My EMS/Paramedic Drug Cards Flashcards

Tachycardia
Terms Definitions
NS is also ___% of....
0.9% of Sodium Chloride
NS Class
Isotonic Crystalloid Solution
NS Mechanism of Action
To replace water and electrolytes.
NS Indications
Heat related problems, freshwater drowning, hypovolemia, diabetic ketoacidosis, Keep IV open.
NS contraindications and Precautions
Contraindicated when CHF is possible due to circulatory overload.
Use caution since it only contains sodium and chloride, when large amounts are administered, it is possible for other important physiologoical electrolytes to become depleted.
Oxygen Class and Description
Class: Gas
Description: Odorless, tasteless, colorless gas necessary for life.
Oxygen Mechanism of Action
Increases the oxygen concentration in the alveoli, which increases the oxygen saturation of avaible hemoglobin. Oxygen is required for efficient breakdown of glucose.
Oxygen Indications
Possible hypoxia
Oxygen Contraindications and Precautions
No contraidications.
Use caution with longterm use in COPD pts due to their respiratory drive being controlled by oxygen, NOT a reason to with hold oxygen. Not good for neonates eyes. Flow rates above 6 lpm should be humidified for longterm use to prevent drying out of mucus membrane and upper airway.
EPI class
sympathetic agonist
EPI description
Naturally occurring catecholamine. It is a potent alpha and beta adrenergic stimulant, however betal stimulation is more profound.
EP Mechanism of Action
Stimulates alpha and beta, more profound beta effects causing: increased heart rate, cardiac contractile force, cardiac electrical activity, systemic vascular resistance, BP, and cardiac automaticity.
EPI Indications
Cardiac arrest, severe anaphylaxis, and severe reactive airway disease.
EPI contraidications
Tachydysrhythmias, coronary artery disease (patients over the age of 65 etc)
EPI Precautions
Like all catecholamines protect from light. It can be deactivated by alkaline solutions such as sodium bicarbonate.
EPI side effects
Palpitations, anxiety, tremors, H/A, dizziness, N/V. Due to strong inotropic and chronotropic properties it increases myocardial oxygen. Tachydysrhythmias, VT, VF, angina, and HTN.
EPI Dose

*(Ped dose depends a lot protocol and may need to be edited)
1:10,000 can be administer IV, IO, or endotracheal.
-Cardiac arrest for adults via IV/IO is 1mg every 3 to 5 minutes.
Via endotracheal is 2-2.5 mg every 3 to 5 mins
*-Cardiac arrest for peds is initialdose of 0.01mg/kg of 1:10,000, subsequent 0.1mg/kg of 1:1,000

