Term
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Definition
Class-Narcotic (opioid)
Action-Analgesia and sedation through binding of opiate receptors
Indications-moderate to severe pain
Contraindications-Hypotension, hypersensitivity to the drug
Doses-2-10 mg
Routes-IV, IO, IM, SQ, PO
Adverse Effects-Hypotension, Syncope, Tachycardia, Bradycardia, Apnea, Nausea, Vomitting, Respitory depression
Other-Use appropriate monitors. Naloxone is an antagonist |
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Term
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Definition
Class-Narcotic (opioid)
Action-Analgesia and sedation through binding to opiate receptors
Indications-Moderate to severe pain
Contraindications-Hypersensitivity to the drug
Doses-0.5-2 mg
Routes-IV, IO, IM, SQ, PO
Adverse Effects-Nausea, Vomitting, Cramps, Respitory depression
Other-use appropriate monitors. Naloxone is an antagonist |
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Term
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Definition
Class-Narcotic (opioid)
Action-Analgesic through binding to opiate receptors
Indications-Moderate to severe pain. Anesthetic
Contraindications-Hypersensitivity to the drug
Doses-50-100 mcg
Routes-IV, IO, IM, SQ, IN
Adverse Effects-Nausea, Vomitting, Cramps, Chest wall rigidity, Respitory depression
Other-Use appropriate monitors. Nalaxone is an antagonist |
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Term
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Definition
Class-Narcotic (opioid)
Action-Analgesic through binding to opiate receptors
Indications-Moderate to severe pain
Contraindications-Hypersensitivity to the drud. Patients recieving monoamine oxidase inhibitors(MAOIs)
Doses-25-100 mg
Routes-IV, IO, IM, SQ, PO
Adverse Effects-Nausea, Vomitting, Euphoria, Dysphoria, Respitory depression
Other-Use appropriate monitors. Naloxone is an antagonist |
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Term
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Definition
Class-Nonnarcotic analgesic, antipyretic (para-aminophenol derivative)
Action-Exact mechanism uncertain but felt to inhibit cyclooxygenase
Inications-Mild-moderate pain, fever
Contraindications-Hypersensitivity to the drug, alcoholism, chronic liver disease, head injury, hypotension, previously taken the drug, inability to swallow, respitory distress, persistent vomitting, under 3 years of age
Doses-3-5 yo 160mg/5ml, 6-9 yo 320mg/10ml, 10 yo an up 640mg/20ml, NR 325-650 mg
Routes-PO
Adverse Effects-Not clinically significant
Other-can be liver toxic- use minimal dose necessary |
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Term
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Definition
Class-NSAID
Action-Anti-inflammatory and antipyretic through inhibition of prostaglandins
Indications-Mild to moderate pain, fever, inflammation
Contraindications-Hypersensitivity to the drug, bronchospasm, angioedema
Doses-200-800 mg
Routes-PO
Adverse Effects-Nausea, Vomiting, GI bleeding, Allergic reactions
Other-Commonly causes gastric upset
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Term
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Definition
Class-NSAID
Action-Anti-inflammatory and antipyretic through inhibition of prostaglandins
Indications-Mild to moderate pain, fever, inflammation, renal colic
Contraindications-Hypersensitivity to the drug, bronchospasm, angioedema
Doses-30 mg (IV and the elderly) 60 mg IM
Routes-IV, IM
Adverse Effects-Nausea, Vomiting, GI bleeding, Allergic reactions
Other-Can cause dizziness and headache |
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Term
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Definition
Class-NSAID
Action-Platlet inhibitor, Anti-inflammatory and antipyretic through inhibition of thromboxane A2
Indications-Chest pain when acute myocardial infarction is suspected, Mild to moderate pain, Fever, Platelet aggregation inhibitor
Contraindications-Hypersensitivity to the drug, Bronchospasm, Angioedema, Patients receiving MAOIs
Doses-Pediatric:not indicated, Adult: 324 mg or 325 mg chewed. NR 350-650 mg
Routes-PO
Adverse Effects-Heartburn, Wheezing, Nausea, Vomiting, GI bleeding, Allergic reactions
Other-commonly causes gastric upset, avoid enteric-coated asperin in chest pain |
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Term
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Definition
Class- Opiate antagonist
Action-Opioid antagonist w/o opiate agonist properties (it has no activity when given in the absence of an opiate agonist)
Indications-Partial reversal of opiate drug effects, opiate overdose
Contraindications-Hypersensitivity to the drug
Doses-0.4-2 mg
Routes-IV, IO, SQ, IN, Nebulizer
Adverse Effects-Fever, Chills, Nausea, Vomiting, Diarrhea, Opiate withdrawal
Other-Administer enough to reverse respitory depression and avoid full narcotic withdrawal syndrome |
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Term
