Class: Sympathomimetic, bronchodilator, beta-agonist

Mechanism of action: beta-2 agonist that stimulates adrenergic receptors of the sympathomimetic nervous system resulting in smooth muscle relaxation.

Indications: treatment of bronchospasm in patients with reversible obstructive airway disease.

Contraindications : tachycardia and known hypersensitivity

Adverse reactions : restlessness, dizziness, tremors

Dosage and Route: 2.5 mg added to 2 ml normal saline given via nebulizer over 10-15 minutes. May repeat every 20 minutes up to 3 times.

Amyl Nitrite (Cyanide Antidote Kit)

Class- Antidote

Mechanism of action- affinity for cyanide ions, reacts with hemoglobin to form methemoblobin

Indications- cyanide poisoning

Contraindications- none

Adverse reactions- can produce severe methemoglobinemia

Dose and Route- breathe 30 seconds out of every minute

Class- corticosteroid

Mechanism of action- suppresses acute and chronic inflammation

Indications- anaphylaxis, asthma, croup

Contraindications- sepsis, bacterial infections

Adverse reactions- hypertension, water retention, GI bleeding

Dose and Route- 10-100 mg IV

Class- carbohydrate, hypertonic solution

Mechanism of action- rapidly increases serum glucose levels

Indications- hypoglycemia, coma of unknown origin

Contraindications- intracranial hemorrhage

Adverse reactions- tissue necrosis of injection site, hyperglycemia

Dose and Route- 12.5 to 25 grams slow IV push

Class- benzodiazepine

Mechanism of action- potentiates effects of inhibitory neurotransmitters, raises seizure thresholds

Indications- DTs, seizures, acute anxiety states

Contraindications- head injury, hypersensitivity, coma

Adverse reactions- respiratory depression, hypotension, drowsiness

Dose and Route- 5-10 mg every 10-15 minutes, max dose is 30 mg

Class- antihistamine

Mechanism of action- blocks cellular histamine receptors, decreases vasodilation

Indications- symptomatic relief of allergies, allergic reactions

Contraindications- asthma, glaucoma, pregnancy

Adverse reactions- sedation, hypotension, seizures

Dose and Route- 25-50 mg IV/IM/PO

Class- sympathomimetic

Mechanism of action- stimulates beta-2 receptors in the lungs, bronchodilation and relaxation of smooth muscles in the lungs

Indications- bronchial asthma, prevention of bronchospasm

Contraindications- hypertension, epiglottitis

Adverse reactions- tachycardia

Dose and Route- 2-3 inhalations metered dose inhaler

Class- Benzodiazepine antagonist

Mechanism of action- antagonizes effects of benzodiazepines on the CNS

Indications- reversal of respiratory depression and sedative effects of benzodiazepines in overdose

Contraindications- tricyclic anti-depressant overdose, seizure patients

Adverse reactions- nausea, vomiting, agitation

Dose and Route- first dose is 0.2 mg IV/IO over 15 seconds, second dose is 0.3 mg over 30 seconds

Class- hyperglycemic agent

Mechanism of action- increases blood glucose level by increasing glycogenesis

Indications- altered level of consciousness when hypoglycemia is suspected

Contraindications- hyperglycemia, hypersensitivity

Adverse reactions- nausea, vomiting, tachycardia

Dose and Route- 0.5-1 mg IM

Class- tranquilizer, antipsychotic

Mechanism of action- inhibits CNS catecholamine receptors. acts on CNS to depress subcortical areas, mid-brain and ascending reticular activating system in the brain

Indications- acute psychotic episodes

Contraindications- agitation secondary to shock or hypoxia

Adverse reactions- restlessness or spasms

Dose and Route- 2-5 mg IM

Class- anticholinergic

Mechanism of Action- antagonizes action of acetylcholine on bronchial smooth muscle in the lungs to cause bronchodilation

Indications- treatment of bronchospasm in patients with reversible obstructive airway disease. Can be used alone or with other bronchodilators

