Paramedic Drug Cards

Calcium Chloride

Class- Antidot e Description- Calcium chloride increases myocardial contractile force and increases ventricular automaticity. Indications- Hyperkalemia, hypocalcemia, hypermagnesemia, and calcium channel blocker toxicity. Contraindications- Ventricular fibrillation, hypercalcemia, and possible digitalis toxicity. Precautions- It may precipitate toxicity in patients taking digoxin. Ensure the IV line is in a large vein and flushed before using and after calcium Dosing Adult Bradycardia of Suspect...

Adenosine

Trade – Adenocard Classification – Antiarrhythmic MOA – Slows the conduction of electrical impulses at the AV node Indication – SVT Contraindications – Sick sinus syndrome, second or 3rd degree heart block, Poison/drug induced tachycardia, asthma, or bronchospasm Side Effects – Sense of impending doom, complaints of flushing, chest pressure, throat tightness, numbness, brief period of asystole after administration. Dosing Adult: 6mg rapid IV/IO followed by a rapid saline flush; If rhythm doesn’t...

Calcium Gluconate

Trade – Calcium Gluconate Class – Electrolyte solution MOA – Counteracts the toxicity of hyperkalemia by stabilizing the membrane of the cardiac cells, reducing the likelihood of fibrillation Indication – Hyperkalemia, hypocalcemia, hypermagnesemia Contraindications - VF, Dig toxicity, hypercalcemia Side effects – soft tissue necrosis, hypotension, bradycardia ( if administered rapidly) Dosing Adult: 500 to 1000mg IV/IO (packaged as 100mg/ml) administer 1-1.5 ml/min max dose 3G IV/IO Pedi: 60-10...

Montelukast, tramadol, pantoprazole

Metoprolol

Trade – Lopressor, Toprol XL Class – Beta Blocker ( Class II antiarrhythmic) MOA – Inhibits the strength of the hearts contraction as well as the heart rate Indication – ACS, HTN, SVT, atrial flutter, Afib, thyrotoxicosis Contraindications – Cardiogenic Shock, AV Block, Bradycardia Side effects – Tiredness, dizziness, diarrhea, heart block, bradycardia, bronchospasm, drop in blood pressure. Dosing Adult: 5mg slow IV/IO over 2 minute period, Repeat at 5 minute intervals as necessary up to 15mg Pe...

Diltiazem

Trade – Cardizem Class – Calcium channel Blocker ( class IV antiarrhythmic) MOA – Blocks Calcium from moving into the heart muscle cell, which prolongs the conduction of electrical impulses through the AV node Indication – Rapid atrial fibrillation Contraindications – Hypotension, Heart block, heart failure Side effects – Flushing, headache, bradycardia, hypotension, heart block, myocardial depression, severe AV block, at high doses cardiac arrest Dosing Adult: 0.25mg/kg IV/IO 2nd dose of 0.35mg...

Atropine

Class – Anticholinergic MOA – Competes reversibly with ACH at the site of the muscarinic receptor. Indication – Symptomatic Bradycardia, asystole or PEA, Nerve agent exposure or organophosphate poisoning. Contraindications – Acute MI, Myasthenia Gravis, GI obstruction, closed angle glaucoma, known sensitivity to atropine, belladonna alkaloids, or sulfites. Atropine may not be effective on second degree type 2 and 3rd degree heart blocks. Side effects – decreased secretions resulting in dry mouth...

Mannitol

Trade – Osmitrol Class – Osmotic Diuretic MOA – Facilitates the flow of fluid out of tissues including the brain and into interstitial fluid and blood, this causes dehydration of the brain which results in decreased swelling. Reabsorption by the kidneys is limited so increased urine output takes place Indications – increased ICP Contraindications - Active intracranial bleeding, heart failure, pulmonary edema, severe dehydration, use caution with hypovolemia and renal failure. Side effects – Pulm...

Dexamethasone

Trade – Decadron Class – Corticosteroid MOA – Reduces inflammation by multiple mechanisms Indication – Asthma, airway edema, acute mountain sickness, cerebral edema and multiple medical conditions requiring anti-inflammatory Contraindications – Fungal infection, use caution in active infections, renal disease, penetrating spinal cord injury. Side effects – Depression, euphoria, headache, restlessness, HTN, Bradycardia, Nausea/vomiting, swelling, diarrhea, weakness, fluid retention, paresthesias ...

