Classification: Cardiac Stimulant, Parasympatholytic, Anticholingergic agent.

Action/Effects: Increases HR, Contractility, Automaticity, Conduction, and Dilation of the peripheral vessels.

Indication: Asystole, Symptomatic Bradycardia, PEA Organophosphate Poisoning.

Contraindication: Hypersensitivity, Tachycardia, 2nd and 3rd degree heart block.

Side Effects: Increased Cardiac consumption, Dryness in mouth.

Adult Dose: Brady .5 mg, Asystole 1 mg q 3-5 min IV, ET 2-5 mg for Organophosphate Poisoning.

Pediatric Dose: .02 mg/kg IV, ET Minimun dose .1 mg

Cautions: A-Fib, A-Flutter, Glaucoma, and COPD.

Classification: Anti-platelet, Antipyretic.

Action/Effects: Decreases platelet aggregation, prolongs clotting time.

Indication: MI, coronary artery disease.

Contraindication: Hypersensitivity, Pt. already on anticoagulants, Bleeding disorders.

Side Effects: Heart Burn, Nausea, Wheezing.

Adult Dose: 160-325mg (2-4 tablets 81mg per tablet) Expected Dose- 324mg

Cautions: Pediatic, GI bleeds, and bleeding disorders this can be containdication.

Trade Name: Proventil, Ventolin.

Classification: Sympathomimetic, Bronchodilator.

Action/Effects: A beta2-adrenergic agonist which helps relax the bronchial smooth muscles.

Indication: Asthma, Relief of bronchospasm with reversible obstuctive airway disease.

Possible Contraindications: Cardiac dysrhythmias, Tachyarrhythmia's, Angina.

Side Effects: Tremors, Dizziness, Palpitations, Tachycardia

Adult Dose: 2.5mg/3ml of NS.

Pediatric Dose: 2.5mg in 3cc NS≥ 1 year old, 1.5mg in 3cc NS < 1 year old.

Cautions: Tachyarrhythmia's, HTN, Angina, Diabetes.

Trade Name: Actidose, Super Char, Charcodate, Liqui-Char, Aqua-Char

Classification: Antidote, Adsorbent.

Action/Effects: A fine black powder with liquid that adsorbs poisonous compounds to its surface, reducing the absorption.

Indication: Oral poisonings, Over dose of a non caustic or other burning poison.

Contraindication: Do NOT use in caustic acids, alkalis, irons tablets and lithium, There is NO value for the ETOH OD pt.

Side Effects: Constipation is possible, vomiting.

Adult and Pediatric Dose: 1gm/kg PO or slow Nasogastric or Orogastic tubes.

Cautions: SOme people like to spit it at YOU!

Trade Name: Adrenalin 1-1,000

Classification: Bronchodilator, Cardiac Stimulant, Sympathomimetic.

Action/Effects: SQ=Bronchodilator and relief of bronchial edema, Beta 1&2. IV=Increases HR, Vasoconstricts, Alpha 1 and Beta 1.

Indication: Anaphylaxis, Acute Allergic Reactions, Asthma.

Side Effects: Acute Hypertension, Anxiety, tremor, and palpatations.

Adult Dose: .3-.5mg SQ.

Pediatric Dose: .01mg/kg with a max dose of .3mg for anaphylaxis. .1mg/kg ET (1-1,000) q 3-5 min with 3 cc flush for cardiac.

Cautions: Use caution with pregnancy and preexisting heart disease.

Intravenous: Most rapidly effective and most dangerous.

Intramuscular: longer reaction time, longer duration of action once administered.

Subcutaneous: given beneath the skin into the fat or connective tissue immediately underlying it, absorbed more slowly over more prolonged period of time.

Inhalation: primarily for aerosolized bronchodilators.

Endotracheal: very rapidly absorbed across bronchial membranes taking effect nearly as rapidly as IV.

Sublingual: under the tongue with rapid absorption.

Oral (p.o.): absorption slow and unpredictable.

Rectal: absorption across rectal mucosa rapid but unpredictable.

