EMS 110 Pharmacology

Drug name, class, description, indiction, contradiction, precaution, side effects, and route.

agonist

a medication that binds to cell receptors and activates the biological response

antagonist

medication that binds to receptors without activating them to block other chemicals from binding/initiating response

Class of drug

set of medications that have similar chemical structures, the same mechanism, a related mode of action, and/or are used to treat the same disease

Indications

reason to use this certain treatment

Contraindications

risk of taking a certain med outweighs the benefit

Precautions

benefit could potentially outweigh the risk, evaluate on case to case basis

Brand names for albuterol

Proventil, Ventolin

Class of albuterol

Bronchodilator, beta 2 agonist (more lung oriented, less cardiac oriented)

Requirement for using albuterol

patient MUST have a prescription

effects of albuterol on beta-2 receptors

specific synthetic sympathomimetic that causes bronchodilation, but less cardiac effects and reduces mucus secretion, pulmonary capillary leaking, and edema in the lungs during allergic reaction

Indication for albuterol

Reactive airway disease exacerbation (asthma, COPD), allergic reaction with wheezing, bronchospasm

Contradiction for albuterol

Known hypersensitivity

Precautions for albuterol

-Vital signs and breath sounds must be monitored

-use caution with elderly, cardiac or hypertensive patients

-HR >150bpm in adults, HR >200bpm in children, significant cardiac history

Side effects of albuterol

Tachycardia (HR ⇑), anxiety/nervousness, nausea/vomiting, cough, tremors, dizzines

Adult dose of albuterol

2.5-5.0mg via continuous nebulizer, O2: 6-8L/min (no max dose)

Pediatric dose of albuterol

1.25mg-2.5mg via continuous neb., O2: 6-8L/min (no max dose)

Class of oxygen

medical gas

Description of oxygen

odorless, colorless, tasteless gas

Indication of oxygen

Hypoxia, anticipated hypoxia, any patient with a need to improve respiratory efficiency

Contradiction of oxygen

COPD patient that is not hypoxic and used for a prolonged period of time

Precaution of oxygen

Supports combustion; because it’s compressed gas in cylinders, do not drop, throw or cause damage to tank

Side effect of oxygen

Cold, dry oxygen can irritate mucous membranes

BVM dosage for oxygen

15L/min

NC (nasal cannula) dosage for oxygen

1-6L/min

NRB (non-rebreather mask) dosage for oxygen

10-15L/min

CPAP dosage for oxygen

5- 25 cm H2O

oral (PO)

by mouth, slow rate

buccal (buc)

in cheek or gum, rapid rate

sublingual (SL)

under the tongue, rapid rate

intramuscular (IM)

injection in the muscle (often with auto-injector), moderate rate

intranasal (IN)

into the nostril, rapid rate

nebulization (neb)

inhaled vaporization, rapid rate

Brand names of aspirin

Bayer, St. Joseph Children's

Class of aspirin

Acetylsalicylic acid, analgesic, antipyretic, anti- inflammatory, platelet aggregation inhibitor, NSAID

Description of aspirin

Decreases inflammation, pain and fever, powerfully inhibits platelet aggregation (breaks up blood clots)

Indication of aspirin

Chest pain consistent with MI or cardiac etiology

Contraindications of aspirin

Known hypersensitivity, asthma Hx, active bleeding ulcer

Precautions of aspirin

Allergies to other NSAIDs, bleeding disorders, children or teenagers with varicella (chicken pox), influenza-like symptoms

Side effects of aspirin

Nausea/vomiting, heartburn, bleeding, bronchospasm, rash, angioedema (swelling around the mouth/lip

Dose/route of aspirin

ADULTS ONLY take 324 mg total PO (4 chewable baby ASA at 81mg each)

What is the requirement for administering nitroglycerin?

Patient MUST have a prescription, systolic BP below 100 mmHg, and no erectile dysfunction/libido enhancement drugs in the last 24 hours

Brand names of nitroglycerin

Nitrostat, Nitrospray

Class of nitroglycerin

Nitrate

Description of nitroglycerin

Vasodilates (relaxes) blood vessels, which lessens heart
workload and allows for more blood to circulate to the heart’s blood vessels

Indication of nitroglycerin

Chest pain associated with angina and acute myocardial infarction

Contraindication of nitroglycerin

*HYPOtension (systolic BP

Precaution of nitroglycerin

Nitroglycerin can lose potency when exposed to light or to the air. Monitor vital signs closely; can cause severe HYPOtension

Side Effects of nitroglycerin

Headache, HYPOtension, diaphoresis, flushed skin,
palpitations

Dose/Route of nitroglycerin

ADULT ONLY takes 0.4mg SL or 1 spray (=0.4mg) every 5 min.
until pain free or SBP

Class

gycogenolytic agent, hormone

Description

Promotes conversion of glycogen stores in the liver into
glucose (also known as glycogenolysis) to be released into the bloodstream

Indication

hypoglycemia (after ruling out oral glucose
administration because of contraindications)

Contraindication

Known hypersensitivity

Precaution

May not have the intended outcome if administered to
those with a lack of glycogen stores in the liver (ie.
children, those with liver disease/failure, etc.)

