Emergency Medical Technician Pharmacology Notes

Respiratory Emergencies

Albuterol (Salbutamol)

  • Class: Beta-2 agonist, bronchodilator.
  • Mechanism: Stimulates β₂ receptors, causing bronchodilation.
  • Indications: Bronchospasm (asthma, COPD), wheezing.
  • Contraindications: Hypersensitivity, severe tachyarrhythmias.
  • Side Effects: Tachycardia, tremors.
  • Adult Dosage: 2.5 mg via nebulizer or 90 mcg (2 puffs) MDI.
  • Pediatric Dosage: 0.15 mg/kg via nebulizer or 90 mcg (2 puffs) MDI.

Ipratropium Bromide

  • Class: Anticholinergic bronchodilator.
  • Mechanism: Blocks acetylcholine receptors, causing bronchodilation.
  • Indications: Bronchial asthma, chronic bronchitis, emphysema.
  • Contraindications: Hypersensitivity, not for acute bronchospasm.
  • Side Effects: Palpitations, anxiety.
  • Adult Dosage: 500 mcg via nebulizer or 2 puffs MDI.
  • Pediatric Dosage: 250 mcg via nebulizer or 1-2 puffs MDI.

Epinephrine (1:1,000)

  • Mechanism: α- and β-adrenergic receptor agonist.
  • Indications: Anaphylaxis, severe asthma, stridor.
  • Contraindications: Cardiovascular collapse (use IV instead).
  • Side Effects: Palpitations, tachycardia, anxiety.
  • Adult Dosage: 0.3-0.5 mg IM.
  • Pediatric Dosage: 0.01 mg/kg IM (max 0.3 mg).

Oxygen

  • Indications: Hypoxia (SpO₂ < 94%), respiratory distress.
  • Contraindications: Non-hypoxic patients, caution in COPD.
  • Delivery: Nasal cannula (1-4 LPM), Simple mask (6-10 LPM), NRB mask (10-15 LPM), BVM (15 LPM).
  • Target SpO₂: 94-99% (88-92% for COPD).

Cardiovascular Emergencies

Aspirin

  • Mechanism: Platelet aggregation inhibitor.
  • Indications: Acute Coronary Syndrome (ACS), suspected Myocardial Infarction (MI).
  • Contraindications: Allergy to aspirin/NSAIDs, active GI bleeding.
  • Side Effects: GI bleeding, nausea.
  • Adult Dosage: 160-325 mg chewable.

Nitroglycerin

  • Mechanism: Smooth muscle relaxant, dilates coronary arteries.
  • Indications: Angina, acute myocardial infarction (MI), acute congestive heart failure (CHF).
  • Contraindications: Hypotension (SBP < 90 mmHg), shock.
  • Side Effects: Headache, dizziness, hypotension.
  • Adult Dosage: 0.3-0.6 mg sublingually every 5 minutes (max 3 doses).

Hypoglycemic Emergencies

Oral Glucose

  • Mechanism: Increases blood glucose levels.
  • Indications: Hypoglycemia (blood glucose < 70 mg/dL) in conscious patients.
  • Contraindications: Unconscious patients, inability to swallow.
  • Side Effects: Nausea, vomiting.
  • Adult Dosage: 15-30 g PO, may repeat every 15 min.
  • Pediatric Dosage: 0.3 g/kg PO, max 15 g per dose.

Glucagon

  • Mechanism: Increases blood glucose by breaking down stored glycogen in the liver.
  • Indications: Severe hypoglycemia (when IV glucose is not available), β-blocker overdose, Calcium-channel blocker overdose.
  • Contraindications: Hypersensitivity to glucagon, ineffective in starving or malnourished patients.
  • Side Effects: Nausea, vomiting, dizziness.
  • Adult Dosage: 1 mg IM every 15 min as needed.
  • Pediatric Dosage: 0.5 mg IM (