MEDS

TRADE NAME

(GENERIC)

INDICATION

HOW IT WORKS

CONTRA-

DOSE

Side effects

Adenosine

(Adenoncard)

SVT

Decreases electrical conduction through AV node

-hypersensitivity

-drug induced tach

-bradycardia

1st-6mg

2nd-12mg

3rd-12mg

(fast IV, followed  w/ flush)

-Light headedness

-hypotension

-nausea

Albuterol

(Proventil)

(Ventolin)

 

Bronchospasm from asthma or COPD

Bronchodilation

(beta 2)

Pregnancy (except in life threatening situation)

1st-2.5mg in 3mL

2nd-same

3rd-same

(if NO improvement after first, combine w/ Atrovent)

-tachycardia

-hypertension

-restlessness

Alcaine

(Proparacaine)

Burns to the eyes or corneal abrasion

Blocks impulses from sensory nerves

-Trauma/Laceration to the eye

 

-Foreign body allergies to CAINE drugs

1-2 drops q 5min

 

MAX of 3 doses

-Initial burning or Stinging Sensations

Amiodarone HCl

(Cordarone)

 

VFib & VTach

Blocks Calcium, Na, K

Channels

-cardiogenic shock

-bradycardia

Adult:

VFib/VTach w/o P-

1st-300mg IV/IO

2nd-150mg IV/IO

VTach w/ P:

150mg over 10 mins

Pediatric:

VFib/VTach w/o P-

1st- 5mg/kg (max of 150mg)

2nd-same as 1st

VTach w/P:

5mg/kg, drip over 30 mins

-hypotension if given rapid infusion

-bradycardia,

-CHF

TRADE NAME

(GENERIC)

INDICATION

HOW IT WORKS

CONTRA-

DOSE

Side effects

Amyl nitrate

· Acute cyanide poisoning with severe symptoms

o Altered mental status

o Dyspnea, cyanosis

o Vomiting, seizures

· Amyl Nitrite: reducing agent that converts hemoglobin to methemoglobin

· Sodium Nitrite: reducing agent that converts hemoglobin to methemoglobin

· Sodium Thiosulfate: sulfate-forming compound that reacts with cyanide-methemoglobin

complex in blood to detoxify the cyanide & allow for excretion in kidneys

Amyl nitrite: do not administer if IV established & able to give sodium nitrite

· Sodium thiosulfate: do not administer until after sodium nitrite administered

Adult & pedi: 1 ampule crushed & inhaled

Hypotension - vasodilation

 (Atrovent) Ipratropium Bromide

Bronchospasm that didn’t improve w/ 1st albuterol

Causes bronchodilation and dries secretions

-Sensitivity to atropine

-bronchospasm due to allergic reaction

Adult- .5mg in 2.5mL

 

 

Pediatric-

<1 year- .25mg

>1 year- adult dose

-dry mouth

-nausea/vomiting

Aspirin

(Acetylsalicylate acid)

Cardiac chest pain

-reduces platelet stickiness

 

-aspirin allergy

-GI bleed

-hemorrhagic stroke

Adult:

324mg

 

Pediatric:

Not given

None in emergency setting

Ativan

(Lorazepam)

Active seizure or status epilepticus

 Sedation:

o To facilitate airway device placement

o Maintenance sedative agent

o Prior to painful procedure (cardioversion)

o Stimulant or hallucinogen ingestion induced chest pain and/or tachycardia

o Excited delirium

 

 

 

Central Nervous System (CNS) Depressant that causes:

o Muscle relaxation

o Sedation

o Amnesia

 

 

 

· Hypotension

 Head injury

 Pregnancy (except eclamptic seizure)

 

 

 

IV, IM, IN

o Adult: 2-10 mg Pedi: 0.05-0.1mg/kg (max. 10 mg)

 

 

 

Hypotension

 Respiratory depression

 Confusion/stupor

 Nausea

 Vein irritation, phlebitis, or sclerosis

 

TRADE NAME

(GENERIC)

INDICATION

HOW IT WORKS

CONTRA-

DOSE

Side effects

Atropine

-symptomatic bradycardia

 

