-
Albuterol
Name/Class
Name: Ventolin, Proventil
Class: Sympathomimetic Bronchodilator
-
Albuterol
Description
Bronchodilation with less cardiac effect than epinephrine
Reduces mucus secretions, pulmonary leaking and edema in the lungs during allergic reactions
-
Albuterol
Indications
- Bronchospasms
- Asthma in COPD
-
-
Albuterol
Contraindications
Hypersensitivity
-
Albuterol
Precautions
- Tachycardia
- Anxiety
- Nausea
- Cough
- Wheezing
- Dizziness
-
Albuterol
Dose/Route
2.5mg in 2.5 - 3ml NS via nebulizer
-
Fentanyl
Name/Class
Name: Sublimaze
Class: Narcotic Analgesic
-
Fentanyl
Description
Potent synthetic narcotic analgesic
Rapid & less prolonged than morphine
-
Fentanyl
Indications
Induce sedation for ETI
-
Fentanyl
Contraindications
MAO inhibitors within 14 days
Myasthenia Gravis
-
Fentanyl
Precautions
- Increased ICP
- Elderly/debilitated
- COPD
- Respiratory problems
- Liver/kidney insufficiency
-
Fentanyl
Dose/Route
25 - 100mcg slow IV
-
Ipatropium
Name/Class
Name: Atrovent
Class: Anticholinergic
-
Ipatropium
Description
- Bronchodilator
- Dries respiratory tract secretions by blocking acetylcholine receptors
-
Ipatropium
Indications
Bronchospasms due to asthma, COPD & inhaled irritants
-
Ipatropium
Contraindications
- Hypersensitivity to Atropine
- Primary treatment for bronchospasms
-
Ipatropium
Precautions
- Elderly
- Cardiovascular disease
- HTN
-
Ipatropium
Dose/Route
500mcg in 2.5 - 3ml NS via nebulizer or 2 sprays from metered dose inhaler
-
Morphine Sulfate
Name/Class
Name: Morphine
Class: Narcotic Analgesic
-
Morphine
Description
- Potent analgesic & sedative
- Causes vasodilation
- Reduces venous return
- Reduces myocardial 02 demand
-
-
Morphine
Contraindications
- Hypersensitivity to opiates
- Undiagnosed head or abdominal injury
- Hypotension/volume depletion
- Asthma
- COPD
- Severe respiratory depression
- Pulmonary edema due to chemical inhalation
-
Morphine
Precautions
- Elderly/debilitated
- Children
- Narcan should be available
-
Morphine
Dose/Route
Pain: 2.5 - 15mg IV; 5 - 20mg IM/Subcutaneous
AMI or PE: 1 - 2mg (6 - 10 min. response)
-
Naloxone
Name/Class
Name: Narcan
Class: Narcotic Antagonist
-
Naloxone
Description
- Blocks effects of natrual and synthetic narcotics
- May reverse respiratory depression
-
Naloxone
Indications
- Narcotic overdose
- Coma of unknown origin
-
Naloxone
Contraindications
Non-narcotic induced respiratory depression
-
Naloxone
Precautions
- Possible dependency
- Short half life
-
Naloxone
Dose/Route
.4 - 2mg IV/IM repeated 2 - 3 min. up to 10mg
-
Diazepam
Name/Class
Name: Valium
Class: Antianxiety, Hypnotic, Anticonvulsant, Sedative
-
Diazepam
Description
- Benzodiazepine sedative
- Skeletal muscle relaxant
- Reduces tremors
- Reduces seizure reoccurance
- Induces amnesia (cardioversion)
- Relaxes muscle spasms due to orthopedic injuries
-
Diazepam
Indications
- Major motor seizures
- Status epilepticus
- Premedication before cardioversion
- Muscle tremors from injury
- Acute anxiety
-
Diazepam
Contraindications
- Shock
- Coma
- ETOH
- Depressed vitals
- Pregnancy
- Neonates
-
Diazepam
Precautions
- Psychosis
- Depression
- Myasthenia Gravis
- Hepatic/renal insufficiency
- Addiction
- Elderly/very ill
- COPD
- Short half life
-
Diazepam
Dose/Route
Seizures: 5 - 10mg IV/IM
Anxiety: 2 - 5mg IV/IM
PreMedication: 5 - 15mg IV
-
Etomidate
Name/Class
Name: Amidate
Class: Hypnotic
-
Etomidate
Description
- Short acting hypnotic
- No analgesic effects
- Limited cardiovascular and respiratory effects
-
Etomidate
Indications
Sedation for RSI
-
Etomidate
Contraindications
Hypersensitivity
-
Etomidate
Precautions
- Hypotension
- Asthma
- Cardiovascular disease
-
Etomidate
Dose/Route
.1 - .3mg/kg IV 15 to 30 sec.
