Paramedic Drug Card Review

Flashcards covering essential paramedic drug information including mechanisms of action, indications, doses, contraindications, and special considerations for various medications.

What is the mechanism of action for Aspirin?

It is an NSAID that decreases inflammation and platelet aggregation.

What are the indications for administering Aspirin?

ACS/Chest pain.

What is the typical oral dose of Aspirin administered by paramedics for ACS/Chest pain?

324 mg, completing the dose with 4 baby aspirins.

What is the mechanism of action for Nitroglycerin?

It is a vasodilator that relaxes smooth muscle and decreases preload & oxygen demand.

What are the indications for administering Nitroglycerin?

Chest pain / ACS / CHF.

What is a significant contraindication for Nitroglycerin related to other medications?

Use of ED Meds (Erectile Dysfunction Medications) in the last 48 hours.

What is the mechanism of action for Epinephrine?

It is a naturally occurring catecholamine that acts as an agonist on alpha1, beta1, and beta2 receptors, causing vasoconstriction, increased HR/BP, increased contractility, and bronchodilation.

What are the primary indications for Epinephrine?

Cardiac arrest, Asthma, Anaphylaxis, COPD, Stridor.

What is the dose and concentration of Epinephrine for a pediatric patient in cardiac arrest?

0.01 mg/kg of 1:10,000 solution IV/IO.

What is the mechanism of action for Norepinephrine?

It is a naturally occurring catecholamine acting as an agonist on alpha and beta receptors, causing potent vasoconstriction and increased blood pressure, with alpha effects being more profound.

What are the primary indications for Norepinephrine?

Shock (to maintain blood pressure/tissue perfusion), severe hypotension, and post resuscitation.

What is the mechanism of action for Dopamine?

It is a sympathetic agonist that acts on alpha1, beta1, and D1+D2 (dopamine) receptors, with effects dependent on the dose (Alpha1: vasoconstriction, Beta1: increased HR/contractility, D1+D2: increased blood flow to kidneys/intestines).

What are the indications for administering Dopamine?

Hypotension (severe), cardiogenic shock, and bradycardia (if atropine doesn’t work).

What is the mechanism of action for Amiodarone?

It prolongs the action potential and refractory period, slows electrical conduction rate, and is a sodium, calcium, and potassium channel blocker.

What are the indications for Amiodarone?

V-tach, V-fib, wide complex rapid tachycardia.

What is the mechanism of action for Lidocaine?

It is a sodium channel blocker that decreases ventricular irritability and reduces the speed of impulses.

What are the indications for Lidocaine?

V-Tach / V-Fib.

What is the mechanism of action for Atropine?

It is a potent parasympatholytic that inhibits the actions of acetylcholine, indirectly increasing HR and AV conduction, decreasing GI secretions, and dilating pupils.

What are the primary indications for Atropine?

Organophosphate poisoning and symptomatic bradycardia.

What is the mechanism of action for Adenosine?

Derived from the breakdown of ATP, it slows AV conduction, decreases HR, and acts as a 'chemical cardioversion'.

What are the indications for Adenosine?

SVT and rapid tachycardias.

What is a key special consideration when administering Adenosine?

Press the print button on the monitor to have an ECG printout of the effect.

What is the mechanism of action for Metoprolol?

It is a beta adrenergic blocking agent selective to the beta 1 receptor, blocking its effects and causing decreased HR, myocardial contractility, cardiac output, and conduction velocity.

What are the indications for Metoprolol?

Rapid atrial fibrillation, rapid atrial flutter, and as a second-line agent after adenosine for SVT.

What is the mechanism of action for Diltiazem?

It is a calcium channel blocker that slows AV conduction, resulting in decreased HR/BP and decreased oxygen demand on the heart.

What are the indications for Diltiazem?

Rapid atrial fibrillation, rapid atrial flutter, and as a second-line treatment after adenosine for SVT.

What is the mechanism of action for Oxygen?

It corrects hypoxia, oxygenates blood, and reduces cardiac workload.

What are the indications for administering Oxygen?

Low oxygen levels (low SPO2), carbon monoxide poisoning, and in conjunction with airway devices to deliver oxygen.

What is the mechanism of action for Albuterol?

It is a sympathomimetic that acts as an agonist on the beta 2 receptor, causing prompt bronchodilation of the lungs.

