Ch.4 Aemt Drug Cards

Generic Name: nitroglycerin, nitroglycerin translingual, nitroglycerin transdermal, nitroglycerin intravenous, nitroglycerin topical

Trade Name: Nitrostat; Nitrobid; Nitrolingual

Class of Medication: nitrates, vasodilator

Mechanism of Action: Relaxes blood vessels; decreases workload of the heart, Smooth muscle relaxant acting on vascular, bronchial, uterine, and intestinal smooth muscle; dilation of aterioles and veins in the periphery: reduces preload and afterload; decreases the work load of the heart and thereby, myocardialoxygen demand

Dose: 0.4 mg; 1/150 of the grain; every 3 to 5 minutes based on blood pressure; max dose is three in 15 minutes, Nitroglycerine spray: 0.4 mg under the tongue 1-2 sprays

Route(s) of Administration: Sublingual

Indications: Acute angina, chest pain, hypertension, CHF, pulmonary edema

Contraindications: Hypotension, hypovolemia; Baseline BP below 100mm Hg systolic; intracranial bleeding, or head injury; patient has already received max dosage; patient has taken Viagra, Revatio, Levitra, Cialis within the last 24 hours; child

Common Side Effects: Hypotension; headache; syncope, reflex tachycardia, flushing, nausea, vomiting, diaphoresis, muscle twitching, increased pulse rate;

Precautions: Acute MI, heart failure, monitor, Hypotensive or volume depleted

Generic Name: Glucose

Trade Name: Glutose ; Insta-glucose

Class of Medication: Hyperglycemic

Mechanism of Action: Increases blood and brain sugar levels, provides quickly absorbed glucose to increase blood glucose levels

Dose: One tube 15g

Route(s) of Administration: Oral, buccal; Placed upon the pressure between cheek and gum and allow to dissolve in mouth

Indications: Hypoglycemia; Patients with altered mental status and known history of diabetes

Contraindications: Unconscious; unable to swallow, Hyperglycemia; nausea, vomiting

Common Side Effects: Nausea, vomiting

Precautions: Unconsciousness

Generic Name: Epinephrine

Trade Name: Adrenaline; Epipen

Class of Medication: Sympathomimetic, Dilates bronchioles; constrict blood vessels

Mechanism of Action: Direct-acting alpha- and beta-agonist. Alpha: vasco constriction. Beta-1 positive inotropic, chronotropic, and dromotrophic effects. Beta-2 bronchial relaxes smooth muscles to improve breathing, stimulates heartbeat, reverses swelling and hives, Mimics response of sympathetic nervous system, constricts blood vessels to improve BP

Dose: For an adult, 0.3 mg to 0.5 mg (1 mL of 1000), child .15 mg

Route(s) of Administration: Autoinjector; intramuscular

Indications: Patient exhibits signs and symptoms of a severe allergic reaction, including either respiratory distress or shock, anaphylaxis, asthma

Contraindications: None is used in a life-threatening anaphylaxis, Hypertension, hypothermia, pulmonary edema, myocardial ischemia, hypovolemic shock.

Common Side Effects: Increased heart rate; pallor; dizziness; chest pain; headache; nausea or vomiting; excitability; anxiety

Precautions: Potentiates other sympathomimetics, MAOIs may potentiate effects, beta blockers may blunt effects

Generic Name: charcoal; activated charcoal

Trade Name: Superchar; Insta char; liquidchar; Actidose

Class of Medication: poison antidote

Mechanism of Action: Binds with poisons in the stomache and prevents absorption into the body

Dose: 0.5-1 gm for Adult, 0.6-2 gm

Route(s) of Administration: Orally

Indications: Poisoning by mouth

Contraindications: Altered mental status; ingestion of acids are alkaline's; unable to swallow

Common Side Effects: Black stools; constipation, diarrhea, nausea, vomiting

Precautions: use with caution if decreased LOC (ensure airway is protected)

Generic Name: Oxygen

Trade Name: Oxygen

Class of Medication: Naturally occuring atmospheric gas

Mechanism of Action: Reverses hypoxemia

Dose: Adult and pediatric 1-6 lpm nasal canula, 10-15 lpm non-rebreather, 15 lpm bag valve mask

Route(s) of Administration: Inhalation

Indications: Hypoxia or anticipated hypoxia, or in any medical or trauma patient to improve respiratory efficiency; ischemic chest pain, respiratory insufficiency, prophylactically during air transport, confirmed or suspected carbon monoxide poisoning, all other causes of decreased tissue oxygenation, decreased level of consciousness

Contraindications: Certain patients with COPD or emphysema who will not tolerate oxygen concentrations over 35%, hyperventilation

Common Side Effects: Decreased level of consciousness and respiratory depression in patients with chronic carbon dioxide retention

Precautions: Oxygen is a safe gas as it is used properly

Generic Name: GLUCAGON

Trade Name: Glucagon

Class of Medication: Hyperglycemic agent, pancreatic hormone, insulin antagonist

Mechanism of Action: Increases blood glucose level by stimulating glycogenesis. Unknown mechanism of stabilizing cardiac rythm in beta blocker overdose. Minimal positive inotropic and chronotropic response. Decreases GI motility and secretions.

