EMT Pharmacology

What are the 8 medications EMTs can administer?

Activated charcoal, aspirin, albuterol, epinephrine, naloxone, nitroglycerin, oral glucose, oxygen.

activated charcoal indication

Most oral poisoning overdoses.

activated charcoal contraindications

Decreased level of consciousness, blocked airway, overdose (OD) on corrosive substances or petroleum substances.

activated charcoal route

Per oral (PO)

activated charcoal dosage

1 g/kg of body weight, adults usually 25-50g, children 12.5-25g

activated charcoal admin concerns

Don't give another per oral (PO) medication with this.

activated charcoal side effects

Vomiting, nausea, black stools.

Aspirin (Bayer) action

Anti-inflammatory agent and anti-fever agent, prevents platelets from clumping, thereby decreasing formation of new clots.

Aspirin (Bayer) indication

Chest pain of cardiac origin, relief of mild pain, headache, muscle aches, fever.

Aspirin (Bayer) contraindication

Allergy, head injury, recent bleeding, asthma, unable to swallow.

Aspirin (Bayer) route

Per oral (PO) chewable

Aspirin (Bayer) dosage

81 mg (1 tablet), 324 mg (4 tablets).

Aspirin (Bayer) admin concerns

Be able to chew. Do not administer for pain caused by trauma or for fevers in children.

Aspirin (Bayer) side effects

Nausea, vomiting, stomach pain, bleeding, allergic reactions.

Aspirin (Bayer) interactions

Caution should be used in patients who are taking anticoagulants (blood thinners).

Albuterol (Proventil, Ventolin) action

Stimulates nervous system, causing bronchodilation.

Albuterol (Proventil, Ventolin) indications

Asthma/difficulty breathing with wheezing.

Albuterol (Proventil, Ventolin) contraindications

Hypersensitivity, tachycardia (relative), chest pain of cardiac origin.

Albuterol (Proventil, Ventolin) routes

Inhalation

Albuterol (Proventil, Ventolin) adverse effects

Hypertension, tachycardia, anxiety, restlessness.

Albuterol (Proventil, Ventolin) interactions

Increases effects of other nervous system stimulants.

Albuterol (Proventil, Ventolin) dosage

1-2 inhalations; wait 5 minutes before repeating dose.

Albuterol (Proventil, Ventolin) admin concerns

Patient must inhale all medication in one breath; coach patient to hold breath for 5 seconds after inhalation.

Ipratroprium (Atrovent) action

Stimulates nervous system, causing bronchodilation.

Ipratroprium (Atrovent) indications

Asthma/difficulty breathing with wheezing.

Ipratroprium (Atrovent) contraindications

Hypersensitivity, tachycardia (relative), chest pain of cardiac origin.

Ipratroprium (Atrovent) routes

Inhalation

Ipratroprium (Atrovent) adverse effects

Hypertension, tachycardia, anxiety, restlessness.

Ipratroprium (Atrovent) interactions

Increases effects of other nervous system stimulants.

Ipratroprium (Atrovent) dosage

1-2 inhalations; wait 5 minutes before repeating dose.

Ipratroprium (Atrovent) admin concerns

Patient must inhale all medication in one breath; coach patient to hold breath for 5 seconds after inhalation.

epinephrine (EpiPen) action

Stimulates nervous system, causing bronchodilation.

epinephrine (EpiPen) indication

Anaphylactic reaction (allergies)

epinephrine (EpiPen) contraindication

Chest pain of cardiac origin, hypothermia, hypertension.

epinephrine (EpiPen) routes

Intramuscular (IM)

epinephrine (EpiPen) adverse effects

Hypertension, tachycardia, anxiety, restlessness.

epinephrine (EpiPen) interactions

Increases effects of other nervous system stimulants.

epinephrine (EpiPen) dosage

Adult: 0.3 mg

Pediatric: 0.15 mg

1:1000 concentration

epinephrine (EpiPen) admin concerns

Medication will last ~5 minutes; do not repeat dose. Ensure ALS is en route for continuing treatment.

naloxone (Narcan, EVZIO auto-injector) action

Reverses respiratory depression secondary to opioid overdose.

naloxone (Narcan, EVZIO auto-injector) indication

Opioid overdose/poisoning.

naloxone (Narcan, EVZIO auto-injector) contraindication

Hypersensitivity.

naloxone (Narcan, EVZIO auto-injector) routes

Intranasal (IN), intramuscular (IM).

naloxone (Narcan, EVZIO auto-injector) adverse effects

Nausea, vomitting.

naloxone (Narcan, EVZIO auto-injector) interactions

Additional doses may be required for severe opioid overdoses.

naloxone (Narcan, EVZIO auto-injector) dosage

2 mg IN or IM auto-injector.

naloxone (Narcan, EVZIO auto-injector) admin concerns

Patients may wake up combative, projective vomiting.

nitroglycerin (Nitrostat, Nitromist) action

Dilates blood vessels, lowers blood pressure (BP).

nitroglycerin (Nitrostat, Nitromist) indications

Chest pain of cardiac origin.

