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Pharmacology
Advanced Care Paramedic Medications
| Term | Definition |
|---|---|
| What is the TRADE name for ACETAMINOPHEN | TYLENOL |
| What is the GENERIC name for TYLENOL | ACETAMINOPHEN |
| What is the CLASSIFICATION of ACETAMINOPHEN | Central Analgesic. Non-narcotic Analgesic. Antipyretic. |
| What is the SUPPLIED does of ACETAMINOPHEN | 120 - 350 mg tablets |
| What are the ACTIONS (pharmacodynamics) of ACETAMINOPHEN | Appears to inhibit prostaglandin synthesis in the CNS and to a lesser extent block pain impulses through peripheral action. Acts centrally on hypothalamic heat regulating centre, producing peripheral vasodilation (heat loss, skin erythema, diaphoresis). |
| INDICATIONS for ACETAMINOPHEN | Relief of mild to moderate pain, fever |
| DOSAGES for ACETAMINOPHEN | 325 - 925 mg PO (q 4 - 6 hour) or 1 g 3 - 4 (3 - 4 times a day; maximum 4 g/day) |
| CONTRAINDICATIONS of ACETAMINOPHEN | Hypersensitivity. Severe hepatic impairment. Severe active liver disease. |
| What are the PRECAUTIONS of ACETAMINOPHEN | Use with cautions in hepatic impairment. Renal impairment. Alcohol dependency. |
| What are some other NOTES about ACETAMINOPHEN | Has little hypnotic activity and rarely causes histamine release. Synergistic effects when given with benzodiazepines. Used in combination with benzodiazepines to maintain "sedation" for advanced airways and advanced procedures. |
| What is the TRADE name for ACETYLCYSTEINE | MUCOMYST PRAVAVOLEX |
| What is the GENERIC name of MUCOMYST / PRAVAVOLEX | ACETYLCYSTEINE |
| What is the CLASSIFICATION of ACETYLCYSTEINE | Antidote for acetaminophen overdose. Mucolytic. |
| What is the SUPPLIED does of ACETYLCYSTEINE | 10%, 20% solutions or 200 mg/ml for injection |
| What are the ACTIONS (pharmacodynamics) of ACETYLCYSTEINE | Acetaminophen Antidote: exact mechanism unknown. It is thought it restores hepatic glutathione or inactivates the toxic metabolite of acetaminophen, preventing haptic damage |
| INDICATIONS for ACETYLCYSTEINE | Acetaminophen (toxicity) antidote |
| DOSAGES for ACETYLCYSTEINE | Acetaminophen Toxicity: 150 mg/kg IV over 60 min. (mix in N/S). Followed by: First maintenance dose: 50 mg/kg IV over 4 hours; then Second maintenance does: 100 mg/kg IV over 16 hours Notes: Adjust infusion according to acetaminophen levels |
| CONTRAINDICATIONS for ACETYLCYSTEINE | Hypersensitivity to the drug. Administering the loading does over 60 minutes may decrease the incidence of hypersensitivity reactions. |
| What are the PRECAUTIONS of ACETYLCYSTEINE | Elderly or debilitated patients with severe respiratory insufficiency. Use cautiously in patients with asthma or a history of bronchospasm (may exacerbate). |
| What are some other notes about ACETYLCYSTEINE | Should be given less than 8 hours after injection. Must be refrigerated. Unpleasant odour. Will discolour after opening (does not impair effectiveness) There are also PO dosages. These will be absorbed if activated charcoal is administered also. |
| What is the TRADE name for ACETYLSALICYLIC ACID | NOVASEN (Canada). ASPIRIN. ASA. BUFFERIN. |
| What is the GENERIC name of NOVASEN (Canada), ASPIRIN, ASA, BUFFERIN. | ACETYLSALICYLIC ACID |
| What is the CLASSIFICATION of ACETYLSALICYLIC ACID | Salicylate. Antiplatelet. Antipyretic. Anti-inflammatory. Non-opioid Analgesic. |
| What is the SUPPLIED does of ACETYLSALICYLIC ACID | 80 or 81 mg tablet. 325 mg tablet. 500 mg tablet. 650 mg tablet. |
| What are the ACTIONS (pharmacodynamics) of ACETYLSALICYLIC ACID | Anticoagulant: at low doses, appears to impede clotting by inhibiting the enzyme COX-1 and prostaglandin synthesis, which prevents formation of platelet-aggregating substance thromboxane A2 (this is irreversible and can prolong bleeding time.) |
| INDICATIONS for ACETYLSALICYLIC ACID | Acute coronary syndromes suggestive of an acute myocardial infarction. |
| DOSAGES for ACETYLSALICYLIC ACID | 160 - 325 mg tablet (chewed and swallowed by the patient) Note: may be given even if the patient had taken ASA prior fo incident. |
| CONTRAINDICATIONS for ACETYLSALICYLIC ACID part 1 | Hypersensitivity to ASA / NSAIDS. Active GI bleed. |
| CONTRAINDICATIONS for ACETYLSALICYLIC ACID part 2 | NSAIDS (except for aspirin), both non-selective as well as COX-2 selective agents, should not be given during hospitalization for STEMI (increased risk of mortality, re-infarction, hypertension, heart failure, and myocardial rupture associated with use. |
| What are the PRECAUTIONS of ACETYLSALICYLIC ACID | Active ulcer disease (suppository recommended) Asthma (may induce bronchospasm) Bleeding Disorders (hemophilia, von Willebrand's disease) Impaired renal and hepatic function Children with viral infections (increase risk of Reye's syndrome) |
| What are some other notes about ACETYLSALICYLIC ACID | Non-enteric chewable or soluble aspirin should be used. the effects of a single does of aspirin persists for the life of the platelet (about 8 days) |
| What is the TRADE name for ADENOSINE | Adenocard |
