meds.txt

160-325mg (generally start with the lowest dose)

Ischemic Chest Pain (angina or MI)

• Allergy to ASA
• Bleeding disorders (eg: hemophilia)
• Unconscious

• GI upset
• N/V
• Heart Burn

• Asthma - May produce bronchoconstriction in asthmatics
• Active ulcer disease
• Impaired renal or hepatic function
• Children and adolescents with influenza or chickenpox infections as it may increase the risk of Reye's syndrome

At low doses, appears to impede clotting by blocking prostaglandin synthesis, which prevents formation of platelet-aggregating substance (this is irreversible) called thromboxane A2

ASA must be chewed & swallowed for proper absorption rate

Offline

25g tube prn 10 minutes

• S/S of hypoglycemia with BGL <3.8mmol/L
• --- hunger
• --- shakiness
• --- nervousness
• --- sweating
• --- dizziness or light-headedness
• --- sleepiness
• --- confusion
• --- difficulty speaking
• --- anxiety
• --- weakness

• Unconscious
• Pt unable to follow commands
• Hyperglycemia: (Blurred vision, Fatigue, Dry mouth, Dry or itchy skin)

N/V

May cause N/V or Pt may gag when administered

Monosaccharide given orally & readily absorbed

• Swallowed for proper absorption rate
• Tongue depressor, or simply squeezed into mouth by Pt

ONLINE! Must be Pt’s & have a Px

• Adult: 6 to 20 puffs of MCI
• Pediatric : 2 to 10 puffs of MCI
• prn 10 mins
• Each MCI = 100mcg/spray.

• Severe bronchospasm due to COPD, or
• Dyspnea from Asthma

Allergic to Salbutamol

• Headache
• N/V
• Nervousness
• Palpitations
• Tachycardia
• Transient muscle cramps
• Muscle tremors
• weakness

• NOT to be used on Pt. presenting with acute heart failure, or CVD
• hyperglycemia: Risk in diabetics
• Hypokalemia: - a lower-than-normal amount of potassium in the blood, which can be further lowered by this med.

Binds to Beta-2 receptor sites promoting bronchodilation. Also activates cardiac Beta-1 receptor explaining increased Heart Rate and BP

• Shake for 30-60 seconds
• Breath in and hold as per obvious

• IPRATROPIUM BROMIDE PROTOCOLS?
• ONLINE! Must be Pt’s & have a Px

• Adult: 4 to 10 puffs of MCI
• Pediatric: 2 to 4 puffs of MCI
• prn 10 mins
• Each MCI = 20mcg/spray.

• Severe bronchospasm due to COPD, or
• Dyspnea from Asthma

• Allergic to Ipratropium or atropine
• Allergic to soy lethicin or sooy, peanuts (it’s the propellant)
• Children under 5

• Headache
• N/V
• Nervousness
• Palpitations
• Tachycardia
• Transient muscle cramps
• Muscle tremors
• weakness

• Pt’s with narrow angle glaucoma
• Don’t spray in any Pt’s eyes!

Inhibits Parasympathetic bronchoconstriction, resulting in open lower airway and bronchodilation.

• Shake for 30-60 seconds
• Breath in and hold as per obvious

ONLINE!

• Adult: 0.3mg given IM at lateral aspect of thigh
• Pediatric: 0.15mg
• prn 5-10mins

Anaphylaxis

None in emergent setting

• PHD-PAN-HAC
• Pallor
• Headache
• Dyspnea
• Palpitations
• Anxiety
• N/V
• Acute Hypertension
• Angina
• Cardiac arrhythmias

• Use with geriatrics
• Acute hypertention (BP over 140/90 that doesn’t respond to meds)
• Cardiac History
• Pulmonary Edema

• Binds to Alpha-1, Beta-1, and Beta-2 receptors of sympathetic system, resulting in bronchodilation and drying of bronchial mucus membranes.
• Activation of Alpha & Beta receptors explains increased HR & BP

Injected into lateral aspect of thigh at 90deg angle, held in place for 10 seconds. Place needle in sharps container after. Massage site to encourage blood flow at site.

NOT ALLOWED!

0.4mg SL spray

Suspected Angina or MI

• Systolic BP <100
• Viagra within last 24hrs
• Ciallis within last 36hrs
• Levitra within last 48hrs

• Lightheadedness & Dizziness
• Headache
• N/V
• Syncope

• Antianginal: relaxes vascular smooth muscle of both arterial and venous beds, causing net decrease of Myocardial O2 consumption.
• Dilates coronary vessels: redistributing blood to ischemic tissue.
• Vasodilating: Dilates peripheral vessels, decreasing venous return to the heart which treats pulmonary edema and heart failure. Also reduces left ventricular load aiding a failing heart.