Drugs and medicine

aspirin brand name

Bayer, St. Joseph Children’s

aspirin class

acetylsalicylic acid, analgesic (painkiller), antipyretic (reduces fever), anti-inflammatory, platelet aggregation inhibitor (prevent platelets from clotting), NSAID (Nonsteroidal Anti-Inflammatory Drug)

aspirin description

makes platelets slippery, not a blood thinner

decreases inflammation, pain, and fever. powerfully inhibits platelet aggregation (makes it slick —> lessens the ability to develop clots)

aspirin indication

chest pain consistent with MI or cardiac etiology (coming from the heart)

aspirin contraindication

known allergy/hypersensitivity, asthma Hx, active bleeding ulcer

aspirin side effect

nausea/vomiting, heartburn, bleeding, bronchospasm (bronchial tubes constrict), rash, angioedema (swelling around mouth/lips)

aspirin dose

adult: 4 chewable baby tablets - 81mg each, 324mg total

ped: do not give

nitroglycerin (NGL) brand name

Nitrostat, Nitrospray

NGL class

nitrate

NGL description

vasodilates (relax) blood vessels, lessens heart workload, allows for more blood to circulate to blood vessels

NGL indication

chest pain associated with angina (not enough oxygen-rich blood) and AMI

NGL contraindication

HYPOtension (systolic BP <100mmHg), use of phosphodiesterase inhibitors (ED meds like Viagra, Cialis) in last 24 hrs, known hypersensitivity, severe anemia (lacks healthy red blood cells to carry oxygen to tissues), trauma, increased ICP (intracranial pressure), glaucoma (eye damage due to high pressure), shock

NGL precaution

monitor BP closely

can cause severe HYPOtension

NGL side effect

headache, HYPOtension, diaphoresis, flushed skin, palpitations

NGL dose

adult: 0.4mg SL tablet OR 1 spray every 5 min

max 3 doses

stop if pain free or SBP <100mmHg

NGL important info

only for patients with a prescription

must have SBP >100mmHg and no ED meds in last 24hrs

oxygen class

medical gas

oxygen description

odorless, colorless, tasteless gas

oxygen indication (give for…)

hypoxia (lack of o2), anticipated hypoxia, any patient with a need to improve respiratory efficiency

oxygen contraindication

COPD patient that is not hypoxic (normal oxygen) and used for a prolonged period of time - they rely on low blood oxygen levels

oxygen precaution

supports combustion, don’t drop/throw/damage tank (compressed gas in cylinders)

oxygen side effect

dry oxygen can irritate mucous membranes

oxygen dose for all patients

NC (Nasal Cannula): 1-6 L/min

Neb (nebulizer treatment): 6-8 L/min

NRB (Non-Rebreather): 10-15 L/min

BVM (Bag Valve Mask): 15 L/min

CPAP (Continuous Positive Airway Pressure): 5-25 cmH20

acetaminophen brand name

tylenol

acetaminophen class

analgesic (painkiller), antipyretic (reduce fever)

acetaminophen description

treats pain and reduces fever with little effect on platelet function

acetaminophen indication

pain and/or fever reducer

acetaminophen contraindication

hypersensitivity, liver failure, children under 3 yrs old

acetaminophen precaution

patients with liver disease, children under 12 with arthritic conditions, alcoholism, malnutrition, thrombocytopenia (low platelet count)

acetaminophen side effect

liver damage in large doses, rash, angioedema

acetaminophen dose

adult: 500-1000 mg PO (orally)

ped: 15 mg/kg PO

activated charcoal brand name

actidose

activated charcoal class

adsorbent (binding agent)

activated charcoal description

when swallowed: it absorbs and binds to toxin in the GI tract

can be combined with Sorbitol to promote GI motility

activated charcoal indication

acute ingested poisoning

activated charcoal contraindication

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

activated charcoal precaution

administer only after emesis or when emesis is contraindicated

activated charcoal side effect

constipation, diarrhea, temporary darkening of the stool, vomiting

activated charcoal dose

adult: 50 g PO

ped: 1g/kg PO (max 25gm dose)

albuterol brand name

ventolin, proventil

albuterol class

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

albuterol 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 indication

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

albuterol contraindication

known hypersensitivity

albuterol precaution

vital signs and breath sounds must be monitored

caution with elderly, cardiac or hypertensive patients, HR >150bpm in adults, HR >200bpm in children, significant cardiac history

albuterol side effect

tachycardia, anxiety/nervousness, nausea/vomiting, cough, tremors, dizziness

albuterol dose

adult: 2.5 - 5.0 mg in Neb (oxygen: 6 - 8 L)