Intracardiac: no advantages over IV or ET.

gtt/minute= volume to be infused x gtt/min of administration set

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total time of infusion in mins

Total mg

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Total mL

Trade Name: Xylocaine

Classification: Antiarrhythmic Agent

Action/Effects: Decreases the automaticity of the purkinje fibers in the ventricle to control excitability of the myocardium. It also increases the V-fib threshold

Indication: V-fib/ V-Tach, Post V-fib/ V-Tach (after conversion), possible symptomatic PVC's

Contraindication: Bradycardia, AV Heart Blocks

Side Effects: Seizures, Coma, Respiratory depression may occur if gien rapidly or in high doses, Sinus Brady, Hypotension

Adult & Ped Dose: 0.75-1.5mg/kg IV/ET/IO q 3-5 min followed by a drip of 1-4mg/min depending on prior boluses

Expected Dose: 1mg/kg IV/IO or 2 1/2 times the dose for ET

Max: 3 doses

Cautions: 1/2 doses for over 70, 1/2 dose for liver disease pt.

Trade Name: Adrenalin 1-10,000

Classification: Sympathomimetic, Cardiac Stimulant, Bronchodilator

Action/Effects: Increases cardiac resistance, BP, Electrical activity, O2 Needs, contractility, and myocardial activity. Alpha 1 & Beta 2

Indication: Cardiac Arrest V-fib, V-tach, Asystole, PEA, and profound Bradycardia

Side Effects: Hypertension, Peripheral constriction

Adult Dose: 0.5-1mg IV every 3-5 mins (ET is 2-2 1/2 time the dose w/20 cc flush)

Expected Dose: 1mg IV

Max: None in a life threatening emergency

Pediatric Dose: 0.01mg/kg IV/IO with a max dose of 1mg IV 0.1mg/kg ET (1-1,000) q 3-5 min w/3 cc flush

Cautions: DO NOT mix with NaHCO3 Heat destroys this drug

Trade Name: Versed

Classification: Short acting benzodiazepine, CNS depressant, Anti-seizure

Action/Effects: Reduces brain excitability and seizure activity Impair memory

Indication: Seizures, including eclampsia. Sedation prior to pacing or cardioversion

Contraindication: Hypersensitivity, Shock

Side Effects: Slurred speech, Respiratory depression, and Hypotension

Adult and Ped Dose: 0.1mg/kg IV/IM, 0.2mg/kg IN with max of 1cc per nostril

Expected Dose: 2-5mg IV/IM 5-10mg IN

Max: 10mg

Cautions: Alcohol intoxication may be contraindicated. Depressed vitals use caution

Trade Name: MS

Classification: Narcotic analgestic, Opioid analgesic

Action/Effects: Controls pain by the effects on the cerebrum and medulla, Peripheral casodilation, Decreases pain, Depresses respiratory

Indication: MI pain, Acute Pulmonary Edema, Minor trauma, Possible diagnosis of abdominal pain

Contraindication: Hypersensitivity, Head injury, CVA, Hypotension, and respiratory depression

Side Effects: Depressed Respirations, Nausea, ALOC, and Rashes

Adult Dose: 2-15mg IV/IM titrated 2mg to pain relief

Ped Dose: 0.1mg/kg

Max: 15mg IV/IM

Caution: Overdosing patients can cause respiratory depression

Trade Name: Narcan

Classification: Narcotic antagonist, Opioid antagonist

Action/Effects: Displace narcotics at the receptor sites in the CNS. Attaches to the receptors and inhibits the narcotics action

Indication: Narcotic overdose, Respiratory depression, coma of unkown origin

Contraindication: Hypersensitivity

Side Effects: Addictivie, Nausea, and Seizures from withdrawl

Adult Dose: 2-4mg IV/IM/IN/ET/IO

Possible Dose: 0.5-1mg IV, 2mg IM

Ped Dose: 0.1mg/kg IV/IM with max of 2mg

Cautions: It can cause seizure from withdrawl in chronic opiate users

Trade Name: Nitrostat

Classification: Coronary Vasodilator

Action/Effects: Dilates the coronary arterioles and veins increasing the perfusion to the myocardium. Lowers the arteriole pressure and increases circulation to the heart

