Paramedic Pharmacology & Drug Profiles

Comprehensive vocabulary flashcards detailing paramedic pharmacology terminology, drug classes, mechanisms of action, clinical indications, dosages, and targeted physiological organ systems.

Action (Mechanism of Action)

The specific therapeutic effects or changes that a medication produces in the body; the intended outcome aimed at alleviating symptoms, treating a disease, or preventing disease.

Indications

The specific medical conditions or symptoms for which a medication is indicated or approved by regulatory authorities to be used as treatment.

Contraindications

Specific situations or medical conditions in which a particular medication should not be given, such as allergies, harmful drug interactions, or conditions where it would be ineffective or harmful.

Precautions

Specific situations or medical conditions where a particular medication should be used with caution, taking into account patient age, pregnancy status, or concurrent medications.

Dosage

The amount of a medication that should be administered to a patient based on their weight, age, and clinical condition.

Route of Administration

The method by which a medication is introduced into the patient's body, including IV, IO, IM, IN, SC, PR, PO, SL, NEB, NC, NRB, ET, and SGA.

Adverse Effects

Any undesired effects resulting from medication administration, ranging from mild symptoms like drowsiness or nausea to serious reactions like anaphylaxis or organ damage.

Onset

The amount of time that elapses from administration until a medication begins to take effect.

Duration

The length of time a medication continues to remain effective in the body after administration.

Cardiovascular System Icon

Represents medications and pathologies targeting the heart and systemic vascular circulation.

Central Nervous System Icon

Represents medications and pathologies targeting the brain, spinal cord, and neural transmission pathways.

Respiratory System Icon

Represents medications and conditions involving the lungs and respiratory tract.

Gastrointestinal System Icon

Represents medications and pathologies localized to the stomach and alimentary tract.

Endocrine System Icon

Represents medications targeting hormone-producing organs such as the pancreas.

Urinary System Icon

Represents medications targeting renal excretion, nephron tubules, and fluid balance via the kidneys.

Acetaminophen (Tylenol®)

An analgesic and antipyretic that inhibits prostaglandin synthesis in the CNS by blocking cyclooxygenase-2 (COX-2); dosed at $325\text{--}1000\,mg$ PO in adults and $10\text{--}15\,mg/kg$ PO/PR in pediatrics (maximum total $4\,g$).

Activated Charcoal (Actidose®)

An antidote that binds to ingested toxins within the GI tract to prevent systemic absorption; indicated for oral toxic ingestions within $1\text{ hour}$ of EMS contact at an adult dose of $1\,g/kg$ PO ($1\text{--}2\,g/kg$ PO in pediatrics).

Adenosine (Adenocard®)

A Class 5 antiarrhythmic that activates potassium channels and inhibits calcium influx, temporarily blocking AV node conduction to terminate SVT/PSVT; dosed as a rapid $6\,mg$ IV/IO bolus, repeatable at $12\,mg$.

Albuterol (Proventil®)

A selective Beta-2 adrenergic bronchodilator used for bronchospasm and asthma/COPD exacerbations; dosed at $2.5\text{--}5\,mg$ NEB diluted in $2.5\,mL$ NS for adults ($1.25\text{--}2.5\,mg$ for pediatrics).

Amiodarone (Cordarone®)

A Class 3 antiarrhythmic (potassium channel blocker) that prolongs the cardiac action potential and refractory period; dosed at $300\,mg$ IV/IO bolus in cardiac arrest (repeatable at $150\,mg$) or $150\,mg$ drip over $10\text{ min}$ for V-Tach with pulse.

Aspirin (Acetylsalicylic Acid®)

An NSAID and platelet aggregation inhibitor that blocks thromboxane $A_2$ formation via cyclooxygenase inhibition; indicated for angina and suspected MI at an adult dose of $162\text{--}324\,mg$ chewed PO.

Atropine Sulfate

An anticholinergic muscarinic antagonist that blocks parasympathetic vagal stimulation at the AV node; indicated for symptomatic bradycardia ($1\text{--}2\,mg$ IV/IO up to $3\,mg$) and organophosphate/nerve gas poisoning ($2\text{--}5\,mg$ IV/IO/IM).

Bumetanide (Bumex®)

A potent loop diuretic ($\approx 40\times$ more potent than Furosemide) that inhibits sodium, potassium, and chloride reabsorption in the ascending loop of Henle; dosed at $0.5\text{--}1\,mg$ slow IV bolus for pulmonary edema and CHF.

