Paramedic Pharmocology & Skills
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| Sodium Bicarb chemical name | NaHCO3
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| Sodium Bicarb indications | Late in management of cardiac arrest (if at all), severe acidosis refractory to hyperventilation,hyperkalemia, upon return of spontaneous
circulation after long arrest interval, tricyclic antidepressant overdose, phenobarbital overdose.
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| Sodium Bicarb contraindications | In patients with chloride loss from vomiting and GI suction, Metabolic and respiratory alkalosis, Hypocalcemia, Hypokalemia
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| Sodium Bicarb side effects | Metabolic alkalosis, fluid overload, tissue necrosis if extravasation occurs.
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| Sodium Bicarb adult dose | 1 mEq/kg, repeat with 0.5 mEq/kg every 10 minutes
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| Sodium Bicarb pediatric dose | 1 mEq/kg, repeat with 0.5 mEq/kg every 10 minutes (infuse slowly)
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| Sodium Bicarb class | buffer
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| Norepinephrine trade names | Levophed, Levarterenol
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| Norepinephrine indications | cardiogenic shock, significant hypotension (>70mm Hg)
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| Norepinephrine contraindications | Hypotension with hypovolemia, pregnancy
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| Norepinephrine class | Sympathomimetic
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| Norepinephrine adult dose | Dilute 8 mg in 500 mL of D5W or 4 mg in 250 mL of D5W (16ug/mL); infuse by IV piggyback at 0.5-1.0 ug/min, titrated to improve blood pressure (up to 30ug/min)
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| Norepinephrine pediatric dose | 0.1-1.0 ug/ming IV insfusion, titrated to patient response
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| Norepinephrine side effects | Headache, arrhythmias, tachycardia, reflex bradycardia, angina pectoris, HTN, decreased perfusion to GI, kidney, skeletal muscle, and skin
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| Albuterol Class | Sypathomimetic, bronchodilator
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| Albuterol trade names | Proventil, Ventolin
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| Albuterol indications | bronchospasm in patients with reversible obstructive airway disease (COPD/Ashtma). Prevention of exercise induced bronchospasm.
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| Albuterol contraindications | Known prior hypersensitivity reactions to albuterol. Tachycardia arrhythmias, especially those caused by digitalis. Synergistic with other sympathomimetics.
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| Albuterol side effects | Often dose related including: restlessness, tremors, dizziness, palpitations, tachycardia, nervousness, peripheral vasodilation, nausea, vomiting, hyperglycemia, increased blood pressure, and paradoxical bronchospam
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| Albuterol Adult dose for Nebulizer | 2.5 mg. Dilute 0.5 mL or 0.5% solution for inhalation with 2.5 mL normal saline in nebulizer and administer over 10-15 minutes.
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| Albuterol Adult dose for MDI | 1-2 inhalations (90-180 ug). Five minutes between inhalations.
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| Albuterol Pediatric dose for Nebulizer | solution of 0.01-0.03 mL (0.05-0.15 mg/kg/dose diluted in 2 mL of 0.9% normal saline. May repeat every 20 minutes 3 times.
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| Oxygen class | Naturally occuring gas. DUH.
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| Oxygen indications | Confirmed or suspected hypoxemia, ischemic chest pain, respitory insufficiency, prophylactically during air transport, confirmed or suspected carbon monoxide poisoning, all other causes of decreased tissue deoxygenation, deceased level of consciousness.
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| Oxygen contraindications | Certain patients with COPD or emphysema who will not tolerate oxygen concentrations over 35%, hyperventilation.
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| Oxygen adult/pedi dose | Cardiac arrest and carbon monoxide poisoning: 100%. Hypoxemia 10-15 L/min via NRB. COPD 1-6 L/min via NC or 28%-35% VM. EXCEPTION: Premature infant, no more than 30-40% oxygen
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| Oxygen side effects | Decreased level of consciousness and respitory depression in patients with chronic carbon dioxide retention. Retrolental fibroplasia if high concentrations are given to premature infants.
