BU EMT Medications

Epinephrine Trade Name: Adult (>30 kg/ 66 lbs)

Epi-Pen: Auvi-Q for adults; 1mg/mL. Check and Inject

Epinephrine Trade Name: Pediatric 15-30 kg/ 22-66 lbs)

Epi-Pen Junior: Auvi-Q for children; 1mg/mL. Check and Inject

Epinephrine Indications

Signs of severe allergic reaction, causing airway breathing, and/or circulatory compromise; anaphylactic reaction.

Epinephrine Contra-Indication

None when used in life-threatening emergencies.

Epinephrine Action

Bronchodilator, vasoconstrictor

Epinephrine Form

Liquid

Epinephrine Dosage: Adult

0.3 mg. Max dose of two, 5 minutes apart.

Epinephrine Dosage: Pediatrics

0.15 mg. Max dose of one.

Epinephrine Route of Administration

Intramuscular (IM)

Epinephrine Adverse Affects

• Hypertension

• Tachycardia

• Headache

• Burning at injection site

• Anxiety

• Sweating

• Pale Skin

• Palpatations

• Dizziness

Epinephrine Interactions

Increase affects of other nervous system stimulants;

Preganancy: Should only be given if potential benefit justifies risk to the fetus

Syncope in asthmatic children

Epinephrine Administration Concerns

• Consult medical control when patient has history of heart disease or acute coronary syndrome

• Ensure ALS is en route

Benadryl: Generic Name

Diphenhydramine

Diphenhydramine: Trade Name

Benadryl

Benadryl Indication

Mild allergic reactions

Benadryl Contra-Indications

• Hypersensitivity

• Asthma

• Glaucoma

• Pregnancy

• Hypertension

• Infants

• Mono amine oxidase inhibitors (MAOs) usage - type psychiatric medication

• Alcohol usage

Benadryl Action

Antihistamine

Benadryl Form

Tablet

Benadryl Dosage

25-30 mg

Benadryl Route of Administration

Oral (PO)

Benadryl Adverse Effects

• Sleepiness

• Dry mouth

• Dry throat

• Some people can have the opposite effects such as stimulation and hyperactivity

Benadryl Interactions

• Monoamine oxidase inhibitor (MAO) usage

• Alcohol usage

Benadryl Administration Considerations

Can use in severe allergic reaction after administration of epinephrine.

Pediatric dosage is weight based.

Acetaminophen: Trade Name

Tylenol

Tylenol: Generic Name

Acetaminophen

Tylenol Indication

Relief of mild pain or fever, headache, muscle aches

Tylenol Contra-Indication

Hyper-sensitivity; Liver failure

Tylenol Action

Anitpyretic; analgesic

Tylenol Form

Tablet

Tylenol Dosage

500-1,000 mg

Tylenol Route of Administration

Oral (PO)

Tylenol Adverse Effects

Allergic reaction

Tylenol Interactions

Overdose

Tylenol Administration Considerations

• Pediatric Dosage

• Liver disease

Ibuprofen: Trade Name

Advil, Motrin, Nuprin

Advil, Motrin, Nuprin: Generic Name

Ibuprofen

Ibuprofen Indications

Relief of mild pain or fever, headache, muscle aches

Ibuprofen Contra-Indications

• Hypersensitivity

• Trauma other than isolated extremity trauma

• Known GI bleeding

Ibuprofen Action

Non-steroidal anti-inflammatory drug (NSAID)

Ibuprofen Form

Tablet

Ibuprofen Dosage

200-400 mg

Ibuprofen Route of Administration

Oral (PO)

Ibuprofen Adverse Effects

• Nausea

• Vomiting

• Stomach pain

• Bleeding

• Allergic Reaction

Ibuprofen Interactions

Do not give with asprin

Ibuprofen Administration Consideration

• Do not give for pain caused by trauma

• Pediatric dose is weight based

Metered Dose Inhalers (MDI) Trade Name:

• Primatene Mist

• Bronitin Mist

• Bronkaid Mist

• ProAir

• Ventolin

• Proventil

• Xopenex

• DuoNeb

Primatene Mist, Bronitin Mist, Bronkaid Mist, ProAir, Ventolin, Proventil, Xopenex, DuoNeb: Generic Name

Metered Dose Inhaler (MDI)

MDI Indication

Treatment of bronchospasm with reversible obstructive airway disease; Signs and symptoms of shortness of breath, current prescription for rescue inhale type MDI

MDI Contra-Indication

• Hypersensitivity

• Unconscious, unable to physically use the device, maximum dose reached prior arrival

• Device is not prescribed to patient

• Inhaler is a maintenance inhaler

MDI Action

Bronchodilator

MDI Form

Powder/Mist

MDI Dosage

Number of puffs as defined by patient’s prescription (3)