Indication: AMI, Pulmonary Edema, Possible Hypertension

Contraindication: EMT-P systolic <90, EMT-I Systolic <100, CVA

Side Effects: Severe Hypotension, Weakness, Headache, Syncope

Adult Dose: 0.3-0.4mg Sublingual q 5 min up to 3 times (may come in spray or tablet)

Cautions: If pt. is wearing a nitroglycerin patch or paste, and additional administration may not be effective. Other drugs may be used if Nitro is not working

Trade Name: D 50, 50% Dextrose

Classification: Carohydrate

Action/Effects: Increases the BSL with the Electrolytes

Indication: Hypoglycemia

Contraindication: Intracranial Hemorrhage, and possible CVA

Side Effects: Tissue necrosis if infiltration occurs with IV

Adult Dose: 25-50gms IV only (lower dose may be given)

Expected Dose: 25gm/50ml given slowly

Ped Dose: 0.5-1gm/kg IV/IO with a max of 25gms

Cautions: Tissue necrosis if infiltration occurs with IV

Trade Name: GlucaGen

Classification: Pancreatic Hormone, Insulin Antagonist

Action/Effects: Raises glucose level by using the glycogen in the liver for glucose, Stimulating glucose syntesis

Indication: Hypoglycemia

Contraindication: Hypersensitivity

Side Effects: Hypotension, Nausea, Hypokalemia

Adult Dose: 1mg IM/IV but usually given IM

Ped Dose: 0.02-0.03mg/kg IM/IV with max of 1mg

Cautions: pt. may have home emergency glucagon kit May be used w/calcium channel blocker & beta blocker toxicity

Trade Name: NaHCO3

Classification: Alkalinizing Agent

Action/Effects: neutralizes acids, returning blood and body fluid to a more normal ph instead of an acidosis state. (Increases ph)

Indication: Metabolic acidosis, Prolonged CPR or down time (more than 5-10 mins) Tricyclic overdose blocking the tricyclic action and preventing the cardiac arrhythmia. (Tricyclic meds=Amitriptyline, Desipramine, Endep, Janimine, Norpramin, Notriptyline, Pamelor, Surmontil, Tofranil, Triavil, Trimpramine)

Contraindication: Hypersensitivity, Alkalosis pt

Side Effects: Pushing a ph to an alkalosis state instead of neutralizing the ph

Adult and Ped Dose: 1mEq/kg followed 1/2 the initial dose q 10 mins. Use 4.2% sloution for pediatrics

Cautions: Avoid making w/Epi or calcium

Trade Name: Pitocin

Classification: Pituitary Hormone

Action/Effects: Stimulates contraction of the smooth muscles in the uterus, constricting uterine blood vessels and controlling excessive bleeding or hemorrhage

Indication: Controlling post-partum hemorrhage

Contraindication: EMS prior to delivery, Maternal bradycardia, Hypersensitivity

Side Effects: Fetal Bradycarida, Nausea

Dose: 10 units IM

Max: 40 units

Cautions: Use caution if placenta is not fully delivered, may be 2nd child

Trade Name: Haldol

Classification: Antipsychotic

Action/Effects: Blocks the stimulation of dopamine receptors

Indication: Acute psychotic episodes

Contraindication: Severe toxic CNS depression, Comatose state, Parkinson's disease, Head injury, Hypersensitivity

Side Effects: Orthostatic Hypotension, Parkinson like symptoms

Adult Dose: 2-10mg IV/IM

Expected Dose: 5mg IM

Caution: Use caution w/ pt. that have cardiovascular disorders, Receiving Anticonvulsants, and anticoagulants Not recommended for peds or head injury.