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| OPA indications | Unresponsive patients, absent gag reflex
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| OPA contraindications | Conscious patients, patients WITH gag reflex
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| OPA advantages | Noninvasive, easily placed, prevents blockage of the glottis by the tongue
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| OPA disadvantages | Does not prevent aspiration
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| NPA indications | Unresponsive patients, patients with AMS who have a gag reflex
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| NPA contraindications | Patient intolerance, most facial fractures or skull fractures
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| NPA advantages | Can be suctioned through, provides a patent airway, can be tolerated by conscious patients, may be placed blindly, does not require use of the oropharynx
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| NPA disadvantages | May result in excessive bleeding, does not protect from aspiration.
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| BVM indications | patients in respitory failure
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| BVM contraindications | patients who are breathing adequately, patients who cannot tolerate the device
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| BVM advantages | Delivers 100% O2 to the patient, allows extended ventilation time without rescuer fatigue, provides excellent barrier from body fluids
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| BVM disadvantages | Difficult to maintain proper seal, requires great effort to master technique, can result in inadequate tidal volume if rescuer is inexperienced with device
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| Epinephrine class | Sympathomimetic
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| Epi-Cardiac arrest indications | Cardiac Arrest (V-fib/pulseless V-tach, asystole, PEA)
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| Epi-Cardiac related indications | Symptomatic bradycardia as an alternative to dopamine infusion. For severe hypotension secondary to bradycardia when atropine and subcutaneous pacing are unsuccessful.
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| Epi-Non-Cardiac related indications | Allergic Reactions, Anaphalaxis, Ashtma
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| Epi-Contraindications | HTN, hypothermia, pulmonary edema, myocardial ischemia, hypovolemic shock
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| Epi-Side effects | HTN, tachycardia, angina, arrythmias, pulmonary edema, psychomotor agitation, headache, nausea, anxiety, restlessness
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| Epi-Adult dose for mild allergic reactions and Asthma | 0.3-0.5 mg
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| Epi-Pediatric dose for mild allergic reactions and asthma | 0.1 mg/kg up to 0.3 mg
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| Epi-Adult dose for Anaphalaxis | 0.1 mg (1ml of 1:10000) IV/IO over 5 minutes
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| Epi-Adult dose for Cardiac arrest | IV/IO dose: 1 mg (10 mL of 1:10,000 solution) every 3-5 minutes during resuscitation. Follow each dose with 20 mL flush and elevate arm for 10-20 seconds after dose. Higher dose for beta blocker or calcium channel blocker overdose: up to .2mg/kg
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| Epi-Pediatric dose for cardiac arrest | 0.01 mg/kg (0.1 mL/kg) of 1:10,000 solution every 3-5 minutes during arrest.
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| Epi-Adult dose for Cardiac arrest with ET tube | 2-2.5 mg diluted in 10 mL normal saline.
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| Epi-Pediatric dose for cardiac arrest with ET tube | 0.1 mg/kg (0.1 mL/kg) or 1:1,000 solution.
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| Epi-Adult dose for profound bradycardia or hypotension | 2-10 ug/min titrate to patient response.
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| Epi-Pediatric dose for symptomatic bradycardia | 0.1 mg/kg (0.1 mL/kg) of 1:10,000 solution
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| Epi-Adult dose for continuous infusion | Add 1 mg (1 mL of 1:1,000 solution) to 500 mL normal saline or D5W. Initial infusion rate or 1 ug/min titrated to effect (typical dose:2-10 ug/min)
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| Epi-Pediatric dose for continuous infusion | begin with rapid infusion, then titrate to response. Typical initial infusion: 0.1-1 ug/min. Higher doses may be effective.
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| Atropine Sulfate Class | Anticholinergic Agent
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| Atropine Sulfate Indications | Hemodynamically unstable bradycardia, bradycardic PEA, asystole, bronchospastic pulmonary disorders, organophosphate poisoning
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| Atropine Sulfate Contraindications | Tachycardia, unstable cardiovascular status in acute hemorrhage and myocardial ischemia, hypersensitivity, narrow-angle glaucoma, Pregnancy Category C
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| Atropine Sulfate Side Effects | Tachycardia, arrythmias, palpitations, paradoxical bradycardia when pushed slowly or in low doses, headache, dizziness, flushed/hot/dry skin, blurred vision, dry mouth, urinary retention
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| Atropine Sulfate Adult Dose for Asystole or Bradycardic PEA | 1 mg IV/IO push. May repeat every 3-5 minutes up to 3 mg.