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Definition
Class- Opiate antagonist
Action-Opioid antagonist w/o opiate agonist properties (it has no activity when given in the absence of an opiate agonist)
Indications-Partial reversal of opiate drug effects, opiate overdose
Contraindications-Hypersensitivity to the drug
Doses-0.5-1 mg
Routes-IV, IO, SQ, IM
Adverse Effects-Fever, Chills, Nausea, Vomiting, Diarrhea, Opiate withdrawal
Other-Duration of effect much longer than naloxone |
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Term
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Definition
Class-Opiate agonist-antagonist
Action-Anelgisia and sedation through bining to opiate receptors. It also has some opiate receptor antagonistic properties
Indications-Moderate to severe pain
Contraindications-Hypersensitivity to the drug, Opiate dependance, Respitory depression
Doses-10-20 mg
Routes-IV, IO, SQ
Adverse Effects-Sedations, Dizziness, Nausea, Vomiting, Opiate withdrawal
Other-Use with caution in patients with liver and renal disease |
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Term
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Definition
Class-Opiate agonist-antagonist
Action-Anelgisia and sedation through bining to opiate receptors. It also has some opiate receptor antagonistic properties
Indications-Moderate to severe pain
Contraindications-Hypersensitivity to the drug, Opiate dependance, Respitory depression
Doses-1-4 mg
Routes-IV, IO, SQ, IM, IN
Adverse Effects-Sedations, Dizziness, Nausea, Vomiting, Opiate withdrawal
Other-Use with caution in patients with liver and renal disease |
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Term
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Definition
Class-Benzodiazepine
Action-Binds to Type A GABA receptors causing seation
Indications-Anxiety, Seizures, Muscle relaxation
Contraindications-History of hypersensitivity to the drug
Doses-2-10 mg
Routes-IV, IM, IO, PO, rectal
Adverse Effects-Hypotension, Sedation, Amnesia, Respitory depression, Nausea, Vomiting
Other-Incompatible with other medications because not as water soluble, Can cause irritation with injection, Flumazenil is an antagonist |
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Term
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Definition
Class-Benzodiazepine
Action-Binds to Type A GABA receptors causing seation
Indications-Anxiety, Seizures, Sedation
Contraindications-History of hypersensitivity to the drug
Doses-1-5 mg
Routes-IV, IM, IO
Adverse Effects-Hypotension, Sedation, Amnesia, Respitory depression, Nausea, Vomiting
Other-Flumazenil is an antagonist |
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Term
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Definition
Class-Benzodiazepine
Action-Binds to Type A GABA receptors causing seation
Indications-Anxiety, Seizures, Sedation
Contraindications-History of hypersensitivity to the drug
Doses-1-4 mg
Routes-IV, IM, IO, PO, rectal
Adverse Effects-Hypotension, Sedation, Amnesia, Respitory depression, Nausea, Vomiting
Other-Flumazenil is an antagonist |
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Term
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Definition
Class-Dissociative anesthetic
Action-Causes dissociation between the cortical and limbic system
Indications-Sedation, Analgesia
Contraindications-History of hypersensitivity to the drug, Hypertension
Doses-0.5-1 mg/kg (IV), 2-4 mg/kg (IM)
Routes-IV, IM
Adverse Effects-Hallucinations
Other-All monitors should be in place, Resuscitative equipment should be immediately available |
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Term
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Definition
Class-Sedative/ anesthetic gas
Action-CNS depressant
Indications-Pain, Sedation
Contraindications-COPD, Pneumothorax, Bowel obstruction
Doses-Self-administered
Routes-Inhalation
Adverse Effects-Dizziness, Hallucinations, Nausea, Vomiting, Altered mental status
Other-Should not be used in any patient who cannot comprehend verbal instructions or who is intoxicated with alcohol or other medications
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Term
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Definition
Class-Nonbarbiturate, nonbenzodiazepine sedative
Action-Uncertain, but appears to potentiate GABA receptors
Indications-Sedation
Contraindications-History of hypersensitivity to the drug. Hypersensitivity to egg or soy products
Doses-25-75 mcg/kg/min
Routes-IV
Adverse Effects-Pain on induction, Nausea, Vomiting, Respitory depression
Other-All monitors should be in place, Resusitative equipment should be immediately available |
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Term
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Definition
Class-Nonbarbiturate, nonbenzodiazepine sedative
Action-Uncertain, but appears to potentiate GABA receptors
Indications-Sedation
Contraindications-History of hypersensitivity to the drug.
