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Medications
| Prompt | Response |
|---|---|
| Adenosine (Nucleoside) Adult Dose: | 1st – 6mg Rapid (IV), Followed by 20ml flush 2nd – 12mg Rapid (IV), Followed by 20ml flush |
| Adenosine (Nucleoside) Pharmacodynamics: | Binds to the adenosine A1 receptors causing efflux of potassium and inhibiting calcium influx, causes hyperpolarization of autorhythmic cells (SA/AV nodes); slows AV conduction. |
| Adenosine (Nucleoside) Indications: | 1st line medication for stable narrow complex SVT, Regular and monomorphic wide complex tachycardia thought to be reentry SVT w/ BBB |
| Adenosine (Nucleoside) Contraindications: | A Fib/ A Flutter, Torsades de Pointes, Poison/ drug induced tachycardia 2nd & 3rd degree AV block |
| Adenosine (Nucleoside) Adverse Effects: | Transient periods of sinus bradycardia, Asystole, And Ventricular ectopy |
| Albuterol (Beta Agonist) Adult Dose: | 2.5mg in 3mL via SVN (small volume nebulizer), repeat every 15-20 mins |
| Albuterol (Beta Agonist) Pharmacodynamics: | Agonist that binds to the B2 receptors |
| Albuterol (Beta Agonist) Indications: | Bronchospasms Allergies/ Anaphalaxis Hyperkalemia |
| Albuterol (Beta Agonist) Contraindications: | Hypersensitivity to medication |
| Albuterol (Beta Agonist) Adverse Effects: | Palpitations Anxiety Tremulousness Headache/ Dizieness Tachycardia |
| Amiodarone (Class 3 Antiarrhythmic) Adult Dose: | Cardiac Arrest 1st – 300mg (IV/IO), Rapid 2nd – 150mg (IV/IO) Stable Vtac 150mg (IV infusion) over 10mins |
| Amiodarone (Class 3 Antiarrhythmic) Pharmacodynamics: | Slows Potassium efflux which delays repolarization. |
| Amiodarone (Class 3 Antiarrhythmic) Indications: | Vfib/ Pulseless Vtac unresponsive to shock, CPR, and EPI; Recurrent hemodynamically stable Vtac with a pulse; Treatment for some arterial and ventricular rhythms |
| Amiodarone (Class 3 Antiarrhythmic) Contraindications: | Allergy to medication Bradycardia including AV blocks Breast feeding mothers |
| Amiodarone (Class 3 Antiarrhythmic) Adverse Effects: | Severe hypotension Bradycardia Prolong QT interval which can lead to TdP |
| Atropine (Parasympatholytic) Adult Dose: | Bradycardia: 1 mg IV push every 3-5 minutes (max 3 mg); Organophosphate: 2-4 mg (or higher) IVP. |
| Atropine (Parasympatholytic) Pharmacodynamics: | Selectively blocks muscarinic receptors inhibiting the parasympathetic nervous system (letting sympathetic take over). |
| Atropine (Parasympatholytic) Indications: | 1st line for symptomatic sinus bradycardia (Adults); AV nodal block; Organophosphate poisoning. |
| Atropine (Parasympatholytic) Contraindications: | Allergic to drug; Avoid in hypothermic bradycardia; caution in myocardial ischemia/hyCpoxia. |
| Atropine (Parasympatholytic) Adverse Effects: | Blurred vision, Dry mouth, Dilated pupils, Confusion, Paradoxical slowing if < 0.5 mg. |
| Atrovent (Ipratropium) (Anticholinergic) Adult Dose: | 500 mcg / 2.5 mL. |
| Atrovent (Ipratropium) (Anticholinergic) Pharmacodynamics: | Selectively blocks muscarinic receptors.. |
| Atrovent (Ipratropium) (Anticholinergic) Indications: | Bronchospasm associated with obstructive lung diseases (asthma, COPD). |
