DSU Paramedic medictions

nausea, vomiting, abdominal pain, GI Bleeding

Analgesic, anti-pyretic, anti-inflammatory

inhibits prostaglandin

mild fever and pain

Known sensitivity, chronic alcoholism, liver/renal disease, pregnancy, anemia

650-1000mg PO

10-15mg/kg max 75mg/kg PO

Stomach irritation, nausea, vomiting, anaphylactic reaction

Analgesic, anti-pyretic, anti-inflammatory, anti-platelet

Prevents the chemical thromboxane A2,

Chest pain that maybe cardiac origin

Known sensitivity, GI bleeds, bleeding disorders, hemorrhagic stroke, peptic ulcers, children with flu like symptoms, children under 12 years old,

324mg PO

Dizziness, drowsiness, orthostatic hypotension, blurred vision,

short acting benzodiazepine

Potentiates the actions of GABA

sedation, anxiety, status epilepticus

Known sensitivity to benzodiazepines and benzyl alcohol, pregnancy, closed angle glaucoma, COPD, sleep apnea

1-4mg over 2-5 minutes IV, IO

neonate 0.05mg/kg IV; children 0.1mg/kg max 4 mg IV, IO

Anxiety, dizziness, headache, palpitations, nausea, vomiting, dry mouth, blurred vision

Anti-cholinergic, bronchodilator

Inhibits interaction of acetylcholine receptors on the bronchial smooth muscles causing bronchodilation.

breathing difficulty, COPD

Known sensitivity to atropine, bromide, soybean or peanuts

0.5mg nebulizer

Tremors, anxiety, restlessness, tachycardia

5-14 years 0.25-0.5mg every 20 min. Max.3 doses nebulizer

Sympathomimetic, bronchodilator, beta 2 agonist

binds to the beta 2 receptors which relaxes smooth muscles causing bronchodilation

asthma, acute bronchospasm, bronchitis, emphysema

Known sensitivity, severe cardiac disease, heart block, tachycardia dysrhythmias

2.5mg max 3 doses Nebulizer

lightheadedness, dizziness, tingling, numbness, chest pressure or pain, hypotension, headache

older than 12: 0.5mg/kg/hr Younger than 12: 0.15mg/kg or 0.5mg/kg/hr Nebulizer

Antidysrhythmic

slows the impulses at the AV node

SVT

Known sensitivity, sick sinus syndrome, second and third degree heart block,

6mg repeat 12 mg IV followed by 10cc rapid flush

above 50kg use adult; under 50kg 0.1mg/kg repeat 0.2 mg/kg IV followed by 10cc rapid flush

Dry mouth, hot skin temperature, facial flushing, dilated pupils, photophobia, restlessness, tachycardia, paradoxical bradycardia

Anti- cholinergic parasympatholytic, anti-muscarinic, Antidysrhythmic

Blocks acetylcholine at the muscarinic receptors sites (blocks the vagal stimulation)

Symptomatic bradycardia, organophosphate poisoning

Known sensitivity to belladonna alkaloids, closed angle glaucoma, Acute MI, myasthenia gravis, GI obstruction

0.5mg 3-5 minutes max 3 mg poisoning: 2-6 mg IV, IO

• Adol: 0.02 mg/kg min.0.1 mg/kg max.1mg/dose total 2mg
• Peds: 0.02 mg/kg min.0.1 mg/kg max. 0.5 mg/dose total 1 mg IV, IO
• Poisoning 0.05 mg/kg every 10 min. IV, IO

Nausea, vomiting, diarrhea, constipation

Absorbent

Absorbs certain toxins

Toxic ingestion

Coma, GI obstruction, ingestions of acids, bases, Cyanide, lithium, Methanol, Ethanol,

1 g/kg PO

Headache, dizziness, tremors, hypotension, bradycardia, nausea, vomiting.

Antidysrhythmic

Prolongs duration of action potential and effective refractory period

Ventricular arrhythmias, second line agent for atrial arrhythmias

Known sensitivity, pregnancy, neonates, infants, cardiogenic shock.

