Paramedic Pharmacology Drugs.txt

Action: Inhibits thromboxane A2 to prevent platelet aggregation.

Indication: Suspected myocardial infarction.

Action: Slows AV conduction.

Indication: Supraventricular tachycardias (SVT).

Action: Beta agonist, bronchodilator.

• Indication: Bronchospasm
• 1. Asthma
• 2. Allergy
• 3. COPD

• Action: Class III anti-arrhythmic.
• 1. Slows sinus rate.
• 2. Increases PR and QT intervals.
• 3. Increases refractory period AV node.

• Indication: Fast rhythms
• 1. V-Tach (Ventricular Tachycardia)
• 2. V-Fib (Ventricular Fibrilation)

Action: Benzodiazepine, binds to GABA receptors.

• Indication:
• 1. Status seizures.
• 2. Chemical restraint.
• 3. Acute alcohol withdrawl.
• 4. Sedation prior to cardioversion.
• 5. Non-traumatic musculoskeletal spasms.

Action: Anticholinergic (blocks muscarinic receptors in parasympathetic nervous system).

• Indication:
• 1. Symptomatic bradycardia.
• 2. Organophosphate poisoning.

Action: Anticholinergic and bronchodilator.

• Indication: Bronchospasm
• 1. Asthma
• 2. COPD
• 3. Allergy
• 4. Anaphylaxis

Action: Antihistamine

• Indication:
• 1. Acute allergic reaction.
• 2. Acute dystonic reaction due to anti-psychotic medìcations.

Action: Primary carbohydrate used by the body.

• Indication:
• 1. Known hypoglycemia.
• 2. Blood glucose less than 60 mg/dL with altered mental status.
• 3. Unconscious with unkown history.
• 4. Status seizures unresponsive to benzodiazepines.
• 5. Hypothermia.

Action: Vasopressor that increases cardiac output.

• Indication:
• 1. Cardiogenic shock.
• 2. Hypotension after hypovolemia has been corrected.
• 3. Unstable bradycardia.

Action: Sympathomimetic, stimulates alpha and beta receptors.

• Indication:
• 1. Ventricular fibrilation.
• 2. Asystole.
• 3. PEA.
• 4. Acute bronchial spasm due to allergy or asthma.
• 5. Anaphylaxis.

Action: Synthetic opiod agonist w/ short duration of action and minimal histamine release.

• Indication:
• 1. Severe pain: trauma, burns, cancer, kidney stones, muscular spasms.
• 2. Alternative to morphine (patients with allergy).

Action: Hormone released from pancreas that stimulates release of glycogen from liver.

• Indication:
• 1. Hypoglycemia when dextrose not available or IV cannot be established.
• 2. Beta blocker overdose.
• 3. Esophageal obstruction.

Action: Loop diuretic, inhibits Na+ reabsorption, increases K+ excretion.

Indication: Acute pulmonary edema secondary to congestive heart failure. CHF exacerbation.

Action: Blocks Na+ channels in cardiac and nervous tissue, results in decreased myocardial automaticity, anesthesia, decreased cough reflex, raises fibrilation threshold.

• Indication:
• 1. V-Fib refractory to defibrilation.
• 2. V-Tach w/out pulses or unstable w/ pulses.
• 3. Wide complex tachycardia of unknown origin that is unstable.
• 4. Significant ventricular ectopy.
• 5. Nasal intubation.
• 6. IO insertion.

Action: Corrects repolarization in cardiac tissue, blocks neuromuscular transmission in seizure patients, decreases cerebral vasospasm.

• Indication:
• 1. Torsades de Pointes.
• 2. Seizures due to eclampsia.
• 3. Bronchospasm unresponsive to other treatment.

Action: Opiate agonist, analgesic, decreases myocardial oxygen demand.

• Indication:
• 1. Severe pain due to fractures, sprains and strains.
• 2. Severe pain due to burns.
• 3. Chest pain secondary to suspected myocardial infarction or unstable angina.

Action: Narcotic antagonist.

• Indication:
• 1. Narcotic overdose.
• 2. Altered mental status of unknown origin.

Action: Smooth muscle relaxant, dilates coronary vessels, decreases peripheral vascular resistance.

• Indication:
• 1. Stable or unstable angina.
• 2. Hypertension and acute pulmonary edema secondary to CHF w/ CPAP in place.
• 3. Hypertension secondary to autonomic hyper-reflexia.

Action: Sympathomimetic binds to alpha and beta receptors to cause vasoconstriction of upper airway and bronchodilation.

