master medic drugs Ind CI PC to MAY25

Albuterol

Ind: Brochospasm and asthma in COPD
CI: Hypersensitivity
PC: 1) tachycardia 2) anxiety 3) nausea 4) cough 5) wheezing 6) dizziness

Fentanyl

Ind: Induce sedation for endotracheal intubation
CI: 1) MAO inhibitors within 14 days 2) myasthenia gravis
PC: 1) increased intracranial pressure 2) elderly 3) debilitated 4) COPD 5) respiratory problems 6) hepatic and renal insufficiency

Ipratropium

Ind: 1) bronchospasm associated with asthma 2) COPD 3) inhaled irritants
CI: 1) hypersensitivity to atropine or its derivatives 2) as a primary treatment for acute bronchospasm 3) nut allergy
PC: 1) elderly 2) cardiovascular disease 3) hypertension

Morphine Sulfate

Ind: 1) moderate to severe pain & 2) in MI & 3) to reduce venous return in pulmonary edema
CI: 1) hypersensitivity to opiates 2) undiagnosed head or abdominal injury 3) hypotension or volume depletion 4) acute bronchial asthma 5) COPD 6) severe respiratory depression 7) pulmonary edema due to chemical inhalation
PC: 1) elderly 2) children 3) debilitated [naloxone available to counteract effects of morphine]

Naloxone

Ind: 1) narcotic overdose 2) coma of unknown origin
CI: 1) hypersensitivity to the drug 2) non-narcotic induced respiratory depression
PC: 1) possible dependency (including newborn) 2) shorter half-life than narcotics: (pt may relapse)

DIAZEPAM

Ind: 1) major motor seizures 2) status epilepticus 3) premedication before cardioversion 4) muscle tremors due to injury 5) acute anxiety
CI: 1) shock 2) coma 3) acute alcoholism 4) depressed vital signs 5) obstetric patients 6) neonates
PC: 1) psychoses 2) depression 3) myasthenia gravis 4) COPD. (Due to a short half-life of the drug, seizure activity may recur.)

ETOMIDATE

Ind: Induce sedation for rapid sequence intubation. CI: none
PC: 1) marked hypotension 2) severe asthma 3) severe cardiovascular disease

FLUMAZENIL

Ind: respiratory depression secondary to the benzodiazepines.
CI: 1) hypersensitivity to flumazenil or benzodiazepines 2) patients who
take medication for status epilepticus or seizures 3) seizure-prone
patients during labor and delivery 4) tricyclic antidepressant overdose
PC: 1) hepatic impairment 2) elderly 3) pregnancy 4) nursing mothers 5) head injury 6) alcohol and drug dependency 7) physical dependence on
benzodiazepines

MIDAZOLAM

Ind: to induce sedation before cardioversion or intubation
CI: 1) hypersensitivity to benzodiazepines 2) narrow-angle glaucoma 3) shock 4) coma 5) acute alcohol intoxication
PC: 1) COPD 2) renal impairment 3) CHF 4) elderly

SUCCINYLCHOLINE

Ind: facilitated endotracheal intubation
CI: 1) family history of malignant hyperthermia 2) penetrating eye injury 3) narrow-angle glaucoma 4) hyperkalemia
PC: 1) severe burn 2) crush injury 3) spinal cord injury

ADENOSINE

Ind: narrow, complex paroxysmal supraventricular tachycardia refractory tovagal maneuvers.
CI: 1)2nd & 3rd degree heart block 2)sinus node disease 3)asthma.
PC: may cause transient dysrhythmias - especially asystole, COPD.

EPINEPHRINE

Ind: 1)restore rhythm in cardiac arrest 2)severe allergic reactions
CI: 1)narrow angle glaucoma 2)hemorrhagic, traumatic, or cardiac shock 3)during labor
PC: none

VASOPRESSIN

Ind: 1)to increase peripheral vascular resistance in arrest (CPR) 2)control bleeding from esophageal varices
CI: 1)PVCs 2)1st stage of labor.
PC: 1)epilepsy 2)migraine 3)heart failure 4)angina 5)vascular disease 6)hepatic impairment 7)elderly 8)children

ATROPINE

Ind: 1)hemodynamically significant bradycardia 2) brady asystolic arrest 3)organophosphate poisoning
CI: none in emergency setting. 2nd degree type 2 & above heart blocks are class 2B (not recommended)
PC: 1) AMI 2)glaucoma

Asperin

Ind: Chest pain suggestive of an MI.
CI: 1)hypersensitivity to salicylates 2)active ulcer disease 3)asthma.
PC: bleeding disorders

Dextrose 50% in Water

Ind: hypoglycemia
CI: none in hypoglycemia
PC: 1)increased ICP 2)determine blood glucose level before administration 3)ensure good venous access

Furosemide

Ind: 1)congestive heart failure 2)pulmonary edema.
CI: hypotension
PC: 1)hepatic impairment 2)nephrotic syndrome
3)cardiogenic shock associated w/ acute MI 4)gout 5)PTs receiving digitalis or potassium-depleting steroids.

