Non-Cardiac drugs 119
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| Dextrose Class | show 🗑
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| Dextrose Route and Dose | show 🗑
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| Dextrose Actions | show 🗑
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Hypoclycemia
Altered LOC
Coma or seizure of unknown origin
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| Dextrose Precautions | show 🗑
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| Dextrose Contraindications | show 🗑
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| Glucagon Class | show 🗑
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| show | IM, IV, IO, IN
Adult hypoglycemia: 0.5mg-1.0mg IM. May q 7-10 minutes.
Adult b blocker or CC Blocker Tox: 1-5mg (average 3mg) IV/IO or 1mg IM if no access.
Ped:
Hypoglycemia: 1-12 yo 1mg IM.
<1 yo 0.5mg IM
BB/CC Blocker tox: 1-12 yo 1mg (consult med
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| show | When administered or released by pancreas, increases breakdown of glycogen to glucose. May be ineffective in chronic states of hypoglycemia.
Also has positive inotropic effect on heart.
Onset within 1 minute
Duration 60-90 minutes.
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Use caution with patients with cardiovascular disease.
Patients with kidney or liver dysfunction.
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| Glucagon Adverse Reactions | show 🗑
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| show | Hypersensitivity to proteins
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| Activated Charcoal Actions | show 🗑
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| Activated Charcoal Duration | show 🗑
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| show | 2 types, Actidose Aqua and Actidose with sorbitol.
Actidose w/sorbitol is charcoal mixed with a sugar alcohol which creates defecation through osmosis. It also sweetens the taste.
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| show | Ingestion of pills, capsules, and tablets.
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| Activated Charcoal Contraindications | show 🗑
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| Activated Charcoal Time | show 🗑
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| Activated Charcoal Dose | show 🗑
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| Narcan (Naloxone) Class | show 🗑
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| show | Competes for and replaces narcotic molecules in the brain.
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| Narcan (Naloxone) Onset and Duration | show 🗑
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| Narcan (Naloxone) Indications | show 🗑
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| show | Will NOT work in barbituate, GHB, Rohypnol or benzodiazepine overdoses.
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| Narcan (Naloxone) Precautions | show 🗑
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| show | .4mg-2mg IV/IM/IN/SQ
Normally .4mg titrated to respiratory rate
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| Diazepam (Valium) Class | show 🗑
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| show | Adult: SLOW IV/IM/Rectal Push (1 minute for each 5mg)
2.5mg increments titrated to achieve effect (usually up to 10mg)
Sedation: 2.5mg - 5.0mg (max 10mg)
Seizure: up to 10mg
Pediatric: 0.5mg/kg rectal up to 10mg
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| show | Central nervous system depressant
Amnesia
Sedation
Muscle relaxation
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| show | 1-5 minutes
Duration 2-4 hours
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| show | Active seizure/status epilepticus
Sedation for cardioversion
Chest pain or tachycardia following O.D. or ingestion of stimulant or hallucinogen (cocaine, meth, extacy, LSD, PCP, ketamine)
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| show | Monitor respiratory status closely.
Administer at site closest to IV catheter, flush well before and after, utilize large veins (scorches veins).
IM is absorbed erratically and has a long onset.
Can cause cleft palate in 1st trimester of pregnancy.
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| Diazepam (Valium) Side effects | show 🗑
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| Diazepam (Valium) Contraindications | show 🗑
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| Diazepam (Valium) Antidote: | show 🗑
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| show | Antihistamine
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| show | Blocks the effects of histamine in the body related to allergic reactions.
Used in adjunctive therapy in anaphylaxis with epinephrine.
Used in the treatment of extrapyramidal (dystonic) reactions.
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| Benadryl Dose | show 🗑
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| show | Max effects in 1-3 hours
Duration is up to 6-12 hours after administration.
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| Benadryl Indications | show 🗑
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| Benadryl Drug interactions | show 🗑
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| Benadryl Adverse reactions | show 🗑
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| Benadryl Contraindications | show 🗑
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| show | Phenothiazine and antihistamine with antiemetic, antimotion, and sedative effects.
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| Promethazine HCL (Phenergan) Route | show 🗑
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| show | Adult: Titrated doses of 12.5-25mg, to achieve desired effect.
Pediatric: Not used in the prehospital setting.
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| Promethazine HCL (Phenergan) Action | show 🗑
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| show | Persistent vomiting due to gastrointestinal problems
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| show | Monitor LOC
Avoid antra-arterial or subcutaneous administration. Give slowly in small boluses and flush well, can cause vein irritation, phlebitis, and sclerosis.
Watch for signs/symptoms of excessive sedation and dystonic reaction.
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| show | Marked drowsiness/sedation
Dystonic reaction
Tissue necrosis if IV infiltrates, or if not given deep IM
Dysrhythmias
In children can cause hallucinations, convulsions, and sudden death.
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| Promethazine HCL (Phenergan) Contraindications | show 🗑
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| show | For dystonic reactions, administer diphenhydramine (Benadryl)
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| show | Antiemetic
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| show | Slow IV Push (over 1 minute)
IM
IN
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| Ondansetron HCL (Zofran) Dose | show 🗑
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| show | selectively blocks serotonin receptor (those that produce nausea/vomiting)
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| show | prevention of nausea and vomiting
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| show | Ondansetron does not work effectively in every patient.
Patients who fail to respond to a single IV dose often do not respond to additional doses.
If valium is used, do not use Zofran.
