-
Amiodarone
Class & Action
Indications & Dosage
Side Effects & Contraindications
- Class & Action
- Antiarrhythmic;Prolongs duration of action potential/refractory period and relaxes smooth muscle reducing peripheral vascular resistance
- Indications & Dosage
- Life threatening Disrhythmias & A-fib; 150 mg given over 10 min. for PVC's and Pulsatile V-Tach, 300 mg for V-fib and Pulseless V-tach (may repeat with 150 mg once after 3-5 min)
- Side Effects & Contraindications
- Vasodilation, Hypotension, Bradycardia, prolonged QT; Known allergy to medication or iodine, cardiogenic shock, bradycardia, or advanced heart block
-
Fentanyl
Class & Action
Indications & Dosage
Side Effects & Contraindications
- Class & ActionSynthetic Opioid Agonist; Narcotic Analgesic
- Indications & Dosage
- Side Effects & ContraindicationsRespiratory depression, nausea, vomiting, bradycardia, orthostatic hypotension, decreased LOC; Known allergy, respiratory depression, uncorrected hypotension
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Zofran
Class & Action
Indications & Dosage
Side Effects & Contraindications
- Class & ActionAntiemetic; Serotonin Receptor Antagonist
- Indications & Dosage
- Side Effects & ContraindicationsFatigue, dizziness, abdominal pain, rash, chest pain; known hypersensitivity to drug
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Aspirin
Class & Action
Indications & Dosage
Side Effects and Contraindications
- Non-steroidal Anti-inflammatory; Platelet inhibition.
- Suspected Cardiac Ischemia; 324 mg.
- Known allergy, patient currently taking Coumadin.
-
Activated Charcoal
Class
Action
Indications
Dosage
Side Effect
Contraindications
- Absorbent
- Inhibits gastrointestinal absorption of toxics
- Conscious patient who has ingested a poison
- 25-50 g (Adult), 12.5-25 g (Ped)
- ALOC, inability to swallow, Ingestion of: acid, alkali, petroleum distillate
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Adenosine
Class
Action
Indications
Dosage
Side Effect
Contraindications
- Antiarrhythmic
- Slows conduction throught the AV node and can interrupt re-entry pathways
- Stable, narrow, complex SVT not responsive to vagal maneuvers (consider for unstable tachycardia prior to cardioversion); monomorphic, regular, wide complex tachycardia
- Adults: 6 mg rapid IV push, followed by 12 mg within 1-2 min (if unsuccessful). Peds: 0.1 mg/kg not to exceed adult dose, 0.2 mg/kg 2nd dose.
- Facial flushing, headache, sweating, palpitations, chest pain.
- Poision/drug induced tachycardia or 2nd or 3rd degree heart block
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Albuterol
Class
Action
Indications
Dosage
Side Effect
Contraindications
- Sympathomimetic
- Bronchodilator
- Adute bronchospasm, anaphylaxis with wheezing.
- 2.5 mg nebulized, continue until improvement or patient becomes tremulous
- Tachycardia, palpitations, anxiousness, headache
- Known allergy
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Atropine
Class
Action
Indications
Dosage
Side Effect
Contraindications
- Parasympathetic blocker
- Cholinergic blocking agent, increases SA node discharge, increases conduction through AV node
- Hemodynamically significant Bradycardia (except 2nd degree Type II or 3rd degree block)
- Adults: 0.5 mg every 3-5 min. Max dose of 0.04mg/kg. Peds: 0.02 mg/kg, may repeat once - min. dose: 0.1 mg, max. dose: 0.04 mg/kg.
- Tachycardia.
- None.
-
Benadryl
Class
Action
Indications
Dosage
Side Effect
Contraindications
- Antihistamine
- Blocks histamine receptors, some sedative effects, anticholinergic
- Allergic Reaction
- Adults: 50 mg. Peds: 1 mg/kg.
- Sedation, palpitations, hypotension, headache, thickened bronchial secretions, blurred vision
- Known allergy
-
Epinephrine 1:1000
Class
Action
Indications
Dosage
Side Effect
Contraindication
- Sympathomimetic
- Positive inotrope, positive chronotrope, bronchodilation
- Allergic reaction, anaphylaxis, bronchospasm
- Adults: 0.5 mg every 15 min IM/SQ for 1.5 mg total. Peds: 0.01 mg/kg every 15 min for max dose of 0.3 mg.
