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Drug  Cards EMS 111

CVCC EMT Course

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Albuterol  (1  of  2) •  Other Name: Proventil, Ventolin, ProAir

•  Classification: Adrenergic B2 Agonist, sympathomimetic, bronchodilator

•  MOA: Causes bronchodilation by action on B2 receptors by relaxing smooth muscle to dilate the lower airways

•  Indications: Difficulty breathing as a result of bronchospasms with or without wheezing

•  Contraindications: Altered mental status, hypersensitivity to medication, tachycardia

Albuterol  (2  of  2) •  Precautions: Hypertension, Tachycardia

•  Major Side Effects: Tachycardia, tremors, shakiness, nervousness, dry mouth

•  Adult Dosage: o  MDI – Follow the patient’s prescription, and medical direction for the

number of puffs of the inhaler

o  Nebulizer – 2.5 mg in 3 mL Normal Saline, may repeat x1 if no improvement

•  BREMS: o  MDI – Not supplied o  Nebulizer – Supplied (2) – Administer as above

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Aspirin  (1  of  2) •  Other Name: Acetylsalicylic acid (ASA)

•  Classification: Salicylate, Analgesic, antiplatelet

•  MOA: Inhibits prostaglandin synthesis and platelet aggregation

•  Indications: Myocardial Infarction, Unstable Angina,

•  Contraindications: Allergic to NSAIDs, Pediatric patient, bleeding ulcer, traumatic chest pain

Aspirin  (2  of  2) •  Precautions: Bleeding disorders, alcohol use, renal

failure, severe hepatic insufficiency,

•  Major Side Effects: Bleeding, Tinnitus, Bronchospasm – use caution in patients with asthma, Angioedema, Reye’s Syndrome

•  Adult Dosage: 162-324 mg •  BREMS:

o  Supplied – (4) 81 mg chewable tablets o  Administer (4) tablets for chest pain of cardiac origin

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Activated  Charcoal  (1  of  2) •  Other Name: Actidose -Aqua, CharcoAid, Liqui-Char

•  Classification: Antidote

•  MOA: Binds poisons, toxins, irritants, increases absorption in GI tract

•  Indications: Patients who have ingested poisons by mouth within the past one hour

•  Contraindications: Hypersensitivity, altered mental status, inability to protect airway, alcohol intoxication, inhalation of poisonous gas, ingestion of acids or alkalis

Activated  Charcoal  (2  of  2) •  Precautions: Potential change in mental status

leading to airway compromise and possible aspiration

•  Major Side Effects: Blackening of the stools, possible vomiting

•  Adult Dosage: 1 gram/kg of body weight; typical adult dose is 25 to 50 grams

•  BREMS: Not used in the BREMS region

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Benadryl  (1  of  2) •  Other Name: Diphenhydramine

•  Classification: Antihistamine, H1 receptor antagonist

•  MOA: Competes with H1 receptors in the blood vessels, GI tract, and respiratory system in order to decrease histamine

•  Indications: Allergic reaction

•  Contraindications: Hypersensitivity, acute asthma attack

Benadryl  (2  of  2) •  Precautions: renal/cardiac disease, hypertension,

asthma, seizure disorder

•  Major Side Effects: Seizures, anaphylaxis

•  Adult Dosage: o  Adults – 25 to 50 mg PO o  Pediatric patients 8 years and younger – Not Given

•  BREMS:

o  Supplied – (2) 25 mg tablets o  Administer 50 mg PO to adult patients

with signs of an allergic reaction

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Epi-­‐‑Pen  (1  of  2) •  Other Name: Epinephrine, Adrenalin, EpiPen Jr.

