All Drugs for Paramedic

Antidysrhythmic

Slows the conduction of electrical impulses at the AV node

Slows the conduction of electrical impulses at the AV node

Sick Sinus Syndrome, 2nd or 3rd degree Heart blocks, poison or drug induced tachycardia

Impending doom, complaints of flushing, chest pressure, numbness. *Patients will have a brief episode of asystole after administration.*

• 1) 6mg rapid IV/IO over 1-3 seconds followed by 20cc NS (wait 1-2 minutes)
• 2) 12mg rapid IV/IO over 1-3 seconds followed by 20cc NS

Bronchodilator, Beta/sympathetic agonist

Stimulates Beta 2 adrenergic receptors (relaxes bronchial smooth muscles)

Asthma, Bronchitis with bronchospasm, COPD, Allergic reactions

Angioedema, Sensitivity to drug, Use with caution in cardiovascular disorders, cardiac arrhythmias, and lactating patients

Hyperglycemia, Hypokalemia, Palpitations, Tach, Anxiety, Tremors, N/V, throat irritation, dry mouth, HTN, Headache, paradoxical bronchospasm.

• 1) 2.5mg over 5-15min
• 2) Repeat if needed
• **Beta blockers may blunt the effects of Albuterol**

Antidysrhythmic

Delays repolarziation and increases the duration of the action potential. Slows sinus rate, increases PR and QT intervals, decreases peripheral vascular resistance

Ventricular arrhythmias. Second-line agent for atrial arrhythmia

Sick Sinus Syndrome, 2nd and 3rd degree Heart block

Hypotension & Bradycardia

• 1) 300mg IV/IO (wait 3-5min)
• 2) 150mg IV/IO

• 1) 150mg IV/IO in 100mL D5W over 10 minute period (wait 10min may repeat again if needed)
• 2) 150mg IV/IO

Antiplatelet, Non-narcotic analgesic, antipyretic

Prevents formation of thromboxane A2 (platelet inhibitor), Anti-inflammatory

Fever, Inflammation, Angina, acute MI, Patients presenting with chest pain, pressure, squeezing, or crushing in the chest that may be cardiac in origin

GI bleeding, Active ulcer disease, Hemorrhagic stroke, Bleeding disorders, Children with chicken pox, sensitivity

Anaphylaxis, Angioedema, Bronchospasm, Bleeding & stomach irritation, N/V

325mg PO (4 81mg baby ASA)

325-650mg PO every 4-6 hours

Parasympatholytic

Increases heart rate, Competes reversibly with acetylcholine

Symptomatic bradycardia, asystole or PEA

Known sensitivity

Dry mouth, hot skin, facial flushing, blurred vision, dilation of pupils. May cause paradoxical bradycardia if administered too slow

0.5mg IV/IO (rapid) every 3-5 min

• 1mg IV/IO (rapid) every 3-5 min
• 2-2.5mg diluted in 5 to 10 mL of NS

2 to 4mg IV/IO/IM, repeat if needed every 20-30min until symptoms resolve

Electrolyte

Increases cardiac contractility

Hyperkalemia, Hypocalcemia, Hypermagnesemia, Calcium channel blocker

V fib, Digitalis toxicity, Hypercalcemia

Tissue necrosis, Hypotension, Bradycardia (if administered too rapidly)

500-1000mg of a 10% solution IV/IO administered SLOWLY

Calcium Channel Blocker

• Prolongs conduction of electrical impulses through the AV node. Causes
• vasodilation. Decreases rate of ventricular response. Decreases
• myocardial oxygen demand

Ventricular rate control in rapid A fib/A flutter

Hypotension, Heart block, Heart failure

Flushing, Headache, Bradycardia, Hypotension, Heart Block, Myocardial Depression, Severe AV block, Cardiac Arrest

• 1) 0.5mg/kg IV/IO over 2 minutes
• 2) 0.35mg

Carbohydrate

Increases blood glucose concentrations

Hypoglycemia

Intracranial and intraspinal hemorrhage. Delirium tremens

Hyperglycemia, Warmth, Burning from IV infusion.

