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Medications - Classifications, Indications, Contraindications

Home Get App Take Quiz Create Albuterol Sulfate (Proventil) Classifications: -B2 selective sympathomimetic -beta agonist Indications: -Asthma -COPD -Wheezing -Reactive Airway Disease -Hyperkalemia Contraindications: - Not indicated in cardiac wheeze Adult: - Broncho-constriction/wheezing/hyperkalemia 2.5mg in 3mL NSS Administered nebulized with 5-8LPM of 02 Pediatric: - Broncho-constriction/wheezing/hyperkalemia 2.5mg in 3mL NSS Administered nebulized with 5-8LPM of 02 Atropine (Atropine) Classifications: - Anticholinergic - Parasympatholytic Indications: - Hemodynamically compromised symptomatic bradycardia (non-ami) - Symptomatic Sinus Arrest or Block - AV block at the Junctional Level - Slow PEA - Asystole - Organophosphate poisoning, cholinesterase inhibiting pesticides, sarin, Parathion and certain chemical weapons (SLUDGEM symptoms) Contraindications: - Contraindicated with heart transplant as there is no parasympathetic connection to the heart due to the vagus nerve being severed Adult: - All cardiac indications 0.5 to 1.0mg IVP q 3-5 min up to max 3mg or 0.04 mg/kg rapidly Alternatively it can be given via ETT at 2.0 to 2.5x IV dosage - Organophosphate poisoning 1-2mg q 5min Pediatric: - All cardiac indications Max 0.04mg/kg - min dose 0.1mg 0.02 mg/kg IVP Alternatively can be given ETT at 2.0 to 2.5X IV dose - Organophosphate poisoning 0.05mg/kg IV q. 10-20 min Bumetanide (Bumex) Classifications: - Loop diuretic Indications: - Pulmonary edema - Fluid overloaded patient Contraindications: - None when clinically indicated Adult: - Diuretic 0.5 - 2.0mg IV Push given over 2 minutes q 2-3 hours Note - 1mg of Bumex = 40mg of Lasix Max dose 10mg per day Pediatric: - Not recommended for pediatric patients Diazepam (Valium) Classifications: - Benzodiazepine - Anticonvulsant; Sedative-hypnotic Indications: - Seizures - Acute Agitation - Cocaine Overdose Contraindications: - Contraindicated with CNS depression and respiratory depression - Use caution in elderly patients Adult: - Seizures 5mg IV push SLOWLY - Cocaine overdose/Acute agitation 5-10mg IVpush SLOWLY Pediatric: - Seizures 0.1mg/kg IV push 0.5mg/kg PR Diphenhydramine (Benadryl) Classifications: - Antihistamine - Anticholinergic (Antimuscarinic) Indications: - Relief of symptoms from allergic reactions - Anticholinergic - used to treat acute dystonic response (stiff gait, cog wheel rigidity), extrapyramidal reactions to antipsychotic drugs (Haldol, Thorazine, Compazine) Contraindications: - None when clinically indicated Adult: - Allergic reaction/Dystonic response 25-50mg IV push or deep IM Pediatric: - All indications 1mg/kg IV push or IM Dexamethasone Sodium Phosphate (Decadron) Classifications: - Synthetic Steroid (long-lasting glucocorticoid) Indications: - Asthma / Croup - Anaphylaxis or allergic state - Brain tumor with edema - Alternative to Solu-Medrol Contraindications: - Contraindicated with systemic fungal infection Adult: - All indications 10mg IV push or IM Pediatric: - Croup 0.6mg/kg IM or IV Epinephrine (Adrenalin) Classifications: - Vasopressor - Catecholamine Indications: - Bradycardia - Cardiac Arrest - Anaphylaxis - Asthma Contraindications: - Outside of cardiac arrest, administer cautiously in presence of older age, debilitation, hyperthyroidism, hypertension - Use with caution in patients with angina, hypertension, CAD - May cause severe hypertension in those taking beta blockers Adult: - Anaphylaxis 0.3 - 0.5mg SC (1:1000 Concentration) - Asthma 0.3 - 0.5mg SC (1:1000 Concentration) - Cardiac Arrest 1mg IV push (1:10,000 Concentration) q 3-5 min 2.0X to 2.5X IV dose for ETT administration (mix 2.0-2.5mg in 10ml of NSS) - Bradycardia 1-10mcg/min IV Drip; 1mg to 500mL Pediatric: - Cardiac Arrest 0.01mg/kg IV Push (1:10,000 concentration) q. 3-5min - Anaphylaxis 0.01 mg/kg IV Push (1:10,000 concentration) 0.01 mg/kg SC (1:1,000 concentration) - Bradycardia 0.01 mg/kg IV push x1 dose only (1:10,000 concentration) Max dose of 1mg Furosemide (Lasix) Classifications: - Loop Diuretic Indications: - Pulmonary edema (acute) - Hyperkalemia (not acute treatment) - Acute renal failure Contraindications: - Relative contraindicated with allergy to sulfa drugs, hypotension with pulmonary edema, and dehydration - Caution with severe renal disease, acute MI Adult: - Acute pulmonary edema (BP > 120 systolic) 20mg IVP - standing orders 1.0mg/kg IV push slowly Pediatric: - Pulmonary edema/Hypertension 1mg/kg IV push q 6-12 hrs Ipratropium Bromide (Atrovent) Classifications: - Anti-Cholinergic - Bronchodilator Indications: - COPD - Asthma Contraindications: - None if clinically indicated Adult/Pediatric: 0.5mg in 2.5ml NSS - 0.02% solution Nebulized with 6-8 liters of 02 Levalbuterol (Xopenex) Classifications: - B2 selective sympathomimetic - Beta agonist Indications: - Asthma - COPD - Wheezing - Reactive airway disease