NREMT-AEMT Drugs with 100% correct answers already graded A+(verified for accuracy)

Oxygen

Class: Gas

Mechanisms of Action:

Oxygen is necessary for cellular energy production. When inhaled, oxygen molecules cross the respiratory membrane to attach to hemoglobin in red blood cells for transport to the tissues.

Indications:

Dyspnea, hypoxia; SpO2 < 95%

Contraindications:

There are no absolute contraindications to the use of oxygen. However, there are complications associated with hyperoxemia, particularly in neonates and patients resuscitated from cardiac arrest.

Precautions:

COPD, not recommended in routine use in uncomplicated acute coronary syndrome, do not use near open flame or sources of combustion, always leave bottle on its side, use a proactive guard over the flow meter to prevent damage.

Side Effects:

Drying of the mucous membrane which can lead to a nosebleed.

Dosage:

Maintain an SpO2 of 95% or higher, ventilator patients are often kept below 50% O2 when possible.

Route:

Inhalation via nasal cannula, face mask, nonrebreather mask, or bag-valve-mask device.

Normal Saline (0.9 Percent Sodium Chloride Solution)

Class:

Isotonic crystalloid

Mechanism of Action:

Used to expand the vascular volume temporarily by replacing water and electrolytes.

Indications:

Hypovolemia, heat exhaustion, heat stroke, and DKA

Contraindications:

Should not be given to patients with heart failure because fluid overload may occur.

Precautions:

Fluid overload may occur, monitor carefully. May be more effective to use Lactated in patients who have lost significant amounts of electrolytes.

Side Effects:

Hemodilution and electrolyte imbalance in large amounts of NS administration.

Dosage:

Keep-open rate is 30 mL/hour. Follow protocols, dosage may vary depending on patient condition.

Route:

Intravenous infusion

Albuterol Sulfate (Proventil, Ventolin)

Class:

Beta-2 selective sympathomimetic bronchodilator

Mechanism of Action:

Acts on beta-2 sympathetic receptors in bronchiolar smooth muscle to cause bronchodilation.

Indications:

Wheezing caused by asthma, COPD, and some other conditions.

Contraindications:

Hypersensitivity and symptomatic tachycardia

Precautions:

Albuterol has minimal beta-1 adrenergic effects, but it may increase HR and myocardial oxygen demand. Use with caution in patients with heart disease.

Side Effects:

Anxiety, palpitations, chest discomfort, headache, and perspiration.

Dosage:

Metered-Dose Inhaler: One or two 90 mcg sprays. The use of a spacer device is preferred when administering albuterol by metered-dose inhaler, especially in pediatric patients.

Small Volume Nebulizer: 2.5 mg diluted in 2.5 mL over five to 15 minutes; pediatric dosage is 0.15 mg/kg diluted in 2.5 mL NS

Route:

Inhalation

Aspirin

Class:

Platelet aggregation inhibitor; nonsteroidal anti-inflammatory; analgesic

Mechanism of Action:

Blocks part of the chemical reaction responsible for activation platelets.

Indications:

Acute coronary syndrome and stroke

Contraindications:

Hypersensitivity; not given to children or adolescents with suspected viral illnesses because it is associated with an increased risk of Reye's syndrome.

Precautions:

Patients with asthma or seasonal allergies, stomach ulcers, liver disease, alcohol abuse, kidney disease, or coagulopathies.

Side Effects:

GI upset, bleeding, nausea, vomiting, and wheezing.

Dosage:

AHA currently recommends 160 to 325 mg of chewable aspirin. Children's aspirin is preferred because it is chewable, which increases the rate of absorption, and does not require water to assist swallowing.

Route:

Oral

50 Percent Dextrose (D50)

Class:

Carbohydrate

Mechanism of Action:

Increases glucose concentration in the blood for the reversal of acute hypoglycemia.

Indications:

Hypoglycemia in adult patients

Contraindications:

Intracranial hemorrhage (traumatic brain injury, stroke) and hyperglycemia.

Precautions:

Check the blood glucose level prior to administration. A solution of 50 percent dextrose is hypertonic and causes severe tissue necrosis if infiltration occurs.

Side Effects:

Localized irritation of the vein.

Dosage:

25 g slow IV push; may be repeated in 10 to 15 minutes if blood glucose level (BGL) remains below 70 ml/dL.

Pediatric Dosage:

0.5 g/kg (500 mg/kg) of a 25 percent solution (25 g/100 mL) of dextrose.

Neonate: 10 percent (10 g/100 mL).

Route:

Slow IV push through at least an 18-gauge IV catheter in a large vein. Monitor the IV site for infiltration during administration.

Nitroglycerin

Class:

Nitrate; vasodilator

Mechanism of Action:

Nitrates are potent vasodilators that increase blood flow to the coronary arteries and decrease cardiac workload by dilating the peripheral vasculature and reducing preload.

Indications:

Chest pain associated with acute coronary syndrome.

Contraindications:

Hypotension, increased intracranial pressure, and use of erectile dysfunction medications within 24 to 36 hours.