25g (50mL) IV/IO

Benzodiazepam

Enhances the effects of GABA. Can produce any level of CNS depression (including sedation, muscle relaxation, anticonvulsant activity)

Anxiety, Skeletal muscle relaxation, Alcohol withdrawl, Seizures, Sedation for cardioversion

Central Nevous System Depression, Alcohol Intoxication, Acute-angle Glaucoma

Respiratory Depression, Drowsiness/fatigue, Headache, Nausea, Confusion, Oversedation, Hypotension

• Moderate- 2-5mg slow
• Severe- 5-10mg slow

10mg

5-10mg slow every 10-15min (max dose 30mg)

5-15mg

Sympathomimetic, Adrenergic Agonist, Inotropic

Stimulates Alpha and Beta adrenergic receptors

• Hypotension, Decreased cardiac output associated with cadiogenic shock and septic shock.
• Hypotension after cardiac arrest.
• Symptomatic bradycardia unresponsive to atropine.

Hypovolemic Shock, V-Fib, V-Tach or other ventricular arrhythmias

Tachycardia, Skin Necrosis, Severe Hypertension, Angina, Headache, Nausea and Vomiting

2-20mcg/kg/min IV/IO

5-10mcg/kg/min

10-20mcg/kg/min

Sympathomimetic, Adrenergic Agent, Inotropic

• Binds with Alpha and Beta receptors
• Increases cardiac contractile force
• Increases heart rate
• Increases blood pressure
• Bronchodilation.

Bronchial Asthma, COPD, Allergic Reactions and Anaphylaxis, Restoration of cardiac activity in cardiac arrest

Arrhythmias other then V-Fib, Asystole, PEA. Cardiovascular disease. Hypertension. Stroke. Shock. Pregnant women. Allergy to

Palpations, Tachycardia, Anxiousness, Headache, Tremors, Chest Pains

1mg (1: 10,000) repeat every 3-5min

1mcg/min (1:10,000) IV infusion

0.3mg to 0.5mg (1:1,000) IM or SubQ (may repeat in 10min max dose 1mg)

0.1mg (1:10,000) IV slowly over 5 minutes

Potent Loop Diuretic

Inhibits the absorption of sodium and chloride ions and water in the loop of Heinle

CHF, Pulmonary Edema, Allergic Reactions

Allergy to

Vertigo, Dizziness, Weakness, Hypokalemia

40mg IV, slowly over 2min period

40-80mg IV

Hormone (antihypoglycemic agent)

Converts glycogen to glucose, Elevates blood glucose levels, Increases heart rate, Increases heart rate

Hypoglycemia, Choking, Beta Blocker Overdose

Allergy to

Hyperglycemia, Nausea and Vomiting, Hypotension, Tachycardia

1mg IV

• 1) 2-5mg IV over 1 minute
• 2) 10mg IV

Antidysrhythmic

Blocks sodium channels & increases recovery period after repolarization

Ventricular Arrhythmias, Cardiac Arrest from V-Fib/V-Tach

AV block, Bleeding, Allergy to

Seizures, Cardiac Arrhythmias, Hypotension, Cardiac Arrest

• 1) 1-1.5mg/kg
• 2) 0.5-0.75mg/kg every 5-10min (max dose 3mg/kg)

• 1) 0.5-0.75mg/kg
• 2) 0.5-0.75mg/kg every 5-10 min (max dose 3mg/kg)

Benzodiaxepine, Anxiolytic, Sedative

Interacts with GABA, antianxiety effects, sedation, reduction of seizure activity

Anxiety, Seizure, Sedation

Allergy to. Altered LOC, Sleep Apnea

Hypotension, bradycardia, respiratory depression, apnea, dizziness, fatigue, amnesia, drowsiness.