Trade Name: Lasix

Classification: Loop Diuretic

Action/Effects: Inhibits the reabsorption of sodium and chloride in the kidney tuble and promotes increased urine formation and excretion

Indication: Pumonary Edema, CHF

Contraindication: Pregnancy, Hypovolemic, and Hypokalemia

Side Effects: Dehydration, hypotension, Tinnitus/hearing impairment with long term, excessive use, and administering to pushing fast

Adult Dose: 40-80mg IV SLOW push

Expected Dose: May be as low as 25mg SLOW and diluted over 1-2 mins

Ped Dose: 1mg/kg

Cautions:PUSH slowly and lower doses to avoid Tinnitus

Trade Name: Adenocard

Classification: Antiarrhythmic

Action/Effects: Slows supraventricular tachycardia rhythms by decreasing the electrical activity in the AV node. It may interrupt the reentry pathways through the AV node

Indication: PSVT Rhythm (after vagal maneuvers)

Contraindication: 2nd or 3rd degree AV Block, SIck Sinus Syndrome, Hypersensitivity

Side Effects: Syncope, Chest pain, facial flushing, SOB, Lightheadedness, Hypotension

Adult Dose: 6mg IV push w/20cc NS fluid bolus, a repeat dose of 12mg in 1-2min up to 2X may be given if not converted

Ped Dose: 0.1mg/kg rapid IV push followed by 5cc bolus, repeat 0.2mg/kg X1

Cautions: Half life is 5 sec Ped doses don't exceed adult doses

Trade Name: Intropin

Class: Sympathomimetic, Vasopressor

Action: Stimulates dopaminergic, beta1/alpha1adrenergic receptors in a dose dependant amount

Indication: Cardiogenic and septic shock to increase the cardiac output

Contraindication: Hypersensitivity

Side Effects: Ventricular irritability, Hypertension, Headache, Infiltration, causes necrosis

Adult Dose: 800mg in a 500cc D5W or NS

Expected Dose: 5-20mcg/kg/min titrating to a BP of 100 systolic

Cautions: May cause fixed and dilated pupils w/ high doses. DO NOT MIX w/ NaHCO3

Trade Name: Benadryl

Class: Antihistamine/Antiemetic/CNS Depressant

Action: Blocks histamine receptors. Produces sedation being a CNS depressant

Indication: Anaphylaxis, Allergic reaction symptoms

Contraindication: Ashtma, COPD, prego or nursing mom

Side Effects: Thicken bronchial secretions, Decrease LOC, Hypotension, restlessness or sleepiness

Adult Dose: 25-50mg IM/IV

Expected Dose: 50mg IM

Ped Dose: 1-2mg/kg IM/IV

Note: May be helpful in acute phenothiazines dystonic reactions

Trade Name: Valium

Class: Benzodiazepine, Anticonvulsant

Action: Antianxiety and anticonvulsant activity. Acts on the CNS

Indication: Satus Epilepticus, Severe Anxiety, Pacing

Contraindication: Hypersensitivity, Depressed Vital Signs

Side Effects: Respiratory Depression, Hypotension, Slurred speech, confusion

Adult Dose: 5-20mg IV/ET/IO

Expected Dose: 5mg IV increasing to desired effects

Ped Dose: ped 0.1mg/kg IV/ET/IO 0.5mg/kg PR

Cautions: EMT's carry nothing to reverse a benzodiazepine over dose.

Trade Name:Vaporole

Class: Vasodilator, Cyanide Antidote

Action: Causes oxidation of hemoglobin to the compound of methemoglobin. Vasodilatation, including coronary artery dilation. Smooth muscle relaxant

Indication: Cyanide poisoning

Contraindication: None when given for cyanide poisoning

Side Effects: Hypotension w/ scyncope, Headache, Nausea and vomiting

Adult Dose: 0.2-0.3ml or an Amyl Nitrate glass ampule

Cautions: Break ampule and hold for 30 sec, then 100% O2 for 50-100 sec

Trade Name: Tylenol

Class: non-narcotic Analgesic, Antipyretic

Action: Antipyretic Activity, Analgesic Activity- Inhibition of central and peripheral prostaglandin synthesis

Indication: Fever, Pain

Contraindication: Hypersensitivity

Side Effects: Possible sleepiness

Adult Dose: 325-1000mg p.o. or Rectal (every 4 hours)