-organophosphate poisoning

-reverses vagal tone

-blocks acetylcholine in organophosphate poisoning

Hypothermic bradycardias

Adult:

Sym Brady-

.5mg IV q 3-5 mins (max of 3 mg)

Poisoning-

2-5mg q 15mins until secretions stop

Pediatric:

Sym Brady-

.02mg/kg (may repeat once up to max of 1 or 3mg)

Poisoning-

.05mg/kg

-tachycardia

-blurred vision

-dry mouth

Calcium Chloride

-hyperkalemia

-hypocalcemia

-Magnesium OD

-Ca Channel Blocker OD

-helps conduct electrical current in heart

 

-assists in normal  contraction of heart

-cardiac arrest

 

-hypercalcemia

 

-digitalis

Adult:

10-15mg/kg

 

Pediatric:

same                                  

Bradycardia and hypotension if too much is pushed too fast

 

 

Calcium Gluconate

-hyperkalemia

-Magnesium OD

-Ca Channel Blocker OD

-black widow bite

 

-cardiac arrest

 

-hypercalemia

Adult:

15-30mL of 10% solution

 

Pediatric:

60-100mg/kg slow IV push

-bradycardia

-hypercalcemia

Cardizem

(diltiazem)

 

Calcium Channel Blocker

-Afib or Aflutter w/ RVR

 

-PSVT unresponsive to adenosine

-Blocks movement of calcium into muscle

 

-slows rate of ventricular response

Systolic < 90

Diastolic < 60

 

Wide complex tach

 

 

Adult:

1st .25mg/kg

2nd .35mg/kg

IV push over 2 mins

 

Pediatric:

Not used pre hospital

-Bradycardia

 

-hypotension

TRADE NAME

(GENERIC)

INDICATION

HOW IT WORKS

CONTRA-

DOSE

Side effects

Decadron

(Dexamethasone)

Reduces swelling & inflammation due to:

o Refractory bronchospasm in:

§ Status asthmaticus

§ Acute exacerbation of Chronic Obstructive Pulmonary

Mechanism of action:

· Synthetic adrenal corticosteroids that:

o Suppresses immune response

o Restores normal capillary permeability

o Inhibits the formation, storage, and release of histamine from mast cells

· Anti-inflammatory effect in management of:

o Allergic reactions and anaphylactic shock

o Sometimes used for swelling in spinal cord injury management

Known hypersensitivity

IVP

· Adult: 4-24 mg IV/IM Pedi: 0.2- 0.5 mg/kg Not to exceed adult dosage

 

May produce hypertension

· Rare instances of:

o Anaphylactic reactions

o Exacerbation of Congestive Heart Failure (CHF)

o Seizures

Dextrose10%

Hypoglycemia

 

Increases blood glucose levels

None in hypoglycemia

 

Use caution w/ head injuries

 

Adult:

250ml D10 IV

 

Pediatric:

5mL/kg of 10% solution

Tissue necrosis w/ infiltration

Diazepam

(Valium)

-active seizure/status epilepticus

 

-premedication

 

 

Central nervous system depressant

 

Amnesia, sedation, muscle relaxant

Alcohol or sedative drug use

 

Head injury

Adult:

5-10mg to max 10mg

(IV/IM)

Pediatric:

.5mg/kg max of 5mg (rectal)

.2/kg max 5mg (IV)

Respiratory depression

 

hypotension

Diphenhydramine

(Benadryl)

-Anaphylaxis

-mod/severe allergic reactions (after epi)

Blocks effects of histamine

-MAOIs

-newborns and nursing mothers

Adult:

25-50mg

Pediatric:

1-2mg/kg

Drowsiness, dizziness, sedation

 

Dopamine

(Inotropin)

Nonhypovolemic hypotension

 

Symptomatic bradycardia if atropine ineffective

Low dose-increases perfusion to organs

Mod dose-increase rate and force of ventricles

High dose-peripheral vasoconstriction

Hypovolemic shock

 

Tachydysrhythmias

 

VFib

2-20mcg/kg/min

 

effects start at

5-10mcg/kg/min

Hypertension

Headache

Nausea/vomiting

TRADE NAME

(GENERIC)