4mg slowly

• Seizure: 4mg/IV over 2min
• Sedation: 2mg/IV
• Anxiety: 2mg/IV

Anticonvulsant, Antidysrhythmic, Electrolyte, Mineral

Controls seizures by blocking peripheral neuromuscular transmission

Torsades De Pointes. Cardiac arrhythmias associated with hypomagnesmia. Eclampsia. Status Asthmaticus

AV block, GI obstruction

1-2g in 10mL D5W IV over 5-10min

1-2g in 50-100mL D5W over 5-60 min, follow with 0.5-1g IV titrate to control torsades de pointes

4-6g IV over 20-30min, followed by an infusion of 1-2g per hour

1.2-2g slow over 20min

Narcotic, Opiate Agonist

Binds with opiate receptors. Reduces heart rate, cardiac work and myocardial oxygen demand

Moderate to severe pain. Chest pain associated with acute coronary syndrome. CHF. Pulmonary edema.

Respiratory depression, Shock, Allergy to

Respiratory depression, Hypotension, Nausea and Vomiting, Dizziness, Bradycardia, Seizures, Cardiac arrest.

2.5-15mg slowly over several minutes

2-4mg slowly over 1-5minutes

Narcotic antagonist, Opioid antagonist

Binds with opioid receptor and blocks the effects of narcotics

Narcotic overdose.

Allergy to

Nausea and Vomiting, Restlessness, Tachycardia, Hypertension, Tremors, Seizures, Cardiac Arrest, Narcotic Withdrawl.

0.4 – 2mg IV, IO, ET, IM, SubQ or 2mg intranasally.

Antianginal

Vascular smooth muscle relaxant

Chest pain or discomfort, Myocardial Ischemia associated with cocaine intoxication.

Hypotension, Children, Severe Bradycardia or Tachycardia, ICP, ED meds, Allergy to, Uncorrected Hypovolemia.

Headache, Lightheadedness, Hypotension, Bradycardia, Cardiovascular Collapse

• Sublingual: 0.4mg at 5 minute intervals
• Spray: 0.4mg at 5 minute intervals
• Paste: 1-2 inches

Antiemetic

Selective 5-HT3 receptor antagonist

Profound nausea and vomiting in Pts over 12

Allergy to. Hypotension, Altered LOC, COPD, Sleep Apnea

Drowsiness, Hypertension, Hypotension, Respiratory Depression

4mg IV/ IM over 2-5min

Antidysrhythmic

Decreases myocardial excitability. Slows atrial and intraventricular conduction. Prolongs ventricular repolarization

Atrial and ventricular dysrhythmia. PVC’s and recurrent VT not controlled by Lidocaine

Allergy to

Hypotension, Ventricular dysrhythmias, Heart Block, widening QRS complex, lengthened QT interval.

20mg/min to a max of 17mg/kg, until dysrhythmia is suppressed, followed by IVPB infusion

1g in 500-1000mL D5W or NSS at 104mg/min to a max dose of 17mg/kg

Electrolyte

Counteracts existing acidosis.

Acidosis, Drug intoxications, Antidepressant overdose, late management to cardiac arrest

Metabolic alkalosis.

Metabolic alkalosis, Hypernatremia, Sodium and fluid retention, edema

• 1) 1 mEq/kg IV slowly repeat after 10min
• 2) 0.5 mEq/kg

Hormone, Nonadrenergic Vasoconstrictor

Causes vasoconstriction. Antidiuretic hormone

Shock. VF or Pulseless VT, Asystole, PEA

Responsive patients with cardiac disease

Cardiac Ischemia, Angina, Hypertension, Bradycardia

• 40U IV single dose only!
• *May replace either the first or second dose of epinephrine.

Calcium Channel Blocker

Slows conduction, prolongs refractory period in the AV node

Narrow complex SVT unresponsive to adenosine and not requiring cardioversion. Rapid A-fib/flutter

Allergy to. Hypotension, Sick Sinus Syndrome, 2nd or 3rd degree Heart Block, WPW, Pts taking beta blockers

Hypotension, Bradycardia, Heart Block, Asystole, Dizziness, Headache, Nausea an Vomiting

• 1) 2-2.5mg slowly over 2-3min
• 2) 5-10mg slowly over 15-30min (max dose 30mg)

Corticosteroid, Anti-Inflammatory

Minimizes allergic responses by inhibiting histamine formation and storage, inhibiting histamine release from mast cells

Allergic reactions, Severe anaphylaxis, Asthma, COPD

Allergy to

fluid retention, CHF, HTN, Tachycardia, Vertigo, Headache, Nausea and Vomiting

40-250mg SIVP at 25mg/min or deep IM

Terbutaline (Breathine, Bricanyl)

Immediate bronchodilation, stimulates beta 2 adrenergic receptors, produces relaxation of bronchial smooth muscles and bronchodilation

Bronchial asthma, reversible bronchospasm associated with chronic bronchitis and emphysema.