• Indication:
• 1. Croup
• 2. Severe stridor and/or accessory muscle use.

Action: Alkalotic (basic) solution.

• Indication:
• 1. Patients in cardiopulmonary arrest after 10 minutes of effective CPR. **Controversial**
• 2. Tricyclic anti-depressant overdose.

Action: Gluco-corticoid, anti-inflammatory, suppresses immune/allergic response.

• Indication:
• 1. Severe respiratory distress due to asthma.
• 2. Severe respiratory distress due to COPD.
• 3. Severe respiratory distress due to anaphylaxis.

Action: Beta agonist, bronchodilator.

• Indication:
• 1. Bronchospasm due to asthma.
• 2. Bronchitis.
• 3. Emphysema.

Action: Topical anesthetic.

Indication: Eye pain due to foreign body irritation or burns.

Action: Vitamin essential for carbohydrate metabolism.

Indication: Administer w/ dextrose in patients with comas of unknown origin who have history of poor nutrition, untreated illness and are suspected of chronic alcoholism.

Action: Hormone produced by the hypothalamus and released by the pituitary gland. Causes vasoconstriction, increase in BP and increased coronary and cerebral perfusion.

• Indication:
• 1. Ventricular fibrilation.
• 2. Ventricular tachycardia.
• 3. PEA.
• 4. Asystole.

Action: Benzodiazepine, binds to GABA receptors.

• Indicatìon:
• 1. Chemical restraint.
• 2. Sedation prior to cardioversion.
• 3. Sedation after intubation.
• 4. Angulated fractures requiring repositioning in the field.
• 5. Non-traumatic musculoskeletal spasms.
• 6. Seizures (2nd line to Ativan).
• 7. Pediatric seizures (IN administration).

Action: Anti-emetic, selective 5HT serotonin receptor antagonist.

Indication: Severe nausea and vomiting.

• 1. Known sensitivity/allergy.
• 2. Bleeding disorders.
• 3. Hemorrhagic CVA.

• 1. History of severe asthma.
• 2. Torsades de Pointes.

• 1. Known sensitivity.
• 2. Cardiac dysrhythmias associated w/ tachycardia (tachy dysrhythmias).

• 1. Slow rhythms: 2nd and 3rd degree AV blocks.
• 2. Known sensitivity to the drug or iodine.

• 1. Respiratory depression.
• 2. Hypotension.
• 3. Caution w/ pregnancy.

• 1. Atrial fibrilation.
• 2. Atrial flutter.
• 3. Any tachycardia.

• 1. Sensitivity to soybeans, peanuts or atropine.
• 2. Under 12 months old.

1. Pregnant or nursing patients.

1. Known or suspected CVA in the absence of hypoglycemia.

• 1. Tachycardic dysrhythmias.
• 2. Hypertension.

• 1. NO contraindications in cardiac arrest.
• 2. Patients in labor.
• 3. Hyperthyroidism.
• 4. Hypovolemic shock.
• 5. Ischemic heart disease.

• 1. Respiratory depression/insufficiency.
• 2. Uncorrected hypotension.
• 3. Head, chest or abdominal injury (differs by system).
• 4. Trauma red patients (differs by system).

1. NONE

• 1. Known or suspected pneumonia.
• 2. Hypovolemia.
• 3. Hypokalemia (low potassium).
• 4. Pregnant.
• 5. Pediatric.

• 1. Bundle branch blocks.
• 2. AV blocks.
• 3. Periods of sinus arrest.
• 4. Atrial fibrilation.
• 5. Atrial flutter.
• 6. Hypotension.

1. 2nd or 3rd degree AV blocks (slow rhythms).

• 1. Respiratory depression/insufficiency.
• 2. Altered mental status.
• 3. Head injury.
• 4. Hypotension.
• 5. Hypovolemia.
• 6. Recent ingestion MAO inhibitor. (Monoamine Oxidase)

1. NONE

• 1. Hypotension.
• 2. Head injury.
• 3. Known or suspected cerebral hemorrhage.
• 4. ED medications.
• 5. Right ventricular myocardial infarction.

1. Known history of sensitivity to medication.

• 1. Pulmonary edema.
• 2. Metabolic or respiratory alkalosis.
• 3. Abdominal pain.
• 4. Electrolyte imbalances (hypocalcemia, hypokalemia, hypernatremia).

• 1. Known hypersensitivity.
• 2. Caution w/ pregnancy.

1. Known hypersensitivity

• 1. Known hypersensitivity.
• 2. Penetrating trauma to eye.

