paramedic pharmacology

paramedic pharmacology - Emergency Drug Review UHHS BMH...

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Unformatted text preview: Emergency Drug Review UHHS BMH Paramedic Training Program Ronald Pristera EMT-P Objectives This will be a quick overview You should have been studying your drug cards. We are not going to talk about pediatric doses Assume that a CI for any drug is known sensitivity. (its not listed here as a CI) Adenosine CLASS; Anti-dysrhythmic IND.; SVT, including bypass tract disease. CI. 2 nd or 3 rd degree AV block SSS, sensitivity, Afib or flutter. Adenosine Dose 6mg rapid IVP followed by 20ml saline flush. May repeat in 1-2 min if no response. 12 mg IVP, then again in 1-2 min. Max single dose is 12 mg Adenosine Practice points Brief periods of asystole are common Pts on theo may require larger doses Transplant recip. May require smaller dose May produce bronchoconstriction is asthma pts. Amiodarone Class III Antidysrhythmic Indicated for Initial rx and prophylaxis of VF & unstable VT refractory to other therapy Contraindicated Pulmonary congestion Cardiogenic shock hypotension Amiodarone Dose 300 mg loading dose (cardiac arrest) flush with 10 ml of D5 or saline 150 mg supplemental bolus dose (cardiac arrest) flush with 10 ml of D5 or saline 360 mg loading infusion-following ROSC over 6 hrs 540 mg maintenance infusion over 18 hr Amiodarone Practice Points May potentiate hemodynamic status when given with beta blocker and CaCl channel blockers May increase risk of AV block when given with CaCl blockers May increase effects of wafarin Incompatible with lasix, heparin & bicar (y site) Amiodarone May effect serum levels of phenytoin, Procainamide Quinindine theo Aspirin Analgesic, anti-inflammatory, antiplatelet Indications AMI CI Only systemic sensitivity in the context of MI Dose 160-325 mg PO (preferably chewed) Aspirin Give it rapidly (ISIS trials) Go ahead if already on 1 pill per day Atropine Sulfate Anticholinergic Indications Symptomatic bradycardia Asystole PEA ACE inhibitor OD Exercise induced bronchospastic disorders Atropine Sulfate CI Tachycardia Obstructive disease of GI tract Unstable cardiovascular status in the context of cardiac ischemia & hemorrhage Narrow angle glaucoma Atropine Sulfate Dose Bradydysrhymias 0.5-1.0mg q 5 min to a max of 0.03-0.04 mg/kg Asystole 1.0 mg IV or ETT(dilute to 10 ml) ACE inhibitors 2mg IVP q 5-15 minutes (no max) Atropine Sulfate Practice Pearls Dilates the pupils Follow ETT with several PPV s Effects are enhanced by; Thiazides, antidepressants, ant psychotics Antihistamines, Procainamide, quinidine Adverse reactions with concurrent admin....
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This note was uploaded on 03/25/2010 for the course PAR 100 taught by Professor Alan during the Spring '10 term at Miramar College.

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paramedic pharmacology - Emergency Drug Review UHHS BMH...

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