EMT-Level Medications

10 Rights of Drug Administration

Right patient, right medication, right dosage, right history/indication, right time, right route, right to refuse, right education, right evaluation, right documentation

Epinephrine Trade Names

Epipen, Auvi-Q, Adrenalin

Epinephrine Class

sympathetic agonist

Epinephrine Action

vasoconstriction, increased heart rate, (stimultes alpha-1 and beta-1 receptors)

Epinephrine Indications

anaphylaxis, acute respiratory distress, hypotension

Epinephrine Contraindications

hypertension, hypothermia

Epinephrine Cautions

pregnancy, heart disease

Epinephrine Side Effects

tachycardia, dizziness, tremors, nausea/vomitting

Epinephrine Route

IM, autoinjector

Epinephrine Dosage IM

Adult: 0.3 mg Pediatric: 0.01 mg/kg, up to 0.3 mg

Epinephrine Dosage Auto-injector

Adult: 0.3 mg Pediatric: 0.15 mg

Epinephrine Onset & Duration

1-2 min, up to 10 min

Albuterol Trade Names

Pro-air, Ventolin, Proventil

Albuterol Class

sympathomimetic, bronchodilator

Albuterol Action

relaxes smooth muscle of the bronchioles, (beta-2 adrenergic receptors)

Albuterol Indications

bronchospasm, asthma, (drowning)

Albuterol Contraindications

hypersensitivity, symptomatic tachycardia

Albuterol Cautions

Prior doses, beta blockers, hypertension, arrhythmias

Albuterol Side Effects

Tachycardia, tremors, dizziness, anxiety, hypertension

Albuterol Route

inhaled/nebulized, MDI

Albuterol Dosage inhaled

Adult and Ped: 2.5 mg, max 3 doses

Albuterol Dosage MDI

1-2 puffs

Albuterol Onset and Duration

5-15 min, up to 6 hours

Oral Glucose Trade Names

Glutose-15, Insta-Glucose

Oral Glucose Class

Carbohydrate

Oral Glucose Action

increased blood glucose level/BGL

Oral Glucose Indication

hypoglycemia, AMS in diabetic patient

Oral Glucose Contraindications

cannot protect airway

Oral Glucose Cautions

short-term energy source, aspiration

Oral Glucose Side Effects

nausea/vomitting, hyperglycemia

Oral Glucose Route

Buccal

Oral Glucose Onset and Duration

variable onset, short duration

Ibuprofen Trade Names

Advil, Motrin

Ibuprofen Class

analgesic, antipyretic, NSAID

Ibuprofen Action

inhibits prostaglandin synthesis, reduces pain, reduces fever, reduces swelling

Ibuprofen Indications

mild to moderate pain, fever

Ibuprofen Contraindications

hypersensitivity, pregnancy, liver disease

Ibuprofen Cautions

on other NSAIDs, history of GI bleeds, on anticoagulants

Ibuprofen Side Effects

nausea/vomitting, headache, GI bleeds, diarrhea

Ibuprofen Route

PO

Ibuprofen Dosage

Adult: 400-600 mg every 4-6 hrs, 2400 mg max/day Ped: 10 mg/kg every 6-8 hours, 600 mg max/day

Ibuprofen Onset and Duration

Onset: up to 30 min Duration: up to 6 hrs

Acetaminophen Trade Names

Tylenol

Acetaminophen Class

non-narcotic analgesic

Acetaminophen Contraindications

hypersensitivity, liver disease

Acetaminophen Cautions

Prior doses in last 4 hours

Acetaminophen Side Effects

gastric irritation, headache

Acetaminophen Route

PO

Acetaminophen Dosage

Adult: 650-1000 mg, single dose Ped: 15 mg/kg, max 650

Acetaminophen Onset and Duration

Onset 20-40 min Duration 4-6 hrs

Aspirin Trade Names

Bayer Aspirin, Ecotrin

Aspirin Class

Platelet inhibitor, NSAID, analgesic

Aspirin Action

decreases platelet aggregation, blocks pain signals

Aspirin Indication

sudden onset cardiac chest pain

Aspirin Contraindications

hypersensitivity, bleeding disorder, asthma, GI bleeds, on other anti-coagulants, rhinitis (stuffy nose)

Aspirin Caution

Pediatrics (Reyes’ syndrome), GI bleeds

Aspirin Side Effects

increased clotting time, nausea, wheezing, heartburn

Aspirin Route

PO

Aspirin Dosage

Adult: 162-325 mg chewed Ped: none

Aspirin Onset and Duration

Onset 15 minutes Duration 2-4 hours

Nalaxone Trade Names

Narcan

Nalaxone Class

opioid antagonist, narcotic antagonist

Nalaxone Action

displaces opioids from opioid receptors

Nalaxone Indication

respiratory depression from suspected opioid OD

Nalaxone Contraindications

hypersensitivity, non-narcotic overdose

Nalaxone Cautions

Aggressive patients (call law enforcement assistance)

Nalaxone Side Effects

withdrawals, tachycardia, diaphoresis, nausea/vomitting

Nalaxone Routes

IM or IN

Nalaxone Dosage

Adult: 0.4-2 mg as necessary Ped: 0.1 mg/kg, max 2

Nalaxone Onset and Duration

Onset w/in 2 min Duration 30-60 min

Nitroglycerin Trade Names

Nitro-Bid, Nitrostat

Nitroglycerin Class

vasodilator

Acetaminophen Action

reduces pain and fever

Acetaminophen Indication

mild pain, fever

Nitroglycerin Action

Increases heart circulation, dilates coronary arteries

Nitroglycerin Indications

severe hypertension, angina pectoris, AMI, CHF

Nitroglycerin Contraindications

systolic BP <90, ED medication in last 24 hrs, hypersensitivity, head injury

Nitroglycerin Cautions

hypotension, prior doses (3 max total), nitro patches, WEAR GLOVES

Nitroglycerin Side Effects

headache, lightheadedness, syncope, hypotension

Nitroglycerin Route

SL (sublingual)

Nitroglycerin Dosage

Adult: 0.3-0.4 mg (1 pill) every 5 min Ped: NONE

Nitroglycerin Onset and Duration

Onset 1-3 min Duration 20-30 min

Activated Charcoal Trade Name

Actidose with Sorbitol

Activated Charcoal Class

adsorbent, antidote

Activated Charcoal Action

absorbs poisonous substances

Activated Charcoal Indication

oral poisoning, OD on non-caustic poison

Activated Charcoal Contraindications

cannot protect airway, caustic poisoning

Activated Charcoal Caution

Perstalsis

Activated Charcoal Side Effects

constipation; nausea/vomiting

Activated Charcoal Route

PO

Activated Charcoal Dosage

1 g/kg

Activated Charcoal Onset and Duration

Onset instant Duration through intestinal tract