What are the indications for Albuterol?

Asthma, anaphylaxis, COPD, hyperkalemia.

What is the mechanism of action for Ipratropium?

It is an anti-cholinergic (parasympatholytic) which inhibits acetylcholine at receptor sites, drying respiratory tract secretions.

What are the indications for Ipratropium?

Asthma, COPD, anaphylaxis (often given with albuterol).

What is the mechanism of action for Levalbuterol?

It is a sympathomimetic selective to the beta 2 receptor, with its effect including the dilation of all airways from the trachea to the bronchioles.

What are the indications for Levalbuterol?

Treatment for bronchospasm from Asthma, COPD, and Anaphylaxis.

What is the mechanism of action for Oxytocin?

It is a pituitary hormone that stimulates uterine smooth muscle contraction, which reduces blood loss.

What are the indications for Oxytocin?

Postpartum vaginal bleeding.

What is the mechanism of action for Oral Glucose?

It will raise a patient's blood glucose levels.

What is the primary indication for Oral Glucose?

Hypoglycemia.

What is a critical special consideration when administering Oral Glucose?

The patient must be alert and able to obey commands.

What is the mechanism of action for Dextrose (D50-D10)?

It elevates blood glucose levels rapidly.

What is the primary indication for Dextrose?

Hypoglycemia.

What is the mechanism of action for Glucagon?

It converts glycogen to glucose in the liver to raise blood glucose levels and also has smooth muscle relaxant properties.

What is the typical IM dose of Glucagon for hypoglycemia in an adult patient?

1 mg IM.

What is the mechanism of action for Methylprednisolone (Solu-medrol)?

It is a synthetic steroid with potent anti-inflammatory effects for acute/chronic inflammation.

What are the indications for Methylprednisolone?

Asthma, COPD, anaphylaxis, adrenal crisis.

What is the mechanism of action for Dexamethasone (Decadron)?

It is a steroid that acts as an anti-inflammatory, can decrease cerebral edema, and suppress immune response.

What are the indications for Dexamethasone?

Asthma, COPD, croup, anaphylaxis.

What is the mechanism of action for Diphenhydramine (Benadryl)?

It is an anti-histamine that blocks H1 and H2 receptors and has slight sedative effects.

What are the indications for Diphenhydramine?

Anaphylaxis, simple allergic reactions, and extrapyramidal reactions.

What is the mechanism of action for Famotidine (Pepcid)?

It is an over-the-counter medication that acts as an H2 antagonist and anti-histamine.

What are the indications for Famotidine?

GERD, ulcers, anaphylaxis, allergic reactions.

What is the mechanism of action for Vecuronium (Norcuron)?

It prevents neuromuscular activity by blocking the effect of acetylcholine at the myoneural junction, acting as a paralytic for RSI.

What is the primary indication for Vecuronium?

RSI (Rapid Sequence Intubation).

What is the mechanism of action for Haloperidol (Haldol)?

It blocks dopamine receptors (D2 receptors), altering mood and behavior as a major tranquilizer.

What are the indications for Haloperidol?

Acute psychosis and emergency sedation for agitation/excited delirium.

What is the mechanism of action for Olanzapine (Zyprexa)?

It is an atypical anti-psychotic and sedative.

What are the indications for Olanzapine?

Acute psychosis and emergency sedation for agitation/excited delirium.

What is the mechanism of action for Ondansetron (Zofran)?

It blocks serotonin receptors and acts as an anti-emetic.

What are the indications for Ondansetron?

Nausea/vomiting.

What is the mechanism of action for Prochlorperazine (Compazine)?

It is an anti-emetic (phenothiazine).

What are the indications for Prochlorperazine?

Nausea/vomiting and migraine.

What is the mechanism of action for Metoclopramide (Reglan)?

It is an anti-emetic that suppresses vomiting and reduces GI reflux.

What are the indications for Metoclopramide?

Nausea and vomiting, GERD, and migraines.

What is the mechanism of action for Naloxone (Narcan)?

It is an opioid antagonist that reverses the effects of the opiate at the mu-opiate receptor.

What is the primary indication for Naloxone?

Opiate overdose with respiratory depression (low RR).

What is the typical adult IV/IO dose for Naloxone?

0.4-2 mg IV/IO.

What is the mechanism of action for Activated Charcoal?