| Atrovent (Ipratropium) (Anticholinergic) Contraindications: | Known hypersensitivity to medication. |
| Atrovent (Ipratropium) (Anticholinergic) Adverse Effects: | Blurred vision, Dry mouth, Dilated pupils, Cough, confusion. |
| Dextrose (Water-soluble monosaccharide) Adult Dose: | 25 grams IV/IO or 10% dextrose in 50 mL (5 gram) IV/IO boluses (max 250 mL). |
| Dextrose (Water-soluble monosaccharide) Pharmacodynamics: | Provides correction of hypoglycemia. |
| Dextrose (Water-soluble monosaccharide) Indications: | Correction of hypoglycemia. |
| Dextrose (Water-soluble monosaccharide) Contraindications: | Known hyperglycemia. |
| Dextrose (Water-soluble monosaccharide) Adverse Effects: | Tissue necrosis if extravasation occurs; with D50 check the line with Draw back on IV line. May worsen preexisting hyperglycemia. |
| Diltiazem (Class IV Antiarrhythmic – Calcium Channel Blocker) Adult Dose: | 1st dose: 0.25 mg/kg (max 20 mg); 2nd dose: 0.35 mg/kg (max 25 mg). |
| Diltiazem (Class IV Antiarrhythmic – Calcium Channel Blocker) Pharmacodynamics: | Slows action potential of autorhythmic cells in the heart by blocking calcium channels. |
| Diltiazem (Class IV Antiarrhythmic – Calcium Channel Blocker) Indications: | 1st line for A-Fib and A-Flutter with RVR (>150 bpm); 2nd line for SVT refractory to adenosine. |
| Diltiazem (Class IV Antiarrhythmic – Calcium Channel Blocker) Contraindications: | Hypotension (< 90 mmHg), CHF/Cardiogenic Shock, Wide-Complex Tachycardia, WPW, Hypersensitivity. |
| Diltiazem (Class IV Antiarrhythmic – Calcium Channel Blocker) Adverse Effects: | Hypotension, Severe CHF (if used with Beta Blockers), N/V/D, Headache. |
| Dopamine (Sympathetic agonist) Adult Dose: | 2 – 20 mcg/kg/min titrated to patient response. |
| Dopamine (Sympathetic agonist) Pharmacodynamics: | Alpha- and Beta-adrenergic agonist (rate dependent); positive chronotropic, inotropic, and dromotropic effects. |
| Dopamine (Sympathetic agonist) Indications: | CHF, Hypotension with signs of shock, 2nd line for symptomatic bradycardia (after atropine). |
| Dopamine (Sympathetic agonist) Contraindications: | Hypovolemia (until replaced), Known history of Pheochromocytoma, Do not mix with Sodium Bicarb. |
| Dopamine (Sympathetic agonist) Adverse Effects: | Hypertension, Palpitations, Headache, Dizziness, Can worsen cardiac ischemia, Tissue necrosis from extravasation. |
| Epinephrine 1:1,000 (Sympathetic agonist) Adult Dose: | Anaphylaxis: 0.01 mg/kg IM with a max dose of 0.3 - 0.5 mg. |
| Epinephrine 1:1,000 (Sympathetic agonist) Pharmacodynamics: | Potent Alpha and Beta agonist. |
| Epinephrine 1:1,000 (Sympathetic agonist) Indications: | Severe anaphylaxis. |
| Epinephrine 1:1,000 (Sympathetic agonist) Contraindications: | Few in emergent setting; benefits vs. risks. |
| Epinephrine 1:1,000 (Sympathetic agonist) Adverse Effects: | Palpitations, Anxiety, Tremulousness, Headache, Dizziness, Hypertension, Tachycardia, Worsens cardiac ischemia. |
| Epinephrine 1:10,000 (Sympathetic agonist) Adult Dose: | Cardiac Arrest: 1 mg IVP/IOP every 3-5 minutes. Bradycardia/Hypotension: 2-10 mcg/minute IV/IO infusion. |
