Medications - Indications/Contraindications Flashcards
(28 cards)
Adenosine
Indications/Contraindications
Indications:
Narrow-complex supra ventricular tachyarrhythmia. Stable, undifferentiated, REGULAR, monomorphic wide-complex tachycardia
Contraindications:
Any irregular tachycardia. Specifically never administer to an irregular wide-complex tachycardia, which may be lethal.
Adverse reactions:
Chest pain, shortness of breath, diaphoresis, palpitations, and lightheadedness
Albuterol Sulfate
Indications/Contraindications
Indications:
Bronchospasm
Contraindications:
Severe tachycardia is a relative contraindication
Adverse reactions:
Tachycardia, palpitations, and dysrhythmias
Amiodarone
Indications/Contraindications
Indications:
Cardiac arrest in patients with shock refractory VF/VT. Stable wide complex tachycardia. Following successful cardioversion of VF/VT
Contraindications:
2nd or 3rd degree AV block
Cardiogenic Shock
Adverse Reactions:
Severe hypotension
Bradycardia
Aspirin
Indications/Contraindications
Indications:
Suspected acute coronary syndrome
Contraindications:
Active gastrointestinal bleeding
Aspirin allergy
Atropine Sulfate
Indications/Contraindications
Indications:
Symptomatic bradycardia
To improve conduction in 2nd and 3rd degree heart block or in pacemaker failure
Organophosphate poisoning
Adverse reactions: Anticholinergic toxidrome in overdose, think “blind as a bat, mad as a hatter, dry as a bone, and red as a beet”
Calcium Gluconate
Indications/Contraindications
Indications:
Adult pulseless arrest associated with any of the following clinical conditions:
Known hyperkalemia
Renal failure with or without hemodialysis history
Calcium channel blocker overdose
Not indicated for routine treatment of pulseless arrest.
Adult or pediatric calcium channel blocker overdose with hypotension, bradycardia
Contraindications:
Known hypercalcemia
Suspected digoxin toxicity (i.e. digoxin overdose)
Dextrose 50%
Indications/Contraindications
Indications:
Hypoglycemia
The unconscious or altered mental status patient with an unknown etiology
Diazepam (Valium)
Indications/Contraindications
Indications:
Status epilepticus, combative or severely agitated patients, sympathomimetic overdose (cocaine, meth), severe musculoskeletal back spasms, sedation for cardioversion or transcutaneous pacing.
Adverse reactions:
Respiratory depression
Loss of protective airway reflexes
Diphenhydramine (Benadryl)
Indications/Contraindications
Indications:
Allergic reactions, dystonic medication reactions, or akathisia (restlessness)
Adverse reactions: Drowsiness Dilated pupils Dry mouth and throat Flushing
Dopamine (Intropin)
Indications/Contraindications
Indications:
Hypotension refractory to adequate fluid resuscitation.
Symptomatic bradycardia with signs of poor perfusion
Contraindications:
Hypovolemia
Hemorrhagic shock
Adverse reactions:
Tachydysrhythmias
Hypertension
Increased myocardial oxygen demand
Droperidol (Inapsine)
Indications/Contraindications
Indications:
Primary use for management of agitated/combative patients.
Second line medication for management intractable vomiting requiring base contact.
Combative head injured patients.
Contraindications:
Suspected acute myocardial infarction.
Systolic blood pressure under 100mmHg, or the absence of a radial pulse.
Exhibiting signs of respiratory depression.
Side effects:
Due to the vasodilation effect, droperidol can cause a transient hypotension that is usually self-limiting and can be treated effectively with position and fluids. Droperidol has also been known to cause tachycardia which usually does not require pharmacologic intervention.
Some patients can have feelings of: restlessness, hyperactivity, anxiety, extra-pyramidal reactions.