-
Flumazenil
Name/Class
Name: Romazicon
Class: Benzodiazepine Antagonist
-
Flumazenil
Description
Reverses sedative, recall and psychomotor effects of benzodiazepines
-
Flumazenil
Indications
Respiratory depression due to benzodiazepines
-
Flumazenil
Contraindications
- Seizure prone patients during labor/delivery
- Tricyclic antidepressant overdose
-
Flumazenil
Precautions
- Hepatic impairment
- Elderly
- Pregnancy/Nursing mothers
- Head injury
- Alcohol/Drug dependency
- Physical dependency on benzodiazepines
-
Flumazenil
Dose/Route
.2mg IV over 30 sec, up to 1mg
-
Midazolam
Name/Class
Name: Versed
Class: Sedative
-
Midazolam
Description
- Short-acting benzodiazepine with CNS depressant
- Muslce relaxant
- Anticonvulsant
- Amterograde amnesic effects
-
Midazolam
Indications
Induce sedation for cardioversion or intubation
-
Midazolam
Contraindications
- Narrow-angle glaucoma
- Shock
- Coma
- Acute ETOH
-
Midazolam
Precautions
- COPD
- Renal impairment
- CHF
- Elderly
-
Midazolam
Dose/Route
- 1 - 2.5mg slow IV
- .07 - .08mg/kg IM
-
Succinylcholine
Name/Class
Name: Anectine
Class: Depolarizing Neuromuscular Blocker
-
Succinylcholine
Description
Ultra-short-acting depolarizing neuromuscular blocker
-
Succinylcholine
Indications
Facilitated ETI
-
Succinylcholine
Contraindications
- Family hx of malignant hyperthermia
- Penetrating eye injury
- Narrow-angle glaucoma
-
Succinylcholine
Precautions
- Severe burn or crash
- Electrolyte imbalances
- Hepatic/renal impairment
- Cardiac/pulmonary impairment
- Fractures
- Spinal cord injury
- Severe anemia
- Porphyria
-
Succinylcholine
Dose/Route
1 - 1.5mg/kg IV/IM
-
Adenosine
Name/Class
Name: Adenocard
Class: Antidysrhythmic
-
Adenosine
Description
- Chemically cardiovert PSVT to NSR
- 10 sec. half life
-
Adenosine
Indications
Narrow & complex supraventricular tachycardia refractory to vagal maneuvers
-
Adenosine
Contraindications
- 2nd & 3rd degree heart blocks
- Sinus Node disease
- Asthma
-
Adenosine
Precautions
- Transient dysrhythmias
- COPD
-
Adenosine
Dose/Route
6mg rapid IV, then flush. If ineffective, 12mg, in 1 - 2 min. repeat
-
Atropine
Name/Class
Name: Atropine
Class: Parasympatholytic
-
Atropine
Description
- Blocks parasympathetic nervous system, vagal effects on heart rate
- Decreases airway secretions
- May increase myocardial O2 demand
-
Atropine
Indications
- Bradycardia
- Bradysystolic arrest
- Organophosphate poisoning
-
Atropine
Contraindications
None
-
-
Atropine
Dose/Route
Asystole/PEA: 1mg IV/IO every 3 - 5 min, 3 dose max
Symptomatic Bradycardia: .5mg IV; 1mg ET. Repeat 3 - 5 min. to 3mg
Organophosphate Poisoning: 2 - 5mg IV/IM/IO 10 - 15 min.