nitroglycerin (Nitrostat, Nitromist) contraindications

Hypotension (systolic BP < 100 mmHg), use of sildenafil (Viagra) or another treatment for erectile dysfunction within the previous 24 hours, head injury.

nitroglycerin (Nitrostat, Nitromist) routes

Sublingual (SL), tablet or spray.

nitroglycerin (Nitrostat, Nitromist) adverse effects

Headache, burning under tongue, hypotension, nausea.

nitroglycerin (Nitrostat, Nitromist) interactions

Increases dilating effects of other blood vessel-dilating medications.

nitroglycerin (Nitrostat, Nitromist) dosage

0.3-0.4 mg sublingual (SL); 0.4 mg spray.

nitroglycerin (Nitrostat, Nitromist) admin concerns

Prescribed, ensure ALS is en route.

oral glucose (Glutose) action

When absorbed, provides glucose for cell use.

oral glucose (Glutose) indications

Low blood glucose (hypoglycemia).

oral glucose (Glutose) contraindications

Decreased level of consciousness (LOC), nausea, vomiting.

oral glucose (Glutose) routes

Per oral/per os (PO).

oral glucose (Glutose) adverse effects

Nausea, vomiting.

oral glucose (Glutose) interactions

None

oral glucose (Glutose) dosage

1 tube (15 g) to 1/2 tube.

oral glucose (Glutose) admin concerns

Patient must be awake, have constant control of airway, and be able to follow commands.

oxygen (no trade name) action

Reverses hypoxia, provides oxygen to be absorbed by lungs.

oxygen (no trade name) indications

Hypoxia, suspected trauma or hypoxia.

oxygen (no trade name) contraindications

Very rarely used in patients with chronic obstructure pulmonary disease (COPD). Do not use near open flames, as oxygen will support combustion.

oxygen (no trade name) routes

Inhalation (nasal cannula, nonrebreather, bag-valve mask (BVM)).

oxygen (no trade name) adverse effects

Decreased respiratory effort in rare cases in patients with chronic obstructive pulmonary disease (COPD).

oxygen (no trade name) interactions

Can support combustion.

oxygen (no trade name) dosage

Use oxygen delivery devices to administer 28-100% oxygen (referring to the oxygen tank).

Nasal cannula (1-6 L/min)

Nonrebreather (10-15 L/min)

Bag-valve mask (BVM) (15 L/min)

oxygen (no trade name) admin concerns

No open flames nearby. Do not withhold oxygen from patients in respiratory distress.

chest pain OAN acronym

Oxygen, aspirin, nitroglyerin.

What are 3 common over-the-counter medications?

Acetaminophen, diphenhydramine, ibuprofen.

acetaminophen (Tylenol) action

Analgesic and fever reducer.

acetaminophen (Tylenol) indications

Relief of mild pain or fever, headache, muscle aches.

acetaminophen (Tylenol) contraindications

Hypersensitivity

acetaminophen (Tylenol) routes

Per oral/per os (PO).

acetaminophen (Tylenol) adverse effects

Allergic reaction.

acetaminophen (Tylenol) interactions

Take caution to avoid potential overdosing; many over-the-counter (OTC) mediations contain acetaminophen.

acetaminophen (Tylenol) dosage

500-1000 mg every 4 hours as needed. Dose is weight-based for children.

acetaminophen (Tylenol) admin concerns

Weight of a child is more important than age.

diphenhydramine (Benadryl) action

Antihistamine (blocks histamine).

diphenhydramine (Benadryl) indications

Mild allergic reactions.

diphenhydramine (Benadryl) contraindications

Asthma, glaucoma, pregnancy, hypertension, infants.

diphenhydramine (Benadryl) routes

Per oral/per os (PO)

diphenhydramine (Benadryl) adverse effects

Sleepiness (although can stimulate children), dry mouth and throat.

diphenhydramine (Benadryl) interactions

Do not take with alcohol or monoamine oxidase (MAO) inhibitors (a type of psychiatric medication).

diphenhydramine (Benadryl) dosage

25-50 mg.

diphenhydramine (Benadryl) admin concerns

Can use in severe allergic reaction. However, epinephrine is administered first.

ibuprofen (Advil, Motrin, Nuprin) action

Nonsteroidal anti-inflammatory drug (NSAID) that reduces inflammation and fever, analgesic.

ibuprofen (Advil, Motrin, Nuprin) indications

Mild pain or fever, headache, muscle aches.

ibuprofen (Advil, Motrin, Nuprin) contraindications

Hypersensitivity

ibuprofen (Advil, Motrin, Nuprin) routes

Per oral/per os (PO).

ibuprofen (Advil, Motrin, Nuprin) adverse effects

Nausea, vomiting, stomach pain, bleeding, allergic reactions.

ibuprofen (Advil, Motrin, Nuprin) interactions

Do not take with aspirin.

ibuprofen (Advil, Motrin, Nuprin) dosage

200-400 mg every 4-6 hours; dose is weight-based in children.

ibuprofen (Advil, Motrin, Nuprin) admin concerns

Do not take for pain caused by trauma. Weight of child is more important than age.