EMT all 16 drugs

acetaminophen (Tylenol®)- Class

Analgesic, antipyretic

acetaminophen (Tylenol®)- Description

Clinically proven to treat pain and reduce fever with little effect on platelet function

acetaminophen (Tylenol®)- Indication

Pain reducer and/or fever reducer

acetaminophen (Tylenol®)- Contraindication

Hypersensitivity, liver failure, children under 3 years old

acetaminophen (Tylenol®)- Precaution

Patients with known liver disease, children under 12 years old with arthritic conditions, alcoholism, malnutrition, and thrombocytopenia (low platelet count)

acetaminophen (Tylenol®)- Side Effect

Liver damage in large doses, rash, angioedema

acetaminophen (Tylenol®)- Dose/Route

ADULT: 500-1000mg PO PED: 15mg/kg PO

activated charcoal (Actidose®)- Class

Adsorbent (binding agent)

activated charcoal (Actidose®)- Description

When swallowed, it absorbs and binds to toxin in the gastrointestinal tract; also combined with Sorbitol to promote GI motility

activated charcoal (Actidose®)- Indication

Acute ingested poisoning

activated charcoal (Actidose®)- Contraindication

Patient unable to control airway (altered LOC), ingestion of cyanide, mineral acids, caustic alkalis, organic solvents, iron, ethanol, methanol

activated charcoal (Actidose®)- Precaution

Administer only after emesis or in those cases where emesis is contraindicated

activated charcoal (Actidose®)- Side Effect

Constipation, diarrhea, temporary darkening of the stool, vomiting

activated charcoal (Actidose®)- Dose/Route

ADULT: 50gm PO PED: 1g/kg PO, max 25gm dose

albuterol (Ventolin®, Proventil®)- Class

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

albuterol (Ventolin®, Proventil®)- Description

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

albuterol (Ventolin®, Proventil®)- Indication

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

albuterol (Ventolin®, Proventil®)- Contraindication

Known hypersensitivity

albuterol (Ventolin®, Proventil®)- Precaution

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

albuterol (Ventolin®, Proventil®)- Side Effect

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

albuterol (Ventolin®, Proventil®)- Dose/Route

•Adult 2.5-5.0mg via continuous nebulizer, O2: 6-8L/min • Pediatric 1.25mg-2.5mg via continuous neb., O2: 6-8L/min **No max dose. Administer until patient improves. ***

albuterol (Ventolin®, Proventil®)- Important Info

*Administration is restricted to ONLY patients who already have a doctor’s order with a prescription for the medication. This can include meter-dosed inhaler.

aspirin (Bayer®, St. Joseph Children’s®)- Class

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

aspirin (Bayer®, St. Joseph Children’s®)- Description

Decreases inflammation, pain and fever. It powerfully inhibits platelet aggregation (makes it slick, which lessens the ability to develop clots)

aspirin (Bayer®, St. Joseph Children’s®)- Indication

Chest pain consistent with MI or cardiac etiology

aspirin (Bayer®, St. Joseph Children’s®)- Contraindication

Known hypersensitivity, asthma Hx, active bleeding ulcer

aspirin (Bayer®, St. Joseph Children’s®)- Precaution

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

aspirin (Bayer®, St. Joseph Children’s®)- Side Effect

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

aspirin (Bayer®, St. Joseph Children’s®)- Dose/Route

ADULT: 4 chewable baby ASA (81mg each or 324mg total) PO PED: NOT INDICATED

atropine auto-injector (AtroPen®)- Class

Anticholinergic, parasympatholytic, antidote

atropine auto-injector (AtroPen®)- Description

Blocks the parasympathetic nervous system’s response to organophosphate or carbamate insecticide poisonings (stops SLUDGE-M). It helps control airway issues by decreasing secretions.