INDICATION

HOW IT WORKS

CONTRA-

DOSE

Side effects

Epi 1:1000

(Adrenalin)

-Asthmatic bronchoconstriction

-Allergic/Anaphylaxis

-Profound Bradycardia (Atropine, Shock, Dopamine have all failed)

chronotropic effects.

o Alpha effects:

§ Produces peripheral vasoconstriction which:

 Increases coronary & cerebral perfusion

 Increases BP in anaphylaxis

o Beta-1 effects:

§ Increases rate, force, & contractility of ventricular contractions

o Beta-2 effects:

§ Bronchodilation

 

-Hypersensitivity

-Hypovolemic shock

-Coronary insufficiency

Adult

Asthma/Allergy: 0.3mg SubQIM

Bradycardia: 2-10mcg/min

Pediatric:

.15mg SubQ or IM

-Tachycardia

-Hypertension

-Can worsen cardiac ischemia

 

Epi 1:10000

(Adrenalin)

-Cardiac Arrest

-Anaphylaxis

chronotropic effects.

o Alpha effects:

§ Produces peripheral vasoconstriction which:

 Increases coronary & cerebral perfusion

 Increases BP in anaphylaxis

o Beta-1 effects:

§ Increases rate, force, & contractility of ventricular contractions

o Beta-2 effects:

§ Bronchodilation

 

-Hypersensitivity

-Hypovolemic shock

-Coronary insufficiency

Adult:

CA: 1mg IV q 3-5 min

AR: 0.3mg may repeat no more than once

Pediatric:

CA: .01mg/kg

AR: .15mg may repeat no more than once

-Palpitations

-anxiety,

-Tremulousness

-Headache

-Dizziness,

-Hypertension

-Can worsen cardiac ischemia

 

TRADE NAME

(GENERIC)

INDICATION

HOW IT WORKS

CONTRA-

DOSE

Side effects

NAME

INDICATION

HOW IT WORKS

CONTRA-

INDICATIONS

DOSE

SIDE EFFECTS

 

Etomidate

Induction agent before the admin of a Neuromuscular blockade agent

Suppresses CNS activity.

-Known hypersensitivity

-Labor/Delivery

0.3 mg/kg MAX 40mg

-N&V

-Dysrhythmias

-SOB

-Hypotension

-Muscle twitch

Fentanyl

-Pain Control

-Sedation for RSI & PAI

Binds w/receptor in brain to produce effects

-Respiratory Depression

-Hypotension

-N&V

1-2 mcg/kg to

MAX 200mcg

-Respiratory Depression

-Bradycardia

-Hypo/

Hypertension

-N&V

Oral Glucose

Altered LOC caused by hypoglycemia.

Provides glucose into bloodstream for cellular metabolism

-No gag reflex

-Unable to protect airway

25-50g (full tube)

Aspiration

Glucagon

-Hypoglycemia (IN or IM)

-Beta-blocker OD

-Calcium Channel Blocker Toxicity

-Converts stored glycogen in liver to glucose

-Improves Cardiac contractility inc. heart rate.

Hypersensitivity to Proteins

 

Low sugar: 1mg IM or IN

CCB or Beta Blocker OD:

1mg IV/IO up to 3mg

Less than age 1

0.5 mg IV/IO/IM/IN/SQ

 

 

-N&V

-Tachycardia

Haldol

(Haloperidol)

Patients who require sedation for comfort or safety during transport

o Acute psychotic episodes

o Severe anxiety and tension

o Acute alcohol withdrawal symptoms (Delirium Tremens)

Butyrophenone derivative that inhibits the transport mechanism of cerebral monamines and by blocking dopaminergic neuron receptors in the brain associated with mood and behavior

Preexisting coma

 Intoxication

 Known cardiovascular disease

 

