Drug Box 2-3B

  1. Furosemide

    Generic Name
  2. Furosemide

    Brand Name
  3. Furosemide

    loop diuretic
  4. Furosemide

    Mechanism of Action
    • * Pharmacologic: Inhibits electrolyte reabsorption in the ascending Loop of Henle. Promotes excretion of sodium, potassium, and chloride.
    • * Vasodilation increases venous capacitance and decreases afterload. * Clinical: Diuresis
  5. Furosemide

    Indications and Field Use
    Pulmonary edema; congestive heart failure
  6. Furosemide

    • * Anuria (relative)
    • * Hypovolemia
    • * Hypotension
  7. Furosemide

    Adverse Reactions
    • * May exacerbate hypovolemia
    • * Hyperglycemia (due to hemoconcentration)
    • * Hypokalemia
    • * May decrease the response to pressors
  8. Furosemide

    Adult Dosage
    • * On oral furosemide therapy: Consider initial dose of 2 times daily oral dose, if no effect in 20 minutes may double initial dose.
    • * Not on oral furosemide therapy: 0.5-1 mg/kg to a maximum of 2 mg/kg (usually 20-40 mg) IV/IO slowly
  9. Furosemide

    Pediatric Dosage
    1 mg/kg IV/IO slow push
  10. Furosemide

    Bonus Points
    Special Notes
    • * Ototoxicity and resulting deafness can occur.
    • * Since furosemide is a sulfonamide derivative, it may induce allergic reactions in patients with sensitivity to sulfonamides (sulfa drugs).
  11. Ipratropium Bromide

    Generic Name
    ipratropium bromide
  12. Ipratropium Bromide

    Brand Name
  13. Ipratropium Bromide

    anticholinergic, bronchodilator
  14. Ipratropium Bromide

    Mechanism of Action
    Anticholinergic (parasympatholytic) agent appears to inhibit vagally-mediated reflexes by antagonizing the action of acetylcholine, the transmitter released from the vagus nerve.
  15. Ipratropium Bromide

    Indications and Field use
    Treatment of bronchospasm associated with COPD (emphysema and chronic bronchitis). To be used either alone or in combination with Albuterol
  16. Ipratropium Bromide

    • * Ipratropium bromide is contraindicated in known or suspected cases of hypersensitivity to ipratropium bromide or to atropine and its derivatives.
    • * Precaution: should be used with caution in patients with narrow angle glaucoma.
  17. Ipratropium Bromide

    Adverse Reactions
    • * Resp: Coughing. Sputum increased
    • * CNS: Dizziness. Insomnia. Tremors. Nervousness
    • * GI: Nausea
  18. Ipratropium Bromide

    Adult Dosage
    Give 500 mcg in 2.5 ml normal saline (1 unit dose vial) via SVN or in-line with a ventilatory device. Repeat according to medical control preference. May mix one unit dose vial of ipratropium with one unit dose vial of albuterol.
  19. Ipratropium Bromide

    Pediatric Dosage
    Not used Pre-hospital for Peds.
  20. Ipratropium Bromide

    Bonus Points
    Special Notes
    • * Anticholinergics produce preferential dilatation of the larger central airways, in contrast to beta agonists, which affect the peripheral airways.
    • *May be more effective used in combination with beta agonists.
    • *Should be kept out of light in foil pouch and avoid excessive humidity.
  21. Methylprednisolone Sodium Succinate

    Generic Name
    methylprednisolone sodium succinate
  22. Methylprednisolone Sodium Succinate

    Brand Name
  23. Methylprednisolone Sodium Succinate

    corticosteroid, glucocorticoid, steroid, anti-inflammatory
  24. Methylprednisolone Sodium Succinate

    Mechanism of Action
    Enters target cells and causes many complex reactions that are responsible for its anti-inflammatory and immunosuppressive effects; thought to stabilize cellular and intracellular membranes.
  25. Methylprednisolone Sodium Succinate

    Indications and Field Use
    • * Reactive airway disease: Acute exacerbation of emphysema, chronic bronchitis, asthma
    • * Anaphylaxis
    • * Burns potentially involving the airway
  26. Methylprednisolone Sodium Succinate

    Preterm infants
  27. Methylprednisolone Sodium Succinate

    Adverse Reactions
    None from single dose
  28. Methylprednisolone Sodium Succinate

    Adult Dosage
    Reactive Airway Disease, Anaphylaxis, Burns Potentially Involving the Airway - Usual dose 125 mg slow IV bolus (much larger doses can be used).
  29. Methylprednisolone Sodium Succinate

    Pediatric Dosage
    Reactive Airway Disease, Anaphylaxis, Burns Potentially Involving the Airway - 2-4 mg/kg slow IV bolus
  30. Methylprednisolone Sodium Succinate

    Bonus Points
    Adult Dosage Continued
    Acute Spinal Cord Trauma: Should be within 6 hours of insult and patient meets criteria, initial bolus dose of 30 mg/kg IV administered over 15 minutes; bolus followed by a 45 minute rest period, then a 23-hour continuous infusion of 5.4 mg/kg/hr.
  31. Methylprednisolone Sodium Succinate

    Bonus Points
    Special Notes
    • * Use for spinal cord trauma is limited to prehospital providers that have completed a special training curriculum in accordance with their medical control authorities. Proper administration of methylprednisolone for spinal cord trauma is imperative.
    • * Infusions: An infusion pump is required for continuous infusions of corticosteroids during interfacility transports; a minimum of microdrip tubing is required for field use if administering loading dose therapy for spinal cord trauma.
    • * Indicates special training requirement
  32. Phenylephrine Nasal Spray 0.5%

    Generic Name
    phenylephrine nasal spray 0.5%
  33. Phenylephrine Nasal Spray 0.5%

    Brand Name
    Neo-synephrine Nasal Spray 0.5%
  34. Phenylephrine Nasal Spray 0.5%

    topical vasoconstrictor
  35. Phenylephrine Nasal Spray 0.5%

    Mechanism of Action
    Stimulates α-receptors in the blood vessels of the nasal mucosa, which causes their constriction, and thereby decreases the risk of nasal bleeding.
  36. Phenylephrine Nasal Spray 0.5%

    Indications and Field Use
    Facilitation of nasotracheal intubation
  37. Phenylephrine Nasal Spray 0.5%

    Known allergy to medication
  38. Phenylephrine Nasal Spray 0.5%

    Adverse Reactions
    • * (rare with single dose, rarely absorbed systemically from nasal instillation)
    • * CV: Hypertension, palpitations
    • * CNS: Tremors
  39. Phenylephrine Nasal Spray 0.5%

    Adult Dosage
    2-4 sprays in each nostril before attempting tube insertion
  40. Phenylephrine Nasal Spray 0.5%

    Pediatric Dosage
  41. Phenylephrine Nasal Spray 0.5%

    Bonus Points
    Special Notes
    • * Single patient use only.
    • * Air or strong light causes potency loss; do not use solution if brown in color or precipitate is in bottle.
Card Set
Drug Box 2-3B
Drug Box 2-3B