Contraindications: - None when clinically indicated Adult: - Broncho-constriction/wheezing 1.25mg in 3ml NSS for more severe wheezing (acute setting) Administered nebulized with 5-8 LPM of 02 - Other doses 0.63mg in 3ml NSS for moderate wheezing (home therapy) Pediatric: 1.25mg in 3ml NSS for more severe wheezing (acute setting) 0.31mg in 3ml NSS for pediatric patients (home therapy) Lorazepam (Ativan) Classifications: - Benzodiazepine - Anti-convulsant - Sedative-hypnotic - CNS depressant Indications: - Control seizure disorders emergent and non-emergent - Relieve anxiety Contraindications: - Contraindicated with known hypersensitivity to benzodiazepines - Caution in elderly patients, very ill patients or patients with reduced pulmonary reserve as hypoventilation, hypoxia Adult: - Seizure/sedation/relieve anxiety IV injection - 1.0mg to 2.0mg IM injection - 2.0mg up to 4.0mg Pediatric: - Seizures 0.05 - 0.1mg/kg IV push Magnesium Sulfate (Magnesium Sulfate) Classifications: - Antiarrhythmic - Smooth muscle relaxant Indications: - Torsades de Pointes - Pulseless VT/VF (refractory) after Amiodarone or Lidocaine - Eclampsia-seizures due to toxemia of pregnancy - Asthma Contraindications: - None when clinically indicated Adult: - Alive Dose - Torsades de Pointes - VTach 1-2g IV drip over 5-15 minutes (BP dependant) - Dead Dose - Recurrent or refractory v-fib / pulseless VTach / Torsades 1-2g IVP -Asthma 2g IV drip given over 20 minutes -Pre-eclampsia/eclampsia 2-4g IV given over 3-5 minutes Pediatric: None available Methylprednisolone (Solu-Medrol) Classifications: - Glucocorticoid steroid (medium-acting) Indications: - Asthma - Neurogenic Shock (controversial) - Acute spine cord injury Contraindications: - Caution with GI bleeding, diabetes mellitus Adult: - Anaphylaxis, Asthma 125mg IV Push Pediatric: - Anaphylaxis, Asthma 2mg/kg dose IV Push Midazolam Hydrochloride (Versed) Classifications: - Benzodiazepine - Sedative-hypnotic (rapid onset, short acting) Indications: - Pre-medication before cardioversion - Sedation - Seizures Contraindications: - Use caution with decreased respiratory drive; AMS - Liver disease / cirrhosis Adult: - Pre-intubation/Sedation 0.1mg/kg IV Push Typical dose 5mg-10mg IV Push - Seizures when no IV access is avail 2-5mg IM -Induction Agent 0.2mg/kg IV push - 7-10mg avg. adult Pediatric: - Seizures without IV access 0.1mg/kg IM Morphine Sulfate (Morphine) Classifications: - Narcotic - Analgesic Indications: - Pain (burns, MI, and others) - Cardiac chest pain (refractory to nitrates) Contraindications: - Contraindicated with existing respiratory depression - Caution with COPD, CNS depression, hypotension Adult: - Pain (MI, sickle cell and other) 2-5mg IV Push q. 5 minutes until desired effects - Pain (Burns) 5-10mg IV Push q. 5 minutes until desired effects Often high dose morphine is required for pain relief Pediatric: - Pain (all indications) 0.1mg/kg IV Push Naloxone (Narcan) Classifications: - Opioid Antagonist (shorter acting) Indications: - Reverse pre-operative opiate induced sedation - Opioid/Opiate overdose Contraindications: - In apneic, narcotized patients, apply BVM resuscitation prior to administration of Narcan. - Too much Narcan can induce withdrawal, only administer enough to maintain respiratory drive and oxygenate patient Adult: - Opiate overdose 0.4 - 2.0mg IM/IV/SC/Inter-Nasal Pediatric: - Opiate reversal (0-5 years old or <20kg) 0.1 mg/kg IV/SC/ETT q. 3 minutes until response Nitroglycerin (Nitrostat, Nitrospan, Nitrodisc, Nitrodur, Tridil) Classifications: - Nitrate - Vasodilator Indications: - MI (without right ventricular involvement) - Angina pain - First line agent for pulmonary edema from CHF Contraindication: - Hypotension - Bradycardia (relative) Adult: - All indications: 0.4mg (2% solution) SL spray administer on mucus membranes of mouth (under toungue) 0.4mg (1/150grains) SL tablet q. 3-5 minutes 1-2 inches as on ointment/paste - apply to skin without hair - avoid self exposure 10-20mcg/min IV drip mixed 50-100 mg in 250mL Increase by 5-10mcg/min q. 5-10 minutes until desired response Pediatric: No prehospital administration recommended Oxygen (Oxygen) Classifications: - Naturally occurring gas Indications: - Confirmed or suspected hypoxia - Ischemic chest pain - Respiratory insufficiency - Confirmed or suspected carbon monoxide poisoning and other causes of decreased tissue oxygenation (cardiac arrest, shock) Terbutaline (Brethine) Classifications: - B2 agonist - Bronchodilator; smooth muscle relaxant Indications: - Asthma - Bronchospasms - Premature labor Contraindications: - Caution with hypertension and ventricular arrhythmias Adult: - Asthma/Bronchospasm/Premature labor 0.25mg SQ to start, wait 15 min repeat if necessary Pediatric: Not recommended for pediatrics in pre-hospital setting.

Author JeremyChrist ID 89548 Card Set Medications - Classifications, Indications, Contraindications Description Medications Updated 2011-09-17T01:18:08Z Show Answers