Dose: Adult Hypoglycemia 0.5-1 mg IM, Pediatric Hypoglycemia 0.5-1 mg IM

Route(s) of Administration: IM

Indications: Altered level of consciousness when hypoglycemia is suspected. May be used as inotropic agent in beta blocker overdose.

Contraindications: Hyperglycemia, hypersensitivity

Common Side Effects: Nausea, vomiting, tachycardia, hypertension

Precautions: Incompatible is solutions with most other substances. No significant drug interactions with other emergency medications.

Generic Name: Dextrose 50%, D50

Trade Name: Dextrose 50%, D50

Class of Medication: Carbohydrate, hypertonic solution

Mechanism of Action: Rapidly increases serum glucose levels. Short-term osmotic diuresis.

Dose: Adult 12.5-25g Pediatric 0.5-1

Route(s) of Administration: IV, IO

Indications: Hypoglycemia, altered level of consciousness, coma of unknown etiology, seizure of unknown etiology, status epilepticus.

Contraindications: Intracranial hemorrhage

Common Side Effects: Extravasation leads to tissue necrosis. Warmth, pain, burning, thrombophlebitis, rhabdomyolysis, hyperglycemia.

Precautions: Use with caution in patients with increasing ICP the added glucose may worsen the cerebrial edema. Consider blood glucose monitoring before and after administration.

Generic Name: sodium chloride, sodium lactate, potassium chloride and calcium chloride;

Trade Name: Lactated Ringer's Solution; Normal Saline Solution; 0.9% Sodium Chloride Solution

Class of Medication: Isotonic crystalloid solution

Mechanism of Action: replaces water and electrolytes

Dose: The specific situation being treated will dictate the rate in which IV Crystalloids will be administered.

Route(s) of Administration: IV

Indications: Hypovolemic shock; Heat related problems; freshwater drowning; hypovolemia; diabetic ketoacidosis

Contraindications: Should not be used in patients with congestive heart failure or renal failure

Common Side Effects: rare in therapeutic dosages

Precautions: few in emergency situations

Generic Name: albuterol inhalation

Trade Name: AccuNeb, Albuteral, ProAir HFA, Ventolin HFA, Proventil HFA

Class of Medication: Sympathomimetic, bronchodilator

Mechanism of Action: Beta-2 agonist that stimulates adrenergic receptors of the sympathomimetic nervous system. Causes smooth muscle relaxation in the bronchial tree and peripheral vasculature.

Dose: Adult 2.5 mg, Dilute 0.5 mL of 0.5 % solution for inhalation with 2.5 mL normal saline in nebulizer. Pediatric 0.01-0.03 mL (0.05-0.15 mg diluted in 2 mL of 0.9% normal saline)

Route(s) of Administration: Inhalation

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

Contraindications: known prior hypersensitivity reactions to albuterol. Tachycardia arrhythmias, especially those caused by digitalis. Synergistic with other sympathomimetics.

Common Side Effects: Restlessness, tremors, dizziness, palpitations, tachycardia, nervousness, peripheral vasodilation, nausea, vomiting, hyperglycemia, increased blood pressure, and paradoxical bronchospasm.

Precautions: May potentiate hypokalemia in some patients.

Generic Name: ipratropium bromide

Trade Name: Atrovent, Apovent, Ipraxa, Aerovent, Rinatec

Class of Medication: bronchodilator

Mechanism of Action: anticholinergic agent, It blocks muscarinic cholinergic receptors

Dose: 2.5 mL which is 1 unit

Route(s) of Administration: Inhalation

Indications: bronchospasm associated with COPD, and chronic bronchitis and emphysema

Contraindications: known or suspected cases of hypersensitivity to ipratropium bromide, or to atropine and it's derivatives

Common Side Effects: dry mouth, nausea, headache, dizziness, heartburn, constipation, urination issues. Some can be serious like rash, hives, itching, swelling of the eyes, face, lips, toungue, throat, hands, feet, ankles, or lower legs. Hoarseness, difficulty breathing, fast heartbeat, and chest pain.

Precautions: use with caution in patients with narrow angle glaucoma, prostatic hypertrophy or bladder neck obstruction