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| Atropine Sulfate Pedi Dose | 0.02 mg/kg via IV/IO ush, may double for second dose. Minimum Dose is 0.1 mg, maximum dose is 0.5 mg up to 1.0 mg / adolescent 1.0 mg up to 2.0 mg
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| Atropine Sulfate Adult ET Dose for Asystole or Bradycardic PEA | 2.3 mg diluted in 10 ml of water or normal saline.
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| Atropine Sulfate Pedi ET Dose | 0.03 mg/kg (absorption may be unreliable)
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| Atropine Sulfate Adult Dose for Unstable Bradycardia | 0.5 mg IV/IO every 3-5 minutes, not to exceed 3.0 mg. In severe cases, shorter time interval of 3 minutes and higher dosage may help.
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| Atropine Sulfate Adult Dose for Organophosphate poisoning | 2-4 mg or higher may be needed
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| Methylprednisolone Class | Anti-Inflammatory glucocorticoid
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| Methylprednisolone Trade Name | Solu-Medrol
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| Methylprednisolone Indications | Acute spinal cord trauma, anaphylaxis, bronchodilator for unresponsive asthma
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| Methylprednisolone Contraindications | Premature infants, systemic fungal infections, caution for GI bleeds
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| Methylprednisolone Side Effects | Sodium and Water retention, HTN, CHF, Headache, Nausea and Vomiting, Hypokalemia, Alkalosis, Peptic Ulcer Disease
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| Methylprednisolone Adult Dose for Acute Spinal Cord Trauma | 30mg/kg IV over 30 minutes followed by infusion @ 5.4mg/kg/h
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| Methylprednisolone Pedi Dose for Acute Spinal Cord Trauma | 30mg/kg IV over 30 minutes followed by infusion @ 5.4mg/kg/h
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| Methylprednisolone Adult Dose for Asthma & COPD | 1-2mg/kg IV
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| Methylprednisolone Pedi Dose for Asthma | 1-2 mg/kg/dose IV
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| Dopamine Class | Sympathomimetic, Inotropic Agent
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| Dopamine Trade Name | Intropin
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| Dopamine Indications | Cardiogenic/Septic/Spinal/Distributive Shock, Hypotension with Low Cardiac Output
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| Dopamine Contraindications | Hypovolemic Shock, Tachyarrythmias, V-Fib, Pheochromocytoma
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| Dopamine Side Effects | HTN, Arrhythmias, Increased Cardiac Oxygen Demand, Tissue Necrosis if Extravated
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| Dopamine Adult Dose | 2-20ug/kg/min tirtrated to patient response
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| Dopamine Pedi Dose | 2-20 ug/kg/min titrated to patient response
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| Dobutamine Class | Sympathomimetic, Inotropic Agent
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| Dobutamine Trade Name | Dobutrex
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| Dobutamine Indications | CHF, Left Ventricular Dysfuntion, Cardiogenic Shock
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| Dobutamine Contraindications | Tachyarrhythmias, IHSS, Severe Hypotension, Incompatable with Sodium Bicarbonate and Furosemide
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| Dobutamine Side Effects | HTN, Headache, Arrythmias, PVC's, May increase Infart Size
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| Dobutamine Adult Dose | IV infusion at 2-20ug/kg/min titrated to desired effect
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| Dobutamine Pedi Dose | IV infusion at 2-20ug/kg/min titrated to desired effect
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| Diphenhydramine Class | Antihistamine, Anticholinergic
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| Diphenhydramine Trade Name | Benadryl
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| Diphenhydramine Indications | Allergic Reactions, Anaphylaxis, Actue Dystonic Reactions (Phenothiazines), Blood Administration Reactions, Motion Sickness, Hay Fever
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| Diphenhydramine Contraindications | HTN, Asthma, Glaucoma, Narrow Angle Glaucoma, MAOI Inhibitors, Pregnancy, Infants
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| Diphenhydramine Side Effects | Hypotension, Sedation, Seizures, Visual Disturbances, Urinary Retention, Vomiting, Arrythmias, Palpitations, Dry Mouth and Throat, Paradoxical CNS excitation in children
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| Diphenhydramine Adult Dose | 25-50mg IM or IV or PO
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| Diphenhydramine Pedi Dose | 1-2mg/kg IV, IO slowly or IM / PO 5mg/kg/24 hours
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| Midazolam Class | Short acting Benzodiazepine, CNS Depressant
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| Midazolam Trade Name | Versed
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| Midazolam Indications | Sedation, Anxiolytic prior to intubation, Conscious Sedation
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| Midazolam Contraindications | Shock, Depressed Vitals, Coma, Overdose, Glaucoma, Concomitant use with other CNS Depressants: Barbiturates, Alcohol, Narcotics, Not recommended in Pediatrics
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| Midazolam Adult Dose | 2.0-2.5 mg IV slowly over 2-3 minutes, may be repeated to total maximum of 0.1 mg/kg.