Nitroglycerin

Ind: 1)chest pain associated w/ angina & acute myocardial infarction, 2)acute pulmonary edema.
CI: 1)hypersensitivity 2)tolerance to nitrates 3)severe anemia 4)head trauma 5)hypotension 6)increased ICP 7)PTs taking sildenafil 8)glaucoma 9)shock
PC: 1)may induce servere headache 2)nitroglycerin is light sensitive & will lose potency when exposed to the air.

Dobutamine

Ind: increase cardiac output in CHF/cardiogenic shock
CI: 1)hypersensitivity to Sympathomimetic amines 2)ventricular tachycardia 3)hypovolemia without fluid resuscitation
PC: 1)atrial fibrillation 2)preexisting hypertension

Dopamine

Ind: Nonhypovolemic hypotension (70 to 100 mmHg) & cardiogenic shock
CI: 1)hypovolemic hypotension w/out aggressive fluid resuscitation 2) tachydysrhythmias 3) ventricular fibrillation 4)pheochromocytoma
PC: 1)occlusive vascular disease 2)cold injury 3)arterial embolism 4)ensure adequate fluid resuscitation of the hypovolemic PT

Isoprotenerol

Ind: bradycardia refractory to atropine when pacing is not available
CI: cardiogenic shock
PC: tachydysrhythmias & those associated w/ digitalis & acute myocardial infarction

Tetracaine

Ind: eye injuries or foreign body
CI: hypersensitivity
PC: 1)be monitored 2)hyperthyroid disease 3)cardiac diseases

Amiodarone

Ind: 1)life-threatening ventricular & supraventricular dysrhythmias 2)frequently atrial fibrillation.
CI: 1)cardiogenic shock 2)severe sinus bradycardia 3)advanced heart block.
PC: none

Bretylium

Ind: ventricular fibrillation & ventricular tachycardia refractory to lidocaine
CI: none
PC: 1)digitalized patients 2)digitalis-induced dysrhythmias

Lidocaine

Ind: 1)pulseless ventricular tachycardia 2)ventricular fibrillation 3)ventricular tachycardia (w/ pulse)
CI: 1)hypersensitivity to amide-type local anesthetics 2)supraventricular dysrhythmias 3)stokes-adams syndrome 4)2nd- & 3rd-degree heart blocks 5)bradycardias
PC: 1)hepatic or renal impairment 2)CHF 3)hypoxia 4)respiratory depression 5)hypovolemia 6)myasthenia gravis 7)shock 8)elderly

Procainamide

Ind: ventricular fibrillation and pulseless ventricular tachycardia refractory to lidocaine.
CI: hypersensitivity to procainamide or procaine, myasthenia gravis, & 2nd- or 3rd-degree heart block.
PC: hypotension, cardiac enlargement, CHF, AMI, ventricular dysrhythmias
from digitalis, hepatic or renal impairment, or bronchial asthma.

DILTIAZEM

Ind: supraventricular tachydysrhythmias (atrial fibrillation, atrial flutter, & PSVT refractory to adenosine) & to increase coronary artery perfusion in angina.
CI: 1) hypersensitivity 2)sick sinus syndrome 3)2nd or 3rd degree HB 4)systolic BP < 90, diastolic BP < 60 5)wide-complex tachycardia
6)WPW
PC: CHF (especially with beta blockers)

TRIDIL

Ind: help relieve the pain associated with angina that does not respond to oral (by mouth) treatment; to control blood pressure; & help treat CHF
CI: hypotension, uncorrected hypovolemia, increased intracranial pressure, constrictive pericarditis & pericardial tamponade
PC: headache, severe hypotension, reflex tachycardia

VERAPAMIL

Ind: PSVT refractory to adenosine, atrial flutter, & atrial fibrillation w/ rapid ventricular response
CI: severe hypotension, cardiogenic shock, 2nd or 3rd degree heart
block, CHF, sinus node disease, & accessory AV pathways, WPW
syndrome. It should not be administered to persons taking beta blockers
PC: none