| What is the GENERIC name of ADENOCARD | Adenosine |
| What is the CLASSIFICATION of ADENOSINE | Antiarrhythmic ( a naturally occurring nucleoside) |
| What is the SUPPLIED dose of ADENOSINE | 3mg/ml in 2 and 5 ml vials |
| What are the ACTIONS (pharmacodynamics) | (antiarrythmic) Acts on the SA and AV node to slow conduction and inhibit reentry pathways. Also useful in PSVT linked to accessory bypass tracts (Wolf-Parkinson White Syndrome) |
| INDICATIONS For ADENOSINE PART 1 | Stable, narrow-complex regular tachycardia (SA and AV nodal origin) Therapeutic and diagnostic maneuver for stable narrow complex SVT (Not AV nodal in origin) |
| INDICATIONS for ADENOSINE Part 2 | May be considered for: Unstable narrow-complex regular tachycardia while preparations are made for cardioversion. stable, regular, monomorphic, wide complex tachycardia thought or previously defined to be re-entry SVT with aberrancy |
| DOSAGES for ADENOSINE | 6mg FIVP (over 1-2 secs) A second dose of 12mg can be given in 1-2 minutes if required NOTE: each dose should be flushed 20ml NS while elevating the arm while informing patient of possible side effects such as dyspnea, chest pain, flushing. |
| CONTRAINDICATIONS of ADENOSINE | Hypersensitivity, Poisoning/ Drug induced tachycardia, 2nd /3rd degree AV block, Sick sinus syndrome, AFIB, A Flutter |
| PRECAUTIONS of ADENOSINE | Concurrent use of drugs that slow AV conduction, Caution in asthmatics : may cause bronchoconstriction GIVE A REDUCED DOSE: to in patients with transplanted hearts, or give via central line, Patients takingTegratol or Dipyridamole. |
| OTHER NOTES on ADENOSINE Part 1 | Does not convert AFIB AFLUTTER or VT. Perform a vagal maneuver before the administration of adenosine. Administer in large peripheral vein like the AC at closest medication port, run monitor strip prior, during and after administration. |
| OTHER NOTES ADENOSINE part 2 | Short, transient 1st, 2nd and 3rd degree blocks or asystole may occur following injection. Usually resolves quickly due to short half-life |
| What is the trade name for AMIODARONE HCL | CODARONE |
| What is there GENERIC NAME for CODARONE | ADENOSINE |
| What is the CLASSIFICATION for AMIODARONE | Benzofuran derivative, ventricular and supra-ventricular antiarrythmic (Class IIIvw) |
| What is AMIODARONE SUPPLIED in | 50g/ml |
| what are the PHARMACODYNAMICS of AMIODARONE PART 1 | Prolongs the action potential and refectory period (depolarization inhibition)-Noted in the QR interval of the ECG. Inhibits adrenergic stimulation and decreases peripheral vascular resistance |
| what are the PHARMACODYNAMICS of AMIODARONE PART 2 | With prolonged therapy, the effective refractory period increases in atria, ventricles, AV node, His Perkinjie system, and bypass tracts and conduction slows in the atria, AV node, Perkinjie system and ventricles. SA node automaticity decreases. |
| INDICATIONS of AMIODARONE | VF/pVT unresponsive to shock delivery, CPR, and a vasopressor Recurrent , hemodynamic stable VT With expert consultation amiodarone may be used for tx of some atrial and ventricular arrhythmias |
| DOSAGE of AMIODARONE VF/pVT | 300mg IVP (recommend dilution in 20 to 30 ml D5W or NS) L 2ND dose if needed 150mg IVP in 3-5 minutes |
| DOSAGE of AMIODARONE LIFE THREATENING ARRYTHMIAS (RAPID INFUSION) | Rapid infusion: 150mg/10 mins q 10 mins (until suppression of arrhythmia or max cumulative dose) Mix 150mg in 100ml bag of NS of D5W (concentration is 1.5mg/ml. Using 10gtt set= 10 got/min (15 mg /min) |
| DOSAGE of AMIODARONE LIFE THREATENING ARRYTHMIAS (SLOW INFUSION & MAINTENANCE) | Immediately post suppression of arrhythmia : 1mg/min over 6 hours (360 mg) Maintenance Infusion: 0.5mg/min over 18 hours (540 mg) Max cumulative dose of 2.2gms/24 hours |
| CONTRAINDICATIONS for AMIODARONE | AV BLOCK, pre-existing 2nd or 3rd degree block without artificial pacemaker; sinus node dysfunction ; bradycardia resulting is syncope; sensitivity to amiodarone or iodine(contains iodine) ; Cardiogenic shock (Hypotnsion) |
| PRECAUTIONS OD AMIODARONE | Avoid use with its receiving beta-blockers or calcium channel blockers use with caution in patients with hepatic failure and thyroid disease, hypotension |
| NOTES on AMIODARONE Part 1 | Decrease the infusion rate if there is a prolongation of the QT interval or heart block; stop the infusion if the QRS widens to 50% of the baseline or hypotension develops. Amiodarone infusions exceeding 2 hours, should be prepared using D5W in glass. |
| NOTES on AMIODARONE Part 2 | Treatment of overdose may require beta adrenergic agonists (isoproterenol) or TCP. Hypotension must be treated with positive inotropes (dopamine, dobutamine)or vasopressors (epic, norepinephrine). Do not administer with other drugs that prolong WT inter |
| NOTES on AMIODARONE part 3 | Do not administer with other drugs that prolong QR interval i.e procainamide; other antiarrythmics can induce tornadoes de points. Beta blockers calcium channel blockers may potentiate bradycardia , sinus arrest and AV block |
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