Doses-0.1-0.3 mg/kg
Routes-IV
Adverse Effects-Myoclonic jerks, Respitory depression, Laryngospasm
Other-Does not have analgesic properties, Calcium-channel blockers can prolong respitory depression, Can cause increased cortisol levels, All monitors should be in place, Resusitative equipment should be immediately available |
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Term
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Definition
Class-Butyrophenone
Action-Blocks dopamine receptors associated with mood and behavior
Indications-Psychosis
Contraindications-Hypotension, Hypersensitivity to the drug
Doses-15-69yoa 5 mg, >69yoa 2.5 mg, 12-14yoa 2.5-5 mg, 6-11yoa 0.05 mg/kg max 2.5 mg, <6yoa contraindivated, NR 2-10 mg
Routes-IM, PO
Adverse Effects-Extrapyramidal reactions, Insomnia, Restlessness, Dry mouth, Hypotension, Tachycardia
Other-Hypotension more common in patients taking antihypertensives |
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Term
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Definition
Class-Phenothiazine
Action-blocks dopamine receptors associated with mood and behavior
Indications-Psychosis, Intractable hiccoughs
Contraindications-Hypotension, Hypersensitivity to the drug
Doses-25-50 mg
Routes-IM, PO
Adverse Effects-Extrapyramidal reactions, Insomnia, Restlessness, Dry mouth, Hypotension, Tachycardia
Other-Hypotensionmore common in patients taking antihypertensives
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Term
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Definition
Class-Unclassified antipsychotic
Action-Inhibits uptake of serotonin and dopamine
Indications-Pyschosis, Tourette,s syndrome
Contraindications-Hypersensitivity to the drug
Doses-50-100 mcg
Routes-IM, PO
Adverse Effects-Extrapyramidal reactions, Insomnia, Restlessness, Dry mouth, Hypotension, Tachycardia
Other-Carbamazepine (Tegretol) can decrease ziprasidone levels
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Term
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Definition
Class-Muscarinic anticholinergic (Parasympatholytic)
Action-Selectively blocks muscarinic receptors inhibiting parasympathetic stimulation
Indications-Bradycardia, Antidote for organophosphate poisoning, Premedication for RSI
Contraindications-Hypersensitivity to the drug
Doses-0.5-2 mg
Routes-IV, IO
Adverse Effects-Blurred vision, Dry mouth, Dilated pupils, Confusion
Other-Organophosphate poisonings may require a significantly higher dose
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Term
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Definition
Class-Muscarinic anticholinergic (parasympatholytic)
Action-Selectively blocks muscarinic receptors inhibiting parsympathetic stimulation
Indications-Bronchospasm associated with obsructive lung disease (asthma, COPD)
Contraindications-Hypersensitivity to the drug
Doses-500 mcg
Routes-Inhaled
Adverse Effects-Blurred vision, Dry mouth, Dilated pupils, Cough, Confusion
Other-Typically administered with a beta agonist (although not as frequently)
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Term
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Definition
Class-Depolarizing neuromuscular blocker
Action-Binds to acetylcholine receptors at the neuromuscular junction causing depolarization and subsequent paralysis
Indications-Rapid sequence intubation (RSI)
Contraindications-Hyperkalemia, Neuromuscular disease, Crush injury, Burns, Increased intracranial pressure, Severe trauma
Doses-1.5 mg/kg (60-150 mg) rapid IV push may repeat at 0.5 mg/kg (20-50 mg) rapid IV push, NR 1-2 mg/kg
Routes-IV, IO
Adverse Effects-Hyperkalmia, Bradycardia, Prolonged paralysis, Malignant hyperthermia, Increased intracranial pressure, muscle fasciculations, Trismus
Other-These agents should only be used by person skilled in their use, competent at complicated airway managment, and necessary resusitative equipment available
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Term
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Definition
Class-Nondepolarizing neuromuscular blocker
Action-Binds to acetylcholine receptors at the neuromuscular junction causing paralysis