-
Epinephrine
Name/Class
Name: Adrenaline
Class: Sympathomimetic
-
Epinephrine
Description
Naturally occuring catecholamine
- Increases:
- Heart rate
- Cardiac contractile force
- Myocardial electrical activity
- Systemic vascular resistance
- Systolic BP
- Decreases:
- Airway resistance
- Automaticity
May reduce pulmonary congestion and increase tidal volume and vital capacity through bronchial artery constriction
-
Epinephrine
Indications
- Cardiac arrest
- Severe allergic reactions
-
Epinephrine
Contraindications
- Narrow-angle glaucoma
- Hemorrhagic shock
- Traumatic shock
- Cardiac shock
- Labor
-
Epinephrine
Precautions
- Elderly
- HTN
- Diabetes
- Hyperthyroidism
- Parkinsons
- Asthma
-
Epinephrine
Dose/Route
Arrest: 1mg of 1:10000 IV 3 - 5 min.; 2 - 2.5mg 1:1000 ET
Allergic Reactions: .3 - .5mg of 1:1000 subcutaneously 5 - 15 min. as needed; .5 - 1mg of 1:10000 IV if subcutaneous ineffective or severe reaction
-
Vasopressin
Name/Class
Name: Pitressin
Class: Hormone, Vasopressor
-
Vasopressin
Description
- Strong vasopressive & antidiuretic properties
- May prescipitate angina or AMI
-
Vasopressin
Indications
- Increase peripheral vascular resistance in arrest
- Control bleeding from esophageal varices
-
Vasopressin
Contraindications
-
Vasopressin
Precautions
- Epilepsy
- Migraine
- Heart Failure
- Angina
- Vascular disease
- Hepatic impairment
- Elderly
- Children
-
Vasopressin
Dose/Route
Arrest: 40 units IV
Esophageal Varices: .2 - .4 units/min IV drip
-
Aspirin
Name/Class
Name: Acetylsalicylic Acid
Class: Acetylsalicylic Acid
-
Aspirin
Description
Acts on PNS and inhibits agents causing inflammation, pain & fever
-
Aspirin
Indications
Chest pain suggestive of an MI
-
Aspirin
Contraindications
- Active ulcer disease
- Asthma
-
Aspirin
Precautions
Bleeding disorders
-
Aspirin
Dose/Route
160 - 325mg PO (chewable)
-
Dextrose 50% in Water
Name/Class
Name: D50W
Class: Carbohydrate
-
Dextrose 50% in Water
Description
Simple sugar the body can rapidly metabolize and create energy
-
Dextrose 50% in Water
Indications
Hypoglycemia
-
Dextrose 50% in Water
Contraindications
None in hypoglycemia
-
Dextrose 50% in Water
Precautions
- Increased ICP
- Determine blood glucose before administration
- Good venous access
-
Dextrose 50% in Water
Dose/Route
25g (50ml) IV
-
Furosemide
Name/Class
Name: Lasix
Class: Diuretic
-
Furosemide
Description
- Potent diuretic
- Antihypertensive
- Inhibits sodium reabsorption by kidneys
- Vasodilating effects reduce venous return & cardiac workload
-
-
Furosemide
Contraindications
- Fluid/electrolyte depletion
- Hepatic coma
- Pregnancy (except in life threatening circumstances)
-
Furosemide
Precautions
- Infants
- Elderly
- Liver impairment
- Nephrotic syndrome
- Cardiogenic shock during acute MI
- Gout
- Patients receiving digitalis or potassium depleting steroids
-
Furosemide
Dose/Route
40 - 120mg slow IV
-
Nitroglycerin
Name/Class
Name: Nitrostat
Class: Nitrate
-
Nitroglycerin
Description
- Rapid smooth muscle relaxant
- Reduces peripheral vascular resistance
- Reduces BP
- Reduces Venous return
- Reduces cardiac workload
-
Nitroglycerin
Indications
Chest pain due to angina, AMI, Acute pulmonary edema
-
Nitroglycerin
Contraindications
- Tolerance to nitrates
- Severe anemia
- Head trauma
- Hypotension
- Increased ICP
- Pts taking sildenafil
- Glaucoma
- Shock
-
Nitroglycerin
Precautions
- Headache
- Nitro is light sensitive, loses potency when exposed to air
-
Nitroglycerin
Dose/Route
.4mg (1 table) SL repeated 3 - 5 min. up to 3 tablets; 1/2" ointment; .4mg (1 spray) SL up to 3 sprays over 25 mins.