METOPROLOL

Ind: AMI
CI: 1)cardiogenic shock 2)sinus bradycardia <45 3)2nd & 3rd degree HB 4)PR interval >0.24 5)asthma or COPD
PC: 1) hypersensitivity 2)hepatic or renal impairment 3)cardiomegaly 4)CHF controlled by digitalis & diuretics 5)AV conduction defects 6)thyrotoxicosis 7)diabetics 8)peripheral vascular disease

Activated Charcoal

Ind: acute ingested poisoning
CI: none
PC: administer only after emesis or in those cases where emesis is CI

Calcium Chloride

Ind: hyperkalemia, hypocalcemia, hypermagnesemia, & calcium channel blocker toxicity
CI: ventricular fibrillation, hypercalcemia, & possible digitalis toxicity
PC: may precipitate toxicity in PTs taking digoxin. ensure the IV line is in a large vein & flushed before using & after calcium

Methylprednisolone

Ind: spinal cord injury, asthma, severe anaphylaxis, COPD.
CI: no major CIs in the emergency setting.
PC: only a single dose should be given in the prehospital setting.

MAGNESIUM SULFATE

Ind: 1)refractory V-Fib 2)pulseless V-Tach (especially torsade depointes) 3)AMI 4)eclamptic seizures.
CI: 1)HB 2)myocardial damage 3)shock 4)persistent hypertension 5)hypocalcemia.
PC: 1)other CNS depressants 2)neuromuscular blocking agents.

PHENYTOIN

Ind: 1)seizures 2)status epilepticus 3)cardiac dysrhythmias secondary to digitalis toxicity.
CI: 1)hypersensitivity to hydantoin products 2)seizures due to hypoglycemia 3)sinus bradycardia 4)HB 5)Adams-Stokes syndrome.
PC: 1)hepatic or renal impairment 2)alcoholism 3)cardiogenic shock
4)elderly 5)debilitated patients 6)diabetes 7)hyperglycemia
8)bradycardia 9)HB 10)respiratory depression

SODIUM BICARBONATE

Ind: 1)tricyclic antidepressant and barbiturate overdose 2)refractory acidosis 3)hyperkalemia.CI: none when used in severe hypoxia or late cardiac arrest.PC: 1)may cause alkalosis if given in too large a quantity 2)may deactivate vasopressors 3)may precipitate w/ calcium chloride.

THIAMINE

Ind: 1)coma of unknown origin 2)chronic alcoholism w/ associated coma 3)delirium tremens.
CI: none.
PC: known hypersensitivity to the drug.

DIPHENHYDRAMINE

Ind: 1)anaphylaxis 2)allergic reactions 3)dystonic reactions
CI: asthma and other lower respiratory diseases
PC: may induce 1)hypotension 2)headache 3)palpitations 4)tachycardia 5)sedation 6)drowsiness 7)disturbed coordination

LORAZEPAM

Ind: sedation for cardioversion and status epilepticusCI: sensitivity to benzodiazepinesPC:
1)narrow-angle glaucoma 2)depression 3)psychosis 4)coma 5)shock 6)acute
alcohol intoxication 7)renal or hepatic impairment 8)organic brain
syndrome 9)myasthenia gravis 10)GI disorders 11)elderly 12)debilitated
13)limited pulmonary reserve

METOCLOPRAMIDE

Ind: nausea &amp; vomitingCI: 1)hypersensitivity 2)allergy to
sulfite agents 3)seizure disorders 4)pheochromocytoma 5)mechanical GI
obstruction or perforation 6)breast cancerPC: 1)CHF 2)hypokalemia 3)renal impairment 4)GI hemorrhage 5)intermittent porphyria

ZOFRAN

Des: selective blocking agent of the serotonin 5-HT3 receptor type
Ind: prevention of nausea &amp; intractible vomiting
CI: None
PC: may mask a progressive ileus &amp;/or gastric distension

CHLORDIAZEPOXIDE

Des: benzodiazepine derivative that produces 1)mild sedation
2)anticonvulsant 3)skeletal muscle relaxant 4)prolonged hypnotic effectsInd: 1)severe anxiety &amp; tension 2)acute alcohol withdrawal symptoms (DTs)CI: 1)hypersensitivity to benzodiazepines 2)pregnant and nursing mothers 3)children under 6PC: 1)primary depressive disorders or psychoses 2)acute alcohol intoxication