MDI Route of Administration

Inhaled

MDI Adverse Effects

• Anxiety

• Tachycardia

• Muscle tremors

• Coughing

MDI Interactions

Increases effect of other nervous system stimulants

MDI Administration Considerations

Wait 5 minutes between doses

Albuterol (Nebulizer): Trade Name

Proventil or Ventolin

Proventil or Ventolin: Generic Name

Albuterol (Nebulizer)

Albuterol (Nebulizer) Indication

Treatment of bronchospasm with reversible obstructive airway disease; Signs and symptoms of shortness of breath, current prescription for rescue inhale type MDI

Albuterol (Nebulizer) Contra-Indication

Hypersensitivity; Unconscious, unable to physically use device, maximum dose reached prior to arrival

Albuterol (Nebulizer) Action

Bronchodilator

Albuterol (Nebulizer) Form

Mist

Albuterol (Nebulizer) Dosage: Adult

• (2yrs+) 2.5 mg in 3 mL saline

• Administer over 5 to 15 minutes depending on flow

Albuterol (Nebulizer) Route of Administration

Inhaled via nebulizer

Albuterol (Nebulizer) Adverse Effects

Restlessness, tremors, dizziness, palpitations, tachycardia, nervousness, peripheral vasodilation, nausea, vomiting, hyperglycemia, increased BP, paradoxical bronchospasm

Albuterol (Nebulizer) Interactions

Increases effects of other nervous system stimulants

Albuterol (Nebulizer) Administration Considerations

Oxygen tank or air compressor is required; Flow rate should be 6-8 lpm

Albuterol (Nebulizer) Dosage: Pediatric

• (6mos - 2yrs) 1.25 mg in 3mL saline

• Administer over 5 to 15 minutes depending on flow

Ipraptromium Bromide (Nebulizer): Trade Name

Atrovent

Atrovent: Generic Name

Ipraptromium Bromide (Nebulizer)

Atrovent Indication

Treatment of bronchospasm with reversible obstructive airway disease; Signs and symptoms of shortness of breath, current prescription for rescuer inhaler type MDI

Atrovent Contra-Indication

Hypersensitivity; Unconscious, unable to physically use device, maximum dose reached prior to arrival; Bromide hypersensitivity

Atrovent Action

Bronchodilator

Atrovent Form

Mist

Atrovent Dosage

• Adult (2yrs+): 500 mcg in 3mL saline

• Pedi (6mos2yrs): 250 mcg in 3mL saline

• Administer over 5 to 15 minutes depending on flow rate

Atrovent Route of Administration

Inhaled via nebulizer

Atrovent Adverse Effects

Restlessness, tachycardia, anxiety, hypertension, chest pain of cardiac origin

Atrovent Interactions

Increases effects of other nervous system stimulants

Atrovent Administration Considerations

Oxygen tank or air compressor is required; Flow rate should be 6-8 lpm; pregnancy-should be given only if the potential benefit justifies the risk to the fetus; May precipitate arrhythmias

Acetylsalicylic Acid (ASA): Trade Name

Aspirin, Bayer

Aspirin, Bayer: Generic Name

Acetylsalicylic Acid (ASA)

Aspirin Indication

Acute chest pain indicative of cardiac problem

Aspirin Contra-Indication

Hypersensitivity; Unconscious, unable to swallow, allergic to aspirin, evidence of a recent or current severe internal bleed, bleeding disorder

Aspirin Action

Platelet inhibitor, analgesic, antipyretic, anti-inflammatory agent

Aspirin Form

Tablet

Aspirin Dosage

162 mg (81 mg x2) - 325 mg (81 mg x4)

Aspirin Route of Administration

Oral or Chewed (PO)

Aspirin Adverse Effects

Heartburn, GI bleeding/stomach pain, nausea, vomiting, wheezing in allergic patients, prolonged bleeding

Aspirin Interaction

Caution with patients taking an anticoagulant

Aspirin Administration Considerations

Do not administer for pain because of trauma or fevers in children (Reye Syndrome)

Nitroglycerin (NTG): Trade Name

Nitrostat, Tridil, Nitromist

Nitrostat, Tridil, Nitromist: Generic Name

Nitroglycerin (Nitro)

Nitroglycerin Indication

Acute chest pain indicative of cardiac problem

Nitroglycerin Contra-Indication

• Hypersensitivity

• Systolic BP <100 mmHg

• Intracranial bleeding or head injury

• Patient has already met the max dose,

• Took Erectile dysfunction medications within last 24 hrs

Nitroglycerin Action

Vasodilator

Nitroglycerin Form

Tablet, Spray

Nitroglycerin Dosage

1 Tablet or 1 Spray (0.3 or 0.4 mg). Max dose of three, 5 minutes apart

Nitroglycerin Route of Administration

Sublingual (SL)

Nitroglycerin Adverse Effects

Headache, tingling under tongue, hypotension, syncope, flushing, nausea, vomiting, diaphoresis, muscle twitching

Nitroglycerin Interactions

Headache, hypotension, nausea, vomiting, burning under tongue