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®)- Precaution

Has history AMI or glaucoma

atropine auto-injector (AtroPen®)- Side Effect

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

atropine auto-injector (AtroPen®)- Dose/Route

ADULT: one auto-injector medical control discretion PED: one PEDIATRIC auto-injector at medical control’s discretion

atropine auto-injector (AtroPen®)- Important Info

*All EMS personnel may self-administer and/or administer to patients. *Commonly packaged as a “kit” or mixed with pralidoxime when used for this specific poisoning

diphenhydramine (Benadryl®)- Class

Antihistamine

diphenhydramine (Benadryl®)- Description

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

diphenhydramine (Benadryl®)- Indication

Allergic reaction or anaphylaxis

diphenhydramine (Benadryl®)- Contraindication

Hypersensitivity, closed angle glaucoma

diphenhydramine (Benadryl®)- Precaution

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

diphenhydramine (Benadryl®)- Side Effect

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

diphenhydramine (Benadryl®)- Dose/Route

ADULT: 25-50mg PO PED: 1mg/kg PO, DO NOT give to infants <3 months

diphenhydramine (Benadryl®)- Important Info

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

epinephrine (Adrenalin®, EpiPen®)- Class

Sympathomimetic (mimics sympathetic nervous system)

epinephrine (Adrenalin®, EpiPen®)- Description

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

epinephrine (Adrenalin®, EpiPen®)- Indication

Anaphylaxis

epinephrine (Adrenalin®, EpiPen®)- Contraindication

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

epinephrine (Adrenalin®, EpiPen®)- Precaution

Caution in administration to elderly patients, diabetics, hypertensive patients, children <6 years old, and patients with: Parkinson’s, asthma, heart disease emphysema and tuberculosis history.

epinephrine (Adrenalin®, EpiPen®)- Side Effect

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

epinephrine (Adrenalin®, EpiPen®)- Dose/Route

WEIGHT-BASED ≥30kg: 0.3mg- 0.5mg of 1:1,000 IM -

< 30kg: 0.15mg of 1:1,000 IM

epinephrine (Adrenalin®, EpiPen®)- Important Info

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

glucagon (GlucaGen®, Gvoke®)- Class

gycogenolytic agent, hormone

glucagon (GlucaGen®, Gvoke®)- Description

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

glucagon (GlucaGen®, Gvoke®)- Indication

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

glucagon (GlucaGen®, Gvoke®)- Contraindication

Known hypersensitivity

glucagon (GlucaGen®, Gvoke®)- 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.)

glucagon (GlucaGen®, Gvoke®)- Side Effect

Headache, nausea, hypotension, irritation at the injection site

glucagon (GlucaGen®, Gvoke®)- Dose/Route

• Adult: 1-2 mg IM. May repeat in 15 minutes if needed • Pediatric 0.1mg/kg IM (max dose: 1 mg). May repeat in 15 minutes if needed to keep BGL > 60mg/dL

glucagon (GlucaGen®, Gvoke®)- Important Info

Comes in 2 containers: powdered med (solute) & liquid (solvent). Must RECONSTITUE: 1. Draw up solvent in a syringe 2. Add solvent to the powdered medication vial. 3. Roll medication vial in hands to mix solute & solvent. 4. Draw up new solution and administer IM.

Glucose, oral (Glutose®, Insta-Glucose®)- Class

Carbohydrate

Glucose, oral (Glutose®, Insta-Glucose®)- Description

Increases blood sugar level for short period of time

Glucose, oral (Glutose®, Insta-Glucose®)- Indication

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

Glucose, oral (Glutose®, Insta-Glucose®)- Contraindication

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

Glucose, oral (Glutose®, Insta-Glucose®)- Precaution

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.

Glucose, oral (Glutose®, Insta-Glucose®)- Side Effect

Hyperglycemia spike for a short period of time after administration

Glucose, oral (Glutose®, Insta-Glucose®)- Dose/Route

ADULT: 1 tube (15g) buccally CHILD: 1 tube (15g) buccally, MIN AGE 3 years old

ibuprofen (Advil®, Motrin®)- Class

NSAID (non-steroidal anti-inflammatory drug)

ibuprofen (Advil®, Motrin®)- Description

Antipyretic, analgesic. It inhibits platelet aggregation and increases bleeding time.

