All Drug Cards - Combined

generic name - narcan

Naloxone Hydrochloride

trade name - narcan

Narcan

drug classification - narcan

narcotic antagonist

supply - narcan

2 mg / 2 mL ampule (may also be a prefilled syringe)

mechanism of action - narcan

displaces narcotic angelsic at opioid receptor in CNS - reverses CNS respiratory depression induced by narcotics and synthetic narcotics

indications - narcan

coma of unknown origin, known or suspected narcotic-induced overdose and/or respiratory depression

contraindications - narcan

none, except known, rare, hypersensitivity

side effects - narcan

rare occurance of hypertension if pushed to fast, ventricular fibrillation, tremors, seizures, nausea/vomiting

dosage - narcan (adults only, N/A for pediatrics)

2-4 mg IN spray (per UPHEMS, SMO) ; 2 mg IN or IM (per PAEMS, SMO)

special considerations - narcan

ineffective for CNS depressants other than narcotics, monitor VS and LOC often as narcans duration is short, may precipitate withdrawal symptoms in patients addicted but not overdosed on narcotics

route - narcan

IN spray or IM injection

generic name - activated charcoal

Activated Charcoal

trade name - activated charcoal

SuperChar, InstaChar, Acticose

drug classification - activated charcoal

adsorbent, antidote

supply - activated charcoal

premixed suspension - bottle of 25-50 g

mechanism of action - activated charcoal

binds and adsorbs ingested toxins in the stomach to prevent absorption of toxins until they are eliminated from the body

indications - activated charcoal

recent poisoning and/or overdose by ingestion

contraindications - activated charcoal

preexisting GI bleeding, patients who cannot protect their own airways (aspiration risk) or cannot swallow

side effects - activated charcoal

nausea/vomiting, constipation, black stools, diarrhea, potential airway compromise/aspiration

adult dosage - activated charcoal

1 g/kg or 25-50 g

pediatric dosage - activated charcoal

1 g/kg or 12.5-25 g

route - activated charcoal

oral suspension - swallowed

special considerations - activated charcoal

monitor airway closely, anticipate vomiting, be prepared to suction airway, patient may be reluctant to drink solution

activated charcoal is _____ in the local EMS system

not used

generic name - benadryl

Diphenhydramine

trade name - benadryl

benadryl

drug classification - benadryl

antihistamine, H₁ blocker

supply - benadryl

50 mg oral tablet

mechanism of action - benadryl

reverses histamines action in the body, decreases bronchconstriction, decreases hypotension, decreases edema

indications - benadryl

anaphylaxis = itching, hives, extrapyramidal (drug-induced movement disorder) reactions from phenothiazines and some antipsychotic drugs

contraindications - benadryl

acute asthma, glaucoma, pregnancy, CNS depression

side effects - benadryl

hypotension, reflex tachycardia, palpitations, drowsiness, dizziness, headache, anxiety, seizures, blurred vision, dry mouth, dry nose and bronchi, nausea/vomiting

adult dosage (pediatrics N/A) - benadryl

50 mg PO via standing order

route - benadryl

orally - chewable tablet

special considerations - benadryl

not effective at reversing anaphylaxis - use in conjunction with epinephrine, do not give SQ, given to children under 12 yoa - may cause CNS excitation and seizures, overdoses can lead to severe convulsions, coma, or death

generic name - zofran

Ondansetron

trade name - zofran

Zofran

drug classification - zofran

antiemetic

supply - zofran

4 mg oral tablet

route - zofran

orally - disintegrating tablet

mechanism of action - zofran

prevention of nausea/vomiting associated with chemo, radiation, post-op, and general nausea/vomiting symptoms

indications - zofran

local EMS: generalized nausea/vomiting, suppress nausea associated with narcotics

contraindications - zofran

hypersensitivity to drug, use with caution in patients with liver failure

side effects - zofran

chest pain, hypotension, drowsiness, dizziness, headache, fatigue, diarrhea, constipation, fever, shivers, urinary retention, rash

adult dosage (pediatrics N/A) - zofran

4 mg oral tablet via standing order

special considerations - zofran

use caution in patients with asthma, peptic ulcer, bone marrow depression, have benadryl available to treat dystonic reactions

generic name - oral glucose

oral glucose

trade name - oral glucose

Glutose, Insta-glucose

drug classification - oral glucose

hyperglycemic

supply - oral glucose

gel in toothpaste-like tube; tablets (NOT for EMS use)

mechanism of action - oral glucose

increases amount of circulating blood sugar, reverses signs/symptoms of hypoglycemia - including decreased LOC

indications - oral glucose

signs/symptoms of hypoglycemia: altered level of consciousness, glucometer reading less than 60 mg/dL (normal range = 70-110 mg/dL)

contraindications - oral glucose

patients who cannot protect their own airway (risk of aspiration) → must be alert enough to swallow, patients with NO gag reflex, head trauma

side effects - oral glucose

airway compromise, nausea/vomiting

dosage - oral glucose

one complete tube (15 grams) if possible + 2nd does ONLY IF blood sugar remains below 60 mg/dL → administered via standing order if indications are met

