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Paramedic Drugs

Morphine Sulfate Narcotic Analgesic Moderate to severe pain and in MI and to reduce venous return in pulmonary edema MI: 2-4 mg IV over 1-5 mins every 5-15 mins. Pain: 2.5-15 mg IV; 5-20 mg IM/SC. Ped: 0.05-0.1 mg/kg IV; 0.1-0.2 mg/kg IM/SC. AMI or PE: 1-2 mg/6-10 min. to response. Morphine
Lorazepam Sedative Sedation for cardioversion and status epilepticus Sedation: 2-4 mg IM, 0.5-2 mg IV. Ped: 0.03-0.5 mg/kg IV/IM/PR up to 4 mg. Status Epilepticus: 2 mg slow IV/PR (2 mg/min.). Ped: 0.1 mg/kg slow IV/PR (2-5 min.) Ativan
Midazolam Sedative To induce sedation before cardioversion or intubation 1-2.5 mg slow IV; 0.07-0.08 mg/kg I (usually 5 mg). Ped: 0.05-0.2 mg/kg IV; 0.1-0.15 mg/kg IM; 3 mg intranasal Versed
Magnesium Sulfate Electrolyte Torsade de Pointes, eclamptic seizures. In children for status asthmaticus non-responsive to beta agents Diluted in 100 mL, over 1-2 mins (in adults only). Peds: 25-50 mg/kg over 5-20 mins. Max dose 2 g. Asthma: same as for Torsades. Eclampsia: 2-4 g IV/IM Magnesium
Oxygen Oxidizing Agent Hypoxia or anticipated hypoxia, or in any medical or trauma patient to improve respiratory efficiency Hypoxia: 100% by inhalation or IPPV Oxygen
Albuterol Sympathomimetic Bronchodilator Bronchospasm and asthma in COPD Two inhalations (90 mcg) via metered-dose inhaler (2 sprays) or 2.5 mg in 2.5-3 mL NS via neb. repeat as needed. The duration of effect is 3-6 hours. Ped: 0.15 mg/kg in 2.5-3 mL NS via neb. repeat as needed. Proventil, Ventolin
Vecuronium Nondepolarizing Skeletal Muscle Relaxant Facilitated Endotracheal Intubation 0.08-0.1 mg/kg IV. Ped: same as adult Norcuron
Succinylcholine Depolarizing Neuromuscular Blocker Facilitated endotracheal intubation 1-1.5 mg/kg IV/IM; Ped: 1-2 mg/kg IV/IM Anectine
Promethazine Antiemetic Nausea and vomiting, motion sickness, to enhance the effects of analgesics, and to induce sedation 12.5-25 mg IV/IM/PR. Ped: 0.5 mg/kg IV/IM/PR Phenergan
Prochlorperazine Antiemetic Severe nausea and vomiting or acute psychosis 5-10 mg IV/IM Ped: 0.13 mg/kg IV/IM/PR if >10 kg or >2 yrs Compazine
Nitroglycerin Nitrate Chest pain associated with angina and acute MI, and acute pulmonary edema 1 tablet (0.4 mg) Sl. May be repeated/3-5 mins up to 3 tablets, or 1/2 -1 inch of topical ointment, or 0.4 mg (one spray) SL up to 3 sprays/25 mins. Nitrostat
Nifedipine Calcium Channel Blocker Severe hypertension and angina One 10-20 mg capsule SL/PO Procardia, Adalat
Verapamil Calcium Channel Blocker PSVT refractory to adenosine, A. flutter, and A. fib with rapid ventricular response 2.5-5 mg IV bolus over 2-3 mins, then 5-10 mg after 15-30 mins to a max of 20 mg. Ped: Newborn = 0.1-0.2 mg/kg (no to exceed 2 mg), age 1-15 = 0.1-0.3 mg/kg (not to exceed 5 mg) Isoptin, Calan
Norepinephrine Sympathomimetic Agent Refractory hypotension and neurogenic shock 0.5-30 mcg/min IV, titrated to BP. Ped:0.1-2 mcg/kg/min titrated to BP (rarely used) Levophed
Sodium Bicarbonate Alkalizing Agent Tricyclic antidepressand and barbiturate overdose, refractory acidosis, or hyperkalemia 1 mEq/kg IV/IO. Ped: same as an adult NaHCO3
Furosemide Diuretic CHF and pulmonary edema 40-120 mg slow IV. Ped: 1mg/kg slow IV Lasix
Activated Charcoal Absorbent Acute ingested poisoning 1 g/kg mixed with at least 6-8 oz. of water, then PO or via and NG tube Actidose
Thiamine Vitamine Coma of unknown origin, chronic alcoholism with associated coma, and delirium tremens 50-100 mg IV/ IM. Ped: 10-25 mg IV/IM Thiamine
