Drug Cards - All

Oxygen - Classification

Atmospheric Gas

Oxygen - Mechanism of Action

Aerobic metabolism - oxidation of glucose to form ATP

Oxygen - Indications

Hypoxia
Shock
Ischemic chest pain
Respiratory Insufficiency
Comfort Measures

Oxygen - Contraindications

COPD Patients (Use caution)

Oxygen - Side effects

Dried mucous membranes

Oxygen - Dosage

Adult & Pediatric: Pt specific (target 94-99%)

Delivery method: NC - 1-6lpm, NRBM - 10-15lpm, BVM - 12-25lpm

Epinephrine (1:1000) - Classification

Sympathomimetic

Sympathetic agonist

Epinephrine (1:1000) - Mechanism of Action

Positive stimulation of Alpha and Beta adrenergic receptors
Antagonizes histamine effects

Epinephrine (1:1000) - Indications

Anaphylaxis (severe allergic reaction)

Asthma

Epinephrine (1:1000) - Contraindications

None in the emergency setting

Epinephrine (1:1000) - Side Effects

Tachycardia

Hypertension

Angina

Headache

Nausea/Vomiting

Epinephrine (1:1000) - Dosage

Adult: 0.3-0.5mg IM/SQ (Preferred IM)
Pediatric: 0.01mg/kg IM/SQ (Preferred IM)

Albuterol - Classification

Bronchodilator

Sympathomimetic selective B-2

Albuterol - Mechanism of Action

Bronchodilation via stimulation of adrenergic receptor sites

Albuterol - Indications

Bronchospasms

Asthma

COPD

Wheezing

Albuterol - Contraindications

Unstable tachycardia

Albuterol - Side effects

Palpitations

Tachycardia

Nervousness

Albuterol - Dosage

Adult & Pediatric: 2.5mg diluted to 3ml with NS nebulized

Oral Glucose - Classification

Hyperglycemic

Carbohydrate

Oral Glucose - Mechanism of Action

Absorption into the GI tract providing prompt increase in circulating blood sugar

Oral Glucose - Indications

Conscious hypoglycemia

Oral Glucose - Contraindications

Hyperglycemia

Inability to protect airway

Oral Glucose - Side effects

Nausea/Vomiting

Oral Glucose - Dosage

Adult & Pediatric: 15gm PO (Max 30gm)

Naloxone - Classification

Opioid Antagonist

Naloxone - Mechanism of Action

Competes at the opiate receptor sites to antagonize the effects of both natural and synthetic opiates

Naloxone - Indication

Opioid overdose

Unconscious/Unknown

Naloxone - Contraindication

None in the emergency setting

Naloxone - Side effects

Withdrawal syndrome

Tachycardia

Seizures

Pulmonary Edema

Naloxone - Dosage

Adult: 0.4-2mg q5-10 mins IN/IV/IM/IO

Pediatric: 0.1mg/kg (max 2mg) q5-10 mins IN/IV/IM/IO

Aspirin - Classification

Platelet anti-aggregator

Aspirin - Mechanism of Action

Blocks platelet aggregation by blocking the synthesis of thromboxane A2

Aspirin - Indications

Symptoms suggestive of myocardial ischemia (ACS)

Aspirin - Contraindications

Active ulcer disease (relative)

Asthma (relative)

Bleeding disorders (relative)

Aspirin - Side effects

Exacerbation of bleeding disorder

Aspirin - Dosage

162-325mg PO

Nitroglycerin - Classification

Vasodilator

Antianginal

Nitroglycerin - Mechanism of Action

Relaxes vascular smooth muscle decreasing preload and afterload on the heart

Nitroglycerin - Indications

Chest pain (ACS)

Pulmonary edema

Hypertensive crisis

Nitroglycerin - Contraindications

Hypotension

Recent ED medication usage

Nitroglycerin - Side effects

Hypotension

Headache

Tachycardia

Syncope

Nitroglycerin - Dosage

Adult: 0.4mg SL q3-5 mins (max 3 doses)

D50w/D25w/D10w - Classification

Antihypoglycemic

Carbohydrate

D50w/D25w/D10w - Action

Brief osmotic diuretic

Sends simple blood sugar to hypoglycemic brain tissue

D50w/D25w/D10w - Indications

Hypoglycemia

AMS (blood sugar unavailable)

Coma of unknown origin

D50w/D25w/D10w - Contraindications

Intracranial hemorrhage

BG >60mg/dL

D50w/D25w/D10w - Side effects

Worsening of brain injury (if present)

D50w/D25w/D10w - Dosage

Adult (50% solution): 12.5-25gm slow IV push (large bore catheter)

Pediatric (25% solution): 0.5-1gm/kg

Glucagon - Classification

Hormone

Glucagon - Action

Increases breakdown of glycogen to glucose
Decreases the synthesis of glycogen from glucose
Positive chronotropic and inotropic agent

Glucagon - Indications

Hypoglycemia (absolutely unable to start an IV or admin oral glucose)
Beta blocker overdose

Glucagon - Contraindications

None

Glucagon - Side effects

Hyperglycemia
Hypokalemia

Glucagon - Dosage

Adult: 0.5-1mg q20 mins IM/IV

Opiate Analgesics - Classification

Opioid Analgesic
Narcotic
Schedule II drug

Opiate Analgesics - Action

Central nervous system depressant that acts on the opiate receptors in the brain
Vasodilator (analgesic specific)

Opiate Analgesics - Indication

Pain indicative of ACS (analgesic specific)
Pulmonary edema
Pain protocol

Opiate Analgesics - Contraindication

Right ventricular infarct (RVI)

Opiate Analgesics - Side effects

Hypotension
Respiratory depression
Decreased LOC

Opiate Analgesics - Dosage

Adult: Morphine: 2-10mg IV/IM/IO
Adult: Fentanyl: 1mcg/kg (max 100mcg) IV/IM/IO/IN
Pediatric: Consult local protocol

Ondansetron - Classification

SSRA (Selective Serotonin Receptor Antagonist)

Antiemetic

Ondansetron - Action

Blocks serotonin receptor sites in the CNS at the CTZ

Ondansetron - Indications

Nausea and Vomiting

Prophylaxis for opiate administration

Ondansetron - Contraindications

Known prolonged QT syndrome

Ondansetron - Side effects

Headache

Dizziness

Ondansetron - Dosage

Adult: 4mg slow IV push

Pediatric: 0.1mg/kg slow IV push (max 4mg)

Epinephrine (1:10,000) - Classification

Catecholamine
Sympathetic agonist

Epinephrine (1:10,000) - Action

Positive stimulation of alpha and beta adrenergic receptors

Epinephrine (1:10,000) - Indications

Dead

Epinephrine (1:10,000) - Contraindications

None in the emergency setting

Epinephrine (1:10,000) - Side effects

Increase myocardial O2 demand
Tachy-dysrhythmias

Epinephrine (1:10,000) - Dosage

Adult: 1mg IV/IO q3-5 mins
Pediatric: 0.01mg/kg (max 1mg) IV/IO