Drug Monogram EMR 2024

Acetylsalicylic Acid (ASA) Classicfication

Platelet Inhibitor (stops formation of blood clots)

Anti-Pyrectic (reduces fever)

analegsic (pain relief)

Anti-infammatory

Acetylsalicylic Acid (ASA) Indications

Cardio suggestive chest pain or MI (Myocardial infrarction)

Chest pain..

Acetylsalicylic Acid (ASA) Contraindications

-Known Hypersensitivity or allergy to ASA

-Bronchospasm (asthma) caused by ASA or anti infammatory drugs

-Active or recent bleeding I.E Gi bleed or major bleeds or peptic ulcer disease

-Pediatric patients with signs of viral illnesses

-Signs of stroke

Acetylsalicylic Acid (ASA) Cautions

Possibility of pregnancy

Currently taking other anti-coagulants (call cinicall)

Recent Surgeries

Entonox (50% Nitrous 50% Oxygen) Classicfication

Inhaled Anesthetic

Must be on high flow oxygen if entoox is discontinued

Entonox (50% Nitrous 50% Oxygen) Mechanism

Potent Analegsic and a weak anaethetic

Entonox (50% Nitrous 50% Oxygen) Indications

Relief of low to moderate pain

givine if Nitro is ineffective or contradicted

Entonox (50% Nitrous 50% Oxygen) Contradictions PAINDIE

Pneumothorax - Auscultation

Air Embolism - Recent IV therapy or drug use

Inhalation Injury

Nitroglycerin in the last 5 Mins

Decompression sickness

inability to comply with medication administration

Enclosed Space

Entonox (50% Nitrous 50% Oxygen) Cautions SADFC

signs of shock

abdominal distension

depressant drug

facial injuries

COPD

Epinephrine Classicfication

Catecholamine, sympathimimetic

Epinephrine Indications

Anaphylaxis

Epinephrine Contraindications

Absolutly no contranindications

Epinephrine Dosages

0.5 IM every 5mins

may repeat up to 3 times

Epinephrine durations

onset 30-90 secs

peak 4-10 mins

duration 5-10 mins

Glucagon Classicfication

Pancreatic hormone and insulin antagonist

Glucagon Indications

confirmed hypoglycemia

Glucagon contraindications

hypersensitivity

pheochromocytoma

insulinoma

under 4 years old

Glucagon dose

1 mg IM

Glucagon duration

onset 5- 10 mins

peak 30-45 mins

duration 12-17 mins

Naloxone (Narcan) Classfication

Narcotic agonist

Naloxone (Narcan) Indications

Respiratory depression or arrest with low mental status

suspectected opioid use

Naloxone (Narcan) contraindications

know allergy or hypersensitivity

neonates

Naloxone (Narcan) dose

IM

every 3 mins

1st dose 0.4mg

2nd dose 0.4mg

3rd dose 0.8mg

4th dose 2.0mg

call clinicall if need more doses

Naloxone cautions

Reversal of narcotics effects might result in combative due to prolonged hypoxia or opioid withdrawal

Assess for adverse effects including hypotension

hypertension

nausea

Vomiting

tachycardia

Nitroglycerin Classifications

Antianginal

vasodilator

Nitroglycerin Indications

Chest pain consistent with cariac ischemia / Myocardial infarction

Nitroglycerin Contraindications

Systolic BP <110

Heart rate <50 or >150

Known allergy or hypersensitive

patient used ED meds like Viagra or levitra <24 hours

ED Cialis <48 hours

Patient doesnt have a prescription (call clinicall)

Nitroglycerin Dosage

Sublingual 0.4mg (one spray) primed

every 3 mins

max 3 doses within 30 mins

Nitroglycerin cautions

Ensure patient not at risk of fall

Viagra past 24 hours monitor BP

If decreased LOC after nitro and drop in BP substantially

-Discontinue nitro

-supine position

-Reassess ABC

-Apply high flow O2

Oral Glucose Gel Classification

Caloric

Oral Glucose Gel indications

Decreased or altered leve of consciousness and blood glucose <4.0

Oral Glucose Gel Contraindications

unable to manage own airway

unable to follow directions

Oral Glucose Gel dose

administer ½ of package (12-15g)

every 5 mins if GCS <15 and BGL <4

salbutamol (Ventolin) Classification

Bronchodilator

Sympathimimetic

salbutamol (Ventolin) indications

Bronchospasm

salbutamol (Ventolin) Contraindications

known hypersensitivity

salbutamol (Ventolin) doseages

5 mg nebulized

meter dose 4 × 100 mcg

salbutamol (Ventolin) Pediatric considerations and dosing

Nebulizer

Age <1 year: 2.5mg

Age > 1 year: 5 mg

Metered dose

<10 KG: not indicated

10-20 kg: 5 × 100 mcg may repeat 3 times

20 kg: 10 × 100 mcg may repeat 10 times

Spinal MOI No multi trauma

Candi

C-spine tenderness

Altered mental status - RTC

New neuro focal deficits - RTC

Distracting injury

Intoxicated

Spinal MOI No multi trauma and no CANDI

High Risk patients

1. 65 or Older

2. osteroperosis

3. exsisting spinal condition or spinal injury

SMR (spinal motion restriction)

1. 30 Degrees stretcher

2. Collar

3. foam roller

4. clam shell

5. pelvin binder

6. tied feet

7. blanket

8. O2

Acetaminophen (Tylenol) Indication

Mild to Moderate pain

Acetaminophen (Tylenol) Contradictions

Hypersensitivity

severe alcoholic hepatitis or liver dysfunctions with active alcohol consumption

acute liver injury

acetaminophen-induced liver disease

Acetaminophen (tylenol) doseage

500-1000 mg

May repeat once after 4 hours

24 hour max 3,000mg

If suspected liver dysfunction 24 hour max lowered 2000mg

Acetaminophen cautions

Patient with pre existing liver disease

Over is 7.5g and 150mg paediatric

4 signs of shock

Low blood pressure

Cool clammy

Altered mental state

Weak and rapid pulse

Ibuprofen indication

Mild to moderate pain

Ibuprofen (advil) contraindications

Hyper sensitivity or other NSAID drugs non-steroidal anti inflammatory drugs

active gi bleed

Pregnancy (first second or third trimester)

Ibuprofen dose

400mg

May repeat every 4-6 hours

Maximum dose 1200mg

Six rights of medication

right person

Right medication

Right time

Right route

Right amount

Right documentation

Medications CI

ASA

EPI

ORAL GLUCOSE

NALOXONE

SALBUTIMOL

GLUCICON

Six rights of administration

Right person

Right medication

Right time

Right route

Right amount

Right documentation