2026 North Carolina EMT Drug Norms

acetaminophen (Tylenol) - Indication

Pain reducer and/or fever reducer

acetaminophen (Tylenol) - Contraindication

Hypersensitivity, liver failure, children under 3 years old

acetaminophen (Tylenol) - Dose

Adult: 500-1000mg PO / Ped: 15mg/kg PO

acetaminophen (Tylenol) - Class

Analgesic, antipyretic

acetaminophen (Tylenol) - Side Effects

Liver damage in large doses, rash, angioedema

acetaminophen (Tylenol) - Precaution

Known liver disease, children under 12 with arthritic conditions, alcoholism, malnutrition, thrombocytopenia

activated charcoal (Actidose) - Indication

Acute ingested poisoning

activated charcoal (Actidose) - Contraindication

Altered LOC, cyanide, mineral acids, caustic alkalis, organic solvents, iron, ethanol, methanol

activated charcoal (Actidose) - Dose

Adult: 50gm PO / Ped: 1g/kg PO max 25gm

activated charcoal (Actidose) - Class

Adsorbent (binding agent)

activated charcoal (Actidose) - Side Effects

Constipation, diarrhea, temporary darkening of stool, vomiting

activated charcoal (Actidose) - Precaution

Administer only after emesis or when emesis is contraindicated

albuterol (Ventolin, Proventil) - Indication

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

albuterol (Ventolin, Proventil) - Contraindication

Known hypersensitivity

albuterol (Ventolin, Proventil) - Dose

Adult: 2.5-5.0mg via continuous neb O2 6-8L/min / Ped: 1.25-2.5mg via continuous neb O2 6-8L/min / No max dose

albuterol (Ventolin, Proventil) - Class

Bronchodilator, beta 2 agonist

albuterol (Ventolin, Proventil) - Side Effects

Tachycardia, anxiety, nervousness, nausea, vomiting, cough, tremors, dizziness

albuterol (Ventolin, Proventil) - Precaution

Monitor vitals and breath sounds; caution with elderly, cardiac/hypertensive patients; HR >150 adults, HR >200 children

albuterol (Ventolin, Proventil) - Important Note

Only for patients who already have a doctor's prescription

aspirin (Bayer) - Indication

Chest pain consistent with MI or cardiac etiology

aspirin (Bayer) - Contraindication

Known hypersensitivity, asthma history, active bleeding ulcer

aspirin (Bayer) - Dose

Adult: 4 chewable baby ASA 81mg each (324mg total) PO / Ped: NOT INDICATED

aspirin (Bayer) - Class

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

aspirin (Bayer) - Side Effects

Nausea/vomiting, heartburn, bleeding, bronchospasm, rash, angioedema

aspirin (Bayer) - Precaution

Allergies to other NSAIDs, bleeding disorders, children/teens with varicella or influenza-like symptoms

atropine auto-injector (AtroPen) - Indication

Organophosphate or carbamate poisonings (insecticides, pesticides, cyanide, mustard gas, sarin gas)

atropine auto-injector (AtroPen) - Contraindication

None in the emergency setting

atropine auto-injector (AtroPen) - Dose

Adult: one auto-injector per medical control / Ped: one pediatric auto-injector per medical control

atropine auto-injector (AtroPen) - Class

Anticholinergic, parasympatholytic, antidote

atropine auto-injector (AtroPen) - Side Effects

Dry mouth, blurred vision, urinary retention, tachycardia, constipation, decreased sweating

atropine auto-injector (AtroPen) - Precaution

History of AMI or glaucoma

atropine auto-injector (AtroPen) - Important Note

All EMS personnel may self-administer; commonly packaged as a kit with pralidoxime

diphenhydramine (Benadryl) - Indication

Allergic reaction or anaphylaxis

diphenhydramine (Benadryl) - Contraindication

Hypersensitivity, closed angle glaucoma

diphenhydramine (Benadryl) - Dose

Adult: 25-50mg PO / Ped: 1mg/kg PO, DO NOT give to infants under 3 months

diphenhydramine (Benadryl) - Class

Antihistamine

diphenhydramine (Benadryl) - Side Effects

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

diphenhydramine (Benadryl) - Precaution

Can cause sedation, confusion, hypotension, tachycardia, palpitations

diphenhydramine (Benadryl) - Important Note

Must be given ORALLY in OTC form only if indicated by protocol or medical control

epinephrine (EpiPen, Adrenalin) - Indication

Anaphylaxis

epinephrine (EpiPen, Adrenalin) - Contraindication

Known hypersensitivity, narrow angle glaucoma, non-anaphylactic shock, coronary insufficiency, dysrhythmias, females actively delivering

epinephrine (EpiPen, Adrenalin) - Dose

30kg or more: 0.3-0.5mg of 1:1000 IM / Under 30kg: 0.15mg of 1:1000 IM

epinephrine (EpiPen, Adrenalin) - Class

Sympathomimetic

epinephrine (EpiPen, Adrenalin) - Side Effects

Tachycardia, pallor, dizziness, chest pain, headache, nausea, vomiting, anxiety, hypertension, tremors, cardiac arrhythmias

epinephrine (EpiPen, Adrenalin) - Precaution

Caution with elderly, diabetics, hypertensive patients, children under 6, Parkinson's, asthma, heart disease, emphysema, tuberculosis

epinephrine (EpiPen, Adrenalin) - Important Note

WEIGHT-BASED dose; can be auto-injector or drawn from vial or ampule

glucagon (GlucaGen, Gvoke) - Indication

Hypoglycemia after ruling out oral glucose due to contraindications

glucagon (GlucaGen, Gvoke) - Contraindication

Known hypersensitivity

glucagon (GlucaGen, Gvoke) - Dose

Adult: 1-2mg IM may repeat in 15 min / Ped: 0.1mg/kg IM max 1mg may repeat in 15 min to keep BGL above 60

glucagon (GlucaGen, Gvoke) - Class

Glycogenolytic agent, hormone