Summary NREMT Paramedic Drugs (Verified)

Summary NREMT Paramedic Drugs (Verified) ACETAMINOPHEN Class: Anti-pyretic Indications: Fever Contraindications: Liver failure; hypersensitivity; exceed max dose Side effects: Liver toxicity Adult Dose: 1 g q 6 hours; max 4 g in 24 hours Pediatric Dose: 15 mg/kg q 6 hours Special info: Tylenol ADENOSINE TRADE NAME: Adenocard CLASS: Antiarrhythmic ACTIONS: Slows (decreases) AV conduction INDICATIONS: Symptomatic PSVT, including Wolff-Parkinson-White Syndrome (WPW) PHARMACOKINETICS: Onset: 20 - 35 seconds Peak Effect: 20 - 35 seconds Duration: 30 - 120 seconds Half Life: 10 seconds CONTRAINDICATIONS: Second or third degree heart block, sick-sinus syndrome, known hypersensitivity to the drug, dysrhythmias other than PSVT, reactive airway diseases like asthmea. PRECAUTIONS: Arrhythmias, including blocks, are common at the time of cardioversion. Use with caution in patients with asthma. SIDE EFFECTS: CNS: Dizziness, near syncope, syncope CV: PVCs, PACs, sinus tachycardia, sinus bradycardia, AV blocks, chest pain, facial flushing, headache Resp: SOB, bronchoconstriction GI/GU: Nausea DOSAGE: ADULT: 6 mg rapid IV bolus over 1-2s; after 1-2 minutes, 12-mg dose over 1-2 seconds. PEDIATRIC: Initial dose: 0.1mg/kg; max 1st does = 6mg; Rapid IV bolus w/5cc flush ROUTES: IV with 20cc flush ALBUTEROL TRADE NAME: Proventil, Ventolin CLASS: Sympathetic Agonist DESCRIPTION: Sympathomimetic bronchodilator selective for β2 adrenergic receptors ACTIONS: Selective direct acting β2 agonist INDICATIONS: Bronchial asthma, emphysema, chronic bronchitis, allergic bronchospasm, or other reversible bronchospasm PHARMACOKINETICS: Onset: 5 - 15 minutes Peak Effect: 1 - 1.5 hours Duration: 3 - 6 hours Half Life: < 3 hours CONTRAINDICATIONS: Know hypersensitivity to Albuterol. SIDE EFFECTS: CNS: Tremor, anxiety, dizziness, seizure CV: Headache, palpations, HTN, tachycardia, chest pain Resp: Bronchospasm (paradoxical effect) GI/GU: Nausea, vomiting, dry mouth DOSAGE For patients in emergency setting: ADULT: Nebulizer: 2.5mg in 3cc normal saline or 5mg in 6cc normal saline via HHN over 5 - 15 min. Repeat 10-20 min. prn, maximum 10mg/hr (4 treatments) MDI- 1-2 inhalations (90mcg each) many repeat every 15 minutes prn. PEDIATRIC: 0.15 mg/kg in 2.5-3.0 ml NS via HHN. Repeat prn. ROUTES: Nebulizer, metered-dose inhaler (MDI) PACKAGED: Premixed unit dose of 2.5mg in 2.5ml NS. AMIODARONE TRADE NAME: Cordarone, Pacerone CLASS: Antiarrhythmic ACTIONS: Prolongs action potential and refractory period. Slows the sinus rate; Increases PR and QT intervals. Decreases Peripheral vascular resistance. INDICATIONS: Life-threatening cardiac arrhythmias such as ventriculartachycardia and ventricular fibrillation. PHARMACOKINETICS: Onset: 2 minutes IV. Oral: 2-3 days Peak Effect: 6 - 20 minutes Duration: Varies Half Life: Varies, 30 - 100 days post oral administration CONTRAINDICATIONS: Hypersensitivity to Amiodarone, heart failure, severe sinus node dysfunction (sinus bradycardia, 2nd Œ 3rd degree blocks), cardiogenic shock SIDE EFFECTS: CNS: dizziness CV: Headache, bradycardia, hypotension, sinus arrest, prolonged PR, QRS, QT intervals, CHF, AV block, cardiogenic shock, palpations, chest pain Resp: Dyspnea, pulmonary fibrosis GI/GU: Nausea, vomiting DOSAGE: ADULT: V-Fib / V-Tach without pulses: 300 mg IV (max is 2.2g IV/24 hrs) Ventricular arrhythmias with a pulse: 150 mg over 10 minute. rpt every 10 min. Maintenance Infusion: 540mg IV over 18 hours (0.5mg/min) PEDIATRIC: Pulseless arrest: 5mg/kg rapid IV bolus, Perfusing tachycardia: 5mg/kg IV over 20-60 min. ROUTE: IV ASPRIN TRADE NAME: ASA, Bufferin, Ecotrin, Empirin, etc. CLASS: Platelet aggregate inhibitor, analgesic, non-steroidal anti-inflammatory (NSAID), antipyretic Description: Anti-inflammatory, inhibits platelet function ACTIONS: Blocks platelet aggregation. INDICATIONS: New-onset chest pain suggestive of MI signs and symptoms suggestive or recent CVA. PHARMACOKINETICS: Onset: 5 - 30 minutes Peak Effect: 15 - 120 minutes Duration: 1 - 4 hours Half Life: 15 - 20 minutes CONTRAINDICATIONS: GI bleed, ulcer, hemorrhagic stroke, bleeding disorders, kids with flu symptoms. Hypersensitivity to salicylates, relatively contraindicated in active ulcer disease & asthma. May cause GI upset/bleeding. Administer cautiously to patients with bleeding disorders and those who report allergies to non-steroidal anti-inflammatory (NSAID) drugs. Contraindicated in children 16 - 19 years of age with flu or chickenpox symptoms due to incidence of Reye's syndrome. SIDE EFFECTS: CV: Prolonged bleeding Resp: Wheezing, bronchspasm GI/GU: Nausea, vomiting, heartburn, GI bleeding DOSAGE: ADULT:324 mg PO (4 x 81 mg chewable preferred) as soon as possible after onset of chest pain. PEDIATRIC: Not recommended for use in the field with children. ROUTE: PO ATROPINE TRADE NAME: Atropine, Atropa CLASS: Anticholingeric Description: Anticholingeric, antimuscarinic, parasympatholytic ACTIONS: Decreases vagal tone resulting in positive chronotropic effect & increases AV conduction. Competitive antagonist for acetylcholine at muscarinic receptors. Atropine bronchodilates via parasympatholytic mechanism. INDICATIONS: Hemodynamically significant bradycardia and asystole. Cholinergic poisoning by certain mushrooms (Amanita spp.), insecticides (carbamates,