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EMT Medications
| Question | Answer |
|---|---|
| Acetaminophen Class | Analgesic, Antipyretic |
| Acetaminophen Action | Inhibits the function of COX enzymes to prevent prostaglandin synthesis |
| Acetaminophen Indications | 1) Pain management in trauma and non-traumatic chest, abdomen, or flank pain 2) Reduce fever in patients with a body temperature above 101°F (38.3°C) |
| Acetaminophen Contraindications | 1) Mental status change 2) Liver disease 3) Taken a dose within the last 6 hours 4) Allergy |
| Acetaminophen Pharmokinetics | Onset: 30 minutes Peak: 1-2 hours Duration: 4-6 hours |
| Acetaminophen Side Effects | GI upset, Liver Injury |
| Acetaminophen Precautions | Pregnancy, Geriatrics, Alcohol Use |
| Acetaminophen Route(s) | PO |
| Acetaminophen Dosage (Per Maine Protocol) | All patients >5 years old and >20lbs, 10-15 mg/kg to max dose of 1,000 mg |
| Acetaminophen Protocols Referenced | Green 18 and Gold 20 |
| Aspirin Class | NSAID, Platelet Aggregate Inhibitor |
| Aspirin Action | Inhibits the function of COX enzymes to make thromboxane preventing platelet function in clot formation |
| Aspirin Indications | Chest pain of cardiac origin |
| Aspirin Contraindications | 1) Active GI Bleeding 2) Allergy |
| Aspirin Pharmacokinetics | Onset: 30 minutes Peak: 4-6 hours Duration: 10 days |
| Aspirin Side Effects | GI bleeding, Wheezing, Nausea, Vomiting |
| Aspirin Precautions | Stomach Ulcers, Children, Asthma |
| Aspirin Route(s) | PO |
| Aspirin Dosage (Per Maine Protocol) | 324 mg PO, (4) 81 mg tabs chewed or swallowed |
| Aspirin Protocol(s) Referenced | Red 2 |
| Epinephrine 1:1,000 Class | Sympathomimetic, Catecholamine |
| Epinephrine 1:1,000 Action | Stimulates Alpha- and Beta-adrenergic receptors to activate the sympathetic nervous system |
| Epinephrine 1:1,000 Indications | 1) Anaphylaxis 2) Bronchospasm |
| Epinephrine 1:1,000 Contraindications | N/A |
| Epinephrine 1:1,000 Pharmacokinetics | Onset: 3-5 minutes Peak: 5 minutes Duration: 5-10 minutes |
| Epinephrine 1:1,000 Side Effects | Headache, Nausea, Restlessness |
| Epinephrine 1:1,000 Precautions | Elderly, Patients with congenital heart defects |
| Epinephrine 1:1,000 Routes: | IM, Auto-Injector |
| Epinephrine 1:1,000 Dosage (Per Maine Protocol) | >25 kg, 0.3 mg IM <25 kg, 0.15 mg IM Does may be repeated every 5 minutes as needed |
| Epinephrine 1:1,000 Protocol(s) Referenced | Gold 1, Blue 7 |
| Oral Glucose Class | Anti-Diabetic, Monosaccharide Carbohydrate |
| Oral Glucose Action | Circulates as blood glucose until consumed by cellular respiration to create usable cellular energy |
| Oral Glucose Indications | Symptomatic Hypoglycemia |
| Oral Glucose Contraindications | 1) Unable to Protect Airway 2) Hyperglycemia 3) Allergy |
| Oral Glucose Pharmokinetics | Onset: 10-15 minutes Peak: 30 minutes Duration: 1 hour |
| Oral Glucose Side Effects | Nausea |
| Oral Glucose Precautions | Patients who are altered but able to follow commands should be carefully monitored while administering |
| Oral Glucose Route(s) | PO, Buccal |
| Oral Glucose Dosage (Per Maine Protocol) | If glucose is <60 mg/dL AND the patient is showing symptoms of hypoglycemia AND the patient can protect their own airway, administer 1 tube (usually 15 G) of glucose. May repeat as needed to effect |
| Oral Glucose Protocol(s) Referenced | Gold 6 |
| Naloxone Class | Opioid Antagonist |
| Naloxone Action | Competitive antagonist, occupies the binding site for opioids preventing interaction |
| Naloxone Indications | Suspected opioid overdose with coma and respiratory depression (RR <12) |
| Naloxone Contraindications | 1) Neonate Overdose 2) Allergy |
| Naloxone Pharmacokinetics | Onset: 3-5 minutes Peak: 15 minutes Duration: 30 minutes |
| Naloxone Side Effects | Irritability, Nausea, Opiate Withdrawal |
| Naloxone Precautions | Patients are often uncooperative and aggressive toward responders when regaining consciousness.Focus should primarily be on restoring the patient's respiratory drive.The effects of many opiates will outlast those of the naloxone and repeat dosing's likely |
| Naloxone Route(s) | IN, Auto-Injector |
| Naloxone Dosage (Per Maine Protocol) | 0.5 mg IN every 2 minutes alternating nostrils until return of spontaneous respirations >12 |
| Naloxone Protocol(s) Referenced | Yellow 1 |
| Nitroglycerin Class | Nitrate, Vasodilator |
| Nitroglycerin Action | Forms nitric oxide which alters chemical responsible for smooth muscle relaxation in the systemic vasculature |