Dextrose

Trade – Dextrose (D50, D25, D10) Class – Antihypoglycemic MOA – Increases blood glucose concentrations Indications – Hypoglycemia Contraindications – Intracranial and instraspinal hemorrhage, delirium tremens. Side effects – Hyperglycemia, warmth, burning from IV infusion. Concentrated solutions may cause pain and thrombosis of peripheral veins. Dosing – Hyperkalemia: Adult: 25G of dextrose 50% IV,IO Pedi: 0.5 – 1G/kg IV/IO Hypoglycemia: Adult: 10-25g dextrose 50% IV Pedi : Older then 2 years 2m...

Bupropion, Potassium, Carvedilol

Bupropion Trade: Wellbutrin Use: Antidepressant Potassium Trade: K-Dur Use: Hypokalemia Carvedilol Trade: Coreg Use: HTN

Fluticasone, Alprazolam, Trazadone

Fluticasone Trade: Flonase Use: Allergies Alprazolam Trade: Xanax Use: Anxiety, Panic disorder Trazodone hydrochloride Trade: Desyrel Use: Depression

Esmolol

Trade – Brevibloc Class – Beta Blocker MOA – Inhibits the strength of the hearts contractions, as well as heart rate. Indication – ACS, MI, acute HTN, Supraventricular tachyarrhythmias Contraindications – COPD, Acute Bronchospasm, Bradycardia, Advanced Heart blocks, cardiogenic shock, Pulmonary Edema, Side Effects – Hypotension, sinus bradycardia, AV block, Cardiac arrest, nausea/vomiting, hypoglycemia, injection site reaction Dosage Adult: 500mcg/kg IV/IO over 1 minute Pedi: 500mcg/kg IV/IO ove...

Glucagon

Trade – Glucagon Class – Hormone MOA – Converts glycogen to glucose Indication – hypoglycemia, beta blocker overdose Contraindications – Pheochromocytoma, Insulinoma Side effects – Nausea/vomiting, rebound hyperglycemia, hypotension, sinus tachycardia Dosages Hypoglycemia Adult: 1mg IM, IV, IO, SQ Pedi: Less than 44 lbs – 0.5mg IM, IV, IO, Sq Beta Blocker/CCB Overdose Adult: 3-10mg IV, IO...

Terbutaline

Trade – Brethine Class – Adrenergic agent MOA – Stimulates B2 receptor producing relaxation of bronchial smooth muscle and bronchodilation. Indication – prevention and reversal of bronchospasm Contraindications – known sensitivity to sympathomimetics Side Effects – Cardiac arrhythmias, arrhythmia exacerbation, angina, anxiety, headache, tremor, palpitations, dizziness Dosages Adult: 0.25mg SQ every 20 minutes for up to 3 doses Pedi: 0.005 to 0.01 mg/kg SQ every 20 mins for up to 3 doses...

Amoxicillin, Citalopram, Fluoxetine Hydrochloride

Ondansetron

Trade – Zofran Class – Antiemetic MOA – Binds and blocks a receptor for the brain chemical serotonin Indication – Prevention and treatment of nausea and vomiting Contraindication – Use caution in hypokalemia, hypomagnesemia, cardiac arrhythmias Side Effects – headache, fatigue, diarrhea, dizziness, hypotension/HTN, Prolonged PR and QT intervals, Widened QRS, Bradycardia, tachycardia, syncope. Dosage Adult: 4– 8mg IV, IO, PO Pedi: (2-16 years) 0.15 mg/kg IV,IO ( max dose 16mg)...

Methyprednisolone

Trade – Solu Medrol Class – Corticosteroid MOA – Reduces inflammation by multiple mechanisms Indications – Anaphylaxis, Asthma, COPD Contraindications – Cushing Syndrome, Fungal infection, HTN, seizures, CHF, Penetrating spinal cord injuries, Renal disease Side effects – depression, euphoria, headache, restlessness, HTN, Bradycardia, nausea/vomiting, swelling, diarrhea, weakness, fluid retention, paresthesia Dosage: Asthma and COPD Adult: 40-80mg/day IV Pedi: 1mg/kg (up to 60) IV/IO per day Anap...

Acetaminophen, Atenolol, Pravastatin Sodium

Generic Acetaminophen Trade: Tylenol Use: Pain/Fever Generic Atenolol Trade: Tenormin Use: HTN Generic Pravastatin Sodium Trade: Pravachol Use: High cholesterol

Magnesium Sulfate

Trade – Magnesium Sulfate Class – Electrolyte, Tocolytic, Mineral Action – Controls seizures by blocking peripheral neuromuscular transmission. Magnesium is also a peripheral vasodilator, and an inhibitor of platelet function. Indication – Torsades de Pointes, cardiac arrhythmias associated with hypomagnesemia, eclampsia and seizure prophylaxis in preeclampsia, status asthmaticus. Contraindications – AV Block, GI obstruction, use caution in renal impairment. Side effects – Mag Toxicity Signs of ...