Precautions:

NTG deteriorates rapidly when exposed to light or air. Monitor blood pressure closely and discontinue administration if the systolic blood pressure falls below 90 mmHg.

Side Effects:

NTG is a potent vasodilator and commonly causes an immediate headache. May cause dizziness, weakness, tachycardia, hypotension, dry mouth, nausea, and vomiting. The spray or tablets may cause a burning sensation on administration.

Dosage:

Administer 0.4 mg sublingually. If chest pain persists and the systolic blood pressure remains at least 90 mmHg, the dose may be repeated every five minutes to a total of three doses.

Route: Sublingual.

Naloxone

Class:

Narcotic Antagonist

Mechanism of Action:

Naloxone has a higher affinity for narcotic receptor sites and, when administered, displaces the narcotic, blocking its effects.

Indications:

Naloxone is indicated to reverse the respiratory depression associated with narcotic overdose.

Contraindications:

Known hypersensitivity

Precautions:

Rapid administration and large doses may cause withdrawal in narcotic-addicted patients. Many EMS systems titrate the dosage to the minimum amount needed to ensure adequate breathing rather than complete reversal of the narcotic.

Side Effects:

These are rare, but hypotension, hypertension, nausea, vomiting, and cardiac arrhythmias may occur.

Dosage:

1 to 2 mg slow IV push titrated to restore respiratory rate. If no effect, may be repeated at five minute intervals. An intranasal formulation is also available.

Route:

Slow IV push.

Epinephrine 1:1,000

Class:

Sympathomimetic

Mechanism of Action:

Epinephrine 1:1,000 is administered in anaphylaxis to cause vasoconstriction and relax bronchiolar smooth muscle.

Indications:

Acute anaphylaxis

Contraindications:

Use with caution in patients with significant cardiovascular disease or hypertension.

Precautions:

Epinephrine is inactivated by exposure to sunlight or when given with an alkaline solution. Mointor the patient's heart rate and blood pressure.

Side Effects:

Palpitations, tachycardia, anxiety, headache, dizziness, nausea, and vomiting are common side effects. Patients with underlying cardiac disease also may experience chest pain and acute myocardial infarction.

Dosage:

Adult - 0.3 to 0.5 mg subcutaneously or intramuscularly every 15 minutes as needed.

PED - 0.01 mg/kg

Route:

Subcutaneous or Intramuscular injection.

Glucagon

Class:

Hormone with antihypoglycemic action.

Mechanism of Action:

Glucagon causes a release of stored glycogen and its conversion to glucose when released into the circulation. When administered, in causes an increase in blood glucose levels if the patient has adequate stores of glycogen for conversion to glucose.

Indications:

Inability to establish intravenous access in patients with significant hypoglycemia.

Contraindications:

Hypersensitivity

Precautions:

Glucagon is not effective if the patient has already depleted glycogen stores.

Side Effects:

Side effects are rare, but hypotension, dizziness, headache, nausea, and vomiting may occur.

Dosage:

1 mg

Route:

Intramuscular Injection

Glucose

Class:

Carbohydrate

Mechanism of Action:

Increases blood glucose levels.

Indications:

Acute hypoglycemia in a patient who is awake and can protect his own airway.

Contraindications:

Inability to maintain a patent airway.

Precautions:

Carefully monitor the patient for the potential of aspiration.

Side Effects:

Nausea and Vomiting

Dosage:

15 grams by mouth or applied to the buccal mucosa.

Route:

Oral or Buccal

Nitrous Oxide

Class:

Analgesic and Anesthetic

Mechanism of Action:

Central Nervous System (CNS) depressant

Indications:

Severe musculoskeletal pain, and chest pain associated with acute coronary syndrome and not relieved by nitroglycerin.

Contraindications:

Decreased level of responsiveness, inability to follow instructions, traumatic brain injury, COPD, suspected pneumothorax, abdominal pain, and suspected bowel obstruction.

Precautions:

Use only in well-ventilated area to prevent sedation of the medical staff. Teratogenic; should not be used by or around pregnant patients or health care providers.

Side Effects:

Dizziness, decreased mental status, hallucinations, nausea, and vomiting.

Dosage:

Self-administered mixture of 50 percent nitrous oxide and 50 percent oxygen.

Route:

Inhalation

Activated Charcoal

Class:

Adsorbent

Mechanism of Action:

Binds with ingested toxins in the GI tract to prevent adsorption.

Indications:

Oral ingestion of toxins.

Contraindications:

Decreased level of responsiveness or increased risk of aspiration; or ingestion of corrosives, caustics, or petroleum distillates.

Precautions:

Activated charcoal inactivates other oral medications.

Side Effects:

Black, tarry stools, and constipation.

Dosage:

1 g/kg orally (adults and pediatric patients).

Route:

Oral

Acetaminophen

Class:

Analgesic; Antipyretic (fever reducer)

Mechanism of Action:

Not completely understood, but acetaminophen increases the pain threshold by blocking prostaglandin synthesis and inhibits the effect of pyrogens in the central nervous system

Indications:

Mild to moderate pain and fever.