Calcium Chloride

An electrolyte and hypertonic solution that increases intracellular calcium, increasing myocardial contractility and automaticity; indicated for hypocalcemia, hyperkalemia, hypermagnesemia, and CCB/BB overdose ($0.5\text{--}1\,g$ IV/IO).

Dexamethasone (Decadron®)

A long-acting corticosteroid that suppresses immune response and proinflammatory cytokines; indicated for asthma exacerbations, croup, cerebral edema, and anaphylaxis at an adult dose of $5\text{--}10\,mg$ IV/IM ($0.1\text{--}0.5\,mg/kg$ in pediatrics).

Dextrose (D5W / D10W / D25W / D50W)

A carbohydrate solution that rapidly raises blood glucose levels in hypoglycemia; adult dose is $12.5\text{--}25\,g$ IV/IO ($25\text{--}50\,mL$ of D50W or $125\text{--}250\,mL$ of D10W).

Diazepam (Valium®)

A long-acting benzodiazepine anticonvulsant and sedative that enhances GABA receptor activity in the CNS; dosed at $5\text{--}15\,mg$ slow IV/IM in adults (repeatable up to $30\,mg$) for active seizures and procedural sedation.

Diltiazem (Cardizem®)

A Class 4 antiarrhythmic (calcium channel blocker) that slows AV nodal conduction; indicated for rapid ventricular response in A-Fib and A-Flutter at an initial dose of $0.25\,mg/kg$ IV (max $20\,mg$), repeatable at $0.35\,mg/kg$ (max $25\,mg$).

Diphenhydramine (Benadryl®)

A first-generation antihistamine that blocks $H_1$ receptors and possesses anticholinergic properties; indicated for allergic reactions, anaphylaxis adjunct, and dystonic reactions at $25\text{--}50\,mg$ IV/IM in adults ($1\text{--}2\,mg/kg$ in pediatrics).

Dobutamine (Dobutrex®)

A synthetic sympathomimetic and inotrope that stimulates Beta-1 adrenergic receptors to increase myocardial contractility with minimal alpha vasoconstriction; infused at $2\text{--}20\,\mu g/kg/min$ for cardiogenic shock and decompensated heart failure.

Dopamine (Intropin®)

An inotropic vasopressor that stimulates Beta-1 receptors at moderate doses ($5\text{--}10\,\mu g/kg/min$) and Alpha-1 receptors at higher doses ($10\text{--}20\,\mu g/kg/min$); titrated for cardiogenic, distributive, and severe hypotensive shock.

Droperidol (Inapsine®)

A butyrophenone antipsychotic and antiemetic that blocks dopamine receptors in the CNS; dosed at $1.25\text{--}5\,mg$ IV/IM for acute agitation, psychosis, nausea, and vomiting.

Epinephrine (Adrenaline®)

A non-selective alpha and beta adrenergic agonist; dosed at $1\,mg$ IV/IO ($1:10{,}000$) every $3\text{--}5\text{ min}$ for cardiac arrest and $0.3\text{--}0.5\,mg$ IM ($1:1{,}000$) for severe anaphylaxis or acute asthma.

Etomidate (Amidate®)

A non-barbiturate hypnotic and sedative that modulates $GABA_A$ receptors causing chloride influx and cellular hyperpolarization; dosed at $0.2\text{--}0.6\,mg/kg$ IV/IO for rapid sequence induction and procedural sedation.

Famotidine (Pepcid®)

A histamine $H_2$ receptor antagonist that blocks gastric parietal cell acid secretion; indicated for peptic ulcers, GERD, and allergic reactions at an adult dose of $20\text{--}40\,mg$ IV.

Fentanyl (Sublimaze®)

A potent synthetic opioid agonist acting on mu-opioid receptors; dosed at $0.5\text{--}2\,\mu g/kg$ IV/IO (max $100\,\mu g$ per dose) for moderate to severe pain and procedural sedation ($100\,\mu g$ is roughly equivalent to $10\,mg$ Morphine).

Flumazenil (Romazicon®)

A competitive benzodiazepine receptor antagonist that reverses sedative and respiratory depressive effects; dosed at $0.2\text{--}0.3\,mg$ slow IV/IO, repeatable up to a total of $3\,mg$.