•  Classification: Sympathomimetic – Adrenergic agonist

•  MOA: o  Alpha-adrenergic receptors – Vasoconstriction o  Beta1-adrenergic receptors – Increased heart rate & contractility o  Beta2-adrenergic receptors – Bronchial dilation

•  Indications: Signs and symptoms of a severe allergic reaction (anaphylaxis)

•  Contraindications: None in Emergency Setting

Epi-­‐‑Pen(2  of  2) •  Precautions: Cardiac disorders

•  Major Side Effects: Increased heart rate, pale skin (pallor), dizziness, chest pain, headache, nausea and vomiting, excitability and anxiousness

•  Dosage: Auto-injectors deliver a single dose o  Adult Dose – 0.3 mg Intramuscular (IM) o  Pediatric Dose – 0.15 mg Intramuscular (IM)

•  BREMS: Not supplied

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Oral  Glucose  (1  of  2) •  Other Name: Oral Glucose, Glutose, Insta Glucose

•  Classification: Caloric

•  MOA: Needed for adequate utilization of amino acids; decreases protein, prevents ketosis

•  Indications: Slight altered mental status with history of diabetes and the ability to swallow the medication

•  Contraindications: Unconscious, Unable to swallow medication

Oral  Glucose  (2  of  2) •  Precautions: Potential for decrease in mental status

•  Major Side Effects: May cause an airway obstruction in the patient without a gag reflex

•  Adult Dosage: One tube – 15 grams •  BREMS: Not supplied in drug box, stocked on most

ambulances

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Nitroglycerin  (1  of  2) •  Other Name: Nitro-stat, Nitro-quick

•  Classification: Antianginal, Nitrate, Coronary Vasodilator

•  MOA: A vasodilator agent, relieves tension on vascular smooth muscle and dilates peripheral veins and arteries.

•  Indications: Angina, Myocardial Infarction, Chest pain of cardiac origin

•  Contraindications: Anemia, concomitant use of

phosphodiesterase inhibitors

Nitroglycerin  (2  of  2) •  Precautions: Pregnancy C, Poor cardiac

function, SBP < 100,

•  Major Side Effects: Hypotension, Flushing, Dizziness, Headache

•  Adult Dosage: o  ANGINA – 0.4 MG TABS – EVERY 5 MINS – MAX OF 3

•  BREMS: o  Supplied – Bottle of 25 tablets, 0.4mg Each o  ** The SBP MUST be greater than 140 mmHg

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Afrin  Nasal  (1  of  2)   •  Other Name: Oxymetazoline

•  Classification: Intranasal Decongestant

•  MOA: Vasoconstricts the respiratory mucosa, provides short-term relief of nasal congestion

•  Indications: Nose Bleed •  Contraindications: HTN, Pregnancy, Increased ocular

pressure (Glaucoma)

Afrin  Nasal  (2  of  2) •  Precautions: Pregnancy C, Liver or Kidney Damage,

Diabetes, Coronary Artery Disease •  Major Side Effects: Allergic Reaction, Irregular or fast

heart beat, Insomnia, nervousness •  Dosage:

o  Adult – 2-4 sprays to the bleeding nostril, followed by direct pressure o  Pediatric – 1-2 sprays to the bleeding nostril, followed by direct pressure

•  BREMS: Supplied as (1) 15 ml Bottle

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Tylenol  PO  (1  of  2)   •  Other Name: Acetaminophen

•  Classification: Nonopioid analgesic, antipyretic

•  MOA: May block pain impulses peripherally that occur in response to inhibition of prostaglandin synthesis; does not possess any antiinflammatory properties; inhibits prostaglandins in the hypothalamus

•  Indications: Mild pain or fever •  Contraindications: Hypersensitivity

Tylenol  PO  (2  of  2) •  Precautions: Pregnancy (B), anemia, renal/hepatic

disease, chronic alcoholism, geriatric •  Major Side Effects: ABD pain, hepatic seizure, renal

failure, leukopenia, anemia, jaundice, delirium •  Adult Dosage: 325-650 mg

•  Supplied: 325 mg tablets •  BREMS: Supplied à 975 mg PO

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Zofran  ODT  (1  of  2) •  Other Name: Ondansetron

•  Classification: Antiemetic

•  MOA: Prevents nausea and vomiting by blocking serotonin

•  Indications: Prevention of nausea and vomiting

•  Contraindications: Hypersensitivity, age < 1 year

Zofran  ODT  (2  of  2) •  Precautions: Pregnancy

•  Major Side Effects: Headache, dizziness, cardiac dysrhythmias

•  Adult Dosage: 4 mg Oral Dissolving Tablet (ODT) •  BREMS:

o  Supplied – 4 mg ODT Tablets (2 tablets)

o  Administer (1) 4 mg ODT o  May repeat in 5 minutes if needed