Contraindications:

Hypersensitivity

Precautions:

Acetaminophen is hepatotoxic in high doses and should be used with caution in patients who have known liver disease.

Side Effects:

Acetaminophen is generally well tolerated and there are no significant side effects in therapeutic doses. In large doses, the medication can be hepatotoxic.

Dosage:

Adults: 650 to 1,000 mg every four to six hours, 4 gram maximum per 24 hours

PED: 10 to 15 mg/kg every four to six hours, 40 mg/kg maximum per 24 hours

Route:

Oral

Ibuprofen

Class:

NSAID (analgesic, antipyretic)

Mechanism of Action:

Inhibits inflammatory response by blocking formation of cyclo-oxygenase (COX-2), a chemical mediator of inflammatory chemicals such as prostaglandins.

Indications:

Mild to moderate pain and fever.

Contraindications:

Ibuprofen allergy or NSAID allergy

Precautions:

High-dose Ibuprofen is known to cause significant gastrointestinal irritation and increases the risk of gastrointestinal bleeding.

Side Effects:

Gastric irritation

Dosage:

200 to 400 mg every six to eight hours

PED: 5 to 10 mg/kg every six to eight hours.

Route:

Oral

Amiodarone

Class:

Cardiac Antidysrhythmic

Mechanism of Action:

Slows depolarization of myocardial cells by blocking potassium and calcium channels.

Indications:

Used for supraventricular tachycardia refractory to adenosine, ventricular tachycardia, or ventricular fibrillation that has not responded to defibrillation.

Contraindications:

Second/Third degree heart blocks, severe bradycardia, pulmonary congestion, hypotension, or hypersensitivity.

Side Effects:

Flushing, bradycardia, dizziness, hypotension, headache, AV node conduction abnormalities.

Dosage:

Adults w/perfusing rhythms: 150 mg infused over 10 minutes, followed by an infusion of 1 mg/min for six hours, and a 0.5 mg/min infusion over the next 18 hours.

PED w/perfusing rhythms: Loading dose 5 mg/kg IV/IO over 20 to 60 minutes, up to 15 mg/kg/day.

Adults w/nonperfusing rhythms (cardiac arrest): 300 mg IV bolus, you may follow with one bolus of 150 mg if rhythm persists, up to a maximum of 450 mg.

Pediatric w/nonperfusing rhythms (cardiac arrest): 5 mg/kg IV bolus.

Atropine

Class:

Anticholinergic, parasympatholytic

Mechanism of Action:

Blocks the effects of acetylcholine, the principle neurotransmitter for the parasympathetic nervous system.

Indications:

Used for symptomatic bradycardia, organophosphate poisoning, and certain specific nerve agent exposure.

Contraindications:

Use with caution in acute coronary syndromes; not effective in treating bradycardia in transplanted hearts.

Dosage:

Bradycardia -

Adults: 0.5 mg IV bolus. May repeat as needed up to a maximum of 3 mg.

PED: 0.02 mg/kg IV/IO/ET (diluted to 3 to 5 mL), minimum dose 0.1 mg, maximum single dose of 0.5 mg for a child and 1 mg for an adolescent. May repeat in five minutes for a maximum total dose of 1 mg for a child and 2 mg for an adolescent.

Organophosphate poisoning/nerve agents -

2 mg IV or IO; repeat every one to five minutes. End point of administration is marked by drying of secretions. Determine dosing regimen based on the type of agent or poison, and the duration of the exposure. Consult medical direction or poison control.

Epi 1:10,000

Class:

Sympathomimetic

Mechanism of Action:

Acts directly and nonselectively on alpha and beta receptors. Causes bronchodilation and vasoconstriction.

Indications:

Cardiac arrest (v-tach, asystole, PEA, v-fib), symptomatic bradycardia, hypotension refractory to other medications, anaphylaxis, severe reactive airway disease.

Contraindications:

None with Cardiac Arrest. Hypovolemic shock and allergies.

Side Effects:

Headache, nausea, restlessness, weakness, dysrhythmias, hypertension, chest pain, tachycardia.

Dose:

Adult Cardiac Arrest: 1 mg 1:10,000 solution IV/IO bolus every three to five minutes.

Adult Bradycardia or Hypotension: IV infusion at 2 to 10 mcg/min.

PED Cardiac Arrest: 0.01 mg/kg IV/IO every 3 to 5 minutes MAX 1 mg per dose.

Ondansetron (Zofran)

Class:

Antiemetic

Mechanism of Action:

Selective serotonin receptor agonist. Acts on the vagus nerve terminals to help reduce vomiting.

Indication:

Nausea and Vomiting

Contraindications:

Allergy

Side Effects:

Hpyotension, tachycardia, constipation, elevated liver enzymes, CNS depression.

Dose:

Adults: 4 mg slow IV bolus over two to five minutes every 4 to 6 hrs.

PED: 0.1 mg/kg slow IV bolus every 4 to 6 hrs.