EMT pharmacology

Oxygen

Action: increases oxygen in the air, helps with hypoxia

Indication: Hypoxia, respiratory distress, pulse oximetry reading is <94%.

Contraindications: n/a

Side-Effects: Nasal burning, etc

Dosage: Nasal Canula 1-6 L/min

nonrebreathing mask: 10-15 L/min

bag-mask device: 15 L/min

Oral Glucose

• Action: Provides a rapid, immediate source of sugar for cellular energy.

• Indication: Documented or suspected hypoglycemia (low blood sugar).

• Contraindications: Unconscious or semiconscious patient; anyone unable to swallow or protect their own airway.

• Side Effects: Nausea, vomiting, risk of airway aspiration if level of consciousness decreases.

• Dosage: One full tube (typically 15g to 25g depending on the manufacturer) placed between the cheek and gum.

Aspirin

• Action: Anti-inflammatory and antipyretic; prevents platelets from sticking together (inhibits platelet aggregation).

• Indication: New-onset chest pain suggestive of an acute myocardial infarction (heart attack).

• Contraindications: Hypersensitivity (allergy) to aspirin, active bleeding disorders, severe asthma, severe liver damage. Do not give to children.

• Side Effects: Nausea, heartburn, stomach upset, bleeding.

• Dosage: 162 mg to 324 mg given as 2 to 4 low-dose "baby" aspirins (81 mg each); must be chewed by the patient before swallowing.

Nitroglycerin

• Action: Powerful vasodilator; relaxes smooth muscle in veins and dilates coronary arteries, increasing blood flow to the heart.

• Indication: Cardiac chest pain (angina pectoris).

• Contraindications: Systolic blood pressure $< 100\text{ mm Hg}$. Use of erectile dysfunction (ED) medications within the past 24–48 hours.

• Side Effects: Immediate mild headache, dizziness, sudden drop in blood pressure (hypotension), flushing.

• Dosage: 0.4 mg sublingually (SL) via a tablet dissolved under the tongue or a metered spray. May repeat every 5 minutes for a maximum of 3 doses, continuously rechecking blood pressure.

Epinephrine

• Action: Sympathomimetic; stimulates nervous system receptors causing bronchodilation (opening airways) and vasoconstriction (raising blood pressure).

• Indication: Life-threatening systemic allergic shock (anaphylaxis).

• Contraindications: None when used in a true life-threatening anaphylactic emergency.

• Side Effects: Tachycardia (rapid heart rate), hypertension, anxiety, tremors, cardiac dysrhythmias.

• Dosage: Delivered Intramuscularly (IM) into the lateral thigh.

  • Adult Auto-Injector: 0.3 mg.

  • Pediatric Auto-Injector: 0.15 mg.

Naloxone

• Action: Narcotic antagonist; binds directly to opioid receptors to block and reverse the effects of narcotics.

• Indication: Known or suspected opioid overdose with respiratory depression (inadequate breathing).

• Contraindications: Hypersensitivity/allergy to the drug.

• Side Effects: Severe, immediate withdrawal symptoms, agitation, vomiting, rapid heart rate.

• Dosage: 2.0 mg to 4.0 mg total, most commonly administered via the Intranasal (IN) route with a mucosal atomizer device. May be repeated after 2–3 minutes if respirations remain inadequate.

Activated Charcoal

• Action: Adsorbent; physically binds to swallowed chemicals and toxins in the gastrointestinal tract.

• Indication: Recent oral poisonings or toxin ingestions.

• Contraindications: Altered mental status, unconsciousness, or inability to swallow (due to severe aspiration risk); ingestion of corrosives, alkalis, or petroleum products.

• Side Effects: Nausea, vomiting, black stools, constipation.

• Dosage: 1 gram of charcoal per kilogram of body weight.

  • Typical Adult range: 25 to 50 grams.

  • Typical Pediatric range: 12.5 to 25 grams.

Albuterol

• Action: Beta-2 agonist; relaxes bronchial smooth muscle to open up constricted airways.

• Indication: Respiratory distress associated with asthma, bronchitis, or COPD.

• Contraindications: Hypersensitivity, severe tachycardia (rapid heart rate) secondary to a pre-existing cardiac condition.

• Side Effects: Anxiety, tremors, tachycardia, palpitations, nervousness.

• Dosage: 2.5 mg dissolved in $3\text{ mL}$ of normal saline via a small-volume nebulizer (run at 6–8 L/min of oxygen), or 1 to 2 puffs via a patient-prescribed Metered-Dose Inhaler (MDI).