Allergy to, significant tachycardia

Palpations, anxiety, dizziness, nervousness, tremors, Hypertension, Headache, Nausea an Vomiting, Chest Pains, Arthythmias

0.25mg SubQ or IM every 20min for 3 doses

Aromatic

Irritates the peripheral sensory receptors of the nasal septum, causing reflex stimulation of the respiratory and vasomotor centers.

Syncope

Respiratory distress, cardiac symptoms, neurological deflects, trauma

Bronchospasm, wheezing, airway irritation, pulmonary edema, laryngospasm, stridor, cough

Hold inhalant 4inches from face

Bronchodilator, sympathetic agonist

Relaxes bronchial smooth muscle through beta2 adrenergic receptors

Relaxes bronchial smooth muscle through beta2 adrenergic receptors

Allergy to. Cardiac dysrhythmias, significant tachycardia

Tachycardia, Palpations, Irritable Dysrhythmia, Hypotension, Anxiety, Dizziness, Headache, Tremors, Nausea an Vomiting

2-3 inhalations every 2 minutes. 0.65mg per dose.

10-15mg diluted in 2-3mL NSS, given over 5-15minutes.

Bronchodilator, Anticholinergic

Antagonizes the acetylcholine receptors on bronchial smooth muscle, producing bronchodilation

Asthma, Bronchospasm associated with COPD

Allergy to. Closed angle glaucoma, bladder neck obstruction, prostatic hypertrophy

Paradoxical acute bronchospasm

Nebulizer, 0.5mg every 6-8hours

Synthetic Hormone

Causes rhythmic contractions of the uterine smooth muscles. Decreases bleeding from the uterine vessels

Postpartum hemorrhage after birth of the placenta

Allergy to

Hypertenstion, Hypotenstion, Water Retention, dysrhythmias, seizures, coma, subarachnoid bleeding, uterine spasms, uterine rupture

• IV piggy back: 10-20 units in 500-1000 mL of NSS, run at 1-2mL/min, titrate to severity of bleeding and uterine response
• IM: 3-10 units.

Antipsychotic Agent

Selectively blocks postsynaptic dopamine receptors

Psychotic Disorders, Agitation

Depressed mental status, Parkinsons disease

Drowsiness, Hypotension, Hypertension, Vtach, tachycardia, QT prolongation, torsades de pointes

• Mild: 0.5- 2mg PO or IM Moderate: 5-10mg PO or IM
• Severe: 10mg PO or IM

Chemical absorbent

Binds with drugs and chemicals within the GI tract and decreases intestinal absorption

Oral poisoning, overdose and/or ingestion of drugs or chemicals

Pediatrics <35kg, Decreased level of consciousness, Ingestion of poisonings due to cyanide, corrosives, petroleum distillates, furrous sulfate (iron), ethanol, methanol, lithium, due to their large molecular size

Vomiting, Constipation, Black stool

1g/kg PO (75gm is typical)

Methylxanthine brochodilator

Relaxes smooth muscles of the bronchial airways and pulmonary blood vessels. May have anti-inflammatory properties. Increases heart rate and contractility

Bronchospasm

Allergy to

Seizure, Cardiac arrest, arrhythmias, nausea, vomiting, abdominal pain or cramping, headache, tachycardia, palpations, anxiety, ventricular arrhythmias

250-500mg in 100 mL D5W, administer over 20-30 minutes, do not exceed 20mg/min

Benzodiazepine

Binds to the benzodiazepine receptor and enhances the effects of GABA. Produces short-acting CNS depression

Sedation, Anxiety, Skeletal muscle relaxation, Sedation before cardioversion

Acute angle glaucoma, Pregnant women, Allergy to

Sedation, Depressed respiratory system

1 – 2.5mg IV/IO

Sedative/Hypnotic, Anesthesia

Unknown. Appears to have GABA like effects.