-
Dobutamine
Name/Class
Name: Dobutrex
Class: Sympathomimetic
-
Dobutamine
Description
- Synthetic catecholamine and beta agent
- Increases strength of cardiac contraction without increasing rate
-
Dobutamine
Indications
Increase cardiac output in CHF & cardiogenic shock
-
Dobutamine
Contraindications
- Vtach
- Hypovolemia w/o fluid resuscitation
-
-
Dobutamine
Dose/Route
2 - 20mcg/kg/min IV
-
Dopamine
Name/Class
Name: Intropin
Class: Sympathomimetic
-
Dopamine
Description
- Catecholamine
- Increases cardiac output without increasing myocardial O2 consumption
- Maintains renal and mesenteric blood flow
- Induces vasoconstriction
- Increases systolic BP
-
Dopamine
Indications
- Nonhypovolemic hypotension
- Cardiogenic shock
-
Dopamine
Contraindications
- Tachydysrhythmias
- Vfib
- Pheochromocytoma
-
Dopamine
Precautions
Adequate fluid resuscitation of the hypovolemic Pt
-
Dopamine
Dose/Route
2 - 5mcg/kg/min up to 20mcg/kg/min, titrated to effect
-
Isoprotenerol
Name/Class
Name: Isuprel
Class: Sympathomimetic
-
Isoproterenol
Description
Increases cardiac output by increasing strength and rate of contraction
-
Isoproterenol
Indications
Bradycardia refractory to Atropine when pacing is not available
-
Isoproterenol
Contraindications
Cardiogenic shock
-
Isoproterenol
Precautions
- Tachydysrhythmias
- Digitalis dysrhythmias
- AMI
-
Isoproterenol
Dose/Route
2 - 10mcg/min titrated to cardiac rate
-
Amiodarone
Name/Class
Name: Cordarone, Pacerone
Class: Antidysrhythmic
-
Amiodarone
Description
- Prolongs the duration of the action potential and refractory period
- Relaxes smooth muscle
- Reduces peripheral vascular resistance
- Increases coronary blood flow
-
Amiodarone
Indications
- Ventricular and supraventricular dysrhythmias
- Afib
-
Amiodarone
Contraindications
- Cariogenic shock
- Sever sinus bradycardia
- Advanced heart block
-
Amiodarone
Precautions
Hepatic impairment
-
Amiodarone
Dose/Route
150 - 300mg IV over 10 mins., then 1mg/min over next 6 hrs.
-
Bretylium
Name/Class
Name: Bretylol
Class: Antidysrhythmic
-
Bretylium
Description
Suppresses ventricular dysrhythmias including vfib with re-entry mechanisms
-
Bretylium
Indications
Vtach & Vfib refractory to lidocaine
-
Bretylium
Contraindications
None
-
Bretylium
Precautions
- Digitalized Pts
- Digitalis induced dysrhythmias
-
Bretylium
Dose/Route
5mg/kg IV then 10mg/kg 15 - 30 mins., max 30mg/kg
-
Lidocaine
Name/Class
Name: Xylocaine
Class: Antidysrhythmic
-
Lidocaine
Description
- Raises automaticity
- Supresses stimulation threshold of ventricles
- Sedation
- Anticonvulsant
- Analgesic effects
-
-
Lidocaine
Contraindications
- Supraventricular dysrhythmias
- Stokes-Adams Syndrome
- 2nd & 3rd degree heart blocks
- Bradycardia
-
Lidocaine
Precautions
- Hepatic/Renal impairment
- CHF
- Hypoxia
- Respiratory depression
- Hypovolemia
- Myasthenia Gravis
- Shock
- Elderly
-
Lidocaine
Dose/Route
Cardiac Arrest: 1 - 1.5mg/kg IV repeated every 3 - 5 mins. up to 3mg/kg, follow conversion with drip of 2 - 4mg/min.
Vtach: 1 - 1.5mg/kg slow IV; repeat at 1/2 dose every 5 - 10 mins. until conversion up to 3mg/kg; follow conversion with infusion of 2 - 4mg/min.
-
Procainamide
Name/Class
Name: Pronesty
Class: Antiarrhythmic
-
Procainamide
Description
- Prolongs ventricular repolarization
- Slows conduction
- Decreases myocardial excitability
-
Procainamide
Indications
- Vfib
- Pulseless Vtach refractory to lidocaine
-
Procainamide
Contraindications
- Hypersensitivity to procaine
- Myasthenia Gravis
- 2nd & 3rd degree heart blocks
-
Procainamide
Precautions
- Hypotension
- Cardiac enlargement
- CHF
- AMI
- Ventricular dysrhythmias from digitalis
- Hepatic/renal impairment
- Asthma
-
Procainamide
Dose/Route
- 20 - 30mg/min IV drip.