Aspirin

Trade – ASA(Acetylsalicylic Acid) Class – Antiplatelet, nonnarcotic analgesic, antipyretic. MOA – prevents the formation of a chemical known as thromboxane A2, which causes platelets to clump together, or aggregate, and form plugs that cause obstruction or constriction of small coronary arteries. Indication – Fever, inflammation, angina, AMI, and patients complaining of pain, pressure, squeezing, or crushing in the chest that may be cardiac in origin. Contraindication – GI bleeding, active ulcer...

Furosemide

Trade – Lasix Class – Loop Diuretic MOA – Inhibits the absorption of the sodium and chloride ions and water in the loop of Henle, as well as the convoluted tubule of the nephron. This results in decreased absorption of water and increased urination Indication – Pulmonary edema, CHF, HTN emergency Contraindications – Known Sensitivity to sulfonamides or furosemide Side Effects - Vertigo, dizziness, weakness, orthostatic hypotension, hypokalemia, thrombophlebitis Dosage: Congestive Heart Failure a...

Methylphenidate, Estradiol, Losartan Potassium

Methylphenidate Trade – Concerta Use – ADHD Estradiol Trade – Climara Use – Menopaus Losartan Potasium Trade – Cozaar Use – High cholesterol

Metoclopramide

Trade – Reglan Class – Antiemetic MOA – promotes gastric emptying Indication – Nausea/vomiting, Migraine with history Contraindication – GI obstruction or perforation, pregnancy, under 6 yo. Side effects – constipation, diarrhea, dry mouth, HTN Dosing Adult 10-15mg IV,IO Pediatric 0.4-0.8mg/kg IV/IO

Procainamide

Trade – Pronestyl Class – Antiarrhythmic – NA+ blocker MOA – Blocks influx of sodium through membrane pores, consequently suppresses atrial and ventricular arrhythmias by slowing conduction in myocardial tissue. Indication – Alternative to amiodarone for stable monomorphic VT with normal QT interval. Reentry SVT if uncontrolled by adenosine and vagal maneuvers if BP is stable. Rapid Afib in WPW Contraindications – AV block, QT prolongation, torsades de pointes, Side effects – Asystole, VF, flush...

Levalbuterol

Trade –Xopenex Description: Sympathomimetic, bronchodilator-Stimulates beta-2 receptors resulting in smooth muscle relaxation of bronchial tree and peripheral vasculature. Indications: Treatment of acute bronchospasm in patients with reversible obstructive airway disease (COPD/asthma). Bronchospasm prophylaxis in asthma patients. Contraindications: Angioedema, tachydysrhythmias, and sever cardiac disease. Avoid use in patients taking phenothiazines; may cause prolonged QT interval and dysrthythm...

Pancuronium

Description: Pancuronium is a non-depolarizing neuromuscular blocker that causes paralysis without bronchospasm or hypotension, it does not cause the fasciculation's associated with polarizing agents. Indications: To facilitate endotracheal intubation. Contraindications: Tachycardia. Dosage/Route: 0.04 to 0.1 mg/kg IV. Pedi: same as adult.

Famotidine

Name/Class: Pepcid) Anti-Ucler Agent / H2-Receptor Antagonist Description: Famotidine is a histamine-2 blocker. It works by decreasing the amount of acid the stomach produces. Indications: Upper GI Bleed, Anaphylaxis. Contraindications: Hypersensitivity, Long QT syndrome. Precautions: Asthma, COPD. Dosage/Route: 20mg IV

Gabapentin, Furosemide, Sertraline

Gabapentin Trade - Neurontin Use – Epilepsy Furosemide Trade – Lasix Use – CHF/HTN/Edema Sertraline HCL Trade – Zoloft Use - Antidepressant

Racemic Epinephrine

Description: Sympathomimetic Agonist is a variation of epinephrine used only for inhalation to induce bronchodilation and to reduce laryngeal edema and mucus secretion. Indications: Croup (laryngotracheobronchitis). Contraindications: Hypersensitivity, hypertension, or epiglottitis. Precautions be monitored. : May result in tachycardia and other dysrhythmias. Patient vital signs and ECG should Dosage/Route: 0.25-0.75ml of a 2.25% solution in 2.0ml NS Pedi: same as adult....