EMT-B Drug Cards

Question 1

Asprin

Answer 1

MOA- NSAID, decreases inflammation, decreases platelet aggregation.

Indications- ACS/chest pain

Contraindications- hypersensitivity/allergic, can’t chew

Adverse reactions- GT symptoms

Dose- 324 mg oral

Question 2

Nitroglycerin

Answer 2

Class- Anti-Anginal Agent

MOA- vasodilator, relaxes smooth muscle, decreases preload & O2 demand

Indications- chest pain/ACS/CHF

Contraindications- hypersensitivity/allergic, ED Meds last 24 hrs, hypotension, right ventricular infarction

Adverse Reactions- dizziness, headache, hypotension.

Dose- 0.4 mg SL every 3-5 minutes (max 3 doses)
IV 10-50 mcg/min

Question 3

Epinephrine

Answer 3

Class- Sympathetic Agonist

MOA- Naturally occurring catecholamine, acts on alpha and beta receptors, potent vasoconstrictor, increased BP, Alpha effects generally more profound.

Indications- shock, severe hypotension, post resuscitation

Contraindications- hypersensitivity/Allergic, tachycardia

Adverse Reactions- palpitations, anxiety, tachycardia, tremors.

Dose- 1-30 mcg/min

Question 4

Norepinephrine

Answer 4

Class- sympathetic Agonist

MOA- naturally occurring catecholamine, acts on alpha, beta receptors as a agonist. Potent vasoconstrictor. Increased BP, alpha effects usually more profound.

Indications- shock (to maintain BP, tissue perfusion), severe hypotension, post resuscitation

Contraindications- hypersensitivity/allergic, tachycardia

Adverse reactions- palpations, anxiety, tachycardia, tremors

Dose- 1-30 mcg/min via IV pump

Special considerations- one of the strongest vasopressors available, monitor BP closely

Question 5

Oxygen

Answer 5

Class- Medical Gases

MOA- corrects hypoxia, oxygenates blood, reduces cardiac work load

Indications- low SPO2, carbon monoxide poisoning, used in conjunction with airway devices to deliver oxygen.

Contraindications- none of SPO2 below 94%

Adverse reactions- drying of mucus membranes

Dose- 1-15 lpm depending on O2 device/airway set up

Special considerations- don’t overload patient we want SPO2 94-99/patient normal. COPD get back to their normal.

Question 6

Albuterol

Answer 6

Class- Sympathomimetic (beta 2 agonist)

MOA- causes prompt bronchodilation of the lungs

Indications- Asthma, anaphylaxis, COPD, hyperkalemia

Contraindications- hypersensitivity/allergy, CHF

Adverse reactions- palpitations, tachycardia, headache.

Dose- 2.5 mg mixed into a mask nebulizer

Special considerations- caution in heart disease and CHF patients, perform cardiac monitoring before and after administering.

Question 7

Oral Glucose

Answer 7

Class- carbohydrate gel

MOA- raise patient’s glucose levels

Indications- hypoglycemia

Contraindications- can’t maintain consciousness or airway, unable to obey commands

Adverse reactions- none in emergency settings

Dose- entire tube 15 grams orally

Question 8

Odansetron (Zofran)

Answer 8

Class- anti- emetic

MOA- blocks serotonin receptors, anti-emetic

Indications- Nausea/vomiting

Contraindications- hypersensitivity/allergy

Adverse reactions- dizziness, drowsiness, headache

Dose- 4-8 mg IV/IO/PO/IM

Special considerations- caution in pregnant patients, ask if already taking serotonin blockers

Question 9

Naloxone (Narcan)

Answer 9

Class- Opioid Antagonist

MOA- will reverse effects of opiates at the mu-opiate receptor

Indications- opiate overdose with resp depression

Contraindications- none in EMS

Adverse reactions- agitation, AMS, tachycardia

Dose- adult 2-4 mg IN/IM, .4 mg IV/IO
Pediatric .1 mg/kg (max dose 2 mg)

Special considerations- watch for violent or withdrawal symptoms when patient awakes. Goal of Narcan is to restore normal respiratory effort in opiate OD

Question 10

Activated charcoal

Answer 10

Class- Adsorbant , anti-dote

MOA- used as an antidote to ingested drugs, will bind to the drug and deactivate it, then eliminate it from the body. Must be given within 1 hr of ingesting the substance.

Indications- numerous oral poisons, med overdoses

Contraindications- corrosives, caustics, unable to obey commands or protect airway

Adverse reactions- N/A

Dose- adult 30-100 g PO, pediatric 1g/kg PO

Special considerations- we have only 1 hour to use this

Question 11

Ibuprofen (Motrin)

Answer 11

Class- NSAID

MOA- acts peripherally as an analgesic. Has anti-inflammatory, analgesic, anti-pyric effects

Indications- mild to moderate pain

Contraindications- hypersensitivity- active GI bleeds, asthma

Adverse reactions- GI irritation, renal impairment, heartburn, dizziness, drowsiness

Dose- adult 200-800 mg PO, pediatric 5-10 mg/kg PO

Special considerations- caution in patients with Asprin or other NSAID allergy, caution in active asthmatics