Diphenhydramine Antihistamine Anaphylaxis, allergic reactions, and dystonic reactions 25-50 mg IV/IM Benadryl
Naloxone Narcotic Antagonist Narcotic and synthetic narcotic overdose, coma of unknown origin 0.4-2 mg IV/IM repeated/2-3 mins. as needed up to 10 mg. Ped: 0.01 mg IV/IM repeated/2-3 mins. as needed up to 10 mg Narcan
Diazepam Antianxiety, Hypnotic, Anticonvulsant, Sedative Major motor seizures, status epilepticus, premedication before cardioversion, muscle tremors due to injury, and acute anxiety Seizures: 5-10 mg IV/IM. Ped: 0.5-2 mg IV/IM. Acute Anxiety: 2-5 mg IV/ IM. Ped: 0.5-2 mg IM Valium
Racemic Epinephrine Sympathomimetic Agonist Croup (Laryngotracheobronchitis) 0.25-0.75 mL of a 2.25% solution in 2 mL NS once by neb. Ped: Same as adult microNefrin, Vaponefrin
Aspirin Analgesic, Antipyretic, Platelet Inhibitor, Antiinflammatory Chest pain suggestive of an MI 160-325 mg PO (Chewable) Acetylsalicylic Acid, Alka-Seltzer, Bayer, Empirin, St. Joseph Children's)
Oxytocin Hormone Severe postpartum hemorrhage 3-10 units IM after delivery of the placenta. 10-20 units in 1,000 mL of D5W or NS IV titrated to effect Pitocin
Glucagon Hormone, Antihypoglycemic Hypoglycemia without IV access and to reverse beta-blocker overdose Hypoglycemia: 1 mg IM/SC repeated/5-20 mins. Ped: 0.1 mg/kg Beta Blocker Overdose: 3 mg IV over 1 min. Ped: 50-150 mg/kg IV over 1 min GlucaGen
Dextrose 50% in Water Carbohydrate Hypoglycemia 25 g D50W (50mL). Ped: 2-4 mL/kg of a 25% solution IV D50W
Methylprednisolone Corticosteroid/ Antiinflammatory Spinal cord injury, asthma, severe anaphylaxis, COPD Asthma/COPD/Anaphylaxis: 125-250 mg IV/IM. Ped: 1-2 mg/kg/dose IV/IM. Spinal Cord Injury: 30 mg/kg IV over 15 min. after 45 min an infusion of 5.4 mg/kg/hr. Solu-Medrol
Procainamide Antiarrhythmic V. Fib and PVTach refractory to lidocaine 20-50 mg/min IV drip up to 17 mg/kg to effect, then 1-4 mg/min. Ped: 15 mg/kg/IV/IO over 30-60 mins. Pronestyl
Odansetron Antiemetic Nausea and vomiting 4 mg over 1-5 mins. IV Zofran
Meperidine Narcotic Analgesic Moderate to severe pain 25-50 mg IV, 50-100 mg IM. Ped: 1 mg/kg IV/IM Demerol
Lidocaine Antidysrhythmic Pulseless VTach, V.Fib., V. Tach (w/pulse) Cardiac Arrest: 1-1.5 mg/kg IV/IO repeated at 0.5-0.75 every 5-10 mins up to 3 mg/kg follow conversion with a dirp of 1-4 mg/min. Ped: 1 mg/kg rapid IV/IO, to 100 mg, follow conversion with a drip of 20-50 mcg/kg/min. V. Tach w/pulse: 0.5-1.5 mg/kg Xylocaine
Fentanyl Narcotic Analgesic Induce sedation for endotracheal intubation/moderate to severe pain 25-100 mcg slow IV (2-3 mins.) Ped: 2 mcg/kg slow IV/IM Sublimaze
Epinephrine Sympathomimetic To restore rhythm in cardiac arrest and severe allergic reactions Arrest: 1 mg 1:10,000 IV (3-5 mins) Allergic Reactions: 0.3-0.5 mg 1:1,000 SQ/IM (5-15 mins.) Adrenalin
Etomidate Hypnotic Induce sedation for rapid sequence intubation 0.1-0.3 mg/kg IV over 15-30 sec. Ped: 0.2-0.4 mg/kg IV/IO over 30-60 sec. Max 20 mg. Amidate
Flumazenil Benzodiazepine Antagonist Respiratory depression secondary to the benzodiazepines 0.2 mg IV over 15 sec/min repeated at 0.3 mg over 30 sec. then 0.5 mg over 30 sec. every minute to affect or 3 mg. Romazicon
Ipratropium Anticholinergic Bronchospasm associated with asthma, COPD, and inhaled irritants 500 mcg in 2.5-3 mL NS via NEb or 2 sprays from MDI. Ped: 125-250 mcg Atrovent
Labetelol Beta Blocker Acute hypertensive crisis 10 mg slow IV, then 20-40 mg/10 mins as needed, up to 150 mg OR a bolus of 10 g, then continuous drip of 2-8 mg/min Trandate, Normodyne