Adult: 18 y.o.+ 5-10 mg IM Not to exceed 100 mg in 24 hours

 Pedi: Less than 5 y.o. Not recommended

6 to 12 y.o. 1-3 mg IM Max: 0.15 mg/kg/day

13 to 17 y.o. 2-5 mg IM Not to exceed adult dosage

Extrapyramidal effects aka dystonic reaction

o Antidote: Diphenhydramine Benadryl 25-50 mg IVP

 Tardive dyskinesia

 Potentially fatal Neuroleptic Malignant Syndrome (NMS) – symptom: fever

 

TRADE NAME

(GENERIC)

INDICATION

HOW IT WORKS

CONTRA-

DOSE

Side effects

Heparin

Prevention of thrombus formation in acute MI

 

Acts at multiple sites in coagulation process

 Binds to antithrombin III catalyzing inactivation of thrombin thereby limiting conversion of prothrombin to thrombin and impairing fibrin formation and therefore clot formation

 

Active bleeding or bleeding tendencies

 Recent major surgery or trauma

 

IV/ IV Infusion

 

 Adult: 5,000 units IV

Follow with 20,000-40,000 units IV over 24 hrs

 Pedi: 100-150 units/kg IV

 

Follow with 28 units/kg/hour IV Infusion

Potentially life-threatening bleeding

 May cause hematologic disorder

 

Hydroxocobalamin (Cyanokit®)

Cyanide toxicity

Vitamin B12 molecule complexed to cobalt: cyanide displaces the cobalt on the molecule, resulting in cyanocobalamin, which is then removed from the body by renal excretion

 

Absolute:  None

 

Relative:  History of anaphylactic reaction to hydroxocobalamin or cyanocobalamin

5 grams (2 vials) over 15 minutes

Flushing, urticaria, itching or rash

 Chest tightness and dyspnea  Transient blood pressure elevation  Anaphylaxis  Red skin, tears, sweat and urine

Ketamine (ketalar)

-Anesthesia prior to RSI

-Chemical sedation for Psychiatric/Behavioral issues

Affects catecholaminergic transmission

-Hypersensitivity

RSI: 1mg/kg IV may repeat every 5-10

 

Sedation: 1mg/kg IV or 4mg/kg  IM

-Hypertension

-Tachycardia

-Sedation

-Vomiting

-Involuntary muscle movement

TRADE NAME

(GENERIC)

INDICATION

HOW IT WORKS

CONTRA-

DOSE

Side effects

Labetolol

(Trandate or Normodyne)

· Acute hypertensive crisis with End-Organ Dysfunction

· Unstable angina

· Non Q-wave MI

· Abdominal Aortic Aneurysm (AAA)

· Supraventricular tachycardia (SVT) with Rapid Ventricular Response (RVR)

· Ventricular Tachycardia refractory to Lidocaine

· Competitively blocks beta-adrenergic receptors in heart and blood vessels

o Lowers heart rate, cardiac output, and blood pressure

o Induces vasodilation

o Reduces peripheral vascular resistance

o Reduces the rate and force of cardiac contraction

· Inhibits the actions of catecholamines

· Decreases A-V conduction

Cocaine or amphetamine overdose

Congestive Heart Failure (CHF)

Hypertension

 

 

Antidote: Glucagon

Positive inotropic action on heart &

decreases renal vascular resistance

· Adult: Hypertensive Crisis: 5-10 mg IV May repeat to total of 20 mg IVP

Add 4 mL Labetalol to 6 mL NS

Administer 2.5-5 mL of mix, may repeat

· Goal: Diastolic BP: 115-130 mmHg

Resolve of End-Organ Dysfunction S/S

· Bronchospasm -· Hypotension (AVOID!) –

· Hallucinations -· Hyponatremia

· Hyperkalemia -

Lasix (Furosmede)

Acute Pulmonary Edema

 

-Diuretic

-Osmotic Gradient

-Hypersensitivity

-Hypovolemia/ Dehydration

1mg/kg over 2 min

 

If Already on Lasix: give twice their daily dose

-Hypotension

-Dry mouth

-Electrolyte imbalance

-if  given too fast, can cause hearing loss

Levophed

(Norepinephrine bitartrate)

-Neurogenic & Cardiogenic Shock & Septic Shock

-BP<70 (hemodynamically

significant. hypotension)