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| Dilatiazem Hydrochloride Class | Calcium Channel Blocker
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| Dilatiazem Hydrochloride Trade Name | Cardizem, Lyo-Ject
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| Dilatiazem Hydrochloride Indications | Control of Rapid Ventricular Rates due to Atrial Flutter, Atrial Fib, And Re-Entry SVT; Angina Pectoris
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| Dilatiazem Hydrochloride Contraindications | Hypotesion, High Degree AV Blocks, Sick Sinus Syndrome, Wide-Complex Tachycardias, Poison/Drug Induced Tachycardia, Cardiogenic Shock
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| Dilatiazem Hydrochloride Side Effects | Bradycardia, High-Degree AV Blocks, Chest Pain, CHF, Syncope, V-Fib, V-Tach, Nausea, Vomiting, Dizziness, Dry Mouth, Dyspnea, Headache
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| Dilatiazem Hydrochloride Adult Dose | 0.25mg/kg (about 15-20mg) IV over 2 Minutes. May wait 15 minutes and administer 0.35mg/kg (about 20-25mg) IV over 2 minutes. Maintenance Infusion of 5-15 mg/h. Not Recommended for Pediatrics.
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| Morphine Sulfate Class | Opiod Analgesic
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| Morphine Sulfate Trade Name | Astramorph/PF and many others
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| Morphine Sulfate Indications | Severe CHF, Pulmonary Edema, Chest Pain Associated with Actue MI, Analgesia for Moderate to Severe Acute and Chronic Pain (use with caution)
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| Morphine Sulfate Contraindications | Head Injury, Exacerbated COPD, Depressed Respiratory Drive, Hypotension, Undiagnosed Abdominal Pain, Decreased Level of Consciousness, Suspected Hypovolemia, MAOI use within the past 14 days
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| Morphine Sulfate Side Effects | Respiratory Depression, Hypotension, Decreased LOC, Nausea, Vomiting, Bradycardia, Tachycardia, Syncope, Facial Flushing, Euphoria :-), Bronchospasm, Dry Mouth
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| Morphine Sulfate Adult Dose | 2-4mg IV over 1-5 minutes, every 5-30 minutes. May repeat dose at 2-8mg at 5-15 minute intervals
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| Morphine Sulfate Pedi Dose | 0.1-0.2mg/kg via IV, IO, IM, or SC. Max dose of 5mg
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| Nitroglycerin Class | Vasodilator
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| Nitroglycerin Trade Name | Nitrostat, Tridil, and others
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| Nitroglycerin Indications | Actue Angina Pectoris, Ishcemic Chest Pain, Hypertension, CHF, Pulmonary Edema
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| Nitroglycerin Contraindications | Hypotension, Hypovolemia, Intracranial Bleeding or Head Injury, Phosphodiesterase Inhibitors (ex. Viagra) in the past 24 hours
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| Nitroglycerin Side Effects | Headache, Hypotension, Syncope, Reflex Tachycardia, Flushing, Nausea, Vomiting, Diaphoresis, Muscle Twitching
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| Nitroglycerin Adult Dose | 0.3-0.4mg Tablets / 0.4mg Spay SL; May repeat every 3-5 minutes up to 3 doses (not recommended for use in pediatrics)
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| Adenosine Class | Endogenous Nucleotide
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| Adenosine Trade Name | Adenocard
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| Adenosine Indications | Conversion of PSVT to Sinus Rythym. May convert Re-Entry SVT due to Wolff-Parkinson-White Syndrome.