Pulseless: 300mg repeat 3-5 min 150mg; Pulse: 150 in 100 mL over 10 minutes IV, IO

5 mg/kg (max. 300mg) R 3-5mins max 15 mg/kg Pulse: 5 mg/kg (max.300mg) repeat 10-60 min. max 15 mg/kg IV, IO

dizziness, drowsiness, hypotension, palpations, nausea, increased thick secretions, wheezing, chest tightness, blurred vision.

Antihistamine

H1 receptor antagonist

allergic reactions

Known sensitivity, acute asthma attack, lower respiratory tract disease, neonates.

older than 12 years 25-50mg IV, IO, IM

1-1.25 mg/kg IV, IO, IM

hypotension, bradycardia, nausea, vomiting, constipation.

Electrolyte

needed for maintenance of nervous, muscular, skeletal function, cardiac contractility, and blood coagulation.

Hypocalcemia, hypomagnesaemia, calcium blocker overdose

Hypercalcemia, digoxin toxicity, ventricular fibrillation.

500-1000mg over 10-15min. IV, IO

10-20 mg/kg IV, IO

Hyperglycemia, hypertension, nausea, necrosis at injection site

Carbohydrate

Increases the blood glucose levels

Hypoglycemia

Hyperglycemia, delirium tremens, intracranial and intraspinal hemorrhage

10-25g IV, IO

above 2 years 2mL/kg D50; less 2 years 2-4mL D10 IV, IO

headache, anxiety, palpations, tachycardia, hypertension, soft tissue necrosis, angina,

Adrenergic

Act on beta 1 and alpha receptors causing increased cardiac output and vasoconstriction

Hypotension after ROSC, Hypotension with the heart rate does not need to be increased, Symptomatic bradycardia when atropine has no effect

Ventricular fibrillation, tachydysrhythmias, pheochromocytoma, hypovolemia.

Cardiac; 5-10mcg/kg/min IV, IO Vasopressor; 10-20mcg/kg/min IV, IO

Tremors, anxiety, headache, palpations, tachycardia, hypertension, dysrhythmias, nausea, vomiting.

sympathomimetic

Stimulates the sympathic nervous system causing an increase heart rate, blood pressure, and bronchodilation.

Anaphylaxis, Bradycardia, acute bronchospasm

Closed angle glaucoma, nonanaphylactic shock, but none in an emergency

0.3-0.5 mg IM/Sub Q Brady; 1mcg/min IV infusion

0.01mg/kg max 0.5mg IM/Sub Q Brady; 1mcg/min IV infusion

Tremors, anxiety, headache, palpations, tachycardia, hypertension, dysrhythmias, nausea, vomiting.

sympathomimetic

Stimulates the sympathic nervous system causing an increase heart rate, blood pressure, and bronchodilation

Cardiac arrest

none in an emergency

Arrest; 1mg repeat every 3-5min. IV, IO

Arrest 0.01mg/kg repeat 3-5 minutes 0.01mg/kg repeat 3-5min IV, IO

Bradycardia, hypotension, nausea, vomiting, abdominal cramping, injection site reaction, cough, hiccups, apnea. laryngospasm.

anesthetic

unknown

Induction of general anesthesia

Known sensitivity, labor/delivery

above 10 years 0.2-0.6 mg/kg slowly IV

Dizziness, delirium, sedation, hypo or hypertension, nausea, vomiting, respiratory depression or arrest, muscle rigidity

Opioid analgesic

Binds the opioid receptors

Pain

Known sensitivity to opioids, myasthenia gravis,

older than 12 years 0.5-1 mcg/kg/dose IM or slow IV, IO

under 12 years 1-2 mcg/kg/dose IM or slow IV, IO

Orthostatic hypotension, polyuria, vertigo, cramps

loop diuretic

Inhibits the reabsorption of sodium and chloride at the distal and proximal tubule and in the loop of henle.

