Health One Drug Card

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ASA, Acetylsalicylic  Acid

AntiPlatelet, Salicylate

• Interrupts Thromboxone
• inhibits prostaglandins

Chest Pain of suspected Cardiac origin.

• Pt. Unable to swallow,
• Active bleeding ulcer,
• asa allergy

• Stomach irritation of stomach
• bronchospasms in some pts. with asthma

162 - 324 mg PO  (2 - 4 81 mg tablets)

• Pills should be chewed not swallowed,
• asa has no effect on existing clots,
• you can give asa to pt. on anticoagulates.

Anticholinergic

Competes with acetylcholine receptor site at the AV/SA  nodes.   Raises HR which Raises conduction at t he SA and AV nodes.

Inhibits secertions bt decreasing PNS effect on bronchial, salivary, sweat glands.

1.  Symptomatic bradycardia

2. organophosphate OD

High degree heart block, glaucoma

Tachycardia, dry flush skin, dilated pupils, elevated BP.

• Symptomatic bradycardia
• 1.  0.5 mg IVP q 3-5 minutes  Max dose 0.04 mg/kg
• Organophosphosate OD
• 2. 2 mg IVP q 3.5 minutes until effective

• Proventil
• Ventolin

• Sympathomimetic
• selective beta2 agonist

• activates beta-2 receptors to relax smooth muscle,
• bronchodilates: relieves spasms, lowers resistance

Ashtma,  Allergic reaction / anaphylaxis, pneumonia, COPD

Myocardial infarction, cardiac pulmonary edema

Restlessness, Dizziness, tachycardia, palpations, dysrhythmias.

2.5 mg in 3 ml of ns given in a nebulizer

Cordarone

Class III antidysthythmic (K+ blockade)

Prolongs period of action potential and effective refractory period .

Non-competitive beta adrenoreceptor and calcium channel blocker.

V-tach  with or without pulse and V-fib

cardiogenic shock, hypotension, bradycardia

hypotension, HA, bradycardia

stable v-tach - 150 mg in 50 ml ns, over 10-15 minutes.

• pulseless v-tach - 300 mg IVP, followup dose 150 mg IVP, max dose of 450 mg, 
• maintence drip,  1mcg/min.

Adenocard

Endogenous nucleoside

slows electrical conductivity through the AV node.

• SVT
• fast narrow complex >160 in stable pt.

Sick Sinus syndrome,  A-flutter, A-Fib, V-tach

• Chest pain,
• SOB,
• Hypotension,
• transient arrhythmias

• 6mg IVP followed by 20 ml ns
• 12mg IVP followed by 20 ml ns
• 12mg IVP followed by 20 ml ns

Trebutaline

Beta-2 agonist

Beta-2 effects and some beta-1 effects

• Obstructive SOB, 
• Asthma
• Bronchitis
• emphsema

MI, cardio pulmonary edema

• Tachycardia / palpations
• anxiety / restlessness
• sleeplessness

0.25 mg im, sq, or prn

Diphenhydramine

Antihistamine

binds to histamine receptor sites, suppressing histamine induced allergis symptoms.

• Allergic reaction / anaphylaxis
• acute dystonia

Asthma

• anticholinergic effects
• drowsiness

40 to 50 mg ivp or deep IM.

Electrolyte

Cardioprotective agent in Hyperkelemia

1. Adult  Pulseless arrest w/known hyperkalemia, renal failure, calcium channel blockers.

2.adult or pedi Calcium channel blocker Overdose w/Hypotension and bradycardia

Known hypercalcemia, suspected digoxin toxicity

Extravasation may cause tissue necrosis, in setting of digoxin toxicity may worsed cadriovascular function.

for pulseless arrest    1 gram slow IVP

for Calcium channer blocker OD 3 grams slow ivp over 2-3 minutes, q 10 minutes total of 3 doses.

Diltiazem

non-dhp calcium channel blocker

slows conduction at the av node,

causes coronary and peripheral vasodialation.

• Rapid a-fib, a-flutter (both with hr >170) 
• multi focal atrial tachycardia, 
• svt refractory to adenosine

BP > 90, wpw syndrome, heart block, sinus tach, cardiogenic shock.

• Hypotension
• bradycardia
• syncope, dyspnea, dizzyness,
• n/v and dry mouth

0.25 mg/kg slow ipv over 2 min.

carbohydrate

increases free sugar in the blood stream.

• Documented hyperglycemia
• unkn cause for coma or seizures.

intercranial Hemorrhage, suspected cva in the absence of Hypoglycemia

Hyperglycemia

• 25g SVIP, 
• Peds, 0.5 - 1mg / kg, 
• or 
• 2-4 ml / kg

Valium

Benzodiazepine

• Increase the effect of GABA, (gamma-aminyobutyvic acid).
• also acts on CNS to raise seizure threshold.