It is an antidote to ingested drugs, binding to the drug to deactivate it and eliminate it from the body, but must be given within 1 hour of ingestion.

What are the indications for Activated Charcoal?

Numerous oral poisons / med overdoses.

What is the mechanism of action for Flumazenil (Romazicon)?

It is a benzodiazepine antagonist that blocks action in the CNS and can reverse sedation.

What is the primary indication for Flumazenil?

To reverse CNS depression from benzodiazepine overdose.

What is the mechanism of action for Etomidate (Amidate)?

It is a short-acting medication that acts on the reticular activating system to produce anesthesia, causing sedative and hypnotic effects.

What is the primary indication for Etomidate?

RSI (sedation).

What is the mechanism of action for Ketamine (Ketalar)?

It is a dissociative agent that causes sedative and hypnotic effects.

What are the indications for Ketamine?

Severe pain, emergency sedation, and as an RSI adjunct for sedation.

What is the mechanism of action for Propofol (Diprovan)?

It is an anesthetic with a quick onset of about 40 seconds; the medication enters the body and inhibits GABA activity in the brain.

What is the primary indication for Propofol?

RSI to sedate/maintain sedation.

What is the mechanism of action for Diazepam (Valium)?

It is a benzodiazepine that increases GABA in the brain, which in turn causes its sedative/hypnotic and anti-convulsant properties.

What are the indications for Diazepam?

Seizures, emergency sedation, and pre-medication for cardioversion.

What is the mechanism of action for Midazolam (Versed)?

It is a short-acting benzodiazepine that causes sedative/hypnotic effects by increasing GABA in the brain.

What are the indications for Midazolam?

Seizures, emergency sedation, and its use in RSI as a sedative agent.

What is the typical adult IM dose for Midazolam in emergency sedation?

10 mg IM (can trial 2.5-5 mg IM in smaller adults).

What is the mechanism of action for Lorazepam (Ativan)?

It acts on GABA in the brain (increases) thus causing its sedative/hypnotic and anti-convulsant properties.

What are the indications for Lorazepam?

Seizures, emergency sedation, RSI sedative, and for pre-sedation for cardioversion.

What is the adult IV/IO/IM dose for Lorazepam for seizures?

4 mg IV/IO/IM.

What is the mechanism of action for Acetylcysteine (Mucomyst)?

It is a mucolytic agent used to reduce the thickness of mucous respiratory secretions; it can also delay hepatotoxicity due to Tylenol OD.

What are the indications for Acetylcysteine?

Tylenol OD and to treat respiratory mucous secretions.

What is the mechanism of action for Rocuronium (Zemuron)?

It prevents neuromuscular activity by blocking the effect of acetylcholine at the myoneural junction; used as a paralytic during RSI.

What is the primary indication for Rocuronium?

RSI (Rapid Sequence Intubation).

What is the mechanism of action for Fentanyl (Sublimaze)?

It is a synthetic opiate that produces analgesia and euphoria, acting as a CNS depressant and opiate agonist.

What are the indications for Fentanyl?

Pain control, ACS, and as an RSI adjunct.

What is the typical adult initial IV/IO/IM/IN dose for Fentanyl?

1 mcg/kg, with a range of 50-100 mcg/dose.

What is the mechanism of action for Morphine?

It acts as an agonist to the mu-opioid receptor, functioning as a CNS depressant that decreases sensitivity to pain, and is shown to decrease preload, afterload, and oxygen demand to the heart.

What are the indications for Morphine?

Pain control, ACS, and MI.

What is the mechanism of action for Hydromorphone (Dilaudid)?

It is a CNS depressant that produces analgesia and sedative properties, functioning as an opioid agonist.

What is the primary indication for Hydromorphone?

Severe pain.

What is the mechanism of action for Acetaminophen (Tylenol)?

It is a COX-2 inhibitor, acting as an anti-pyretic and non-opiate analgesic.

What are the indications for Acetaminophen?

Mild to moderate pain and fever.

What is the mechanism of action for Ibuprofen (Motrin)?

It is an NSAID medication that acts peripherally as an analgesic, having anti-inflammatory, analgesic, and anti-pyretic effects.

What are the indications for Ibuprofen?

Mild to moderate pain.

What is the mechanism of action for Ketorolac (Toradol)?

It is an NSAID, acting as an anti-inflammatory and non-opioid analgesic.