Indications-Papid sequence intubation (RSI)
Contraindications-Hypersensitivty to the drug
Doses-0.05 mg/kg (2-5 mg) IVP, NR 01-0.15 mg/kg
Routes-IV, IO
Adverse Effects-Skeletal muscle weakness, Malignant hyperthermia, Apnea
Other-Thses agents should only be used by peson skilled in their use, competent at complicated airway management, and with all necessary resusitative equipment available
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Term
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Definition
Class-Nondepolarizing neuromuscular blocker
Action-Binds to acetylcholine receptors at the neuromuscular junction causing paralysis
Indications-Papid sequence intubation (RSI)
Contraindications-Hypersensitivty to the drug
Doses-1 mg/kg
Routes-IV, IO
Adverse Effects-Hypertension, Hypotension, Skeletal muscle weakness, Malignant hyperthermia, Apnea
Other-Thses agents should only be used by peson skilled in their use, competent at complicated airway management, and with all necessary resusitative equipment availabl |
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Term
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Definition
Class-Sympathetic agonist
Action-α- and β- adrenergic agonist (β effects more pronounced although dose-related)
Indications-Cardiac arrest, Sympathetic bradycardia, Normovolemic hypotension, Allergies/anaphalaxis, Severe bronchospasm
Contraindications-Few in emergency setting
Doses-Cardiac Arrest 1 mg (1;100000), Anaphylaxis, Asthma 0.01 mg/kg IM (1:1000) max single dose 0.5 mg, NR 0.3-1 mg
Routes-IV, IO, IM, SQ, ET, Inhaled
Adverse Effects-Palpations, Anxiety, Tremulousness, Headache, Dizziness, Hypertension, Can worsen cardiac ischemia
Other-Two preperations are commonly available: 1:1000 (1mg/ml) 1:10000 (1mg/10ml)
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Term
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Definition
Class-Sympathetic agonist
Action-α- and β- adrenergic agonist (β effects more pronounced)
Indications-Normovolemic hypotension, Septic shock, Cardiogenic shock
Contraindications-Should not be used in hypovolemia until volume replacement has occured
Doses-0.1-0.5 mcg/kg/min (titrate to effect)
Routes-IV
Adverse Effects-Palpations, Anxiety, Tremulousness, Headache, Dizziness, Hypertension, Can worsen cardiac ischemia, Reflex bradycardia
Other-Extravasation can cause localized tissue damage, Best administered through a central line |
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Term
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Definition
Class-Sympathetic agonist
Action-α- and β- adrenergic agonist
Indications-Normovolemic hypotension, Symptomatic bradycardia, Septic shock, Cardiogenic shock
Contraindications-Should not be used in hypovolemia until volume replacement has occured
Doses-2-20 mcg/kg/min (titrate to effect)
Routes-IV
Adverse Effects-Palpations, Anxiety, Tremulousness, Headache, Dizziness, Hypertension, Can worsen cardiac ischemia, Reflex bradycardia
Other-Extravasation can cause localized tissue damage, Best administered through a central line, Proposed renal benefit has been disproven |
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Term
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Definition
Class-Sympathetic agonist
Action-α- and β- adrenergic agonist (inotropic properties more pronounced than chronotropic properties)
Indications-Congestive heart failure
Contraindications-Should not be used in hypovolemia until volume replacement has occured
Doses-2-20 mcg/kg/min (titrate to effect)
Routes-IV
Adverse Effects-Palpations, Anxiety, Tremulousness, Headache, Dizziness, Hypertension, Can worsen cardiac ischemia, Reflex bradycardia
Other-Extravasation can cause localized tissue damage, Best administered through a central line, Other agents preferred in cardiogenic shock |
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Term
Albuterol
Ventolin, Proventil
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Definition
Class-β-agonist
Action-β-agonist with preference for β2 adrenergic receptors
Indications-Bronchospasm, Allergies/anaphylaxis, Hyperkalemia
Contraindications-Known Hypersensitivity to the medication
