Drug Formulary

Question 1

Acetaminophen (tylenol, Feverall, Panadol)

Answer 1

I) Pain control, fever
A) Oral liquid, Rectal Suppository, PO (adults)
Da) up to 100mg PO
Dp) 10-15mg/kg PO/PR
TE) Relif of mild pain and fever reduction
CI) caution w/ liver and renal disease
SE) None in therapeutic dosage range

Question 2

Activated Charcoal USP (Actidose, CarcoAid)

Answer 2

I) Poisoning, Overdose, (Ideal for Asa, Dilantin, Phenobabital, Amphetamines, Strychnine)

A) PO, NGtube

Da) 1gm/kg mixed w/ h2o

Dp) 1gm/kg mixed with h20 Only with direct medical order

TE) binds and absorbs ingested toxins still present in the GI tract following emesis. Once bound, it is excreated.

CI) Before or together before ipecac, renders ipecac ineffective, Not for cyanide. Does not work for Methanol, Iron, Casutics, lithium

SE) Non, unless a/w cannot be controlled

Notes) Should only be given in PO or NG in a slurry solution w/water

Question 3

Adenosine (adenocard)

Answer 3

I) PSVT, SVT

A) Rapid IV, IO

Da) Initial dose up to 12mg rapid Iv bolus. 12mg within 1-2 minutes of continuing SVT. May be repated every 1-2 minutes Max Dose 36mg

Dp) .1mg/kg (over 1-2s) Iv followed by rapid saline flush. Max inital dose of 6mg.
.2mg/kg within 1-2 minutes of continuing SVT given rapid IV bolus. Max single dose 12mg.

TE) Slows conduction time through the AV node. Interruption of reentry pathways through AV node. Restoration of NSR in patients of PSVT

CI) 2nd or 3rd degree AV block

SE) Short lasting. 1st, 2nd or 3rd degree AV block.
Transiet Asystole
Various arrhythmias lasting only a few seconds

Notes) The onset and effect is generally w/in < 1 min.

Question 4

Afrin Nasal Spray

Answer 4

I) Epistaxis, Pre-medication for nasal intubation

A) Nasal spray

Da) 2 to 3 sprays in affected nostril

Dp) 2 to 3 sprays in affected nostril

TE) Decongestant for reducing nasal/sinus stuffiness

CI) MAO Inhibitor use within 14 days
Use with caution in patients with hypertension, cardiovascular disease, diabetes, or glaucoma

SE)Nasal irritation/dryness 
Dizziness 
Hypertension 
Tachycardia/Palpitations 
Restlessness/Insomnia

Question 5

Albuterol Sulfate (ventolin / Proventil)

Answer 5

I) Acute bronchospasm
Cardiac arrest associated with asthma

A) Handheld nebulizer OR Nebulizer Mask Or via ET Tube
Connection Per Medical Order or Standing Order / Protocol.

D) All patients regardless of age: May receive a dosage of up to a
maximum of 1cc (5mg) of aerosolized Albuterol with no on-line medical control.
Repeat treatments of aerosolized Albuterol per Local protocol.

TE) Decreases bronchospasm; Improves pulmonary function

CI) none

SE) Tremor; Dizziness; Nervousness; Headache; Nausea; Tachycardia; Bronchospasm

SPECIAL NOTES /
RESTRICTIONS:
NOTES) Repeat treatments of aerosolized Albuterol per Local protocol.
When administering via endotracheal tube, the maximum dosage
may be doubled to 2 cc. For Bronchospasm associated with
COPD refractory to Albuterol.

Question 6

Amiodarone (Cordarone)

Answer 6

I) Shock resistant Ventricular Fibrillation or pulseless Ventricular
Tachycardia.
 Unstable Ventricular Tachycardia
 Rapid atrial arrhythmias with impaired LV function

A) IV Push and by Continuous Infusion

Da) Pulseless VT / VF
 Rapid 300 mg IV diluted 20 – 30 cc of D5W or NS
Unstable VT
 150 – 300 mg IV followed by IV infusion @ 1 mg / min
Rapid atrial arrhythmias with impaired LV function
 150 mg over 10 minutes

Dp) Pulseless VT / VF 
 5mg/kg IV/IO Rapid IV bolus 
 VT 
 5mg/kg IV/IO over 20 to 60 minutes 
Repeat does of 5mg/kg up to maximum dose of 15 mg/kg per day 

TE)Class IIb agent for treatment of cardiac arrest due to shock-resistant
VF or pulseless VT.
Increases Action Potential and Refractory Period
Reduces Ventricular Dysrhythmias

CI) Marked Sinus Bradycardia
Second or Third Degree AV Block (unless pacemaker is available)
Do not routinely administer Amiodarone and Procainamide together

SE)Hypotension, Bradycardia, AV Block, Asystole, PEA, Hepatoxicity

Question 7

Amyl Nitrate

Answer 7

I) Cyanide Poisoning

A) Inhalation only

Da) One or two inhalants of amyl nitrite should be crushed and inhaled for
15 to 30 seconds.

Dp) One inhalant should be crushed and inhaled for 15 to 30 seconds.
(Smallest effective dosage should be used.)

TE)It is effective in the emergency management of cyanide poisoning.
Amyl nitrite causes the oxidation of hemoglobin to a compound called
methemoglobin. Methemoglobin reacts with the toxic cyanide ion to
form cyanomethemoglobin, which can be enzymatically degraded.

CI) NONE

SE) Headache and hypotension have been known to occur following
inhalation.

Question 8

Aspirin (Children’s chewable)

Answer 8

I) Myocardial Infarction
 Chest pain suspicious of cardiac origin

A) Chew; P.O.

Da) 162mg to 324mg
Give two (2) to four (4) “children’s” chewable Aspirin (81mg x 4 =
324mg)

Dp) Not Approved

TE)Given as an early potent anticoagulant. Blocks formation of
Thromboxane A2. Thromboxane A2 causes platelets to aggregate
and arteries to constrict.
Reduce overall mortality of acute MI
Reduce nonfatal re-infarction.

CI) Active ulcer;

SE) Allergic reaction; Nausea/Vomiting; Indigestion; Heartburn; Tinnitus