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| show | Headache, Dizziness, Musculoskeletal pain, Drowsiness/Sedation, burning sensation at injection site, hypersensitivity
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| Ondansetron HCL (Zofran) Contraindications | show 🗑
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| show | Synthetic steroid
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| show | SIVP (over 5 minutes)
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| show | Adult: 60-125mg IV push for anaphylaxis or airway emergencies; 30mg/kg IV over 15 minutes followed by a maintenance infusion for 23 hours.
Pediatric: 1-2 mg/kg/IV
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| show | Strengthens and stabilizes cell membranes, leading to:
decreases in capillary permeability - prevents leakage and edema.
Blockage of the release of histamine, bradykinin and other substances that cause vasodilation, tissue permeability, and irritation.
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| Methylprednisolone Sodium Succinate (Solu-Medrol) Action | show 🗑
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| Methylprednisolone Sodium Succinate (Solu-Medrol) Indications | show 🗑
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| show | Consult Med Control for patients who are diabetic (hypoglycemic responses to insulin and oral hypoglycemia), have severe infections, and active gastrointestinal bleeding.
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| Methylprednisolone Sodium Succinate (Solu-Medrol) Side Effects | show 🗑
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| show | Hypersensitivity
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| Proparacaine HCL (Alcaine) Class | show 🗑
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| show | Dropped into the affected eye or eyes
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| show | Adult: 1-2 drops in the affected eye or eyes repeat dose (if indicated) every 5 minutes.
No max dose.
Pediatric: same as adult
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| show | Topical anesthetic for eyes that blocks nerve impulses from sensory nerves.
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| show | Burns to the eyes or corneal abrasions.
Patient comfort prior to irrigation of eyes exposed to chemicals such as pepper spray or mace.
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| show | Caution patient not to rub eye.
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| show | Initial burning or stinging sensation.
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| show | Trauma/lacerations to the eyes.
Foreign bodies in the eyes.
Allergies to the "caine" drugs.
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| show | Gaseous Analgesic/Anesthetic
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| show | Inhalation: self-administered.
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| show | Adult: Instruct patients to inhale deeply as they hold the mask.
Pediatric: Same as above.
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| Nitrous Oxide:Oxygen (50:50) (Nitronox) Action | show 🗑
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| Nitrous Oxide:Oxygen (50:50) (Nitronox) Indications | show 🗑
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| show | Must be self administered
Check machine gauges daily for proper concentrations.
Monitor blood pressure and pulse oximetry values.
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| show | Hypotension
Dizziness
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| Nitrous Oxide:Oxygen (50:50) (Nitronox) Contraindications | show 🗑
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| Furosemide (Lasix) Class | show 🗑
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| Furosemide (Lasix) Action | show 🗑
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| show | Onset 15-20 minutes.
Duration 2-6 hours.
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| show | Pulmonary edema
Renal disease
Hyperkalemia
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| Furosemide (Lasix) Contraindications | show 🗑
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| show | Hypotension
Electrolyte imbalance
Ototoxicity
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| show | Digitalis toxicity
Increased ototoxicity when used with some antibiotics
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| show | 10mg/mL
2,4,8,10mL
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| Furosemide (Lasix) Dose/Route | show 🗑
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| show | Topical Anticholinergic
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| Ipratropium Bromide (Atrovent) Route | show 🗑
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| show | All doses are combined with 2.5mg of Albuterol.
Adult: Nebulizer: 0.5mg in 2.5mL NS
Pediatric: Nebulizer:
<1yr old - 0.25mg in 2.5mL NS
>1yr or older - 0.5mg in 2.5mL NS
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| Ipratropium Bromide (Atrovent) Action | show 🗑
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| Ipratropium Bromide (Atrovent) Indications | show 🗑
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| Ipratropium Bromide (Atrovent) Precautions | show 🗑
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| Ipratropium Bromide (Atrovent) Side effects | show 🗑
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| Ipratropium Bromide (Atrovent) Contraindications | show 🗑
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| Albuterol (Ventolin, Proventil) Class | show 🗑
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| Albuterol (Ventolin, Proventil) Route | show 🗑
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| show | Liquid
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| show | Nebulizer: 2.5mg over 5-15minutes 2-15 Liters per minute - preferably 8 lpm.
Pediatric: same as adult
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| Albuterol (Ventolin, Proventil) Action | show 🗑
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| show | Bronchospasm associated with asthma and COPD
Bronchospasm from chemical toxins: nerve agents, cyanide, blistering agents, choking agents, allergic reactions unresponsive to Epinephrine or Diphenhydramine (Benadryl)
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| show | Known heart disease
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| show | Restlessness
Hypertension
Tachycardia - palpations
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| Albuterol (Ventolin, Proventil) Contraindications | show 🗑
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| show | Schedule IV, short-acting benzo.
Benzodiazepine
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| Midazolam (Versed) Midazolam (Versed) Actions | show 🗑
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| Midazolam (Versed) Indications | show 🗑
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| show | Adult: Sedation, combative pts, CP from SNS.
Seizures: 1-2.5mg titrated up to 10mg SLOW IV/IO/IN push.
PAI: 0.1mg/kg IV/IO to achieve effect with max dose 5.0mg.
Pediatric: 0.5mg/mg rectal up to 10mg or 0.1mg/kg IN up to 10mg or 0.1mg/kg IV
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| show | CNS depressant
Amnesia
Sedation
Muscle relaxation
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| Midazolam (Versed) Onset and duration | show 🗑
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| Midazolam (Versed) Precautions | show 🗑
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| Midazolam (Versed) Side effects | show 🗑
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| Midazolam (Versed) Contraindications | show 🗑
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| Midazolam (Versed) Antidote | show 🗑
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