Drugs for Primary Care Paramedics

What is the generic name of Aspirin?

acetylsalicylic acid/ASA

Classifications of acetylsalicylic acid?

Anitplatelet, analgesic, anti-inflammatory, antipyretic

Mechanism of action of acetylsalicylic acid?

Prevents platelets from clotting

Indications of acetylsalicylic acid?

ischemic chest pain

Contraindications of acetylsalicylic acid?

hypersensitivity, active bleeds, bleeding disorders

Dose of acetylsalicylic acid?

160-325 mg oral

Mechanism of action of D50?

increases blood glucose levels

Indications of D50?

hypoglycemia, coma of unknown origin

Contraindications of D50?

none

Precautions of D50?

Head injury

Side effects of D50?

Tissue necrosis, pain to injection site, phlebitis

Dose of D50?

.5-1g/kg up to 25g. If head injury suspected half the dose.

Adrenalin generic name?

epinephrine 1:1000

Classification of epinephrine?

Sympathomimetic agonist, hormone

Mechanism of action of epinephrine?

alpha and beta agonist. Alpha agonism causes vasoconstriction. B1 agonism causes increased inotropic, chronotropic, and dromotropic effects. B2 agonism relaxes smooth muscles of bronchus

Indications of epinephrine?

Anaphylaxis

Contraindications of epinephrine?

none

Epinephrine dose?

0.3 - 0.5 mg IM/SQ q 10 - 15 min

Ped 0.15 mg

Classification of glucagon

pancreatic hormone, antihypoglycemic

Glucagon mechanism of action?

enters liver and causes breakdown of glycogen stores into glucose. Inhibits synthesis of glucose into glycogen

Glucagon indications?

Hypoglycemia and unable to get IV for D50

Glucagon contraindications?

hypersensitivity, allergy to pork or beef

Glucagon dose?

1 mg IM/SC q 7-10 min

Atrovent generic name?

ipratropium bromide

ipratropium bromide classification?

anticholinergic, bronchodilator

ipratropium bromide mechanism of action?

Anticholinergic blocks acetylcholine receptors thus inhibiting parasympathetic stimulation.

This causes bronchodilation and dries respiratory tract secretions

ipratropium bromide indications?

Bronchospams due to chronic bronchitis, emphysema, asthma.

COPD exacerbation

ipratropium bromide contraindications

Hypersensitivity, allergy to atropine, soybean protein or peanuts

ipratropium bromide adult dose?

250 - 500 mcg neb q 5-10 min to max of 1500 mcg

4-8 puffs MDI 20 mcg/puff q 20 minutes to max of 30 puffs

Narcan generic name?

naloxone

Naloxone Classification?

opioid antagonist

naloxone mechanism of action ?

Mechanism of Action: Reverses the respiratory depression and CNS sedation of narcotics by competing for opiate receptor sites in the brain

Naloxone Indications?

complete or partial reversal of CNS and respiratory depression induced by opioids

Naloxone Contraindications?

Hypersensitivity

naloxone dose?

titrate to effect

0.4 mg IV/IM total max single dose of 2mg

1 mg / nare IN q 3 - 5 min prn

Nitrolingual/Nitrostat generic name?

nitroglycerin

nitroglycerin classification?

Vasodilator, Antianginal

nitroglycerin mechanism of action?

Smooth muscle relaxant

Vasodilator

Reduces preload and afterload, decreasing myocardial oxygen demand.

Nitroglycerin Indications

ischemic chest pain

angina

Nitroglycerin Contraindications

1. Blood pressure less than 100 mmHg systolic or 30 below baseline

2. Patients who have taken Erectile Dysfunction (PDE5 inhibitors) medications in the last 24-48 hours

3. Cerebral hemorrhage

4. HR: <50 or >100 in absence of heart failure

nitroglycerin dose?

0.4 mg SL q 5 m or until BP < 100 or max dose of 3 sprays within 15 min

Entonox/Nitronox generic name?

nitrous oxide

nitrous oxide classification?

gaseous analgesic, anesthetic gas

nitrous oxide mechanism of action?

CNS depression and rapid pain relief

nitrous oxide indications?

Musculoskeletal injury/pain

Burns

Back pain

Ischemic chest pain

active labour child birth

Nitrous Oxide Contraindications

Patient is unable to self-administer

Head/face injury

patient has need for > 50% oxygen

undiagnosed abdominal pain

pneumothorax

COPD

bowel obstruction

Oral glucose classification?

carbohydrate, antihypoglycemic

Oral glucose mechanism of action?

rapidly increases blood glucose

oral glucose indications

hypoglycemia

oral glucose contraindications

no gag reflex

patient unable to follow directions

hyperglycemia

oral glucose dose?

24 - 31 g PO

Oxygen indications?

hypoxia

ischemic chest pain with SpO2 < 95%

Respiratory insufficiency

confirmed or suspected Co poisoning and other causes of hypoperfusion

any critical patient

Oxygen contraindications

Oxygen never withheld from critical patient

oxygen flow rates (LPM) and oxygenation % ranges of:

Nasal Cannula

NRB

BVM and vent rate?

NC: 1-6 = 24-44%

NRB: 10-15 = 80-95%

BVM: 15 = 90-100% and vent @ 12-20 breaths/min

Ventolin (albuterol) generic name?

salbutamol sulfate

salbutamol sulfate classification?

bronchodilator, sympathomimetic

salbutamol sulfate mechanism of action?

sympathomimetic selective for B2 adrenergic receptors.

Relaxes smooth muscles of bronchial tree and peripheral vasculature

salbutamol sulfate indications?

Bronchospasm

Anaphylaxis with bronchospasm

salbutamol sulfate contraindications?

Hypersensitivity

salbutamol sulfate adult dose?

2.5-5 mg neb q 5-10 min

5-10 puffs MDI 100 mcg/puff q 5 - 10 min no max

NaCl / normal saline generic name

0.9% Sodium Chloride

NaCl classification

isotonic crystalloid solution

NaCl mechanism of action

replaces water and electrolytes

NaCl indications

hypovolemia

heat related issues

freshwater drowning

diabetic ketoacidosis

TKVO for medication administration

Medication route

NaCl contraindications

Left sides CHF with coarse crackles in lungs

NaCl dose

20ml/kg up to 3L

60ml/hr TKVO

acetylsalicylic acid precautions?

GI bleeding

D50W pertinent side effects?

Possible phlebitis and pain to injection site

Tissue necrosis

epinephrine pertinent side effects?

Chest pain

HTN

Dyspnea

increased myocardial oxygen demand

glucagon pertinent side effects?

may take up to 15 min to see effects

ipratropium bromide pertinent side effects?

urinary retention

narcan pertinent side effects?

narcotic withdrawal syndrome

cardiac dysrhythmias

hypotension

HTN

Nitrolingual / nitroglycerin pertinent side effects?

Hypotension

Tachycardia

entonox pertinent side effects?

ALOC

hallucinations

ventolin pertinent side effects?

arryhythmias

tachycardia

muscle cramps

NaCl pertinent side effects?

may cause circulatory overload in patients with CHF