Hypertension emergencies, Pulmonary Edema, CHF

Known sensitivity, hypovolemia, renal impairment

40-80mg IV, IO

1 mg/kg IV, IO, IM

Nausea, vomiting, hypotension, rebound hyperglycemia, sinus tachycardia

Pancreatic hormone

converts glycogen into glucose

Hypoglycemia, beta blocker over dose

Known sensitivity, insulinoma, pheochromocytoma

Hypoglycemia; 1mg IV, IO, IM, SubQ Beta blocker OD 2-5mg IV, IO over 1 minute

under 20kg 0.5mg IV, IO, IM, SubQ

Tardive dyskinesia, drowsiness, headache, orthostatic hypotension, dry mouth, nausea, vomiting,

Anti-psychotic

Blocks postsynaptic dopamine receptors

psychotic episodes, agitation

Known sensitivity, depressed mental status, Parkinson’s disease

mild 0.5-2mg, Mod. 5-10 mg, severe 10mg OP/IM

Hypertension, anaphylaxis, headache, red colored urine, nausea, injections site reaction, photophobia.

Vitamin/Antidote

cyanide poisoning

Known sensitivity

5g over 10 min max 10 g IV, IO

70 mg/kg IV, IO

Headache, dizziness, seizures, hypotension, bradycardia

Antidysrhythmic

blocks the sodium channels and increases the action potential

Ventricular arrhythmias when Amiodarone is not available

Known sensitivity to amides, heart block, supraventricular dysrhythmias, Adam-stokes syndrome, Wolf-Parkinson-white syndrome.

1 mg/kg max 3 mg/kg IV, IO

1-4mg/min IV, IO

20-50mcg/kg/min IV, IO

Nausea, vomiting, cramps

Electrolyte/ anticonvulsant

Blocks peripheral neuromuscular transmission and a peripheral vasodilator

Torsades de pointes, preeclampsia, eclampsia, status asthmaticus

AV block, GI obstruction

torsade or arrhythmias 1-2g in 50-100mL DW5 over 5-60 min. IV,IO

25-50mg/kg over 10-20 min IV,IO

Drowsiness, dizziness, headache, sedation, respiratory depression

Opioid analgesic

Binds to the opioid receptors

Pain

Known sensitivity to opioids

50-150mg slowly PO/IM/Sub Q

1-2mg/kg slowly PO/IM/Sub Q

Drowsiness, dizziness, headache, sedation, respiratory depression

Opioid analgesic

Binds to the opioid receptors

Pain

Known sensitivity to opioids, shock, hypovolemia, head trauma

2-15mg IV, IO, IM, SubQ

0.2mg/kg IV, IO, IM, SubQ

Hypotension, tachycardia, nausea, vomiting, respiratory depression hiccups, laryngospasm.

short acting benzodiazepine

Binds to benzodiazepine receptors producing GABA effects

seizures, sedation, anxiety

Known sensitivity

1-2mg max 5mg, elderly or chronically ill 1-1.5mg max 3.5 IV, IO

above two months 0.15mg/kg IV, IO

Narcotic withdraw, combativeness, tachycardia, nausea, vomiting, seizures

Opioid agonist

Binds and blocks the opioid receptors

Narcotic overdose

Known sensitivity

0.4-2mg may repeat 1/3-2/3 original dose IV, IO, intranasally

under 5 or 20kg 0.1mg/kg IV, IO, intranasally

Headache, hypotension, dizziness, flushing, cardio vascular collapse

Nitrate/Vasodilator

Causes the vascular smooth muscles to dilate

Angina, hypertension emergency, CHF, Acute MI

Known sensitivity, increased intracranial pressure, erectile dysfunction medications.