-Vasoconstrictor

-Adrenergic Agonist

Hypovolemia

8-12 mcg/min

-HTN

-Dysrhythmias

-Angina

-Reflex Brady

-Tissue Necrosis

Lidocaine

-Cardiac Arrest from VT / VF

-Maintenance Infusion @ ROSC assoc. w/ VT/VF

-Diastolic Depolarization

-Supresses PVC’s

-Inc. VF threshold

-2nd/3rd heart block

-Strokes-Adams syndrome

-Prophylactic use in AMI

CA- 1-1.5mg/kg

Q 5-10min to MAX 3mg/kg

 

ROSC- 1-4mg/min

-Light-headed

-Confusion

-Blurred Vission

-Hypotension

-Bradycardia

-Altered LOC

-Seizures

TRADE NAME

(GENERIC)

INDICATION

HOW IT WORKS

CONTRA-

DOSE

Side effects

Magnesium Sulfate

-Eclamptic Seizure

-Ventricular Dysrhythmias

-Torsades

-Digitoxin Toxicity

-Asthma

-CNS Depressant

-Physiologic Calcium Channel Blocker

-Heart Block

-Myocardial Damage

Eclampsia, Torsades, Asthma: 1-2 g over 10mis

 

Cardiac Arrest 1-2g IV push

-Diaphoresis

-Hypothermia

-Respiratory Depression

-Facial Flush

-Bradycardia

-Hypotension

-N/V

Methylprednisolone (Solu-medrol®)

Wheezing refractory to inhaled bronchodilators

Status asthmaticus

Severe anaphylaxis, in conjunction with epinephrine and diphenhydramine

 

Potent anti-inflammatory steroid

Known hypersensitivity to the product and its constituents

60 – 125 mg IV/IO, if there are no contraindications

IM in Asthma

Anaphylaxis bp is to low for IM

Pedi: 2 mg/kg

May produce hypertension

Rare instances of:

Anaphylactic reactions

Exacerbation of congestive heart failure

Seizure

Midazolam

(Versed)

-Active Seizure

-Status Epilepticus

-Sedation prior to Cardioversion/Pacing

CNS Depressant

(amnesia, sedation, relaxation)

-Hypersensitivity

-Acute Narrow Angle Glaucoma

2.5-5mg may repeat once (IV or IN)

-Respiratory Depression

-Confusion

-Hypotension

-Nausea

Morphine

-Pain & Anxiety

-Chest Pain unrelieved by NITRO

-Alleviates Pain

-Dec. Anxiety

-Vasodilator

-BP <90

-Traumatic Brain Inj.

-Respiratory Depression

2-4 mg q 3-5 mins to hypotension or respiratory depression

-Respiratory depression

-Dizziness

-N/V

-Hypotension

-Bradycardia

Narcan

(Naloxone)

Opiate OD

Narcotic Antagonist

Hypersensitivity

0.4mg to MAX 2mg

-Dysrhythmias

-N/V

-HTN

-Tachycardia

-Violent Behavior

TRADE NAME

(GENERIC)

INDICATION

HOW IT WORKS

CONTRA-

DOSE

Side effects

Nitroglycerin

(Nitrostat)

-Chest pain or cardiac origin

-Pulmonary Edema assoc. w/ CHF

Vasodilator

-Systolic BP <90

-Increased intracranial pressure

-ED drugs

-Extreme Brady/Tachycardias

1 spray 0.4mg

1 SL tablet 0.4mg

-Hypotension

-Headache

-Reflex Tach

-N/V

-Diaphoresis

Nitrous Oxide

(Nitronox)

-A&O PT w/pain (Kidney stones, Thermal burns, AMI, Labor, Fractures)

CNS Analgesic/Anesthetic

(short term)

-Decompression Sickness

-COPD

-Chest Trauma

-Abd. Distention

-Altered LOC

Self Dose

-Hypotension

-Dizziness

Norcuron

(Vecuronium)

Long-term muscle paralysis to facilitate endotracheal intubation

Works as competitive antagonist to ACh at post-synaptic receptors in the

cholinergic receptor sites at the neuromuscular junction (NMJ).