| Epinephrine 1:10,000 (Sympathetic agonist) Pharmacodynamics: | Potent Alpha and Beta agonist. |
| Epinephrine 1:10,000 (Sympathetic agonist) Indications: | Cardiac arrest, Symptomatic bradycardia (Pediatric), Normovolemic hypotension, Severe anaphylaxis. |
| Epinephrine 1:10,000 (Sympathetic agonist) Contraindications: | Few in emergent setting; benefits vs. risks. |
| Epinephrine 1:10,000 (Sympathetic agonist) Adverse Effects: | Palpitations, Anxiety, Tremulousness, Headache, Dizziness, Hypertension, Tachycardia, Worsens cardiac ischemia. |
| Glucagon (GlucaGen) (Hormone) Adult Dose: | Hypoglycemia: 1mg IM/IN, may repeat after 10-15 CCB & BB Overdose: 3-10mg IV, Slow Bolus, followed by NS flush. Main drip of 3-5mg/hr. |
| Glucagon (GlucaGen) (Hormone) Pharmacodynamics: | Stimulates glycogenolysis increasing blood glucose levels rapidly. This provides a source of energy to the body in emergency situations. Also relaxes smooth muscles of the GI tract, primarily the esophagus, indicated for esophageal obstructions. |
| Glucagon (GlucaGen) (Hormone) Indications: | Hypoglycemia Insulin overdose Esophageal Obstruction CCB & BB Overdose |
| Glucagon (GlucaGen) (Hormone) Contraindications: | Hypersensitivity Hyperglycemia |
| Glucagon (GlucaGen) (Hormone) Adverse Effects: | Dizziness Nausea & vomiting Hypertension Tachycardia Rebound Hyperglycemia |
| Lidocaine (Class IB Antiarrhythmic) Adult Dose: | 1-1.5 mg/kg IV/IO; repeated 0.5-0.75 mg/kg every 5-10 min to max 3 mg/kg. Maintenance: 1-4 mg/min. |
| Lidocaine (Class IB Antiarrhythmic) Pharmacodynamics: | Blocks sodium channels in cardiac cells; slows depolarization and decreases automaticity. |
| Lidocaine (Class IB Antiarrhythmic) Indications: | Cardiac arrest from VF/PVT; Stable monomorphic VT with preserved LVF. |
| Lidocaine (Class IB Antiarrhythmic) Contraindications: | Prior IV calcium channel blockers, Not given prophylactically in AMI setting. |
| Lidocaine (Class IB Antiarrhythmic) Adverse Effects: | Drowsiness, Slurred speech, Confusion, Seizures, Hypotension. |
| Magnesium Sulfate (Mineral / Electrolyte) Adult Dose: | Torsades: 1-2g IV/IO Asthma: 2g IV over 20 min 1-4 mg/min. |
| Magnesium Sulfate (Mineral / Electrolyte) Pharmacodynamics: | Organic Salt – act as a physiologic calcium channel blocker and Bronchodilator. It is a very powerful non-adrenergic bronchodilator used for cases of severe asthma that is not responding to traditional adrenergic medications. |
| Magnesium Sulfate (Mineral / Electrolyte) Indications: | Torsades do Pointes; Status asthmaticus; Eclampsia. Pediatric Asthma |
| Magnesium Sulfate (Mineral / Electrolyte) Contraindications: | |
| Magnesium Sulfate (Mineral / Electrolyte) Adverse Effects: | Magnesium toxicity results in loss of deep tendon reflexes and respiratory depression |
| Midazolam (Versed) (Benzodiazepine) Adult Dose: | Seizures: 0.1-0.2 mg/kg IV/IO (max 10 mg) or 5 mg IM/IN. ET Tube Bucking: 0.05 mg/kg slow IV/IO over 1 – 2 minutes (maintain a systolic BP) – stop once bucking has resolved. RSI: 0.1-0.3 mg/kg (max 10 mg). |
| Midazolam (Versed) (Benzodiazepine) Pharmacodynamics: | Binds with GABA receptors causing an influx of chloride. |