Doses-2.5 mg (SVN), 90 mcg (MDI)
Routes-Inhalation
Adverse Effects-Palpations, Anxiety, Tremulousness, Headache, Dizziness, Tachycardia
Other-The patient's heart rate and SpO2 should be monitored during treatment
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Term
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Definition
Class-β-agonist
Action-β-agonist with preference for β2 adrenergic receptors. It is racemic isomer of albuterol
Indications-Bronchospasm, Allergies/anaphylaxis, Hyperkalemia
Contraindications-Known Hypersensitivity to the medication
Doses-0.63 mcg (SVN)
Routes-Inhalation
Adverse Effects-Palpations, Anxiety, Tremulousness, Headache, Dizziness, Tachycardia
Other-The patient's heart rate and SpO2 should be monitored during treatment
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Term
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Definition
Class-β-agonist
Action-β-agonist with preference for β2 adrenergic receptors
Indications-Bronchospasm, Allergies/anaphylaxis, Hyperkalemia
Contraindications-Known Hypersensitivity to the medication
Doses-0.2-0.3 ml of solution containing 15 mg/ml (SVN); 0.65 mg (MDI)
Routes-Inhalation
Adverse Effects-Palpations, Anxiety, Tremulousness, Headache, Dizziness, Tachycardia
Other-The patient's heart rate and SpO2 should be monitored during treatment |
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Term
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Definition
Class-Sympathetic agonist
Action-Relatively nonselective β-agonist. It is a mix of both racemic isomers of epinephrine
Indications-Croup
Contraindications-Known hypersensitivity to the medication
Doses-0.25-0.75 ml of a 2.5% solution
Routes-Inhalation
Adverse Effects-Palpations, Anxiety, Tremulousness, Headache, Dizziness, Tachycardia
Other-The patient's heart rate and SpO2 should be monitored during treatment
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Term
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Definition
Class-Class III antiarrhythmic
Action-Prolongs action potentialand duration in cardiac tissues through sodium, potassium, and calcium channels; blocks α- and β- adrenergic receptors
Indications-Ventricular tachycardia, Ventricular fibrillation, Narrow-complex tachycardias
Contraindications-Breast feeding, Bradycardia, High-grade heart block, Hypersensitivity to the drug
Doses-150-300 mg
Routes-IV
Adverse Effects-Hypotension, Bradycardia, Prolonged PR, QRS, and QT
Other-Constant ECG monitoring, Now first-line agent in ventricular fibrillation and tachycardia
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Term
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Definition
Class-Class IB antiarrhythmic; local anesthetic
Action-Amide-type local anesthetic; slows depolarization and automaticity
Indications-Ventricular tachycardia and fibrillation refactory to amiodarone, Local anesthetic
Contraindications-Should not be administered to patients receiving IV calcium channel blockers
Doses-1-1.5 mg/kg
Routes-IV
Adverse Effects-Drowsiness, Slurred speach, Confusion, Seizures, Hypotension
Other-Use with caution when administered with other antiarrhythmics
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Term
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Definition
Class-Class IA antiarrhythmic; local anesthetic
Action-Ester-type local anesthetic; reduces automaticity and AV conduction
Indications-Ventricular tachycardia with pulse, Pre-excited atrial fibrillation
Contraindications-Should not be administered to patients receiving IV calcium channel blockers
Doses-20-50 mg/min
Routes-IV
Adverse Effects-Drowsiness, Slurred speach, Confusion, Seizures, Hypotension
Other-Carefully monitor ECG (QRS duration) during administration
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Term
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Definition
Class-Class IB antiarrhythmic;anticonvulsant
Action-Depresses automaticity and AV conduction; reduces voltage and spread of electrical discharges in motor cortex
Indications-Life-threatening arrhythmias from digitalis toxicity, seizures