Ped Dose: 15mg/kg p.o. or Rectal (caution on max dose)(Liquid Form)

Max: 4gms per day

Cautions: Extreme caution must be used when considering the use on a suspected liver dysfunction

Class: Hypotonic Solution

Indication: Mixing meds (Lidocaine, Dopamine)

Adult Dose: Medication Dependant

Cautions: Use caution if used for main IV solution

Trade Name: Advil, Motrin

Class: Analgesic, Antipyretic, Anti-inflammatory, NSAID

Action: Reduces the inflammatory response through the chemotaxis. Reduces the fever by blocking the prostaglandin synthesis

Indication: Fever, Pain, Inflammation Reducer

Contraindication: Hypersensitivity

Side Effects: G.I. intolerance, many other possible

Adult Dose: 200-800mg p.o. every 6-8 hours

Ped Dose: 10mg/kg p.o. max of 40mg/kg per day(liquid form)

Cautions: You may want to alternate w/ Acetaminophen

Trade Name: LR

Class: Isotonic fluid but is slightly more hypertonic than NS

Action: Assist in fluid replacement for dehydration or blood loss

Indication: IV fluid for IV maintenance or Electrolyte replacement

Precautions: CVA, Diabetics, Mixing w/ blood sets

Adult Dose: 200-500cc

Ped Dose: 20cc/kg for fluid replacement

Max: 60cc/kg or 2-3 liters of fluid

Trade Name: Demerol

Class: Narcotic Analgesic, Opioid Analgesic

Action: Addictive narcotic that depresses the CNS and may relieve pain

Indication: Pain Relief, Trauma Pain, Kidney Stones

Contraindication: Hypersensitivity, MAO inhibitors, Head injury

Side Effects: Depressed respirations and BP, Tremor, Nausea, Vomiting

Adult Dose: 50-100mg IM/IV

Expected Dose: 50mg w/25mg of Promethazine Slow Push

Ped Dose: 1-2mg/kg

Cautions: May mix w/ promethazine for increase and ptentiate analgesics

Trade Name: Normal Saline

Class: Isotonic IV Fluid

Action: Assists in the rehydration of fluid and electrolytes in the vascular system

Indication: IV maintenance, Fluid Bolus, Combination w/blood sets on trauma pts

Contraindication: Hypersensitivity

Side Effects: 3rd spacing of fluid is pssible on bolus doeses

Dose: 200-500cc bolus or TKO

Ped Dose: 20cc/kg w/ a max of 60cc/kg

Max: 3 liters max during treatment may be suggested as max dose for trauma blood loss

Cautions: Use caution w/ overloading peds/geriatrics/ and pulmonary edema pts.

Trade Name: Phenergan

Class: CNS Depressant, Antihistamine, Antiemetic

Action: Produces an antihistamine and Antiemetic response. It also potentiates narcotics & increases the effectiveness

Indication: Nausea and vomiting, potensiates sedative effects of analgesics (Meperidine)

Contraindication: Hypersensitivity

Side Effects: Prounouced sedation, confusion, & tissue irritation

Adult Dose Range: 25-50mg IV/IM (may dilute with 10cc w/given to lesson tissue damage in IV)

Expected Dose: 12.5-25mg w/10cc NS

Ped Dose: 0.5mg/kg

Cautions: Tissue irritation is possible on IV infiltration or SQ area injection. Use caution w/ peds

Trade Name: Ipecac

Class: Emetic (Vomit)

Action: Induces vomiting by acting on the chemoreceptor trigger zone in the medulla and by direct stimulation of the GI tract

Indication: Overdose in a conscious patient w/ a secure airway

Contraindication: Semiconscious, Ingestion of phenothiazine, antiemetic, tricyclics, theophylline, pregnancy patients

Side Effects: Aspiration, Cardiotoxic effects in large doses if not regurgitated

Dose: 15-60cc p.o. w/8oz or more of water

Max: 60cc

Cautions: Rarely indicated for intitial treatmeant of overdose