Haloperidol Anti-psychotic Acute psychotic episodes 2-5 mg IM Ped: Children>3 years, 0.015-0.15 mg/kg/day PO in 2 or 3 divided doses Haldol
Ipecac Syrup Emetic Poisoning and overdose 30 mL PO, followed by 1-2 glasses of water, repeat in 20 mins as needed. Ped: 15 mL PO followed by 1-2 glasses of water, repeat in 20 mins. as needed Ipecac Syrup
Ketorolac NSAID Mild or Moderate Pain 30 mg IV/IM (15 mg>65 years or weighs <50kg Toradol
Atropine Parasympatholitic Hemodynamically significant bradycardia, bradyasystolic arrest, and organophosphate poisoning Asystole/PEA: 1 mg IV/IO ever 3-5 mins (max 3 doses) Sympathomatic Brady.: 0.5 mg IV Repeat 3-5 mins to 3 mg. Ped: 0.02 mg/kg IV Organophosphate Poisoning: 2-5 mg IV/IM/IO/10-15 mins. Ped: 0.05 mg/kg IV/IM/IO/10-15 mins. Atropine
Calcium Chloride Electrolyte Hyperkalemia, hypocalcemia, hypermagnesmia, and calcium channel blocker toxicity 2-4 mg/kg IV/10 mins. as needed. Ped: 60-100 mg/kg IV/IO repeat at 10 mins/ as needed Calcium Chloride
Diltiazem Calcium Channel Blocker SVT dysrhythmias (A. Fib., A. Flutter, and PSVT refractory to adenosine) and to increase coronary artery perfusion in angina 0.25 mg/kg IV over 2 mins., may repeat in 15 mins with 0.35 mg/kg followed by a drip of 5-10 mg/hr not to exceed 15 mg/hr over 24 hrs Cardizem
Dexamethasone Steroid Anaphylaxis, asthma, COPD, spinal cord edema 4-24 mg IV/IM Ped: 0.5-1 mg/kg Decadron
Dopamine Sympathomimetic Nonhypovolemic hypotension (70-100 mmHg) and cardiogenic shock 2-20 mcg/kg/min. titrated to effect. Ped: same as adult Intropin
Bumetanide Loop Diuretic To promote diuresis in CHF and pulmonary edema 0.5-1 mg IM/IV over 1-2 mins. repeat in 2-3 hours as needed Bumex
Calcium Gluconate Electrolyte Hyperkalemia, hypermagnesemia, and calcium channel blocker toxicity 5-10 mL of 10% solution, repeated as necessary at 10 min. intervals Kalcinate
Amiodarone Antidysrhythmic Life threatening recurrent ventricular and supraventricular dysrhythmias that have not responded to other antidysrhythmic agents 150-300 mg IV over 10 mins, then 1 mg/min over next 6 hours. Ped: 5 mg/kg IV/IO, then repeat up to 15 mg/kg Cordarone, Pacerone
Alteplase Recombinant Thrombolytic To thrombolyse in AMI, Acute ischemic stroke, and pulmonary embolism MI: 15 mg IV, then 0.75 mg/kg up to 50 mg over 30 mins, then 0.5 mg/kg up to 35 mg over 60 mins up to 100 mg. Stroke: 0.09 mg/kg over 1 min, then 0.91 mg/kg up to 90 mg over next 60 min. Pulmonary embolism: 100 mg IV infusion over 2 hours tPA, Activase
Adenosine Antidysrhythmic Narrow, complex SVT refractory to vagal maneuvers 6 mg rapidly (over 1-3 sec.) IV, then flush th eline rapidly with saline. If ineffective, 12 mg in 1-2 min, may be repeated. Ped: 0.1 mg/kg to a max of 6 mg. IV followed by rapid saline flush, then 0.2 mg/kg in 1-2 min to max 2nd dose of 12 mg Adenocard
Dobutamine Sympathomimetic To increase cardiac output in CHF/cardiogenic shock 2-20 mcg/kg/min IV. Ped: same as adult Dobutrex
Nitrous Oxide Analgesic (gas) Musculoskeletal, burn, and ischemic chest pain and sever anxiety (including hyperventilation) Self-Administered inhalation until the pain is relieved or the patient drops the mask Nitronox
Ibuprofen NSAID Reduce fever and relieve minor to moderate pain 200-400 mg PO/4-6 hours up to 1,200 mg/day. Ped:5-10 mg/kg PO/4-6 hours up to 40 mg/kg/day Advil, Motrin, Nuprin, Excedrin IB
Acetaminophen Analgesic, Antipyretic For mild to moderate pain and fever when aspirin is otherwise not tolerated 325 to 650 mg PO/4-6 hours. 650 mg PR/4-6 hours. Tylenol, Anacin-3
Created by: 674541819
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