Paramedic pharmacology updated

Updated meds with accurate information and more detail for some

What class of medication is adenosine/ Adenocard?

• misc antidysrythmic

• Potassium channel agonist/ calcium channel antagonist

What are the indications for adenosine?

• atrial tachycardia - for stable patients give adenosine after attempting vagal maneuvers

Adenosine dosages:

• Adult: 6 mg rapid ivp, may repeat 12 mg rapid ivp

  • Use a three way stopcock if you have it and attach the flush to one and meds to the other

Proventil/ Ventolin generic name

albuterol- used for reactive bronchoconstriction and hyperK

albuterol trade name:

Proventil/ Ventolin

What class of medication is albuterol?

sympathomimetic (bronchodilator)

Albuterol indications:

• reactive bronchoconstriction

• Hyperkalemia

For reactive bronchoconstriction, what is the dosage for albuterol?

2.5 mg neb

For HyperK, what are the dosages for albuterol?

10 mg neb

What class of medication is amiodarone?

• antidysrhythmic (potassium channel antagonist)

Amiodarone trade name:

Cordarone

How does amiodarone work?

• by prolonging the action potential and refractory period in myocardial tissue, stabilizing heart rhythm.

How does adenosine work?

• by slowing conduction through the AV node, effectively interrupting reentrant pathways and restoring normal sinus rhythm

Amiodarone indications:

• pulseless VT/ VF

• VT w/ pulses

For pulseless VT/ VF, what are the dosages for amiodarone?

• Adult

  • 300 mg ivp, may repeat 150 mg ivp

For VT w/ pulses, what are the dosages for amiodarone?

• Adult

  • 150 mg IV infusion over 10 mins

  • Put 150 mg into 100mL bag w/ a 10 drop set, do abt 2 drops per second.

etomidate indications:

RSI

etomidate trade name:

Amidate

Etomidate dose:

0.3 mg/kg IVP

• 260 lbs =117.934 kg, 118× 0.3= 35.4 mg

• 240 lbs=108.862 kg, 109×0.3= 32.7 mg

• 220lbs =99.79 kg, 100×0.3= 30 mg

• 200lbs = 90.718 kg, 91×0.3= 27.3 mg

• 180 lbs=81.647 kg, 81×0.3=24.3 mg

• 160 lbs=72.575 kg, 73×0.3=21.9mg

Fentanyl trade names:

Duragesic, Sublimaze

Fentanyl dosages:

1- 2 mcg/kg slow ivp

furosemide dosages:

40 mg slow ivp, or double their PO dose nte 80 mg

furosemide indications:

CHF with a pulmonary event

furosemide trade name:

Lasix

What class of medication is Lasix?

a loop diuretic

What class of medication is glucagon/glucagen?

hormone

Glucagon/ glucagen indications:

• hypoglycemia

• Beta blocker OD

• Calcium channel blocker OD

For treating hypoglycemia, what is the dosage for glucagon?

Adult: 1 mg IM

Peds: 0.5 mg IM

For treating a beta blocker or calcium channel blocker OD, what is the dosage for glucagon?

2-5 mg IVP

Hydromorphone dosage:

1-2 mg slow IVP

Hydromorphone trade name:

Diluadid

What class of medication is ipratropium?

parasympathetic bronchodilator

ipratropium trade name:

Atrovent

indications for Atrovent:

reactive bronchoconstriction

ipratropium dosage:

0.5 mg along with 2.5 mg of albuterol nebulized

What class of medication is diltiazem/ Cardizem?

Class IV antidysrythmic (calcium channel antagonist)

Cardizem indications:

A fib, a flutter, A fib RVR

diltizem dose:

0.25 mg/kg- 0.35 mg/kg slow IVP

diphenhydramine medication class?

anti- histamine

benadryl dose and generic name?

• dose: 25- 50 mg slow ivp

• diphenhydramine

What class of medication is dopamine?

sympathomimetic

dopamine trade name:

Intropin

dopamine indications:

• symptomatic bradycardia

• Cardiogenic shock

intropin dosages:

2-20 mcg/kg/min IV infusion

epinephrine medication class:

sympathomimetic

epinephrine indications:

• cardiac arrest

• Symptomatic bradycardia

• Cardiogenic shock

• Mild to moderate allergic reaction

• Anaphylaxis

• Reactive bronchoconstriction

Epinephrine trade name:

Adrenalin

Epi cardiac arrest dose:

• Adult

  • 1 mg IVP, may repeat every 3-5 mins, 1:10,000

• Peds

  • 0.01 mg/kg nte 1 mg, may repeat every 3-5 mins

epi symptomatic bradycardia dose:

• Adult

  • 2-10 mcg/min IV infusion, 1:1,000

• Peds

  • 0.01 mg/kg nte 0.5 mg

Epi cardiogenic shock dose:

• Adult

  • 2-10 mcg/min IV infusion 1:1,000

• Peds: NR

epi dose for mild to moderate allergic reaction:

• Adult

  • 0.3 mg 1:1,000 SQ/IM

• Peds

  • 0.01 mg/kg nte 0.3 mg

epi anaphylaxis dose:

• Adult

  • 0.3 mg 1:10,000 IV

• Peds

  • 0.01 mg/kg 1:10,000 IV nte 0.3 mg

epi dose for reactive bronchoconstriction:

• Adult

  • 0.3 mg 1:1,000 SQ/IM

• Peds

  • 0.1 mg/kg 1:1,000 SQ/ IM nte 0.3 mg

What class of medication is rocuronium?

non depolarizing neuromuscular blocking agent (paralytic)

rocuronium bromide trade names:

Esmeron/ Zemuron

rocuronium dose:

• A &P: 1 mg/kg slow IVP

rocuronium indications:

RSI

Sodium bicarbonate medication class:

Electrolyte (buffer)

sodium bicarbonate indications:

• metabolic acidosis

• Tricyclic antidepressant OD

succinylcholine medication class:

depolarizing neuromuscular blocking agent (paralytic)

Succinylcholine trade name:

Anectine

succinylcholine dose:

1- 1.5 mg/kg slow IVP

thiamine medication class:

vitamin B1

thiamine trade name:

Thiamilate

Thiamilate indications:

Pt who has been administered IV dextrose with a history of ETOH or an eating disorder

thiamine dose:

• Adult: 100 mg in 1000 mL bag of normal saline

• Peds: NR

tranexamic acid medication class:

hemostatic agent

Tranexamic acid trade name:

Cyklokapron

TXA indications:

adults in traumatic hemorrhagic shock with suspected need for massive blood transfusion

TXA dosages:

• Adult: 1 gram in 100 mL normal saline IV infusion over 10 mins

• Peds: NR

Vecuronium bromide medication class:

non depolarizing neuromuscular blocking agent (paralytic)

vecuronium trade names:

Norcuron/ Vecuron

vecuronium dosages:

• Adult

  • 0.1 mg/kg slow IVP

• Peds > 20 kg

  • 0.1 mg/kg slow IVP

morphine trade names:

Astromorph, Duramorph, MS Cotin, Roxanol

morphine dosages:

• Adult: 5-10 mg slow IVP

• Peds: NR

Naloxone dosages:

• Adult: 0.4 mg-2 mg slow IVP

• Peds: 0.1 mg/kg slow IVP nte 2 mg

Nitroglycerin medication class:

vasodilator

nitro trade names:

Nito-bid, Nitro-stat

Nitro dosages:

0.4 mg SL, may repeat for total of three doses

norepinephine medication class:

Sympathomimetic

norepinephrine trade name:

Levophed

Levophed indications:

cardiogenic shock

Norepinephrine dosages:

• Adult: Initial 2-10 mcg/min IV infusion, titrate to a max dose of 30 mcg/min

• Peds: NR

Zofran medication class:

antiemetic

ondanestron trade name:

Zofran

Zofran indications:

N/V

ondansetron dosages:

• Adult: 4mg slow IVP

• Peds: 2mg slow IVP

Promethazine medication class:

Antihistamine

promethazine trade name:

Phenergan

Promethazine indications:

N/V

Phenergan dosages:

• Adult: 12.5-25 mg slow IVP

• Peds: 0.25-0.5 mg/kg slow IVP nte 12.5 mg

atropine sulfate medication class:

parasympatholytic (anticholingergic)

Atropine sulfate indications:

symptomatic Bradycardia. Acetylcholinesterase inhibition

atropine dose for symptomatic bradycardia:

• Adult: 1 mg rapid IVP, may repeat every 3-5 mins to a max dose of 3m

• Peds: 0.02 mg/kg, min dose 0.1 mg nte 0.5 mg

Atropine sulfate for acetylcholinesterase inhibition dose:

• Adult: 2-4 mg, may repeat every 5-15 mins to dry secretions

• Peds: 0.05 mg/kg, may require multiple doses

bumetanide indications

chf with a pulmonary event

Bumetanide trade name:

Bumex

Bumex doses:

• Adult

  • <70 kg =1 mg slow IVP

  • >70 kg =2mg slow IVP

• Peds: NR

calcium chloride medication class:

electrolyte

calcium chloride indications:

• Calcium channel blocker OD

• Hyperkalemia