ped: 1.25 - 2.5 mg in Neb (oxygen: 6 - 8 L)

administer until patient improves

albuterol important info

administration ONLY for patients who already have a doctor’s order with a prescription for the medication (can include meter-dosed inhaler)

atropine auto-injector brand name

atropen

atropine auto-injector class

anticholinergic (inhibit the parasympathetic nervous system), parasympatholytic (reduces the activity of the parasympathetic nervous system), antidote (used to counteract or neutralize the effects of a poison, toxin, or overdose)

atropine auto-injector description

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

atropine auto-injector indication

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

atropine auto-injector contraindications

none in the emergency setting

atropine auto-injector precaution

history AMI or glaucoma

atropine auto-injector side effect

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

atropine auto-injector dose

adult: one auto-injector at medical control discretion

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

atropine auto-injector 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 brand name

benadryl

diphenhydramine class

antihistamine (treat allergy symptoms)

diphenhydramine description

blocks histamine release, reduces bronchoconstriction, vasodilation, edema

diphenhydramine indication

allergic reaction or anaphylaxis

diphenhydramine contraindication

hypersensitivity, closed angle glaucoma

diphenhydramine precaution

can cause sedation or confusion, hypotension, tachycardia, and palpitations

diphenhydramine side effect

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

diphenhydramine dose

adult: 25 - 50 mg PO

ped: 1 mg/kg PO

DO NOT give to infants under 3 months

diphenhydramine important info

must be given orally in OTC for only if indicated by protocol or medical control

glucagon brand name

GlucaGen, Gvoke

glucagon class

glycogenolytic agent, hormone

glucagon description

triggers the liver to rapidly release stored glycogen into the bloodstream as glucose

glucagon indication

hypoglycemia (dangerously low blood sugar)

glucagon contraindication

known hypersensitivity

glucagon precaution

may not have the intended outcome if administered to patients with a lack of glycogen stores in the liver (ex: children or people with liver disease/failure)

glucagon side effect

headache, nausea, hypotension, irritation at the injection site

glucagon dose

adult: 1-2 mg IM (can repeat in 15 min if needed)

ped: 0.1 mg/kg IM , max dose: 1 mg (can repeat in 15 min if needed to keep BGL >60 mg/dL)

glucose, oral brand name

Glutose, Insta-Glucose

glucose class

carbohydrate

glucose description

increases blood sugar level for short period of time

glucose indication

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

glucose contraindication

patient does NOT have gag reflex, altered mental status, HYPERglycemic patients, unresponsive patients

glucose precaution

medication is thick and sticky

allow patient to medicate themselves

MUST have intact gag reflex and ability to control secretions (to lessen chance of aspiration)

glucose side effect

hyperglycemia spike for short period of time after administration

glucose dose

adult: 1 tube (15g) buccally (dissolve in cheek pouch)

ped: 1 tube (15g) buccally *at least 3 yrs old

ibuprofen brand name

advil, motrin

ibuprofen class

NSAID (non-steroidal anti-inflammatory drug)

ibuprofen description

antipyretic, analgesic, inhibits platelet aggregation and increases bleeding time

ibuprofen indication

reduces fever, relieves minor to moderate pain

ibuprofen contraindication

known hypersensitivity, recent GI bleed Hx, renal insufficiency, patients currently taking anticoagulants

ibuprofen precaution

hypertension, cardiac decompensation

ibuprofen side effect

rash, tinnitus (ringing in ears), headaches, dizziness, drowsiness, abdominal pain, nausea/vomiting, diarrhea, constipation, heart burn

can cause more bleeding than normal (bc it reduces ability of blood to clot)

ibuprofen dose

adult: 400 - 800 mg PO

ped: 10 mg/kg PO

DO NOT USE on infants under 6 months

naloxone brand name

narcan

naloxone class

narcotic antagonist

naloxone description

blocks effects of natural and synthetic narcotics, reversing respiratory depression and altered mental status

naloxone indication

narcotic (opiate) and synthetic narcotic overdose patient, unconscious/unresponsive patient with known etiology (cause)

naloxone contraindication

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

naloxone precaution

medication half-life is sometimes shorter than the half-life of the opiate/narcotic taken —> continue to monitor the Pt bc they might need another dose

Pt could also wake up very anxious or aggressive and can projectile vomit

naloxone side effect

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

naloxone dose

adult: 0.4 - 2 mg intra-nasally via atomizer

ped: 0.1 mg/kg intra-nasally via atomizer (repeat in 4 min if no effect —> max dose 2mg)

naloxone important info

EMT admin is limited to intra-nasal route ONLY

goal is to reverse respiratory depression —> use MINIMUM amount needed

nitrous oxide brand name

nitronox