium CV: hypotension/bradycardia/circulatory depression/ Eyes: Miosis/blurrred | 1mcg/kg MAX 150mcg slow IV 1m (2-3 better)/ same can be used nasaly can dilute with NS for easy administration PEDI: 1.7 - 3.3 mcg/kg 2-12yr | |
| Ondansetron (Zofran) | Antiememtic | ON 30m for 3-6hr adult 2-3hr child | Use to prevent nausea & vomiting (typically given to help with pain med) | Hypersensitive | >10% cardiovasc (malaise/ fatigue)/CNS: Headache | Adult: 4mg IV/Child: <30kg 1mg/>30kg 2mg | |
| Vassopressin (Pitressin) | Hormone Vassopressor/polypeptide hormone extracted from posterior pituitary glands of animals/ Possess Pressor and anitdiuretic properties | Onset: variable/peak: variable/duration: 30-60min/half: 10-20 | Need for increase in peripheral vascular resistance during cpr | non during CPR/chronic nephritis/ischemic Hrt dis/PVCs | skin blanch/abdominal cramps/nausea/hypertension/bradycardia/minor disrythmia | 40 units IV (replaces EPI during CPR 2nd) PEDI: same | None in ACLS |
| METOPROLOL (Lopressor) | Selective Beta Antagonist/Block both B1 and B2 but mostly B1 | Onset Immediate - Peak 20m- Duration 13-19hr halflife 3-4hr | Used in patients with MI/ or suspect MI that are hemodynamically stable | HR<45bpm/SysBP<100/CHF/early or late signs of shock/advanced av block/ 1st block PR wave >0.24s | Bradycardia/Hypotens/lethargy/CHF/Dyspnea/wheezing/weakness | 5mg IVP slow if stable vitals still can give 5mg/ total 15mg MAX | NOT to be given to a patient that has received Verapamil |
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rdslack
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