Paramedic Drug Cards

Trade: Toradol Class: NSAIDMOA: inhibits the production or prostaglandins in inflamed tissue, which decreases the responsiveness of pain receptors. Indications: Moderately severe acute painContraindications: Patients with a hx of peptic ulcer disease or GI bleed, patients with renal insufficiency, hypovolemic patients, 3rd trimester pregnancy, nursing mothers, allergy to other nsaids, stroke or head trauma, having surgery within the next 7 days.  Side effects:  headache, drowsiness, dizziness, abdominal pain, dyspepsia, N/V, Diarrhea.Dosing:Adult IV 30mgIM 60mg Senior (65 and older)/ Pediatric < 50kgsIV 15mgIM 30mg

Trade: MorphineClass: Opiate agonist/Narcotic Analgesic MOA: Binds to the opiate receptors. Reduces stimulation of the sympathetic nervous system caused by pain and anxiety. Reduction of sympathetic stimulation reduces heart rate, cardiac work, and myocardial O2 consumptionIndications: moderate to severe pain including chest pain associated with ACS, CHF, and pulmonary edema.Contraindications: Respiratory depression, shock.Side effects: Respiratory depression, hypotension, N/V, dizziness, lightheadedness, sedation, diaphoresis, euphoria, seizures, cardiac arrest, anaphylactoid reaction.Dosage:Adult  2-10mg IV/IO/IMPediatric < 110 lbs 0.025 – 0.2mg/kg IV/IO/IM

Trade: SublimazeClass: Narcotic Analgesic MOA: Binds to opiate receptors producing analgesia and euphoriaIndication: PainContraindication: Use caution in traumatic brain injury, Respiratory depression Side effects: Respiratory depression, apnea, hypotension, N/V, dizziness, sedation euphoria, Sinus bradycardia, sinus tachycardia, palpitations, HTN, diaphoresis, syncopeDosingAdult 50-100mcg IM/IVPedi 1-2mcg/kg IM/IV

Trade: Valium Class: BenzodiazepineMOA: Binds to the benzodiazepine receptor and enhances the effects of GABAIndications: Anxiety, Skeletal muscle relaxation, anticonvulsant Contraindications: Children younger then 6 months, acute angle glaucoma, CNS depression, alcohol intoxication. Side effects:  Respiratory depression, drowsiness, fatigue, headache, pain at the injection site, confusion, nausea, hypotension, cardiac arrest at high doses•Dosing:Adult: Anxiety: 2-10mg IV/IMSeizure: 5-10mg IV/IOPediatric:Anxiety: 0.2 – 0.3mg/kg IV/IMSeizure:  Older then 5 years: 1mg IV/IOOlder then 30 days less then 5 years: 0.2 to 0.5mg IV/IO                Neonate: 0.1-0.3mg/kg IV/IO

Trade: Tegretol Class:  Anticonvulsant MOA: Binds preferably to voltage gated Sodium channels in their inactive conformation, which prevents repetitive and sustained firing of an action potential.Indications: Partial and generalized tonic – clonic seizures Contraindications: AV Block, bundle branch block, agranulocytosis, bone marrow supression, monoamine oxidase inhibitor therapySide effects: Dizziness, drowsiness, ataxia, N/V, blurred vision, confusion, headache, transient diplopia, visual hallucinations, life threatening rashes.Dosing:Adult:200mg POPediatric:6-12 years old: 100mg PO        Less then 6: 10mg/kg PO

First and foremost, THANK YOU to everyone who was listened to this Podcast over the past year. In just under 12 months we have risen to one of the top listened to and searched paramedic pod casts on spotify and apple podcasts. Again, thank you so much!If you love listening to my voice read these drugs, but want an extra visual aid to go along with it, my classmate is currently selling laminated, professionally printed copies of every drug we have covered. They are  available one etsy RIGHT NOW! Head over there, check them out, and if you think they'll help, place an order. He will be running a discount exclusively for listeners of Paramedic Drug Cards for a limited time. Dont miss out!www.paramedicstudents.etsy.comExclusive DISCOUNT CODE for my listeners: MEDIC22

Trade – CardeneClass – Calcium Channel blocker MOA – Blocks calcium movement into the smooth muscle of the blood vessel walls, causing vasodilation.Indication – Angina, HTNContraindication – Aortic stenosis, hypotension, use caution in heart failure, cardiac conduction abnormalities, Cerebrovascular disease, depressed AV node conduction. Side effects – Edema, headaches, flushing, sinus tachycardia, hypotension Dosages :Adult: 5mg/hr IV/IO Pedi: 0.5 – 5 mcg/kg/min

Trade – CyanokitMOA:  Antidote, cyanide poisoning adjunct Binds with cyanide to form nontoxic cyanocobalamin, preventing its toxic effects; excreted renallyIndications: Treatment of known or suspected cyanide poisioning.Contraindications:  None is the emergency settingSide Effects:  Hypertension, allergic reactions, GI bleeding, nausea, vomiting, dyspepsia, dyspnea, dizziness, headache, injection site reactions.Dosage:  Adult: 5 g IV infusion over 15 minutes at a rate of 15 mL/min.Pedi:  70 mg/kg IV one time, may be repeated one time at the same dose.