Contraindications-Bradycardia, High-grade heart block, Hypersensitivity to the drug
Doses-15-18 mg/kg
Routes-IV
Adverse Effects-Drowsiness, Dizziness, Headache, Hypotension, Arrhythmias, Nausea, Vomiting
Other-Fosphenytoin is preferred for seizure management
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Term
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Definition
Class-Nucleoside
Action-Slows AV conductio; short half-life
Indications-Supraventricular tachyarrhythmias
Contraindications-Atrial fibrillation, Torsades des pointes
Doses-6 mg
Routes-IV
Adverse Effects-Facial flushing, Headache, Chest pain, Nausea
Other-Should be given by rapid IV push followed by saline bolus, Arrhythmias common following administration
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Term
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Definition
Class-Class II antiarrhythmic; beta-blocker
Action-Slows heart rate through selective blockage of β1 receptors; short half-life
Indications-Tachycardia
Contraindications-Asthma, Heart block, Bradycardia, Cardiogenic shock
Doses-50-100 mcg/kg/min
Routes-IV
Adverse Effects-Bradycardia, Hypotension, Congestive heart failure, Lethargy
Other-Hypotension is common but dose-related, Should not be administered to patients receiving IV calcium channel blockers
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Term
Labetalol
Trandate, Normdyne
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Definition
Class-Class II antiarrhythmic; beta-blocker
Action-Lowers blood pressure through nonselective blockage of β receptors (and limited blockade of α2 receptors
Indications-Hypertensive emergency
Contraindications-Asthma, Heart block, Bradycardia, Cardiogenic shock
Doses-10-20 mg
Routes-IV, PO
Adverse Effects-Bradycardia, Hypotension, Congestive heart failure, Lethargy
Other-Should not be administered to patients receiving IV calcium channel blockers |
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Term
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Definition
Class-Class IV antiarrhythmic; calcium channel blocker
Action-Lowers blood presure by relaxing vascular smooth muscle; slows AV conduction
Indications-Rapid ventricular rate associated with atrial fibrillation, Stable narrow-complex tachyarrhythmias
Contraindications-Hypotension, Congestive heart failure, Cardiogenic shock, Wide-complex ventricular tachycardia
Doses-0.25 mg/kg IV bolus (max 20mg), NR 15-20 mg
Routes-IV
Adverse Effects-Nausea, Vomiting, Dizziness, Headache, Hypotension
Other-Can be given as IV bolus or IV infusion, Calcium chloride can reverse some of the untoward effects
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Term
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Definition
Class-Mineral/electrolyte
Action-Physiologic calcium-channel blocker; bronchodilator
Indications-Torsades des pointes, Asthma, Hypertensive disorders of pregnancy
Contraindications-High-degree heart blocks, Shock, Dialysis, Hypocalcemia
Doses-1-2 g
Routes-IV
Adverse Effects-Flushing, Sweating, Bradycardia, Respitory depression, Hypothermia
Other-Can cause cardiac conduction problems in conjunction with digitalis
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Term
Nitroglycerin
Nitrostat
(tablet, spray)
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Definition
Class-Nitrate
Action-Relaxes vascular smooth muscle causing vasodilation, ddecreased cardiac work, and improved coronary blood flow
Indications-Chest pain, Congestive heart failure
Contraindications-Hypotension, Increased intracranial pressure
Doses-0.4 mg
Routes-SL (tablet or spray)
Adverse Effects-Headache, Dizziness, Weakness, tachycardia, Hypotension
Other-Tablets will lose effectivness after exposure to air, Monitot BP closely
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Term
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Definition
Class-Nitrate
Action-Relaxes vascular smooth muscle causing vasodilation, ddecreased cardiac work, and improved coronary blood flow
Indications-Chest pain, Congestive heart failure
Contraindications-Hypotension, Increased intracranial pressure
Doses-0.5-1 inch
Routes-Transdermal
Adverse Effects-Headache, Dizziness, Weakness, tachycardia, Hypotension