Furosemide (Lasix®)

A loop diuretic that inhibits the $Na^+\text{--}K^+\text{--}2Cl^-$ cotransporter in the ascending loop of Henle; indicated for pulmonary edema and heart failure at $0.5\text{--}1\,mg/kg$ slow IV/IO (max initial $80\,mg$).

Glucagon (GlucaGen®)

A pancreatic hormone that promotes hepatic glycogenolysis to elevate blood glucose; dosed at $1\,mg$ IM/IN for hypoglycemia when IV access is unobtainable, or $3\text{--}10\,mg$ IV for beta-blocker/CCB overdose.

Haloperidol (Haldol®)

A first-generation butyrophenone antipsychotic that blocks dopamine $D_2$ receptors in the CNS; administered at $2\text{--}5\,mg$ IV/IM for acute psychotic agitation (max total $15\,mg$).

Heparin Sodium

An anticoagulant that potentiates antithrombin III, inactivating thrombin and Factor Xa to prevent blood clot formation; dosed as a bolus of $70\text{--}80\,\text{units}/kg$ IV (max $4{,}000\,\text{units}$) followed by a continuous infusion.

Hydralazine (Apresoline®)

A direct arteriolar vasodilator that decreases peripheral vascular resistance and cardiac afterload; dosed at $10\text{--}20\,mg$ slow IV/IM for hypertensive emergencies and acute heart failure.

Hydromorphone (Dilaudid®)

A potent semi-synthetic opioid analgesic with high affinity for mu-opioid receptors; dosed at $0.5\text{--}2\,mg$ slow IV/IO/IM for moderate to severe acute pain.

Hydroxocobalamin (Cyanokit®)

An antidote for known or suspected cyanide poisoning that binds cyanide ions to synthesize non-toxic cyanocobalamin, excreted renally; infused at an adult dose of $5\,g$ IV over $15\text{ min}$.

Hydroxyzine (Vistaril®)

A first-generation antihistamine ($H_1$ blocker) with sedative and antiemetic properties; dosed at $25\text{--}50\,mg$ IM for anxiety, agitation, and pruritus/urticaria in allergic reactions.

Ipratropium Bromide (Atrovent®)

An anticholinergic bronchodilator that antagonizes muscarinic acetylcholine receptors on bronchial smooth muscle; administered via nebulizer at $0.25\text{--}0.5\,mg$ diluted in NS, often combined with Albuterol (DuoNeb).

Ketamine (Ketalar®)

A dissociative NMDA receptor antagonist and anesthetic; provides analgesia and amnesia while preserving airway reflexes; dosed at $0.5\text{--}2\,mg/kg$ IV/IO for procedural sedation and acute severe pain.

Ketorolac (Toradol®)

A potent non-steroidal anti-inflammatory drug (NSAID) that inhibits COX-1 and COX-2 enzymes to decrease prostaglandin synthesis; administered as $15\text{--}30\,mg$ IV/IM for moderate to severe acute pain.

Labetalol (Trandate®)

A non-selective beta-blocker with selective alpha-1 blocking activity that decreases systemic vascular resistance and blood pressure; administered at $10\text{--}20\,mg$ slow IV bolus for severe hypertension.

Lactated Ringer's (LR)

An isotonic crystalloid solution containing sodium, chloride, potassium, calcium, and lactate (metabolized by the liver to bicarbonate); indicated for fluid resuscitation in hypovolemia, trauma, and burn management.

Levalbuterol (Xopenex®)

The pure (R)-enantiomer of albuterol, acting as a selective Beta-2 agonist that produces bronchodilation with potentially fewer beta-1 cardiovascular side effects; dosed at $0.63\text{--}2.5\,mg$ NEB.

Lidocaine (Xylocaine®)

A Class 1b antiarrhythmic that blocks fast voltage-gated sodium channels, suppressing automaticity and ventricular dysrhythmias; dosed at $1\text{--}1.5\,mg/kg$ IV/IO bolus in cardiac arrest from V-Fib/pulseless V-Tach.

Lorazepam (Ativan®)

An intermediate-acting benzodiazepine that enhances central GABA receptor activity; dosed at $2\text{--}4\,mg$ slow IV/IM in adults for active status epilepticus, severe anxiety, and sedation.

Magnesium Sulfate

An electrolyte and calcium antagonist that stabilizes excitable membranes and produces smooth muscle relaxation; indicated for Torsades de Pointes, eclamptic seizures, and severe status asthmaticus ($1\text{--}4\,g$ IV/IO).