Contraindications- hypersensitivity to anticholinergic drugs

Adverse reactions- hypertension, palpitations, nervousness

Dose and Route- 500 mcg (1 vial) doses 6-8 hours apart

Class- Non-steroidal anti inflammatory drug (NSAID)

Mechanism of action- NSAID that also exhibits nonnarcotic analgesic activity

Indications- moderate to severe pain

Contraindications- allergies to NSAIDs, hx of asthma and bleeding disorders

Adverse reactions- anaphylaxis, GI bleeding, sedation

Dose and Route- 30-60 mg IM

Class- bronchodilator, beta-2 agonist

Mechanism of action- relaxes smooth muscle and bronchodilation by acting on beta-2 pulmonary receptors

Indications- bronchospasm in patients 6 years and older

Contraindications- tachycardia and known hypersensitivity 

Adverse reactions- tachycardia, tremors, anxiety

Dose and Route- 1.25 mg in 3 mls of saline nebulized

Class- benzodiazepine

Mechanism of action- anxiolytic, anticonvulsant, has sedative effects

Indications- seizures, anxiety, sedation

Contraindications- glaucoma, suspected drug abuse

Adverse reactions- respiratory depression, apnea, drowsiness

Dose and Route- 2-4 mg slow IV push at 2 mg/minute, IM, max dose is 8 mg

Class- Anti-inflammatory glucocorticoid

Mechanism of action- suppresses acute and chronic inflammation, potentiates smooth muscle relaxation by beta adrenergic agonist.

Indications- bronchodilator for unresponsive asthma, anaphylaxis

Contraindications- premature infants, systemic fungal infections, GI bleeding

Adverse reactions- headache, hypertension, water retention

Dose and Route- 1-2 mg/kg IV push

Class- 5-HT3 antagonist

Mechanism of action- blocks action of seretonin

Indications- nausea/vomiting

Contraindications- known allergy

Adverse reactions- chest pain, wheezing/hives

Dose and Route- 4 mg IV/IM

Class- Paralytic

Mechanism of action- binds to acetylcholine receptors

Indications- maintenance of paralysis after intubation

Contraindications- inability to control and maintain airway, hypersensitivity

Adverse reactions- apnea, weakness, hypotension

Dose and Route- 0.1 mg/kg slow IV push repeat every 30-60 minutes as neccesary

Class- Cholinesterase reactivator

Mechanism of action- reactivation of cholinesterase to act as antidote for organophosphate poisoning

Indications- organophosphate poisoning

Contraindications- pts with reduced renal function

Adverse reactions- dizziness, blurred vision, headache

Dose and Route- 1-2 gram infusion in 100 cc bag over 15-30 minutes

Class- antihistamine

Mechanism of action- blocks action of histamine, possesses sedative, anti mimetic and anticholinergic activity

Indications- nausea/vomiting

Contraindications- coma, CNS depression

Adverse reactions- sedation, dizziness, nausea

Dose and Route-dilute 1-3 mg in 10-30 ml of D5W, administer slowly at a rate of 1 mg/minute IV

Class- Paralyzing agent

Mechanism of action- binds to acetylcholine receptors

Indications- to facilitate intubation, terminate laryngospasm and to promote muscle relaxation

Contraindications- glaucoma, penetrating eye injuries, inability to control airway

Adverse reactions- apnea, hypotension, cardiac arrest

Dose and Route- 1-2 mg/kg rapid IV push, repeat once if needed

Class- Vitamin

Mechanism of action- combines with ATP to form thiamine pyrophosphate coenzyme

Indications- coma of unknown origin, DTs

Contraindications- none

Adverse reactions- hypotension, diaphoresis

Dose and Route- 100 mg slow IV/IM

Class-paralytic agent

Mechanism of action- non-depolarizing neuromuscular blocking agent, paralytic

Indications- to facilitate intubation, to terminate laryngospasm and to promote muscle relaxation.

Contraindications- glaucoma, eye injuries, inability to control the airway

Adverse reactions- apnea, weakness, PVCs

Dose and Route- 0.1 mg/kg IV push, maintenance dose within 25-40 minutes 0.01 to 0.05 mg/kg IV push