Side Effect

Headache, nausea, hypotension, irritation at the
injection site

Dose/Route

ADULT takes 1-2 mg IM (may repeat in 15 minutes if needed, Pediatric takes 0.1mg/kg IM (max dose of 1 mg, may repeat in 15 minutes if needed to keep BGL > 60mg/dL)

Important Info for mixing glucagon powder in solution

Comes in 2 containers

Brand name of diphenhydramine

Benadryl®

Class of diphenhydramine

Antihistamine

Description of diphenhydramine

Blocks histamine release, thereby reducing
bronchoconstriction, vasodilation and edema.

Indication of diphenhydramine

Allergic reaction or anaphylaxis

Contraindication of diphenhydramine

Hypersensitivity, closed angle glaucoma

Precaution of diphenhydramine

Can cause sedation or confusion. May also cause hypotension, tachycardia and palpitations

Side Effects of diphenhydramine

Fatigue, sedation, dizziness, disturbed coordination, photosensitivity, drying/thickening of secretions, abdominal pain

Dose/Route of diphenhydramine

ADULT, 25-50mg PO
PED, 1mg/kg PO, DO NOT give to infants

Brand name of epinephrine

Adrenalin®, EpiPen®

Class of epinephrine

Sympathomimetic (mimics sympathetic nervous system)

Description of epinephrine

Is naturally occurring catecholamine. It increases heart rate, increases cardiac contractility, increases systemic vascular resistance, vasoconstriction, bronchodilation, increases respiratory tidal volume and vial capacity.

Indication of epinephrine

Anaphylaxis

Contraindication of epinephrine

Known hypersensitivity, narrow angle glaucoma, NON-anaphylactic hypoperfusion (shock), coronary
insufficiency, dysrhythmias, and in females actively delivering a baby.

Precaution of epinephrine

Caution in administration to elderly patients, diabetics, hypertensive patients, children

Side Effect of epinephrine

Tachycardia, pallor, dizziness, chest pain, headache, nausea/vomiting, excitability, anxiety, hypertension,
tremors, cardiac arrythmias

Dose of epinephrine

*****WEIGHT-BASED*****
≥30kg takes 0.3mg- 0.5mg of 1

Route of epinephrine

Can be given as auto-injector or may have to be
drawn up from vial or ampul

Brand name of oral glucose

Glutose®, Insta-Glucose®

Class of oral glucose

Carbohydrate

Description of oral glucose

Increases blood sugar level for short period of time

Indication of oral glucose

HyPOglycemia in known diabetic patients, possible altered mental status, weakness, diaphoresis

Contraindication of oral glucose

Pt DOES NOT HAVE GAG REFLEX intact, altered mental status and not mentating appropriately, hyPERglycemic
patients, unresponsive patients

Precaution of oral glucose

Medication is thick and extremely sticky. Allow patient to medicate themselves. Pt must have INTACT GAG REFLEX and the ABILITY TO CONTROL SECRETIONS to lessen the chance of aspiration.

Side Effect of oral glucose

Hyperglycemia spike for a short period of time after administration

Dose/Route of oral glucose

both adult and child take 1 tube (15g) buccally, MIN AGE 3 years old

Brand name of naloxone

Narcan®

Class of naloxone

Narcotic antagonist

Description of nalaxone

Blocks the effects of both natural and synthetic
narcotics, reversing respiratory depression and altered mental status

Indication of nalaxone

Narcotic (opiate) and synthetic narcotic overdose
patient, unconscious/unresponsive patient with unknown etiology

Contraindication of nalaxone

Known hypersensitivity, non-narcotic induced altered mental status, non-narcotic respiratory depression

Precaution of nalaxone

Medication half-life is sometimes shorter than the half-life of the opiate/narcotic taken, for this reason, continue to monitor the Pt because they may need another dose. Pt also may wake up very anxious or aggressive and can projectile vomit.

Side Effects of naloxone

Abrupt reversal of narcotic depression may result in
nausea, vomiting, sweating, tachycardia, increased
blood pressure, tremors, seizures, and cardiac arrest.

Dose/Route of naloxone

ADULT takes 0.4mg-2mg intra-nasally via atomizer, 4 minutes if no effect (as many as necessary), PED takes 0.1mg/kg intra-nasally via atomizer, repeat in 4 minutes if no effect, max dose 2mg.

Brand name of pralidoxime auto-injector

2-Pam®

Class of pralidoxime

Cholinesterase reactivator

Description of pralidoxime

Restores neuromuscular transmission by reactivating the cholinesterase enzyme. Used for SEVERE organophosphate poisoning

Indication of pralidoxime

Organophosphate or carbamate poisoning

Contraindication of pralidoxime

Known hypersensitivity

Precaution of pralidoxime

Rapid administration may result in tachycardia,
laryngospasm and muscle rigidity. Excited or manic
behavior may be noted after regaining consciousness.
Caution if myasthenia gravis or renal failure history.

Side Effect of pralidoxime

Blurred/double vision, difficulty focusing vision,
dizziness, tachycardia, HYPERtension, muscle
weakness/stiffness, difficulty speaking, difficulty
breathing, tachypnea

Dose/Route of pralidoxime

ADULT takes 1 auto-injector per medical control, PED takes 1 pediatric auto-injector per med contro