Mannitol (Osmitrol®)

An osmotic diuretic that draws free water out of brain parenchymal tissue into the intravascular space to reduce cerebral edema and intracranial pressure; dosed at $0.5\text{--}1\,g/kg$ IV drip.

Meperidine (Demerol®)

A synthetic opioid agonist targeting mu-receptors with rapid onset and short duration; dosed at $25\text{--}100\,mg$ slow IV/IO/IM for moderate to severe pain (metabolized to neurotoxic normeperidine).

Methylprednisolone (Solu-Medrol®)

An intermediate-acting synthetic glucocorticoid corticosteroid that suppresses immune activation and inflammatory cascades; dosed at $125\text{--}250\,mg$ IV/IM for status asthmaticus, COPD, and anaphylaxis.

Metoprolol (Lopressor®)

A selective Beta-1 adrenergic blocker that decreases heart rate, contractility, and cardiac output; indicated for rate control in A-Fib/A-Flutter and acute MI, dosed at $5\,mg$ slow IV over $2\text{--}5\text{ min}$, repeatable up to $15\,mg$.

Midazolam (Versed®)

A short-acting water-soluble benzodiazepine that enhances central inhibitory GABA activity; dosed at $2\text{--}5\,mg$ IV/IM/IN for active seizures, behavioral agitation, and RSI sedation.

Morphine Sulfate

A naturally occurring opioid analgesic that stimulates mu-opioid receptors and causes peripheral vasodilation; dosed at $2\text{--}5\,mg$ slow IV/IO for severe pain and ischemic chest pain.

Naloxone (Narcan®)

A pure, competitive opioid antagonist that displaces narcotics from mu, kappa, and delta receptors; indicated to reverse opioid-induced respiratory depression at $0.4\text{--}4\,mg$ IV/IO/IM/IN.

Nicardipine (Cardene®)

A dihydropyridine calcium channel blocker that selectively relaxes vascular smooth muscle to decrease systemic vascular resistance; infused at $5\,mg/hr$ IV (titrated up to $15\,mg/hr$) for acute hypertensive crises.

Nitroglycerin (Nitrostat®)

An organic nitrate vasodilator that generates nitric oxide, stimulating cGMP production and promoting venous and coronary vasodilation; dosed at $0.4\,mg$ SL every $3\text{--}5\text{ min}$ for angina and cardiogenic pulmonary edema.

Nitrous Oxide (Nitronox®)

An inhaled gaseous analgesic and NMDA receptor antagonist administered as a premixed $50\%\text{ }N_2O$ and $50\%\text{ }O_2$ concentration for the self-directed management of acute moderate to severe musculoskeletal pain.

Norepinephrine (Levophed®)

A potent peripheral vasopressor that stimulates Alpha-1 and Beta-1 adrenergic receptors; infused at $0.1\text{--}0.5\,\mu g/kg/min$ IV/IO for distributive, septic, and cardiogenic shock refractory to fluid resuscitation.

Normal Saline (0.9% Sodium Chloride)

An isotonic crystalloid solution ($154\,mEq/L\text{ }Na^+$ and $154\,mEq/L\text{ }Cl^-$) used for intravascular fluid volume replacement and medication dilution; given as a $1\text{--}2\,L$ bolus in hypovolemia.

Ondansetron (Zofran®)

A selective serotonin $5\text{-}HT_3$ receptor antagonist that blocks vagal and central triggers of the vomiting reflex; dosed at $4\,mg$ IV/IO/IM for nausea and vomiting prevention.

Oral Glucose

A fast-acting simple carbohydrate administered buccally ($15\text{--}25\,g$) to conscious, intact-airway patients with documented symptomatic hypoglycemia.

Oxygen

An essential medical gas delivered via nasal cannula ($1\text{--}6\,L/min$), non-rebreather mask ($10\text{--}15\,L/min$), or bag-valve mask ($15\,L/min$) to reverse hypoxemia and maintain blood oxygen saturation $\ge 94\%$.

Oxytocin (Pitocin®)

A synthetic pituitary hormone that stimulates rhythmic uterine smooth muscle contractions; administered at $10\text{--}40\,\text{units}$ IV infusion to control postpartum hemorrhage following delivery of the placenta.

