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

• monomorphic wide beat tachycardia

Adenosine dosages:

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

• Peds: 0.1 mg/kg rapid ivp, may repeat 0.2 mg/kg

Proventil/ Ventolin generic name

albuterol

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?

Class III 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

• Peds

  • 5 mg/kg ivp nte 300 mg

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

• Adult

  • 150 mg IV infusion over 10 mins

• Peds

  • 5 mg/kg IV over 10 mins nte 150mg

etomidate indications:

RSI

etomidate trade name:

Amidate

Etomidate dose:

0.3 mg/kg IVP

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, 1:1,000

• 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, 1:10,000

• Peds

  • 0.01 mg/kg nte 0.5 mg

Epi cardiogenic shock dose:

• Adult

  • 2-10 mcg/min IV infusion

• 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