EMT Drugs

ACERIP FA 26

Indications for acetaminophen

Pain and fever, specifically in pts who have gastrointestinal/kidney/cardiovascular risks

Adult dose of acetaminophen

1000mg

Peds dose of acetaminophen

10-15 mg/kg

Repeat acetaminophen?

No

MOA for acetaminophen

Inhibits pain receptors, reduces rever

Side effects of acetaminophen

liver damage in large doses

Contraindications of acetaminophen

Liver disease

Route for acetaminophen

Oral

Indication for activated charcoal

Ingested poison—use within 1 hour pref

Adult dose of activated charcoal

50g

Peds dose of activated charcoal

1g/kg up to 25kg

MOA for activated charcoal

Absorbs toxin, speeds up elimination

Contraindications for activated charcoal

AMS; unable to swallow or maintain airway

Ingested caustic substances

Side effects of activated charcoal

Constipation, diarrhea, darkening of stool, vomiting

Adult dose of albuterol

2.5 - 5.0 mg in 3cc

*pt must have Rx, otherwise call medical control

Peds dose of albuterol

<15 y/o

1.25 - 2.5mg in 3cc

*pt must have Rx, otherwise call medical control

Can you repeat activated charcoal?

no

Can you repeat albuterol?

Yes x3.

Up to 15 mg adult

7.5mg peds

MOA for albuterol

Bronchodilator

Indications for albuterol

bronchospasm, asthma, COPD w/wheezing

Contraindications of albuterol

HR > 150 in adults

>200 in peds

Cardiac disease

Route for albuterol

MDI (metered dose inhaler) /Nebulizer

set o2 at 6-8L for nebulizer

Side effects of albuterol

Tachycardia, anxiety, cough, tremors, dizziness

Adult dose of aspirin

4×81mg tab (324 mg total)

Peds dose of aspirin

not indicated.

can you repeat aspirin?

no

MOA of aspirin

prevents platelets from aggregating

Indications for aspirin

Chest pain

Contraindications of aspirin

Allergy to aspirin

Bleeding

Route for aspirin

oral, chewed

Side effects of aspirin

Bleeding, wheezing or bronchospasm, nausea/vomiting

Dose of atropine

Each kit has 2.1mg atropine, 600mg pralidoxime
<7 years old - 1 kit

8-14 years old - 2 kits

>14 years old - 3 kits

Can you repeat atropine?

Every 10-15 minutes until symptoms resolve

MOA for atropine

Blocks acetylcholine receptors (the body’s rest and digest) so it puts you into fight or flight.

Organophosphate poisoning causes the buildup of acetylcholine; atropine acts as a competitive antagonist

Indications for atropine

Organophosphate poisoning, insecticides and nerve agent exposure

Contraindications for atropine

None if you’re organophosphate poisoned

Route for atropine

IM autoinjector in mid-lateral thigh, delivers both atropine and pralidoxime

Side effects of atropine

Dry mouth and eyes (organophosphate poisoning makes you bleed from everywhere), vision changes, tachycardia, nausea, vomiting, dizziness, headache, muscle weakness, dry skin, rash

Dose calcium gluconate (paste/gel)

liberal application to affected area w/continuous massage

Can you repeat calcium gluconate?

Repeat 15 min

MOA for calcium gluconate

Neutralizes flouride ions in the acid

Indications for calcium gluconate

Hydroflouric acid exposure

Contraindications for calcium gluconate

None if you’ve been exposed to hydroflouric acid

Route for calcium gluconate

Dermal

Side effects of calcium gluconate

none listed

Dose of diphenhydramine

Adult: 25-50mg

Peds: 1mg/kg (liquid)

Can you repeat diphenhydramine?

No

What is the MOA of diphenhydramine?

Reverses effects of histamines

Indications for diphenhydramine

Allergic reactions

Contraindications for diphenhydramine

none for anaphylaxis, but do NOT give to a person having only an asthma attack

Route for diphenhydramine

Oral

Side effects of diphenhydramine?

Sedation, thickening of oral/respiratory secretions

Dose for epinephrine

Adult: 0.3 to 0.5 mg

Peds: 0.15 or 0.01 mg/kg up to 0.3 mg max (per NC protocol)

Can you repeat epinephrine?

Yes, every 5 min if necessary

MOA for epinephrine

opens airways, reduces swelling, vasoconstricts to increase BP

Indications for epinephrine

Anaphylaxis with at least 2 body systems affected

Contraindications for epinephrine

None if severe allergic reaction

Route for epinephrine

Intramuscular by auto-injector or manual draw

Side effects for epinephrine

tachycardia, dizziness, tremors, headache, nausea/vomiting, anxiety, restlessness, pallor/paleness, sweating

Dose for glucagon

Adult: 1-2mg

Peds: 0.5 mg if <25 kg or <6 y/o

Can you repeat glucagon?

Yes, every 15 minutes

MOA of glucagon

Causes liver to convert glycogen into glucose

Indications for glucagon

Hypoglycemia in unresponsive pt or pt cannot protect their airway

Contraindications for glucagon

None

Route for glucagon

IM deltoid

Side effects of glucagon

Nausea, vomiting, tachycardia

Dose of oral glucose

Adult: 15g

Peds: 0.5 g/kg

Can you repeat oral glucose

Yes, in 10-15 minutes

MOA of oral glucose

Increases blood sugar

Indication for glucose

AMS and known history of diabetes

Contraindications for oral glucose

Unconscious or inability to swallow

Route for glucose

Oral

Side effects of oral glucose

None when given properly

Dose for ibuprofen

Adult: 400-800mg
Peds: 10 mg/kg

Can you repeat ibuprofen?

No

MOA for ibuprofen

Anti-inflammatory

Indications for ibuprofen

Fever and pain

Contraindication to ibuprofen

Allergy to NSAIDs, history of GI bleeding, renal insufficiency, anticoagulants

Route for ibuprofen

Oral

Side effects of ibuprofen

Rash, abdominal pain, nausea, diarrhea, constipation, heartburn

Dose for isopropyl alcohol

1 IPA pad

Can you repeat isopropyl alcohol?

Yes, as needed

MOA for isopropyl alcohol

Unknown, but peak effect in ~4 min

Indication for isopropyl alcohol

Nausea

Contraindications for isopropyl alcohol

Unresponsive

Route for isopropyl alcohol

Nasal, hold pad 1/2” away from nostrils

Side effects of isopropyl alcohol

None when given properly

Dose for naloxone

Adult: 1-2mg at 1mg/mL split between nares

Peds: 0.1 mg/kg

Can you repeat naloxone?

Yes as needed

MOA for naloxone

Binds to opiate receptors blocking narcotics

Indication for naloxone

Narcotic or synthetic overdose

Contraindications for naloxone

non-narcotic induced respiratory depression otherwise none

Route for naloxone

Nasal atomizer

Side effects of naloxone

ABRUPT reversal of narcotic depression, nausea/vomiting, sweating, tachycardia, increased BP, seizures

Dose for Afrin/Oxymetazoline

Adult: 2 sprays per nare

Peds: 1-2 sprays

Can you repeat Afrin/Oxymetazoline?

No

MOA for Afrin/Oxymetazoline

Vasoconstrictor

Indications for Afrin/Oxymetazoline

epistaxis (nose bleed)

Contraindictions for Afrin/Oxymetazoline

Hypertension

Route for Afrin/Oxymetazoline

nasal spray