Drug Cards

Albuterol trade name

proventil, ventolin

Albuterol generic name

Albuterol sulfate

Albuterol classification

synthetic sympathomimetic (mimics SNS), bronchodilator, Beta-2 agonist

Albuterol supplied

2.5 mg/3 mL

Albuterol mechanism of action

relaxes bronchial, uterine, and vascular smooth muscle by stimulating Beta2 receptors. relieves bronchospasm and reduces airway resistance

Albuterol indications

bronchospasm/wheezing associated with chronic bronchitis, emphysema, asthma, and/or anaphylaxis

Albuterol contraindications

none except known hypersensitivity

Albuterol dosage (adult)

2.5 mg/ 3 mL via 6-8 lpm of oxygen over 15 minutes

Albuterol medical control order

if patient has an inhaler, find frequency/last application, then inform medical control for further action

Albuterol routes

inhalation via “t-piece” handheld nebulizer, mask nebulizer, or “bagged” in using in-line adapter and ET tube

Albuterol side effects

cardiovascular - palpitations, tachycardia, hypertension

CNS - tremors, nervousness, hyperactivity, headache

other - nausea/vomiting, dry mucous membranes, bad taste, muscle cramps

Albuterol considerations

maintenance dosage of 2 puffs every 4-6 hours by inhaler, used with spacer

administered along with Atrovent (Ipratropium) for asthma/COPD

Aspirin trade name

Bayer, St. Joseph

Aspirin generic name

Aspirin (acetylsalicylic acid)

Aspirin classification

antiplatelet, anti-inflammatory pain reliever, anti-pyretic (fever)

Aspirin supplied

81 mg chewable tablets

Aspirin mechanism of action

hinders clotting and arterial constriction by preventing the blood platelets from aggregating (clumping); relieves pain and inflammation

Aspirin indications

chest pain suspicious of cardiac origin; substernal chest pain, jaw pain, tightness, radiation of pain to shoulders, arms, and jaw

Aspirin contraindications

patients with bleeding disorders such as von Willebrand’s or hemophilia, active ulcer disease and asthma, or known allergy to aspirin

Aspirin dosage (adult)

324 mg (4 81 mg tablets)

Aspirin medical control order

no but local age requirements apply (<30 yo)

Aspirin routes

PO (chewable)

Aspirin side effects

at large doses tinnitus and hearing loss, nausea/vomiting, GI bleeding, prolonged bleeding time, heartburn, bruising, Reye’s syndrome when given for pain/fever associated with influenza

Aspirin considerations

doses higher than 324 mg are not beneficial for preventing clots

use with anticoagulants may increase risk of bleeding

Oxygen trade name

Oxygen (O2)

Oxygen classification

compressed non flammable gas for medical use

Oxygen supplied

tanks (green or green/chrome) of 100% O2

Oxygen mechanism of action

increases amount of oxygen in blood/cells/organs, increasing perfusion

Oxygen indications

respiratory distress/difficulty breathing, hypoperfusion (pale, cool, clammy skin; dizziness, weakness, altered level of consciousness)

Oxygen contraindications

none

Oxygen dosage (adult)

10-15 lpm via nonrebreather, 4-6 lpm via nasal cannula

Oxygen medical control order

no

Oxygen routes

mask or cannula for breathing patient, bag-valve mask for non-breathing or agonal breathing patient

Oxygen side effects

none, may interfere with respiratory drive in COPD patients

Oxygen considerations

monitor pulse oximetry, goal is 95% but treat the signs and symptoms

Atrovent trade name

Atrovent, Apovent

Atrovent generic name

Ipratropium bromide

Atrovent classification

anticholinergic (blocks acetylcholine), parasympatholytic bronchodilator (blocks PNS)

Atrovent supplied

0.5 mg/2.5 mL unit dose

Atrovent mechanism of action

inhibits interaction of acetylcholine at receptor sites on the bronchial muscle, resulting in bronchodilation. Relieves bronchospasm and airway resistance and dries respiratory secretions

Atrovent indications

bronchial asthma and bronchospasm associated with chronic bronchitis and emphysema

Atrovent contraindications

should be used with albuterol for acute treatment of bronchospasm

Atrovent dosage (adult)

nebulized treatment of 0.5 mg over 15 min using 6-8 lpm O2

Atrovent medical control order

standing medical order

Atrovent routes

administered via nebulizer with albuterol

Atrovent side effects

cardiovascular - palpitations, tachydysrhythmias

CNS - anxiety, dizziness, nervousness, headache

other - nausea, vomiting

Atrovent considerations

monitor vitals closely, use with caution when administering to elderly patients and patients with preexisting CV disease and/or hypertension

Nitroglycerine generic name

Nitroglycerine

Nitroglycerine trade name

Nitrostat, Nitrospray, Nitro-Bid

Nitroglycerine classification

vasodilator, anti-anginal

Nitroglycerine supplied

0.4mg SL tablets, 0.4mg metered dose spray, ointment 2% in 1g foil packet

Nitroglycerine mechanism of action

dilates arterial and venous vasculature.

relaxes smooth muscle on vascular, uterine, bronchial, and intestinal muscle.

decreases the pressure the heart has to pump against and increases blood flow to the myocardium

Nitroglycerine indications

ischemic chest pain (angina/MI); cardiogenic pulmonary edema with systolic blood pressure over 100mmHg

Nitroglycerine contraindications

erectile dysfunction drug use within 24-48 (72 hr UPHEMS) hour, hypotension, severe bradycardia/tachycardia, hypovolemia, head trauma or cerebral hemorrhage

Nitroglycerine adult dosage

1 metered dose (0.4mg) SL spray or tablets at 3-5 minute intervals for a maximum of 3 doses

Nitroglycerine medical control order?

contact medical control prior to administration unless patient is >30 years and chest pain is consistent with acute myocardial infarction

Nitroglycerine route

sublingual (tablets, spray), ointment

Nitroglycerine side effects

cardiovascular: orthostatic hypotension, reflex tachycardia, palpitations

CNS: headache, dizziness, blurred vision, weakness

other: nausea/vomiting, SL burning, dry mouth

Nitroglycerine considerations

establishing IV access recommended. in cases of acute inferior MI, nitro may cause hypotension and bradycardia

a RV AMI cannot be detected by a 12-lead EKG

do not shake spray

epinephrine trade name

adrenaline

epinephrine classification

natural catecholamine, sympathomimetic (mimics SNS)

epinephrine supplied

1 mg/1 mL (1:1000 solution) ampoule; epi-pen auto injector (0.3mg)

epinephrine mechanism of action

stimulates alpha and beta-adrenergic receptors; as a beta2 agonist, it causes bronchodilation and dilation of vessels in skeletal muscles

epinephrine indications

anaphylactic shock, severe bronchospasm in status asthmaticus after albuterol/atrovent

epinephrine contraindications

tachydysrhythmias, hypertension, ventricular irritability, CVD, pulmonary edema

epinephrine adult dosage

0.3mg IM

epinephrine medical control order?

yes if patient is >40 years, has an irregular heart rate, has a heart rate of >150, or has a history of heart disease/hypertension

epinephrine side effects

cardiovascular: tachydysrhythmias, precipitation of angina or MI, palpitations, hypertension

CNS: anxiety, tremor, nervousness, headache

other: pupil dilation, nausea/vomiting

epinephrine considerations

monitor VS and cardiac monitor frequently and watch for developing arrhythmias if given for anaphylaxis