- Tachycardia, palpitations, ectopic beats, hypertension, headache, anxiousness
- Underlying cardiovascular disease, angina, hypertension, pregnancy, hyperthyroidism
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Epinephrine 1:10,000
Class
Action
Indications
Dosage
Side Effect
Contraindications
- Sympathomimetic
- Positive inotrope, positive chronotrope, bronchodilation
- Asystole, PEA, VF, cardiac arrest; bradycardia in peds
- Adults: 1 mg every 3-5 min (2-2.5x dose for ETT). Peds: 0.01 mg/kg initial dose, 0.1 mg/kg of 1:1000 every 5 minutes thereafter
- None
- None
-
Epinephrine Drip
Class
Action
Indications
Dosage
Side Effect
Contraindications
- Sympathomimetic
- Alpha and Beta adrenergic receptor agonist
- Bronchial asthma, acute allergic reaction, cardiac arrest, profound symptomatic bradycardia
- 1-4mcg/min
- Headache, nausea, restlessness, weakness, dysrhythmias, hypertension, angina pectoris precipitation
- Hypersensitivity, hypovolemic shock, coronary insufficiency, hypertension
-
Dextrose50
Class
Action
Indications
Dosage
Side Effect
Contraindications
- Carbohydrate
- Quick absorption of sugar for metabolism
- Hypoglycemic patient
- Adults: 25 g may repeat once. Peds: 0.5 g/kg. <5 kg - dilute D25% 1:1 with sterile water, 4 ml/kg. 5-15 kg, D25% 2ml/kg. >15kg, D50% 1ml/kg.
- None
- None
-
Versed
Class
Action
Indications
Dosage
Side Effect
Contraindications
- Class IV Benzodiazepine
- Sedative, hypnotic, amnesic
- Anxiety, conscious sedation, status seizures
- Adults: 0.1 mg/kg titrated to effect, to max. single dose of 5 mg, may be repeated once (2x dose Intranasal). Peds: give slowly over 3-5 min.
- CNS depression, hypotension, bradycardia, respiratory depression, nausea, vomiting, headache
- Known allergy, hypotension, acute narrow angle glaucoma
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Morphine
Class
Action
Indications
Dosage
Side Effect
Contraindications
- Narcotic
- CNS depression
- Severe pain, burns, pulmonary edema and CHF
- Adults: 2-5 mg titrated to pain relief, Peds: 0.1 mg/kg
- Respiratory depression, nausea, vomiting, bradycardia, orthostatic hypotension, decreased LOC
- Known opiate allergy, head/chest/abdominal injury, undiagnosed abdominal pain, signs of shock
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Narcan
Class
Action
Indications
Dosage
Side Effect
Contraindications
- Narcotic antagonist
- Reverses effects of narcotics
- Suspected narcotic use
- Adults: 2 mg titrated to effect at max. 10 mg. Peds: 0.1 mg/kg not exceeding adult dose
- Rapid administration can cause nausea and vomiting
- Known allergy
-
Nitroglycerin
Class
Action
Indications
Dosage
Side Effect
Contraindications
- Vasodilator
- Dilates systemic arteries and veins reducing preload and afterload
- Angina, suspected MI, pulmonary edema
- 0.4 mg every 5 min until pain relieved or Systolic BP<100
- Hypotension, headache, flushing
- Known allergy to medication, hypotension, right ventricle infarct, ED meds used within last 24 hours
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Glucose
Class
Action
Indications
Dosage
Side Effect
Contraindications
- Carbohydrate
- Quick absorption of sugar for metabolism
- Conscious hypoglycemic patients able to maintain their own airway
- 15 g
- 1 g/kg
- Possible vomiting
- None
-
Sodium Bicarbonate
Class
Action
Indications
Dosage
Side Effect
Contraindications
- Alkalinizing agent
- Increases blood pH
- Crush syndrome, tricyclic overdose, hyperkalemia
- 1 mEq/kg, repeat dose at 1/2.
- Hypokalemia
- Alkalosis, respiratory acidosis
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