DuoDote
Indications/Contraindications
Indications:
Suspected nerve agent exposure accompanied with signs and symptoms of nerve agent poisoning
Epinephrine
Indications/Contraindications
Indications:
Pulseless arrest, anaphylaxis, asthma, bradycardia with poor perfusion, airway obstruction secondary to croup or epiglottis
Adverse reactions: Tachycardia and tachydysrhythmia Hypertension Anxiety Angina pectoris
*Should not be added to sodium bicarbonate or other alkaloids as epinephrine will be deactivated.
Fentanyl (Sublimaze)
Indications/Contraindications
Indications:
Moderate to severe pain
Treatment of shivering after therapeutic induced hypothermia
Contraindications:
Hypotension, hemodynamic instability or shock
Respiratory depression
Side Effects:
Respiratory depression, hypotension, increased intracranial pressure, and chest wall rigidity
Glucagon
Indications/Contraindications
Indications:
Altered level of consciousness where hypoglycemia is suspected and IV access is unavailable. Hypotension, bradycardia from beta-blocker or calcium channel blocker overdose.
Side effects:
Tachycardia, headache, nausea/vomiting
Atrovent (Ipratropium Bromide)
Indications/Contraindications
Indications:
Bronchospasm
Contraindications:
Do not administer to children <2 years
This does not contain the allergen (soy/peanuts) that are contained in the metered dose inhaler.
Adverse reactions:
Palpitations
Tremors
Dry mouth
Magnesium Sulfate
Indications/Contraindications
Indications:
Antiarrhythmic (torsades de pointes associated with prolonged QT interval)
Respiratory (severe bronchospasm unresponsive to continuous albuterol, ipratropium, and IM epinephrine.
Obstetrics (>20 weeks gestational age with evidence of eclampsia or pre-eclampsia:
Pre-eclampsia: hypertension >180mmHg systolic or > 120mmHg diastolic, localized edema, headache and/or altered mental status.
Eclampsia: preeclampsia + seizures)
Adverse reactions:
Bradycardia, hypotension, and respiratory depression
Methylprednisolone (Solu-medrol)
Indications/Contraindications
Indications:
Anaphylaxis
Severe asthma
COPD
Contraindications:
Evidence of an active GI bleed
Adverse reactions:
GI bleeding
Hypertension
Hyperglycemia
Midazolam (Versed)
Indications/Contraindications
Indications:
Status epilepticus
Sedation of the severely agitated/combative patient
Sedation for cardioversion or transcutaneous pacing (TCP)
Contraindications:
Hypotension
Adverse reactions:
Respiratory depression
Hypotension
Sedative effect of versed may be heightened by associated use of opioids, alcohol, or other CNS depressants
Morphine Sulfate
Indications/Contraindications
Indications:
Pain Management
Cardiogenic Pulmonary edema
Contraindications:
Hypovolemia
Hypotension (relative)
Side effects: Respiratory depression Hypotension Nausea/vomiting Itching (Histamine release)
Naloxone (Narcan)
Indications/Contraindications
Indications:
For reversal of suspected opioid-induced CNS and respiratory depression
Coma of unknown origin
Seizure of unknown etiology (rule out narcotic overdose, specifically propoxyphene)
Adverse reactions:
Tachycardia
Nausea/Vomiting
Pulmonary Edema
Nitroglycerine
Indications/Contraindications
Indications:
Pain or discomfort due to suspected acute coronary syndrome
Pulmonary edema due to congestive heart failure
Contraindications:
Suspected right ventricular infarct (inferior STEMI pattern plus ST elevation in right sided precordial leads)
Hypotension SBP < 100
Recent use of erectile dysfunction medication
Adverse reactions:
Hypotension
Headache
Syncope
Ondansetron (Zofran)
Indications/Contraindications
Indication:
Nausea/Vomiting
Oxygen
Indications/Contraindications
Indications: Suspected hypoxemia or respiratory distress from any cause Acute chest or abdominal pain Hypotension/shock states from any cause Trauma Suspected carbon monoxide poisoning Obstetrical complications, childbirth