· By blocking/occupying the receptor sites, it prevents stimulation of the muscle without depolarizing the muscle (no fasiculations) leading to muscle paralysis

Hypersensitivity

IV/IO

o Adult: 0.1 mg/kg Pedi: 0.1 mg/kg

o Onset: 30 sec

o Duration: 30-40 min.

· Hypotension or hypertension

· Tachycardia or bradycardia

· Patients with neuromuscular disease – Multiple Sclerosis

· Hepatic or Renal impairment

TRADE NAME

(GENERIC)

INDICATION

HOW IT WORKS

CONTRA-

DOSE

Side effects

(Pancuronium) Pavulon:

Long-term muscle paralysis to facilitate endotracheal intubation

Works as competitive antagonist to ACh at post-synaptic receptors in the

cholinergic receptor sites at the neuromuscular junction (NMJ).

· By blocking/occupying the receptor sites, it prevents stimulation of the muscle

without depolarizing the muscle (no fasiculations) leading to muscle paralysis

Hypersensitivity

IV/IO

o Adult: 0.04 - 0.1 mg/kg Pedi: 0.04-0.1 mg/kg

o Onset: 30 sec

o Duration: 180 min.

· Hypotension or hypertension

· Tachycardia or bradycardia

· Patients with neuromuscular disease – Multiple Sclerosis

· Hepatic or Renal impairment

Phenergan

(Promethazine)

-Persistent vomiting

-GI problems

-Allergic Reactions

Better than Zofran if Pt. already vomiting

Potent Antiemetic w/sedative effects

-Hypersensitivity

-Comatose States

-Altered LOC

12.5mg to max MAX of 25mg

-Drowsiness/

sedation

-Dystonic Reaction

-Necrosis

Pralidoxime Chloride (2-PAM®)

•Second drug given for the treatment of poisoning due to organophosphate pesticides and chemical nerve agents (First drug is atropine)

•Primary indication for pralidoxime administration is muscle weakness or respiratory depression in these patients

•Reactivates cholinesterase which has been deactivated by chemical nerve agents and organophosphate poisons

•Relieves paralysis of the respiratory muscles following chemical nerve agent or organophosphate

Contraindications: No absolute contraindications

600mg (1 autoinjector) - 1800mg (3 auto-injectors) - standing order

•Tachycardia, laryngospasm, muscle rigidity if IV and infused too quickly

•Mild to moderate pain at injection site

•Blurred or double vision, dizziness, loss of coordination, headache drowsiness, hypertension, tachycardia

TRADE NAME

(GENERIC)

INDICATION

HOW IT WORKS

CONTRA-

DOSE

Side effects

Pronestyl

(Procainamide)

Suppress ectopy in ventricular tissue & reduce ventricular dysrhythmias such as:

o Refractory & recurrent Ventricular Fibrillation (V-Fib)

o Pulseless Ventricular Tachycardia (V-Tach)

o Stable monomorphic or polymorphic Ventricular Tachycardia w/ pulse

o Wide-complex tachydysrhythmias of uncertain type

o Malignant, refractory PVCs

 I-C: Suppress ectopy in atrial tissue & reduce supraventricular dysrhythmias such as:

o PACs, PAT, A-Fib, A-Flutter, WPW

· Slows myocardial conduction by stabilizing the myocardial membranes

 Reduces the automaticity and therefore:

o Effectively suppresses a variety of atrial and ventricular dysrhythmias

 

 

 

· TCA Overdose

 Previous use of Amiodarone

 2nd and 3rd degree heart block

 

 

 

IV Infusion

o 20 – 30 mg/min IV infusion titrate to effect

o Max dose: up to 17 mg/kg

o Add 1 Gram Procainamide to 250 mL NS, use 10 gtts/min drip set

 

 

 

· Hypotension

 2nd or 3rd degree AV block

 Widening of the QRS complex

 

Racemic epi

(Vaponefrin)

· Acute bronchospasm in reactive airway disease such as:

o Acute asthma attack

o Acute exacerbation of Chronic Obstructive Pulmonary Disease (COPD)

o Allergic reaction unresponsive to other treatment

o Racemic epinephrine: laryngotracheobronchitis (Croup)