route of administration - oral glucose

orally, squirt gel or apply with tongue depressor between cheek and gum

special considerations - oral glucose

monitor airway closely if patient is at risk of aspiration, patient may become combative or confused upon improved level of consciousness, oral glucose has a short lifetime within the body → patient must eat something to maintain blood sugar levels

oral glucose may be administered in the local EMS systems if patients _____ before contact with medical control

blood sugar levels below 60 mg/dL, is alert to at least verbal stimuli, able to sit upright, and has good airway control / intact gag reflex

generic AND trade name - glucagon

Glucagon

drug classification - glucagon

amino acid peptide hormone

supply - glucagon

1 mg and 1 unit vial diluent

mechanism of action - glucagon

promotes conversion of glycogen to glucose in the liver, and thus raises blood glucose levels

indication - glucagon

hypoglycemia (below 60 mg/dL) if unable to initiate an IV

contraindication - glucagon

patients with pheocromocytosis (tumor of adrenal gland - glucagon causes excess release of epi-/norepinephrine potentially leading to a hypertensive crisis)

side effects - glucagon

hypotension, nausea/vomiting, hypokalemia (low potassium in blood), bronchospasm, respiratory distress

adult dosage - glucagon

1 mg IM (intramuscular injection) → mix 1 mg with 1 mL diluent

pediatric dosage - glucagon

1 mg IM

special considerations - glucagon

monitor glucose concentrations before/after administration, once patient is awake → give oral glucose to prevent secondary hypoglycemia due to short duration of glucagon

why must glucagon be diluted prior to administration? And what must NOT be done to the mixed solution?

glucagon comes in powdered form, DO NOT shake the mixed solution, instead roll it gently prior to administration

generic name - nitroglycerine

Nitroglycerine

trade name - nitroglycerine

Nitrostat, Nitrospray, Nitro-Bid

drug classification - nitroglycerine

vasodilator, anti-anginal (angina = chest pain)

supply - nitroglycerine

0.4 mg sublingual tablets OR metered dose spray ; 2% in 1 g packet - ointment

mechanism of action - nitroglycerin

dilates arterial and venous vasculature, decreases amount of pressure the heart has to pump against, and increases blood flow to the myocardium

indications - nitroglycerin

ischemic chest pain (angina/MI), cardiogenic pulmonary edema + systolic BP over 100 mmHg

contraindications - nitroglycerin

ED drug use within 24-48 hours, hypotension, severe bradycardia OR tachycardia, hypovolemia, head trauma, cerebral hemorrhage

side effects - nitroglycerine

orthostatic hypotension, reflex tachycardia, palpitations, headache, dizziness, blurred vision, weakness, sublingual burning, dry mouth, and nausea/vomiting

adult dosage - nitroglycerin (NOT COMMON FOR CHILDREN)

1 metered dose sublingual spray OR tablet at 0.4 mg every 3-5 minute intervals, may repeat, for a total of 3 doses

when is it indicated to give up to 3 doses for nitroglycerin

when chest pain is unresolved, and systolic BP remains above 100 mmHg

what does nitroglycerin require before administration per local protocol

medical control order must be established, UNLESS patient is older than 30 yoa and is having chest pain consistent with an MI

special considerations - nitroglycerine

established IV access is strongly recommended prior to administration, uses with acute inferior MI → may cause hypotension and bradycardia, monitor vital signs before, during, and after administration

route(s) - nitroglycerin

orally - sublingual (spray and tablets)

generic name - epinephrine

Epinephrine

trade name - epinephrine

Adrenaline

drug classification - epinephrine

natural catecholamine sympathomimetic

supply - epinephrine

1 mg / 1 mL (1:1000 solution) ampule ; 0.3 mg Epi-Pen auto injector

mechanism of action - epinephrine

vasoconstriction, increases heart rate, bronchodilation

indications - epinephrine

anaphylactic shock, severe bronchospasm in status asthmaticus after failed response to albuterol/atrovent treatment

contraindications - epinephrine

tachydysrhythmias, hypertension, ventricular irritability, cardiovascular disease, pulmonary edema*

side effects - epinephrine

tachydysrhythmias, angina (chest pain) or MI, palpitations, hypertension, anxiety/nervousness, tremor, headache, pupil dilation, nausea/vomiting

adult dosage - epinephrine

0.3 mg IM (intramuscular) injection - via medical control order

pediatric dosage - epinephrine - anaphylaxis

0.01 mg/kg (1:1000) → 0.3 mg (max) IM injection - every 20 minutes

pediatric dosage - epinephrine - respiratory distress/failure

0.01 mg/kg → 0.3 mg (max) sub cutaneous injection - every 20 minutes

special considerations - epinephrine

monitor VS and cardiac monitor frequently, watching for arrhythmias if given for anaphylaxis

special consideration should be given to administering epinephrine if the patient is _____

over 40 yoa, has irregular heart rate, has a heart rate above 150 BPM, or has a history of heart disease or hypertension

generic name - oxygen

oxygen

trade name - oxygen

oxygen (O₂)

drug classification - oxygen

compressed nonflammable gas for medical use (oxygen enhances combustion)

supply - oxygen

tanks (green/green-chrome) - contains 100% oxygen

mechanism of action - oxygen

increases amount of oxygen in blood/available to cells and organs, increases perfusion