- Stop Points:
- 1. up to 17mg/kg to effect then 1 - 4 mg/min
- 2. Ectopy resolves
- 3. QRS complex widens more than 50% from original
- 4. Hypotension
-
Diltiazem
Name/Class
Name: Cardizem
Class: Calcium channel blocker
-
Diltiazem
Description
Dilates coronary and peripheral arteries & arterioles, which increases circulation to the heart and decreases peripheral vascular resistance.
-
Diltiazem
Indications
- Supraventricular tachydysrhythmias (Afib, Aflutter, PSVT)
- Increase coronary artery perfusion in angina
-
Diltiazem
Contraindications
- Sick sinus syndrome
- 2nd or 3rd degree heart block
- Systolic BP <90
- Diastolic BP <60
- Wide complex tachycardia
- WPW
-
Diltiazem
Precautions
CHF
-
Diltiazem
Dose/Route
.25mg/kg IV over 2 mins., repeat as need with .35mg/kg followed by drip of 5 - 10mg/hr. Do not exceed 15mg/hr over 24hrs.
-
Verapamil
Name/Class
Name: Isoptin, Calan
Class: Calcium channel blocker
-
Verapamil
Description
- Slows AV conduction
- Suppresses re-entry dysrhythmias
- Slows ventricular responses to atrial tachydysrhythmias
- Dilates coronary arteries
- Reduces myocardial O2 demand
-
Verapamil
Indications
- PSVT refractory to adenosine
- Aflutter
- Afib with rapid ventricular response
-
Verapamil
Contraindications
- Hypotension
- Cardiogenic shock
- 2nd & 3rd degree heart block
- CHF
- Sinus Node Disease
- Accessory AV pathways
- WPW syndrome
- Beta blockers
-
Verapamil
Precautions
Hepatic/renal impairment
-
Verapamil
Dose/Route
2.5 - 5mg IV bolus over 2 - 3 mins., then 5 - 10mg after 15 to 30 mins. to a max of 30mg in 30 mins.
-
Tridil
Name/Class
Name: Nitroglycerin Injection
Class: Vasodilator, Nitrate
-
Tridil
Description
- Relaxes blood vessels
- Increases blood and O2 supply to heart
-
Tridil
Indications
- Relieve pain associated with angina that does not respond to oral tx
- Control BP
- CHF
-
Tridil
Contraindications
- Hypotension
- Uncorrected hypovolemia
- ICP
- Contrictive pericarditis
- Pericardial tamponade
-
Tridil
Precautions
- Headache
- Hypotension
- Tachycardia
-
Tridil
Dose/Route
.2 - 1.5mcg/kg/min
-
Calcium Chloride
Name/Class
Name: Calcium Chloride
Class: Electrolyte
-
Calcium Chloride
Description
- Increases myocardial contractile force
- Increases ventricular automaticity
-
Calcium Chloride
Indications
- Hyperkalemia
- Hypocalcemia
- Hypermagnesemia
- Calcium channel blocker toxicity
-
Caclium Chloride
Contraindications
- Vfib
- Hypercalcemia
- Digitalis toxicity
-
Caclium Chloride
Precautions
- May precipitate toxicity in Pts taking digoxin
- IV in large vein
- Flush before & after use
-
Caclium Chloride
Dose/Route
2 - 4mg/kg IV (10% solution)/10 mins. as needed
-
Methylprednisolone
Name/Class
Name: Solu-Medrol
Class: Corticosteriod, Antiinflammatory
-
Methylprednisolone
Description
- Aniinflammatory
- Allergic reactions
- Shock
- Spinal cord injuries
-
Methylprednisolone
Indications
- Spinal cord injury
- Anaphylaxis
- COPD
- Asthma
-
Methylprednisolone
Contraindications
None
-
Methylprednisolone
Precautions
Only 1 dose should be given
-
Methylprednisolone
Dose/Route
Asthma/COPD/Anaphylaxis: 125 - 250mg IV/IM
Spinal cord injury: 30mg/kg IV over 15 mins., after 45 mins. an infusion of 5.4mg/kg/hr
|
|