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| Adenosine Contraindications | Second or Third Degree Block or Sick Sinus Syndrome, A-Flutter, A-Fib, V-Tach, Hypersensitivy to Adenosine, Poison-Induced Tachycardia
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| Adenosine Side Effects | Facial Flushing, SOB, Chest Pain, Headache, Paresthesia, Diaphoresis, Palpitations, Hypotension, Nausea, Metallic Taste
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| Adenosine Adult Dose | 6mg rapid IV push immediately followed by 20ml Saline Flush and Extremity Elevation. May Administer a Second and Third dose of 12mg in 1-2 Minute Intervals if no Initial Response
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| Adenosine Pedi Dose | 0.1-0.2mg/kg rapid IV push, Maximum Single Dose of 12mg
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| Amiodarone Class | Antiarrhythmic
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| Amiodarone Trade Name | Cordaron, Pacerone
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| Amiodarone Indications | V-Fib, Pulseless V-Tach and Unstable V-Tach in Patients Refractory to Other Therapy
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| Amiodarone Contraindications | Known Hypersensitivity, Cardiogenic Shock, Sinus Bradycardia, Second or Third Degree Block in Absence of a Functioning Pacemaker
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| Amiodarone Side Effects | Hypotension, Bradycardia, Prolongation or the P-R, QRS, and Q-T Intervals
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| Amiodarone Adult Dose For V-Fib/Pulseless V-Tach | 300mg IV Push, Repeated in 3-5 Minutes with 150mg IV Push
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| Amiodarone Adult Dose for Life Threatening and Recurring Ventricular Arrythmias | Rapid Infusion: 150 mg IV over 10 minutes. May Repeat Every Ten Minutes
Slow Infusion: 360 mg over 6 Hours
Maintenance Infusion: 540mg over 10 Hours
Max Dose is 2.2g over 24 Hours
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| Amiodarone Pedi Dose for Refractory V-Fib/Pulseless V-Tach / Perfusing SVT/VT | 5mg/kg IV Bolus (Over 20-60 Minutes for Perfusing SVT/VT) Max single dose is 300mg
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| Vasopressin Class | Antidiuretic Hormone
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| Vasopressin Trade Name | Pitressin Synthetic
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| Vasopressin Indications | Cardiac Arrest
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| Vasopressin Contraindications | Responsive Patients with CAD
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| Vasopressin Side Effects | Bronchoconstriction, Ischemic Chest Pain, Nausea and Vomiting, Abdominal Pain
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| Vasopressin Adult Dose | 40 Units to Replace Either the First or Second Dose of Epinephrine during Cardiac Arrest. Not Recommended for Pediatrics.
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| Diltiazem Hydrochloride Class | Calcium Channel Blocker
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| Diltiazem Hydrochloride Trade Name | Cardizem, Lyo-Ject
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| Diltiazem Hydrochloride Indications | Control of Rapid Ventricular Rates Due to A-Flutter, A-Fib, and Re-Entry SVT; Angina Pectoris
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| Diltiazem Hydrochloride Contraindications | Hypotension, Sick Sinus Syndrome, Second or Third Degree Blocks, Cardiogenic Shock, Wide-Complex Tachycardias, Poison/Drug Induced Tachycardia
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| Diltiazem Hydrochloride Side Effects | Bradycardia, Second or Third Degree Blocks, Chest Pain, CHF, Syncope, V-Fib, V-Tach, Nausea, Vomiting, Dizziness, Dry Mouth, Dypsnea, Headache
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| Diltiazem Hydrochloride Adult Dose | 0.25mg/kg IV over 2 minutes. May repeat in 15 minutes at 0.35mg/kg IV over 2 minutes. Maintainence Infusion of 5-15 mg/h. Not Recommended in Pediatrics
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| Glucagon Class | Hyperglycemic Agent, Pancreatic Hormone, Insulin Antagonist
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| Glucagon Trade Names | Glucagon
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| Glucagon Indications | Altered LOC when Hypoglycemia is suspected. May be uses as an Inotropic Agent in Beta-Blocker Overdose
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| Glucagon Contraindications | Hyperglycemia, Hypersensitivity
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| Glucagon Side Effects | Nausea, Vomiting, Tachycardia, Hypertension
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| Glucagon Adult Dose | Hypoglycemia: 0.5-1mg IM, May repeat in 7-10 Minutes
Calcium Channel/Beta Blocker Overdose: 3mg , followed by infusion at 3mg/hr as necessary
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| Glucagon Pedi Dose | Hypoglycemia: 0.5-1mg IM for children less than 20kg. Not recommended for Calcium Channel/Beta Blocker Overdose in Pediatrics.