· Activates beta-2 adrenergic receptors in respiratory tract causing relaxation of smooth

muscle & bronchodilation

 

· Hypersensitivity

· Pregnancy – except in life-threatening situation

· Racemic epinephrine: Epiglottitis

Inhaled/Nebulized

o 0.5 mL of 2.25% soln. in 2.5 mL N.S. every 4 hours prn

Side Effects:

· Tachycardia

· Restlessness/nervousness/tremors

· Hypertension

TRADE NAME

(GENERIC)

INDICATION

HOW IT WORKS

CONTRA-

DOSE

Side effects

Sodium Bicarbonate

-TCA OD

-Hyperkalemia or Acidosis

-Prolonged CPR

-DKA

-Rhabdomyolysis

-Compartment Syndrome

Buffers metabolic acidosis

-Alkolosis

-PE

-Abdominal Pain w/ unknown orgin

-Hypocalemia

1mEq/kg

-Acidosis

-Hypoxia

-Tissue sloughing

-Seizures

-Hypernatremia

-Inc. PCO2

Succinylcholine

To facilitate intubation

Depolarizing neuromuscular blocker

-Burn injuries w/in 12hrs

-Inability to control airway

-Acute Rhabdomyolysis

Relax: 0.3-1.1mg/kg

 

 

RSI: 1-1.5 mg/kg

-Respiratory depression

-Bradycardia

-Dysrhythmias

-Allergic Reaction

Terbutaline

· Acute bronchospasm in reactive airway disease such as:

o Acute asthma attack

o Acute exacerbation of Chronic Obstructive Pulmonary Disease (COPD)

o Allergic reaction unresponsive to other treatment

· Activates beta-2 adrenergic receptors in respiratory tract causing relaxation of smooth

muscle & bronchodilation

· Hypersensitivity

· Pregnancy – except in life-threatening situation

 

Subcutaneous (SC)

o Adult: 0.25 mg SC May repeat once in 15 min if no response

o Pedi: 0.01 mg/kg (Not to exceed adult dosage)

· Tachycardia

· Restlessness/nervousness/tremors

· Hypertension

Thiamine

Thiamine: vitamin required to convert glucose to energy – must be ingested, body does

not manufacture.

Thiamine: vitamin required to convert glucose to energy – must be ingested, body does

not manufacture.

A history of sensitivity to thiamine or to any of the ingredients in this drug is a contraindication

IVP/IM

o Adult: 50 mg IV/IM May repeat to total of 100 mg

 

Verapamil (calan)

-SVT

-Aflutter w/RVR

-Afib

-Atrial Tach

-Unstable angina

Inhibiting the movement of calcium ions across cell membranes.

-Hypersensitivity

-Bradycardia

Initial: 2.5-5mg

 

Repeat: 5-10mg bolus every 15 min

 

-Dizziness

-Headache

-N&V

-Hypotension

-Bradycardia

TRADE NAME

(GENERIC)

INDICATION

HOW IT WORKS

CONTRA-

DOSE

Side effects

Zemuron

(Rocuronium)

Long-term muscle paralysis to facilitate endotracheal intubation

Works as competitive antagonist to ACh at post-synaptic receptors in the

cholinergic receptor sites at the neuromuscular junction (NMJ).

· By blocking/occupying the receptor sites, it prevents stimulation of the muscle

without depolarizing the muscle (no fasiculations) leading to muscle paralysis

Hypersensitivity

IV/IO

o Adult: 1 mg/kg Pedi: 1 mg/kg

o Onset: 60-90 sec

o Duration: 45-70 min.

· Hypotension or hypertension

· Tachycardia or bradycardia

· Patients with neuromuscular disease – Multiple Sclerosis

· Hepatic or Renal impairment

Zofran (ondansetron)

Prevention of Nausea Vomiting

Blocks Serotonin Receptor

Hypersensitivity,

 

Pedi <2yrs of age, 

 

Do Not administer Phenergan & Zofran to same PT.

2mg to MAX of 4mg

 

 

-Dizziness,

-Burning @ injection site,

-Drowsiness