Seizure activity, procedures, extreme anxiety.

Resp. depression

• Resp. depression
• Ataxia
• confusion
• psychomotor imparment
• Hypotension

2-10 mg SIVP over 2 min. q 10-15 min.  Max dose of 30 mg.

Intropin

Sympathomimetic / inotrope

• low to medium = dose beta effects and some alpha effects
• high dose  = alpha effects

• 1 cardiogenic shock and symptomatic bradycardia refractory to atropine
• 2. Distributive shock

Hypovolemia

• elevated HR and BP, 
• MI
• CP, SOB, ectopy

• low to med. 2-10 mcg/kg/min  
• med to high  10-20 mcg/kg/min

Sympathomimetic

• Bronchodilation, vasoconstruction
• Chronotropic     raise hr ,
• Inotropic            raise contracility
• dromotropic       av conduction  and raise automaticity

• 1.  asthma (refractory to albuterol
• allergic reaction w/sob

2. symptomatic bradycardia (refractory to atropine)

none

• HTN
• Tachycardia,
• dysrhythmias, restlessness,
• MI
• CP

• 1. 0.3 - 0.5 mg IM
• 2. 1 mg into 250 ml ns, 2-10 mcg / min

• 1 v-tach
• 2 anaphylaxis

none

• HTN
• Tachycardia
• dysrhythmias
• restlessness
• nausea

Amidate

non-benzo sedative/hypontic

GABA Effects (gamma aminobutric acid)

• RSI, 
• procedures

NONE

resp. depression.

0.2 - 0.6 mg/kg IVP

Romazicon

benzodiazpine antidote

decrease the effect of GABA.

to not be overdosed by the provider

seizures.

0.2 mg IVP  ONCE ONLY

Sublimaze

synthetic opioid analgesic

combines w/ receptors in the brain to produce analgesic effects.

• pain control
• undiagnosed abd pain
• isolated trauma,
• mi

• head injury,
• bp < 90

• depressed resp rate and depth,
• pinpoint pupils,
• hypotension

1-2 mcg / kg IV im or IO

Lasix

loop diuretic

inhibits reabsorbtion of sodium and chloride in the "Loop of Henle" and proximal and distal renal tubules.

cardiac pulmonary edema.

BP < 90

• polyuria
• hypotension
• hypokalemia

20 - 40 mg SIVP over 1-2 min.

Hormone

raise BGL by converting glycogen in liver to glucose

Hypoglycemia w/o vascular access.

Betablocker OD

NONE

• Tachycardia
• Hypotension

for Hypoglycemia 0.5 to 1.0 unit

for Betablocker OD 2 units repeat PRN

Haldol

butyropheone

blocks dopamine receptors for mood and behavior.

exerts strong antiemetic effects and impairs central thermoregulation

Chemical restaint.

NONE

• hypotension,
• sedation
• long q-t syndrome,
• anticholonergic toxidrome
• distonic reaction

2-5 mg im

atrovent

Anticholinergic

blocks acetylcholine receptors on bronchial smooth muscle.

obstructed SOB;   asthma, bronchitis, emphysema, pneumonia

MI/angina, pulmonary edema, glaucoma

• tachycardia
• anxiety / toxidrome
• anticholonergic toxidrome

0.5 to 2.5 ML SVN,  q 30-45 min

xylocaine

class 1b

• sodium channel blocker,
• alters phase "0" diasolic depolarization

• 1.  v-tach w/pulse
• 2. v-tach w/o pulse
• 3. local anesthetic

heart blocks

• Slurred speech,
• seizures
• heartblocks
• raise conduction of a-fib, and a-flutter
• neurologic anesthesia

for v-tach with pulse  =  1-1.5 mg/kg q 8min (second dose 1/2 of first.(max 3 mg/kg)

for v-tach w/o pulse  = 1.5 mg/kg  (max 3 mg/kg)

for anesthtic,  0.5 mg/kg io bolus (max 50 mg)

Electrolyte

CNS depressant, and depressant of smooth, skeletal and cardiac muscle.

• Seizures,
• refractory bronchoconstriction
• torsades de pointes

NONE

• CNS depression
• Hypotension, 
• resp. dep. Hypocalcemia

• seizures :  4- 6 g ivp
• bronchoconstriction: 1-2 g ivp
• Torsades de points 1 - 4 g ivp

Osmitrol 

Osmotic diuretic

causes a fluid shift in the brain, pulls fluid into to vascular space and to be urinated off

Inner cranial pressure

NONE

Hypotension

0.5 - 2.0 g/kg