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| Oral Glucose Class | Hyperglycemic
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| Oral Glucose Trade Name | Insta-Glucose
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| Oral Glucose Indications | Concious Patients with suspected Hypoglycemia
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| Oral Glucose Contraindications | Decreased LOC, Nausea, Vomiting
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| Oral Glucose Side Effects | Nausea, Vomiting
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| Oral Glucose Dose | Should be Sipped Slowly Until Clinical Improvement Noted in Adults and Pediatrics
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| Thiamine Class | Vitamin B1
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| Thiamine Trade Name | Vitamin B1
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| Thiamine Indications | Coma of Unknown Origin, Delirium Tremens, Beribei, Wernicke's Encephalopathy
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| Thiamine Contraindications | None.
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| Thiamine Side Effects | Hypotension from Too Rapid of an Injection or Too High of a Dose, Anxiety, Diaphoresis, Nausea, Vomiting, Allergy
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| Thiamine Adult Dose | 100mg Slow IV or IM
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| Thiamine Pediatric Dose | 10-25 Slow IV or IM
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| Dextrose Class | Carbohydrate, Hypertonic Solution
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| Dextrose Trade Name | Dextrose
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| Dextrose Indications | Hypoglycemia, Altered LOC, Coma of Unknown Cause, Seizure of Unknown Cause, Status Epilepticus
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| Dextrose Contraindications | Intercranial Hemorrage
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| Dextrose Side Effects | Extraversion Leads to Tissue Necrosis. Warmth, Pain, Burning, Thrombophlebitis, Rhabdomyloysis, Hyperglycemia
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| Dextrose Adult Dose | 12.5-25g Slow IV, repeat as Necessary
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| Dextrose Pedi Dose | 0.5-1g/kg Slow IV, repeat as Necessary
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| Naloxone Hydrochloride Class | Narcotic Antagonist
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| Naloxone Hydrochloride Trade Name | Narcan
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| Naloxone Hydrochloride Indications | Opiate OD, Coma of Unknown Origin
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| Naloxone Hydrochloride Contraindications | Caution in Narcotic Dependant Patients, and Neonates of Narcotic Dependant Mothers
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| Naloxone Hydrochloride Side Effects | Withdrawal Symptoms in Addicted Patients, Tachycardia, Hypertension, Nausea and Vomiting, Diaphoresis
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| Naloxone Hydrochloride Adult Dose | 0.4-2mg IV, IM, SC, or ET. Repeat in 5 Minutes to Max dose of 10mg. Infusion: 2mg in 500ml D5W at 0.4mg/hr
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| Naloxone Hydrochloride Pedi Dose | 0.1mg/kg IV, IM, SC, or ET, Max dose of 0.8mg, repeat in 10 Minutes at 0.1mg/kg
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To hide a column, click on the column name.
To hide the entire table, click on the "Hide All" button.
You may also shuffle the rows of the table by clicking on the "Shuffle" button.
Or sort by any of the columns using the down arrow next to any column heading.
If you know all the data on any row, you can temporarily remove it by tapping the trash can to the right of the row.
To hide a column, click on the column name.
To hide the entire table, click on the "Hide All" button.
You may also shuffle the rows of the table by clicking on the "Shuffle" button.
Or sort by any of the columns using the down arrow next to any column heading.
If you know all the data on any row, you can temporarily remove it by tapping the trash can to the right of the row.
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Created by:
saxman6699
Popular Paramedic/EMT sets