-Severe anaphylaxis or asthma for adults is 0.3-0.5mg of 1:1000 via SQ repeat in 5 to 15 mins PRN
-In peds administer 0.01mg/kg IVP of 1:10,000 every 5 to 15 mins
Dopamine Class
Sympathetic agonist or Adrenergic Agonist
Dopamine Description
Naturally occurring catecholamines, and a chemical precursor of norepinephrine. It acts on the alpha, beta 1, and dopaminergic receptors. Alpha effects are at high doses.
Dopamine Mechanism of Action
Dose dependant, low doses primarily effecting dopaminergic receptors causing renal and mesenteric vasodilation. High doses effect borth dopaminergic and beta 1 receptors causing cardiac stimulation and renal vasodilation. Higher doses include alpha receptors causing peripheral vasoconstriction.
Dopamine Indications
Adjunct tx in significant and symptomatic hypotention not resulting from hypovolemia or cardiogenic shock.
Dopamine Contraindications
Hypovolemia, known pheachromocytoma (adrenal gland tumor), tachycardia, HTN
Dopamine Precautions
Can induce or worsen SVT and ventricular dysrhythmias. Can cause localize tissue necrosis.
Dopamine Side Effects
tachydysrhthmias, HTN, N/V, HA, ischemia, AMI, dyspnea, chest pain, anxiety, and palpitations.
Dopamine Interactions
Deactivated by alkaline solution such as Sodium BiCarb. Dose must be reduced with pts on Monoamine oxidase inhibitors (MAOIs) are a class of antidepressant drugs prescribed for the treatment of depression. May cause hypotension with pheytoin(Dilantin).
Dopamine Dose and Route
Route is IV/IO
Renal dose is 2 to 5 mcg/kg/min.
Inotopic dose is 5 to 10 mcg/kg/mine.
Pressor dose is > 10 mcg/kg/min.
ASA Class
Platelet aggregator, Anti-inflammatory agent, Salicylate
ASA Description
Anti-inflammatory agent which inhibits platelet functions.
ASA Mechanism of Action
Blocks the formation of the substance thromboxane A2, which causes platelets to aggregate and arteries to contrict.
ASA Indications
New onset chest pain suggest of acute coronary syndrome.
ASA Contraindications
Active ulcers or asthma.
ASA Precautions
Pt allergic to NSAIDs, pts with asthma, ulcers, GI bleeds and other bleeding disorders.
ASA Side Effects
Heartburn, GI bleeding, N/V, wheezing, and prolonged bleeding.
ASA interactions
Together with other anti-inflammatory and may increase side effect and increase blood levels of other drugs. Decrease absorption rate when mixed with antacids.
ASA Dose and Route
160 to 325mg
4 baby ASA is 324mg
Route is PO
Furosemide Brand Name
Lasix
Furosemide Class
Loop Diurectic
Furosemide Description
Inhibits reabsorption of sodum and chloridein the ascending loop of Henle and distal renal tubule, interfering with the chloride binding cotransport system, thus causing increase excretion of water, sodium, chloride, magnesium, and calcium. Increase venous dilation causing a decrease in cardiac work.
Furosemide Indications
CHF and pulmonary edema. Sometimes used for tx of HTN.
Furosemide Contraindications
Pregnancy except when life-threat. Hypersensitivity to sulfa class. Dehydration, hypokalemia, and hepatic coma.
Furosemide Precautions
Monitor BP for hypotension. Protect from light.
Furosemide Side Effects
HA, dizziness, hypotension, volume depletion, potassium depletion, dysrhythmias, and N/V/D.
Furosemide Interations
Do not administer in same IV line as amrinone(Inocor) as it forms precipitate.
With other diurectics it increases volume depletion and electrolyte imbalance.
Furosemide Dose and Route
Pts already on lasix usually receive 40mg slow IVP. Pts not on Lasix receive 20 mg slow IVP.
Doses may as high as 80 to 120mg in severe cases.
Lidocaine Brand Name
Xylocaine
Lidocaine Class
Antidysrhthmic
Lidocaine Desciption
Amide-type localanesthetic, also frequently used to tx life threatening ventricular dysrhythmias.
Lidocaine Mechanism of Actions
Depresses depolarization and automaticity in the ventricles with little effects on atrial tissues. Therapeutic dose do not show AV conduction and does not depress myocardial contractility. Suppresses ventricular ectopy in the setting of myocardial infartion and increase the ventricular fibrillation theshold. Prevents PVCs from inducing ventricular fibrillation. Because electrical defibrillation tends to cause ventricular irritability, pts who have been successfully defibrillated should be tx with lidocaine.
Lidocaine Indications
Ventricular Tachycardia, Vitricular Fibrilation, and malignant premature ventricular contractions.
Lidocaine Contraindcations
Second-degree type 1 and third degree blocks.
Lidocaine Precautions
Dose over 300mg/hr cause CNS depression. Excessively high doses can result in coma and death.
Lidocaine Side Effects
Drowsiness, seizures, confusion, HTN, bradycardia, heart blocks, N/V, and respiratory and cardiac arrest. Slurred speech.
Lidocaine Interactions
Caution when given with procainamide, hyenytoin, quindine, beta blockers due to toxicity.
Lidocaine Dose and Route
-Cardiac arrest is 1 to 1.5 mg/kg IV/IO
Repeat every 5 to 10 mins at 0.5 to 0.75 mg/kg IV/IO
Max dose is 3mg/kg
ET dose 2 to 4 mg/kg

V-Tach with pulse is 1-1.5 mg/kg IVP than repeat in 5 to 1o mins at 0.5 to 0.75 mg/kg up to 3 mg/kg.

PVCs: 0.5 to 1.5 mg/kg than half the original dose up to 3 mg/kg

Once loading dose works start maintance drip
Adenosine Brand name
Adenocard, Adenoscan
Adenosine Description
A naturally occurring nucleoside that slows AV conduction through the AV node. Has a short half-life and a good safety profile.
Adenosine Mechanism of Action
Slows conduction time through the AV node, interrupting the re-entry pathways through the AV node, [hopefully] restoring NSR.
Adenosine Indications
Tx of PSVT refactory to common vagal maneuvers.
Adenosine Contraindications
Pt's with 2nd and 3rd degree heart blocks, sick sinus syndrome.

