AV Drugs

• 1mg in 1ml or 1mg in 10ml
• Persistant VF or unc/pulseless VT
• Asystole
• PEA/electro-mechanical dissasociation
• Severe Asthma
• Unconcious asthma, no recordable BP
• Anaphylactic reactions
• Inadequate perfusion (cardogenic)
• Inadequate perfusion ( non-cardiogenic non-hypovolemic)
• Bradycardia with poor perfusion
• Croup or suspected Croup

Contra: Hypovolemic shock without adequate fluid replacement

Prec: Elderly Pts; Pts with cardiovascular disease; Pts on monoamine oxidase inhibitors ; Pts on beta blockers (may require higher dose)

S.E: Sinus tachycardia; SV dysrythmias; V dysrythmias; Hypertension; Pupillary dilation; May increase the size of MI; Feelings of anxiety/palpitations in a concious Pt.

600mcg tablet or 400mcg/hr patch

Ind: Chest pain a/w ACS; Hypertension a/w ACS (m); Acute left ventricular failure; Autonomic dysreflexia; Pre-term labour (consult)

Contra: BP<110 (tablet); BP<90 (patch); HR>150; HR<50 (exluding autonomic dysreflexia); Viagra/Levitra in prev 24 hrs or Cialis in prev 4 days; VT; inferior STEMI BP<160; Right ventricular infarct; Known hypersensitivity.

Prec: No previous administration; Elederly Pts; Recent acute MI; concurrent use with other tocolytics.

S.E: Tachycardia; Hypotension; Headache; Skin flushing; Bradycardia (occasional)

300mg chewable/dispersable tablet

Ind: To minimise platlet aggregation and thrombus formation in order to retard the progression of coronary artery thrombosis in ACS.

Contra: Hypersensitivity; Actively bleeding peptic ulcer; Bleeding disorders; Suspected dissecting AA; Chest pain a/w psychostimulant OD if BP>160.

Prec: Peptic ulcer; Asthma; Pts on anti-coagulant medication eg. Warfrin

S.E: Heartburn, nausea, GI bleeding; Increased bleeding time; Hypersensitivity reactions.

10mg in 2ml

Ind: N+V a/w : Cardiac chest pain/discomfort; Opiod administration for pain; Radiotherapy or cytotoxic therapy; Previously diagnosed migrane; Sever gastrointeritis; Rx or proph of awake spinaly imobilised Pt; Eye trauma.

Contra: Children; GI haemhorage; Suspected bowel obtruction or perferation.

Prec: Adolecents (<20); Undiagnosed abdominal pain; Administer slowly.

S.E: Drowsiness; Lethargy; Dry mouth; Muscle tremor; EP reactions (ususally of the dystonic type)

250mcg in 1 ml

Ind: Severe respiratory distress a/w bronchospasm.

Contra: known hypersensitivity to Atropine or derivitives

Prec: Glaucoma; Avoid contact with eyes.

S.E: Headache, Nausea; Dry mouth; Skin rash; Tachycardia (rare); Palpitations (rare); Acute angle closure glaucoma secondary to dir contact with eyes (rare).

400mcg in 1ml or 2mg in 5ml (pre-prep)

• Ind: Altered concious state and resp depression secondary to administration of narcotics or related drugs.
• Contra: Nil in above indication.
• Prec: Possibly combative Pt (esp if Pt is physically dependant on narcotics); Neonates.
• S.E: Symptoms of narcotic withdrawl: sweating; goose flesh; tremor; N+V; dilated pupils; aggitation: convulsions.

5mg in 1ml or 15mg in 3ml

Ind: Continuous/recurrent siezures; Sedation in an agitated Pt; sedation in a psychostimulant OD; Convulsions a/w lignocaine toxicity; RSI; Sedation to facillitate intubation; Sedation to maintain intubation; Sedation to enable sychronised cardioversion.

Contra: Known hypersensitivity to Benzodiazapines

Prec: Reduced dose for: Elderly, Chronic renal failure, Congestive cardiac failure, or Shock; CNS depressant effects may be enhanced by narcotics or other tranquilizers (including alchohol); May cause resp depression in Pts with COPD; Pts with myasthesia gravis.

S.E: Hypotension; Depressed level of conciousness; Resp depression; Loss of airway control.

12.5mg in 1ml IM only

Ind: Rx or Proph of N+V - Motion sickness; Aero-medical evac; Vertigo; Allergy/contra to Maxalon; Headache (irrespective of N+V)

Contra: Children; CNS depression: Circulatory collapse; previous hypersensitivity.

Prec: Epilepsy; Hypotension; Pts affected by alcohol or on anti-depresants.

S.E: Drowsiness; Blurred vision; Hypotension; Sinus tachycardia; Skin rash; EP reactions (usually of the dystonic type)

5mg in 5ml; 5mg in 2.5ml; 500mcg in 1ml

• Ind: Resp distress w suspected bronchospasm a/w - Asthma; Pulmonary oedema; COPD; Severe allergic reaction; Smoke inhalation; oleoresin Capsicum spray.
• Contra: nil of significance
• Prec: O2 to be admin btw doses; Lg IV doses may cause metatbolic acidosis
• S.E: Sinus tachycardia; Muscle tremor (common)

3ml glass bottle

• Ind: Pre-hospital pain relief
• Contra: Renal disease/impairment; Concurrent use of tetracycline antibiotics; exceeding max dose (6ml) in 24hrs.
• Prec: Inhaler held by Pt so as to fall away from face if unconciousness occours; Continually monitor Pt level of conciousness; Pre-eclampsia.
• S.E: Drowsiness; Decreased BP + bradycardia; Exceeding max dose may cause renal toxicity.

100mcg in 2ml; 600mcg in 2ml

Ind: Analgesia (IV/IN); Sedation to - 1. facilitate 2. maintain 3. RS - Intubation.

Contra:  Known hypersensitivity; Late 2nd stage labour; IV amiodarone; Severe undiagnosed headache (w/out consult).

Prec: Pt's on MOA's; Elderly Pts; Resp depression; Facial trauma, rhinitis, rhinorea (IN); Impaied hepatic/renal function; Current asthma; Known narcotic addiction; Oral amiodarone.

S.E: Resp depression; Aponea; Bradycardia; Rigidity of diaphragm and intercostal muscles.

? 50g in 500ml or 25g in 250ml.

Ind: Diabetic hypoglycemia (RBG<4) for Pts in an altered conscious state who are unable to self-administer oral glucose.

• Contra:
• Prec:            NIL of significance in above presentation
• S.E: 

1mg in 1ml hypokit.

Ind: Diabetic hypoglycemia  (BGL<4) for Pts in an altered conscious state, unable to self-administer oral glucose

• Contra: Nil
• Prec:     Nil

S.E: N+V (rare)

10mg in 1ml

Ind: Pain relief; Acute left ventricular failure w SOB and full field crackles; Sedation to enable and maintain intubation; RSI.

Contra: Known hypersensitivity; Late 2nd stage labour.

Prec: Pts on MOA's; Elderly Pts; Resp depression; Resp tract burns; Hypotension; Current asthma; Known addiction to narcotics; Acute alcoholism.

S.E: Drowsiness; Resp depression; Hypotension: Bradycardia; Euphoria; Pin point pupils; N+V; addiction.