1. Known hypersensitivity.

1. NONE

• 1. Hypotension.
• 2. Respiratory distress.

• 1. Known hypersensitivity.
• 2. Children under 2 years.

324 mg (4 childrens chewable Aspirin)

Adult: 6 mg IV, IO (can repeat w/ 12 mg)

Peds: 0.1 mg/kg IV, IO (can repeat w/ 0.2 mg/kg)

Adult: 2.5 mg w/ 3 mL saline NEBULIZER

Peds: 2.5 mg w/ 6 mL saline NEBULIZER

• Adult:
• Pulseless 300 mg IV, IO
• With pulse 150 mg IV, IO

Peds: 5 mg/kg IV, IO (slow if pulses are present)

• Adult:
• Seizure 2 mg IV, IO, IM seizure
• Anythin else 1-2 mg

Peds: 0.05-0.1 mg/kg IV, IO, IM.

• Adult:
• Bradycardia 0.5 mg IV, IO
• Organophosphate 1-2 mg until symptoms subside

Peds: 0.02 mg/kg IV, IO, ET

• Adult: 500 mcg w/ 2.5 mL saline NEBULIZER.
• (can also be mixed w/ 2.5 mg albuterol)
• *max 3 doses

• Peds: 500 mcg w/ 6 mL saline NEBULIZER.
• (can also be mixed w/ 2.5 mg albuterol)
• *max 3 doses

Adult: 10-50 mg IV, IO, IM

Peds: 1-2 mg/kg IV, IO, IM

Adult: 25 gm IV, IO

Peds: 2 mL/kg IV, IO

Adult: 2-20 mcg/kg/min IV, IO

Peds: 2-20 mcg/kg/min IV, IO

• Adult:
• Cardiac arrest 1 mg 1:10 IV, IO, ET repeat every 5 min
• Allergy/Asthma/Bronchospasm 0.3 mg 1:1 SQ, IM
• Severe asthma/anaphylaxis 0.1-0.3 mg 1:10 IV, IO

• Peds:
• Cardiac arrest 0.01 mg/kg 1:10 IV, IO repeat every 5 min
• Allergy/Asthma/Bronchospasm 0.01 mg/kg 1:1 SQ, IM repeat every 5 min

• Adult: 1-2 mcg/kg IV, IO, IN, IM (usually 50-100 mcg)
• *max dose 200 mcg

Peds: 1-2 mcg/kg IV, IO, IN, IM

• Adult:
• Hypoglycemia 1 mg IM, IN
• Beta blocker overdose 0.1 mg/kg up to 1 mg IV, IO
• Esophageal obstruct 1 mg IV

• Peds:
• Hypoglycemia 0.1 mg/kg up to 1 mg IM, IN
• Beta blocker overdose 0.1 mg/kg up to 1mg IV, IO

Adult: 20-80 mg slow IVP

• Adult:
• Cardiac 1-1.5 mg/kg IV, IO (second dose half)
• IO placement 20-40 mg slow

• Peds:
• Cardiac 1 mg/kg
• IO placement 0.5 mg/kg

• Adult:
• Torsades 1-2 grams diluted IV, IO
• Seizure 1-4 grams diluted slow IV, IO
• Respiratory 1-2 grams diluted slow IV, IO

Adult: 2-10 mg IV, titrate to effect

Peds: 0.1-0.2 mg/kg IV

Adult: 0.4-2 mg IV, IM, SQ, ET, IN, titrate to respirations

Peds: 1 mg IV, IM, SQ, ET, IN

Adult: 0.4 mg SL, may be repeated every 5 min BP tolerating

Adult: 5 mL w/ 3 mL saline NEBULIZER

Peds: 0.5 mL w/ 6 mL saline NEBULIZER

• Adult:
• Cardiac 1 mEq/kg IV, IO
• TCA overdose contact physician adviser

• Peds:
• Cardiac 1 mEq/kg IV, IO
• TCA overdose contact physician adviser

Adult: 125 mg IV

• Peds: 2 mg/kg IV
• *max 125 mg

Adult: 0.25 mg SQ (second dose half after 15-30 min)

Adult: 1-2 drops as needed

Peds: 1-2 drops as needed

Adult: 100 mg slow IV, IM

Adult: 40 units IV, IO (one time dose only)

Adult: 1-5 mg IV, IO, ET, IM, Rectal

Peds: 0.05 mg/kg slow IV, IO, ET, IM, Rectal, IN

Adult: 4 mg IV, IM

Peds: 0.1 mg/kg IV, IM (single dose)