| Midazolam (Versed) (Benzodiazepine) Indications: | Active seizures, RSI induction agent, Chemical restraint, Anxiety, Sedation. |
| Midazolam (Versed) (Benzodiazepine) Contraindications: | History of hypersensitivity to the drug. |
| Midazolam (Versed) (Benzodiazepine) Adverse Effects: | Hypotension, Respiratory depression/arrest. |
| Naloxone (Narcan) (Opioid Antagonist) Adult Dose: | 0.4–2 mg IV/IO/IM/IN; titrate until breathing resumes |
| Naloxone (Narcan) (Opioid Antagonist) Pharmacodynamics: | Competitive opioid receptor antagonist in the central nervous system. It rapidly displaces opioids from these receptors, reversing respiratory depression and other effects caused by opioid overdose. |
| Naloxone (Narcan) (Opioid Antagonist) Indications: | Suspected opioid overdose with respiratory depression |
| Naloxone (Narcan) (Opioid Antagonist) Contraindications: | Hypersensitivity |
| Naloxone (Narcan) (Opioid Antagonist) Adverse Effects: | Precipitates acute withdrawal Tremors N/V Behavioral changes Hypertension Tachycardia Seizures Arrythmias |
| Norepinephrine Sympathomimetic (Vasopressor) Adult Dose: | 0.1 – 0.5 mcg/kg/min IV/IO infusion |
| Norepinephrine Sympathomimetic (Vasopressor) Pharmacodynamics: | Stimulates both alpha -1 and beta-1 adrenergic receptors leading to vasoconstriction, narrowing blood vessels which increases B/P and enhancing the force of the heart’s contraction, improving cardiac output. |
| Norepinephrine Sympathomimetic (Vasopressor) Indications: | Severe Hypotension Cardiogenic, anaphylactic, Neurogenic, and Septic shock |
| Norepinephrine Sympathomimetic (Vasopressor) Contraindications: | Hypersensitivity Hypovolemic Shock with fluid replacement |
| Norepinephrine Sympathomimetic (Vasopressor) Adverse Effects: | Dizziness Dyspnea Nausea & Vomiting Tachycardia Hypertension Tissue Necrosis Ischemia Arrhythmia’s |
| Solu-Medrol (Synthetic Glucocorticoid) Adult Dose: | 125 – 250 mg IV/IO |
| Solu-Medrol (Synthetic Glucocorticoid) Pharmacodynamics: | Anti-inflammatory; suppresses immune response |
| Solu-Medrol (Synthetic Glucocorticoid) Indications: | Bronchial asthma COPD Anaphylaxis |
| Solu-Medrol (Synthetic Glucocorticoid) Contraindications: | Known hypersensitivity to medication |
| Solu-Medrol (Synthetic Glucocorticoid) Adverse Effects: | Increase in blood glucose level Effects are delayed and usually not seen during prehospital care |
| Terbutaline (Bronchodilator, Sympathomimetic) Adult Dose: | 0.25 mg IM |
| Terbutaline (Bronchodilator, Sympathomimetic) Pharmacodynamics: | Stimulates the Beta 2 adrenergic receptors in the smooth muscles of the airways, leading to activation of adenylate cyclase and subsequent increase in cyclic adenosine monophosphate cAMP levels. |
| Terbutaline (Bronchodilator, Sympathomimetic) Indications: | Asthma or COPD Exacerbation Acute Bronchospasm |
| Terbutaline (Bronchodilator, Sympathomimetic) Contraindications: | Hypersensitivity Tachyarrhythmias |
| Terbutaline (Bronchodilator, Sympathomimetic) Adverse Effects: | Tremors N/V Hypokalemia Hyperglycemia Tachycardia Hypertension Palpations |
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