0.4mg every 5 min. max of 3 doses Sublingual IV bolus: 12.5-25 mcg

5 mcg/min titrate to B/P

0.25-0.5mcg/kg/min

Seizures, hypo or hypertension, bradycardia or tachycardia, dysrhythmias, nausea, vomiting

Pituitary hormone

Causes uterine smooth to contract

Postpartum hemorrhage

Known sensitivity, second fetus, hypertonic uterus,

3-10 units IM after placenta delivery

Sedation, dizziness, allergic reaction, drowsiness, nausea, vomiting, dysrhythmias

anti-emetic/antihistamine

Competes with H1 receptors

Nausea, vomiting, allergic reactions

Known sensitivity, breastfeeding, coma, jaundice, Reye`s syndrome, bone marrow suppression

12.5-25 mg IV

Headache, anxiety, tremors, dizziness, palpations, tachycardia, hypertension, angina, nausea, vomiting, tissue necrosis.

Adrenergic

Alpha 1 agonist causing vasoconstriction

spinal and neurogenic shock, hypotension

Known sensitivity, ventricular fibrillation, tachycardia dysrhythmias, pheochromocytoma, closed angle glaucoma, severe hypertension

hypotension 2-5mg SubQ, IM 0.1-0.5mg IV shock: 100-180 mcg/min IV

Hypotension: 0.1mg/kg/dose SubQ, IM shock: 5-20mcg/kg followed by 0.1-0.5 mcg/kg/min IV

Bradycardia, hypotension, nausea, vomiting, abdominal cramping, injection site reaction, cough, hiccups.

anesthetic

Produces GABA like effects

Anesthesia

Known sensitivity to Propofol, soybean oil, eggs, benzyl alcohol.

40 mg over 10 seconds maintenance infusion: 100-200mcg/kg/min IV

Apena, respiratory depression, brady or tachycardia, nausea, vomiting, edema.

2.5-3.5mg/kg over 30 seconds 125-300mcg/kg/min IV

Neuromuscular blocker

Inhibits transmission of nerve impulses by binding with cholinergic receptors sites

Muscle relaxation, general anesthesia

Known sensitivity

0.6-1.2mg/kg IV

older than 3 months 0.6mg/kg IV

Metabolic alkalosis, muscle twitching, headache, irregular pulse.

alkalinizer

neutralizes acidosis

Metabolic acidosis

Metabolic alkalosis

1 mEq/kg repeat 0.5 mEq/kg IV

Apena, respiratory depression, brady or tachycardia, nausea, vomiting, edema.

neuromuscular blocker

Inhibits transmission of nerve impulses by binding with cholinergic receptors sites

Muscle relaxation, general anesthesia

Known sensitivity, malignant hyperthermia, trauma

0.3-1mg/kg max 150mg IV; maintenance 0.04-0.07mg/kg 5-10 minutes as needed

1mg/kg small children/infants 2mg/kg max 150mg IV; maintenance not recommended

irregular heart rate, bradycardia, tachycardia, blood in urine or stool, nose bleed, coughing up blood, bleeding around IV site

Thrombolytic enzyme

produces fibrin conversion of plasminogen to plasmin

Acute Myocardium infarction

Known sensitivity, active internal bleeding, history of CVA, known bleeding diathesis, severe uncontrolled hypertension, intracranial or intraspinal surgery or trauma within two months, intracranial neoplasm, ateriovenous malformation, or aneurysm

30 mg in 6 mL IV over five seconds

35 mg in 7mL IV over five seconds

40mg in 8 mL IV over five seconds

45 mg in 9 mL IV over five seconds

50mg in 10 mL IV over five seconds

Cardiac ischemia, angina

hormone

Causes vasoconstriction independent of the adrenergic

Asystole, PEA, adult shock refractory VF or pulseless VT, vasodilatory shock

Responsive patients with cardiac disease

40 units IV, IO.

Hypotension, apnea, tachycardia, flushing.

non depolarizing neuromuscular blocker

Inhibits transmission of nerve impulses by binding with cholinergic receptors sites

Muscle relaxation, general anesthesia

Known sensitivity

.08-0.1mg/kg IV, IO

Less than 1 years 0.1mg/kg

Muscle pain, headache, dizziness, drowsiness

anti-emetic

Binds the serotonin receptors

Nausea

Known sensitivity, GI obstruction

4-8 mg max of 16 mg IV, IM, PO

2-12 years 0.1mg/kg IV, IM, PO