ibuprofen (Advil®, Motrin®)- Indication

Reduce fever, relieve minor to moderate pain

ibuprofen (Advil®, Motrin®)- Contraindication

Known hypersensitivity to NSAID, recent GI bleed Hx, renal insufficiency, & patients currently taking anticoagulants

ibuprofen (Advil®, Motrin®)- Precaution

Hypertension, cardiac decompensation

ibuprofen (Advil®, Motrin®)- Side Effect

Rash, tinnitus (ringing in ears), headaches, dizziness, drowsiness, abdominal pain, nausea/vomiting, diarrhea, constipation, and heart burn. Can cause more bleeding than normal because it reduces the ability of blood to clot

ibuprofen (Advil®, Motrin®)- Dose/Route

ADULT: 400-800mg PO PED: 10mg/kg PO; DO NOT use on infants <6 months

naloxone (Narcan®)- Class

Narcotic antagonist

naloxone (Narcan®)- Description

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

naloxone (Narcan®)- Indication

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

naloxone (Narcan®)- Contraindication

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

naloxone (Narcan®)- Precaution

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.

naloxone (Narcan®)- Side Effect

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

naloxone (Narcan®)- Dose/Route

ADULT: 0.4mg-2mg intra-nasally via atomizer PED: 0.1mg/kg intra-nasally via atomizer, repeat in 4 minutes if no effect, max dose 2mg.

naloxone (Narcan®)- Important Info

EMT admin is limited to intra-nasal route ONLY. Goal is to reverse respiratory depression, use MINIMUM amount needed of med to achieve this goal.

nitroglycerin (Nitrostat®, Nitrospray®)- Class

Nitrate

nitroglycerin (Nitrostat®, Nitrospray®)- Description

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

nitroglycerin (Nitrostat®, Nitrospray®)- Indication

Chest pain associated with angina and acute myocardial infarction

nitroglycerin (Nitrostat®, Nitrospray®)- Contraindication

*HYPOtension (systolic BP <100mmHg), *use of phosphodiesterase inhibitors (ie. Viagra, Cialis) in last 24 hours, known hypersensitivity, severe anemia, trauma, increased ICP, glaucoma, shock

nitroglycerin (Nitrostat®, Nitrospray®)- Precaution

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

nitroglycerin (Nitrostat®, Nitrospray®)- Side Effect

Headache, HYPOtension, diaphoresis, flushed skin, palpitations

nitroglycerin (Nitrostat®, Nitrospray®)- Dose/Route

ADULT: 0.4mg SL or 1 spray (=0.4mg) every 5 min. until pain free or SBP <100mmHg, MAX 3 doses. PED: not indicated

nitroglycerin (Nitrostat®, Nitrospray®)- Important Info

• Administration is restricted to ONLY patients who already have a doctor’s order with a prescription for the medication. AND must have SBP >100mmHg AND must not have had a phosphodiesterase inhibitor in last 24hrs.

nitrous oxide (Nitronox®)- Class

Analgesic

nitrous oxide (Nitronox®)- Description

Odorless, colorless, non-flammable gas. Effect is through non-competitive NMDA (N-methyl-D-aspartate) receptor inhibition of the central nervous system

nitrous oxide (Nitronox®)- Indication

Acute pain management

nitrous oxide (Nitronox®)- Contraindication

Known hypersensitivity, bowel obstruction, hypotension, pneumothorax, pregnancy, significant respiratory compromise, increased intracranial pressure, pulmonary hypertension, impaired consciousness

nitrous oxide (Nitronox®)- Precaution

Monitor for proper ventilation if used for long periods of time

nitrous oxide (Nitronox®)- Side Effect

Dizziness, headache, nausea, blurred vision, hypotension

nitrous oxide (Nitronox®)- Dose/Route

ADULT: 50:50 mixture of N2O:O2 self-admin inhaled PED: 50:50 mixture of N2O:O2 self-admin inhaled

nitrous oxide (Nitronox®)- Important Info

Should not be used if in the vicinity of pregnant patient or provider during the first trimester.

oxygen- Class

Medical gas