Other-Do not get paste on your finger as this may cause a headache, Monitot BP closely |
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Term
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Definition
Class-Antihistamine
Action-Nonselctively blocks H1 and H2 histamine receptors
Indications-Allergies, Extrapyramidal reactions, Parkinson's disease, Sedation, Anaphylaxis
Contraindications-Hypersensitivity to the drug, Glaucoma, Pregnancy
Doses-25-50 mg
Routes-IV, IM, IO, PO
Adverse Effects-Drowsiness, Dizziness, Sedation, Dry mouth
Other-If given IM, give deep in muscle
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Term
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Definition
Class-Antihistamine
Action-Selectively blocks H2 histamine receptors
Indications-Duodenal/peptic ulcer, Anaphylaxis
Contraindications-Hypersensitivity to the drug
Doses-300 mg
Routes-IV, IM, IPO
Adverse Effects-Diarrhea, Drowsiness, Dizziness
Other-Can be used as an adjunct for severe allergic reactions and anaphylaxis
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Term
Prochlorperazine
Compazine
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Definition
Class-Phenothiazine
Action-Supresses the CTZ; has anthistaminic effects
Indications-Nausea, Vomiting, Anxiety, Psychosis
Contraindications-Hypersensitivity to the drug, Small children, Pregnancy
Doses-5-10 mg
Routes-IV, IM, IO, PO
Adverse Effects-Drowsiness, Dizziness, Sedation, Dry mouth, Extrapyramidal symptoms
Other-Can poteniate CNS depressants (e.g., alcohol)
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Term
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Definition
Class-Phenothiazine
Action-Supresses the CTZ; has anthistaminic effects
Indications-Nausea, Vomiting
Contraindications-Hypersensitivity to the drug
Doses-12.5-25 mg
Routes-IV, IM, PO
Adverse Effects-Drowsiness, Dizziness, Sedation, Dry mouth, Extrapyramidal symptoms
Other-Can poteniate CNS depressants (e.g., alcohol), Extravasation can cause local tissue injury, Rarely used |
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Term
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Definition
Class-Serotonin antagonist
Action-Selectively blocks 5-HT3 serotonin receptors including those in the CTZ and vegas nerve terminals
Indications-Nausea, Vomiting
Contraindications-Hypersensitivity to the drug
Doses-4-8 mg
Routes-IV, IM, PO
Adverse Effects-Dizziness, Lightheaded
Other-Commonly used in emergency medecine because of good safety profile
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Term
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Definition
Class-Hormone (analog of antidiuretic hormone)
Action-Non-adrenergic vasoconstrictor; promote fluid retention in the kidney
Indications-Cardiac arrest, Normovolemic hypotension
Contraindications-Few in emergency setting
Doses-40 units
Routes-IV
Adverse Effects-Blanching of the skin, Abdominal cramping, Nausea, Hypertension
Other-Benefits in cardiac arrest are questionable
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Term
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Definition
Class-Hormone (oxytocin)
Action-Oxytocin; causes uterine contractions and lactations
Indications-Postpartum vaginal bleeding, Induction/augmentation of labor
Contraindications-Anything other than post-partum bleeding (in the prehospital setting)
Doses-10-20 units in 500 ml IV; 3-10 units (IM)
Routes-IV, IM
Adverse Effects-Anaphylaxis, Arrhythmias
Other-Ensure placenta (and possible additional baby) has delivered before administering
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Term
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Definition
Class-Hormone (glucagon)
Action-Elevates blood glucose levels through conversion of glycogen to glucose and other factors
Indications-Hypoglycemia, Beta-blocker overdose
Contraindications-Hypersensitivity to the drug
Doses-0.25-0.5 u(IV) 1 mg IM
Routes-IV, IM, IO
Adverse Effects-Few in the emergency setting
Other-Less effective in patients with decreased glcogen stores (e.g., alcoholics)
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Term
Insulin