| Nitroglycerin Indications | 1) Chest Pain |
| Nitroglycerin Contraindications | 1) Systolic BP <100 mm/Hg 2) Phosphodiesterase inhibitor use within 48 hours prior to encounter 3) Increased Intracranial Pressure 4) Allergy |
| Nitroglycerin Pharmokinetics | Onset: 1-3 Minutes Peak: 5 Minutes Duration 30 minutes |
| Nitroglycerin Side Effects | Hypotension, Syncope, Headache, Nausea |
| Nitroglycerin Precautions | Patient tolerance and sensitivity varies. Some patients will become profoundly hypotensive following administration. Vitals should be closely monitored following administration. |
| Nitroglycerin Route(s) | SL, Buccal |
| Nitroglycerin Dosage (Per Maine Protocol) | With OLMC, administer 0.4 mg SL of the patient's own nitroglycerin tab for cardiac chest pain |
| Nitroglycerin Protocol(s) Referenced | Red 2 |
| Oxygen Class | Medical Gas |
| Oxygen Action | Binds to hemoglobin molecules and is carried to cells to be used in aerobic respiration |
| Oxygen Indications | 1) Hypoxia 2) Respiratory Complaints 3) Shock 4) Seizures 5) TBI |
| Oxygen Contraindications | Oxygen saturations above 99% |
| Oxygen Pharmokinetics | Onset: Rapid Peak: Rapid Duration: Variable |
| Oxygen Side Effects | Claustrophobia with administration equipment |
| Oxygen Precautions | Patients with COPD are at risk of losing their hypoxic drive with long term, high-concentration oxygen therapy. Oxygen saturations above 94% in chest pain patients has been linked to increasing cardiovascular ischemia |
| Oxygen Route(s) | Nasal Cannula, Non-Rebreather Mask, Simple Mask, Bag-Valve Mask, CPAP |
| Oxygen Dosage (Per Maine Protocol) | 1-25 LPM as a first line of defense against acute hypoxia, respiratory failure, shock, and neuological complaints |
| Oxygen Protocol(s) Referenced | Pretty much all of them |
| Ipratropium Bromide Class | Bronchodilator, Anticholinergic |
| Albuterol | Bronchodilator, Beta-2 Antagonist |
| DuoNeb Action | Acts on Beta-2 receptors to cause bronchodilation and prevents further mucous production in the bronchioles |
| DuoNeb Contraindications | 1) Pulmonary Edema 2) Allergy |
| DuoNeb Pharmacokinetics | Onset: Rapid Peak: 30 minutes Duration: 5 hours |
| DuoNeb Side Effects | Tachycardia, Tremors, Anxiety, Nausea |
| DuoNeb Precautions | Patients with known fluid issues (CHF or CKD), patients with pneumonia |
| DuoNeb Route(s) | MDI, Nebulizer |
| DuoNeb Dosage (Per Maine Protocol) | >1-year-old, 0.5 mg Ipratropium Bromide / 2.5 mg Albuterol in 3 mL normal saline |
| DuoNeb Protocol(s) Referenced | Blue 7, Gold 1 |
| What is the brand name of Acetaminophen? | Tylenol |
| What is the brand name of Aspirin? | Bayer |
| What is Epinephrine 1:1,000? | Adrenaline |
| What is the brand name of Irpatropium Bromide/Albuterol? | DuoNeb |
| What is the brand name of Oral Glucose? | Glucose15 |
| What is the brand name of Naloxone? | Narcan |
| What is the brand name of Nitroglycerin? | Nitrostat |
| What are the brand names of Activated Charcoal? | Actidose, Insta-Char, SuperChar |
| Activated Charcoal Class | Absorbent |
| Activated Charcoal Action | Absorbs (binds) many toxins and poisons within the gastrointestinal tract, preventing absorption into the bloodstream |
| Activated Charcoal Indications | 1) Certain poison or toxin ingestions 2) Usually within 1 hour of ingestion 3) ONLY when approved by Poison Control or Medical Control (Depending on local protocol) |
| Activated Charcoal Contraindications | 1) Decreased LOC 2) Unable to swallow or protect airway 3) Ingestion of: Acids, Alkalis, Petroleum products (gasoline, kerosene, lighter fluid), Alcohols, Heavy Metals (Iron, Lithium) 4) Gastrointestinal Obstruction 5) Active Vomiting |
| Activated Charcoal Route(s) | PO (Usually black slurry) |
| Activated Charcoal Dose | 1 g/kg Typically 25-50 g PO Protocols Vary |
| Activated Charcoal Pharmokinetics | Onset: Immediately Peak: Not clinically significant Duration: Until eliminated through the gastrointestinal tract (~4-6 hours) |
| Activated Charcoal Side Effects | Black stools, Black vomit, Nausea, Vomiting, Constipation, Aspiration if airway is unprotected |
| Activated Charcoal Precautions | Ensure intact gag reflex, Protect the airway, Shake well before administration, Charcoal does NOT absorb every poison |
| How do you convert lbs to kg mentally (Med Math) | Example: 100lbs/2=50, 0% of 50 = 5 50-5=45kg |
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