Potassium Chloride

An essential systemic electrolyte supplement administered via controlled IV infusion ($10\text{--}40\,mEq/hr$) for the treatment of documented hypokalemia and metabolic alkalosis.

Pralidoxime (2-PAM®)

A cholinesterase reactivator that cleaves organophosphate molecules from acetylcholinesterase before chemical aging occurs; administered at $1\text{--}2\,g$ IV infusion alongside atropine.

Procainamide (Pronestyl®)

A Class 1a antiarrhythmic that blocks fast inward sodium currents, prolonging refractory periods; dosed at $20\text{--}50\,mg/min$ IV/IO infusion (up to $17\,mg/kg$) for stable ventricular tachycardia and pre-excited atrial fibrillation.

Promethazine (Phenergan®)

A phenothiazine derivative with $H_1$ antihistaminic, anticholinergic, and antiemetic activity; dosed at $12.5\text{--}25\,mg$ deep IM or diluted slow IV for nausea, vomiting, and sedation.

Propofol (Diprivan®)

An ultra-short-acting intravenous sedative-hypnotic that potentiates $GABA_A$ transmission; dosed at $1.5\text{--}3\,mg/kg$ IV bolus for rapid induction of general anesthesia and procedural sedation.

Propranolol (Inderal®)

A non-selective competitive Beta-1 and Beta-2 adrenergic receptor antagonist; dosed at $1\text{--}3\,mg$ slow IV for tachyarrhythmias, angina, and severe hypertension.

Protamine Sulfate

A strongly basic heparin antagonist that forms an inactive, stable salt complex with acidic heparin; dosed at $1\text{--}1.5\,mg$ per $100\,\text{units}$ of heparin administered (max single dose $50\,mg$).

Racemic Epinephrine (Micronefrin®)

A nebulized racemic mixture of epinephrine enantiomers that induces upper airway mucosal vasoconstriction ($\alpha_1$) and bronchodilation ($\beta_2$); dosed at $0.5\,mL$ of a $2.25\%$ solution for croup and laryngeal edema.

Rocuronium (Zemuron®)

An intermediate-acting non-depolarizing neuromuscular blocking agent (NMBA) that competitively blocks acetylcholine at nicotinic motor endplate receptors; dosed at $0.6\text{--}1.2\,mg/kg$ IV/IO for RSI paralysis.

Sodium Bicarbonate

A systemic alkalizing agent that elevates plasma and urinary pH; dosed at $1\,mEq/kg$ IV/IO for severe metabolic acidosis, tricyclic antidepressant (TCA) toxicity, and hyperkalemia.

Succinylcholine (Anectine®)

A depolarizing neuromuscular blocker that stimulates nicotinic receptors, inducing transient muscle fasciculations followed by prolonged flaccid paralysis; dosed at $1\text{--}2\,mg/kg$ rapid IV/IO for RSI.

Terbutaline Sulfate (Brethine®)

A selective Beta-2 adrenergic receptor agonist that activates adenylate cyclase to produce bronchodilation; administered at $0.25\text{--}0.5\,mg$ SC for severe acute bronchospasm.

Thiamine (Betaxin®)

A water-soluble B-vitamin (Vitamin $B_1$) cofactor required for cellular carbohydrate metabolism; dosed at $100\,mg$ slow IV/IM prior to dextrose to prevent Wernicke's encephalopathy in malnourished/alcohol-dependent patients.

Tranexamic Acid (TXA / Lysteda®)

A synthetic antifibrinolytic lysine analog that competitively inhibits plasminogen activation, preventing clot degradation; administered as $1\,g$ IV infusion over $10\text{ min}$ for severe traumatic hemorrhage within $3\text{ hours}$ of injury.

Vasopressin (Pitressin®)

An endogenous antidiuretic hormone peptide that stimulates vascular $V_1$ receptors producing vasoconstriction; infused at $0.01\text{--}0.04\,\text{units}/min$ IV/IO for vasodilatory refractory septic shock.

Vecuronium (Norcuron®)

An intermediate-acting non-depolarizing neuromuscular blocking agent that competitively blocks nicotinic acetylcholine receptors at the motor endplate; dosed at $0.1\,mg/kg$ IV/IO for post-intubation paralysis.

A Class 4 antiarrhythmic (non-dihydropyridine calcium channel blocker) that slows AV nodal conduction velocity and prolongs refractory periods; dosed at $2.5\text{--}5\,mg$ slow IV bolus for paroxysmal SVT conversion.