Humulin, NovoLog, Novolin
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Definition
Class-Hormone (insulin)
Action-Causes glucose uptake by the cells thus lowering blood glucose levels
Indications-Diabetes, Hyperglycemia, Diabetic ketoacidosis
Contraindications-Hypoglycemia, Normoglycemia
Doses-Varies
Routes-IV, SQ
Adverse Effects-Few in the emergency setting
Other-Dosages of the various insulin types vary significantly
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Term
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Definition
Class-Carbohydrate
Action-Substrate for carbohydrate metabolism
Indications-Hypoglycemia
Contraindications-None in the emergency setting
Doses-12.5-25 g
Routes-IV, PO
Adverse Effects-Local venous irritation common, Tissue injury
Other-Less concentrated solutions (e.g., 10%)equally effective with fewer side-effects
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Term
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Definition
Class-Hormone (analog of corticosteroid)
Action-Anti-inflammatory supresses immune response
Indications-asthma, COPD, anaphylaxis
Contraindications-Hypersensitivity to the drug
Doses-125-250 mg
Routes-IV, IO
Adverse Effects-GI bleeding, Increases blood glucose levels
Other-Effects are delayed and not typically seen in the prehospital setting
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Term
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Definition
Class-Opiate antagonist
Action-Opiate antagonist without opiate agonist properties (it has no activity when given in the absence of an opiate agonist)
Indications-Partial reversal of opiate drug effects, Opiate overdose
Contraindications-Hypersensitivity to the drug
Doses-0.4-2 mg
Routes-IV, IO, SQ, IN, nebulizer
Adverse Effects-Fever, Chills, Nausea, Diarrhea, Opiate withdrawal
Other-administer enough to reverse respitory depresion and avoid full narcotic withdrawal syndrome |
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Term
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Definition
Class-Benzodiazepine antagonist
Action-Competively blocks benzodiazepines at the GABA/ benzodiazepine receptor complex
Indications-Benzodiazepine overdose
Contraindications-Hypersensitivity to the drug
Doses-0.2 mg
Routes-IV
Adverese Effects-Fatigue, Headache, Nervousness, Dizziness
Other-Administer with caution in patients dependent on benzodiazepines as life-threatening withdrawal (includingseizures) can occur
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Term
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Definition
Class-Cyanide antodote
Action-Vasodilator; oxides hemoglobin to methemoglobin which reacts with cyanide ion to form cyanomethemoglodin, that is enzymatically degraded
Indications-Cyanide poisoning
Contraindications-None in the emergency setting
Doses-1-2 inhalents
Routes-Inhaled
Adverse Effects-Headache, Weakness, Dizziness, Flushing, Tachycardia, Orthostatic hypotension
Other-Headache and hypotension common, Can worsen hypoxia in the setting of carbon monoxide poisoning |
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Term
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Definition
Class-Cyanide antodote
Action-Vasodilator; oxides hemoglobin to methemoglobin which reacts with cyanide ion to form cyanomethemoglodin, that is enzymatically degraded
Indications-Cyanide poisoning
Contraindications-Should not be administered to asymptomatic patients
Doses-150-300 mg
Routes-IV
Adverse Effects-Headache, Weakness, Dizziness, Flushing, Tachycardia, Orthostatic hypotension
Other-Headache and hypotension common, Can worsen hypoxia in the setting of carbon monoxide poisoning
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Term
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Definition
Class-Cyanide antodote
Action-Converts cyanide to thiocyanate which is removed by the kidneys
Indications-Cyanide poisoning
Contraindications-None in the emergency setting
Doses-12.5 g
Routes-IV
Adverse Effects-Nausea, Vomiting, Joint pain, Psychosis
Other-Should be administered as part of the standard (Pasadena) cyanide kit
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