Rapid sequence intubation, induction of anesthesia

Allergy to. Pregnant women, nursing mothers

Hypotension, Respiratory depression, nausea/vomiting, adrenal insufficiency, Hyperventilation, Hypoventilation, Apnea, Laryngospasm, Cardiac arrhythmias

0.1-0.3mg/kg IV over 15-30 seconds. (typical adult intubating dose of etomidate is 20mg slow IV

Narcotic Analgesic

Binds to opiate receptors producing analgesia and euphoria

Severe pain, adjunct to rapid-sequence induction/sedation. Maintenance of analgesia

Allergy to. Respiratory depression

Sedation, Depressed respiratory system, Hypotension, Nausea, Vomiting, dizziness, bradycardia, tachycardia, palpations, hypertension, syncope

25-100mcg/kg IM or slow IV/IO

Neuromusclar blocker

Competes with acetylcholine, resulting in muscle paralysis

To induce neuromuscular blockade for the use of ET intubation

Malignant hyperthermia, burns, trauma.

Anaphylactiod reactions, respiratory depression, apnea, bronchospasm, cardiac arrhythmias, hypertension, hypotension

• 0.5mg/kg IV/IO
• 3-4mg/kg IM (max 150mg)

Antihistamine

Binds and blocks H1 histamine receptors

Anaphylactic reactions

Asthma (can thicken secreations), Allergy to, Pts with cardiac histories

Tachycardia, PVC’s, Hypertension, Hypotension, Palpations, Arrhythmias, Sedation

25-50mg IV/IM/IO

ACE- inhibitior

Blocks angiotensin converting enzymes, preventing formation of angoitesion II. Improves cardiac output

Congestive heart failure

Hypotension, Allergy to, Pregnancy

Hypotension, chest pain, hyperkalemia, nausea, vomiting, diarrhea, abdominal pain, loss of appetite, dizziness, headache.

0.625mg - 1.25mg IV

ACE- inhibitior

Blocks angiotensin converting enzymes, preventing formation of angoitesion II. Improves cardiac output

Congestive heart failure

Hypotension, Allergy to, Pregnancy

Hypotension, chest pain, hyperkalemia, nausea, vomiting, diarrhea, abdominal pain, loss of appetite, dizziness, headache.

25mg sublingual

Adrenergic beta -1 agonist, inotropic agent

Increases inotrophy (contractility) with litte effect on chronotropy (heart rate) or vasculatures. Indications: Congestive heart failure

Congestive heart failure

Hypovolemia shock

Palpations, tachycardia, PVC's, hypertension, chest pain, nervousness, headache, leg cramps

2-5mcg/kg/min Drip only

Anticoagulant

Inhibits the formation of new clots

Symptomatic bradycardia unresponsive to atropine when external pacing is not available or not effective. Severe status asthmaticus

Tachycardia, V-tach, Cardiac Arrest, AMI, Hypotension

Chest pain, ventricular irritability, tachydysrhythmias, V-fib, hypertension, hypotension, headache, nervousness, anxiety, excitement, fatigue, nausea, vomiting

2-20mcg/min IVPB

Sympathomimetic, pure beta agonist

Increases blood pressure and cardiac output by increasing the "big 4" through beta-1 stimulation

Symptomatic bradycardia unresponsive to atropine when external pacing is not available or not effective. Severe status asthmaticus.

Tachycardia, V-tach, Cardiac Arrest, AMI, Hypotension

Chest pain, ventricular irritability, tachydysrhythmias, V-fib, hypertension, hypotension, headache, nervousness, anxiety, excitement, fatigue, nausea, vomiting

2-20mcg/min IVPB

Vitamin B1

Combines with adenosine triphosphate

Wernkcke-Korsakoff syndrome

Allergy to

Itching, rash, pain at injection site

100mg IV/IO