Note: Sick sinus syndrome is a relatively uncommon syndrome. It can result in many abnormal heart rhythms (arrhythmias), including sinus arrest, sinus node exit block, sinus bradycardia, and other types of bradycardia (slow heart rate).

Sick sinus syndrome may also be associated with tachycardias (fast heart rate) such as paroxysmal supraventricular tachycardia (PSVT) and atrial fibrillation. Tachycardias that occur with sick sinus syndrome are characterized by a long pause after the tachycardia.
Adenosine Precautions
May cause dysrythmias at time of cardioversion, may even cause asystole. Use caution with pts with asthma.
Adenosine Side Effects
Facial flushing, HA, SOA, dizziness, N/V. Note side effects are usually very limited secondary to short half-life.
Adenosine Interactions
Methylxanthrines may decrease effects so consider increasing dose.
Dipyridamole may increase effects of adenosine so cosider decreasing the dose.
Adenosine Route and Dose
Rapid IVP
Initial 6mg, repeat in 2 to 3 mins with 12mg if indicated.
A second 12mg may be administered if the first 2 doses donot work.
Sodium Bicab Class
Alkalinizing agent
Sodium Bicarb Description
A salt that provides bicarbonate to buffer metabolic acidosis, which can accompany several disease processes.
Sodium Bicarb Mechanism of Action
Dissociates to provide bicarbonate ion which neutralizes hydrogen ion concentration and increase blood and urine pH.
Sodium Bicab Indications
Management of metabolic acidosis (ie cardiac arrest with long down time). Tx of hyperkalemia. Management of tricyclic antidepressant, ASA, and phenobarbital overdoses.
Sodium Bicarb Contraindications
Alkalosis, hypernatremia, severe pulmonary edema, and hypocalcemia.
Sodium Bicarb Precautions
Be cautions with dose as overdosing can cause alkalosis.
Sodium Bicarb Side Effects
Metabolic alkalosis, decrease potassium, and fluid overload.
Sodium Bicarb Interactions
Deactivates most catecholamines and vasopressors (ie. dopamine and epinephrine). Never administer with calcium chloride as it basically makes chalk.
Sodium Bicarb Route and Dose
IV
1mEq/kg follow by 0.5mEq/kg every 10 mins
Atropine Brand Name
Atropiso, Isopto
Atropine Class
Anticholinergic
Atropine Description
A parasympatholytic that is derived from parts of the Atopa belladonna plant.
Atropine Mechanism of Action
Blocks the action of acetylcholine at parasympathetic sites in smooth muscle, secretory glands and the CNS; increase cardiac output, dries secretions, antagonizes histamine and serotonin.
Atropine Indications
Hemodynamically significant bradycardia and asystole (soon to be taken off of standard for asystole). Also used for antidote for organophosphate poisoning.
Atropine Contoraindications
None in an emergency situation. Glaucoma, tachycardia, and Mobitiz type II block.
Atropine Precautions
May actually worsen bradycardia associated with second degree Mobitz type II block.
Increases cardiac and O2 demand.
Atropine Side Effects
Blurred vision, dilated pupils, dry mouth, tachycardia, drosiness, and confusion.
Atropine Interactions
Few interactions in prehospital setting.
Atropine Route and Dose
Max is 3mg or 0.04mg/kg

Bradycardia 0.5 IV repeat every 3 to 5 mins.

Asystole is 1mg ever 3-5 mins via IV or 2 to 2.5 mg every 3 to 5 mins via endotracheal.
Morphine Class
Narcotic analgesic
Morphone Description
Potent anagesic with properties additional effects.
Morphine Mechanism of Action
Binds to opiate receptors in the CNS, causing inhibition of ascending pain pathways, altering the perception of and response to pain. Produces a generalize CNS depression. Also increases peripheral venous capacitance and dereases venous return, thus decreasing myocardial oxygen demand.
Morphine Indications
Severe pain especially related to active MI. Also used in severe CHF.
Morphine Contraindications
Volume depletion, hypotensive, undiagnose head injury.
Morphine Precautions
Very addictive, schedule II drug.
Morphine Side Effects
N/V, abdominal craping, blurred vision, constricted pupils, alter mental status, headache, and respiratory depression.
Morphine Interactions
Inhances antihistamines, antimetics, sedatives, hypnotics, barbiturates, and alcohol.
Morphine Dose and Route
Initial 2 to 10mg IV with 2mg every few mins. IM 5 to 15mg based on pt weight.
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