Trade – IsoptinClass – Calcium Channel blockerMOA – Blocks calcium from moving into the heart muscle cell, which prolongs conduction of the electrical impulses through the AV node.Indications – AF, HTN, paroxysmal SVT, Paroxysmal SVT prohylaxisContraindications – 2nd or 3rd degree AV block, Hypotension, cardiogenic shock, Sick sinus syndrome, WPW.Side effects – Sinus bradycardia, 1st, 2nd, or 3rd degree AV blocks, CHF, reflex tachycardia, transient asystole, hypotension.Dosing Adult 2.5-10mg IV/IO over 2 minutes. May repeat at 5-10mg every 15-30 mins to a maximum dose of 30mgPedi 1-16 years old: 0.1mg/kg IV/IO max single dose 5mg over 2mins may repeat in 30 mins to a max dose of 10mg

Trade – PlavixClass – Antiplatelet MOA – Blocks platelet aggregation by antagonizing the IIb/IIIa receptors Indications – ACS, chronic coronary and vascular disease, ischemic stroke.Contraindications – Hx of intracranial hemorrhage, GI bleed or trauma.Side effects – Nausea, Abdominal pain, hemorrhage. Dosing : Unstable angina pectoris or non Q wave AMI.Adult – Loading dose 300-600mg POPedi – Not recommended for pedi patients

Trade – PhenerganClass – Antiemetic MOA - Decreases nausea and vomiting by antagonizing H1 receptors Indications – Nausea/Vomiting Contraindication – Altered level of consciousness, jaundice, bone marrow suppression, Use caution in seizure disorder.Side effects – Paradoxic excitation in children and older adults. Dosing:Adult - 12.5 - 25mg IV, IO, IMPedi - 2years and older 0.25 – 1 mg/kg IV, IO, IM 

Trade – CortefClass – Corticosteroid MOA – Reduces inflammation by multiple mechanisms. As a steroid it replaces the steroids that are lacking in adrenal insufficiency.Indications – Adrenal insufficiency, allergic reactions, anaphylaxis, asthma, COPDContraindications – Cushing Syndrome, known sensitivity to benzyl alcohol, Use with caution in diabetes, HTN, CHF, known systemic fungal infection, renal disease, idiopathic thrombocytopenia, psychosis, seizure disorder, GI disease, glaucoma. Side effects – Leukocytosis, hyperglycemia, increased infection, decreased wound healing, increased rate of death from sepsis.  Dosing Anaphylactic shock Adult 100-500mg IV,IO, or IM Pedi 2-10 mg/kg per day IV,IO, or IM max 500mg 

Trade – Nipride Class – Antihypertensive agentMOA – Causes direct relaxation of both arteries and veins Indication – HTN emergencies Contraindications – Hypotension, increased ICP, cerebrovascular disease, coronary artery disease, hepatic disease, renal disease, pulmonary disease.Side effects – Cyanide or thiocyanate toxicity, N/V, dizziness, headache, restlessness, abdominal pain, methemoglobinemia.Dosing Adult 0.3-10mcg/kg/minPedi 0.5 – 10mcg/kg/min

Trade – ApresolineClass – Vasodilator MOA – Directly dilates peripheral blood vesselsIndication – HTN associated with preeclampsia and eclampsia, HTN crisis Contraindication – Patients taking diazoxide or MAOI's, coronary artery disease, stroke, angina, dissecting aortic aneurism, mitral valve and rheumatic heart disease. Side effects – Headache, angina, flushing, palpitations, reflex tachycardia, anorexia, N/V, diarrhea, hypotension, syncope, peripheral vasodilation, peripheral edema, fluid retention, pareshesias. DosingPreeclampsia and eclampsia:         Adult : 5-10mg IV repeat every 20-30mins until Systolic pressure of 90-105mmhgAcute HTN ( not associated with preeclampsia )        Adult :10-20mg IV/IM        Pedi : 1mo – 12yr  0.1-0.2 mg/kg IV/IM max 20mg per dose

Trade – HaldolClass – Antipsychotic agent MOA – Selectively blocks postsynaptic dopamine receptorsIndications – Psychotic disorders, agitation Contraindications – Depressed mental status, Parkinson diseaseSide effects – extrapyramidal symptoms, drowsiness, tardive dyskinesia, hypotension, hypertension, VT, sinus tachycardia, QT prolongation, torsades de pointes. Dosing Adult: Mild agitation :  0.5-2mg PO/IMModerate agitation : 5-10mg PO/IM  Severe agitation : 10mg PO/IMPedi: 1-5mg IM/PO

Trade: TetraViscClass: Anesthetic MOA: Short acting pain suppressantIndication: Topical anesthetic for eye injuriesContraindication: allergySide Effects: numbness, blurred vision in treated eye, mild short burning sensationDose: Adult: 1-2 drops every 5 minutes, repeat as needed           Pediatric1-2 drops every 5 minutes, repeat as needed

Trade – Diprivan Class – Anesthetic MOA – Produces rapid and brief state of general anesthesia. Indication – Anesthesia inductionContraindication – HypovolemiaSide effects – Apnea, Cardiac arrhythmias, asystole, hypotension, hypertension.Dosing Initial induction: 1.5-3mg/kg IV/IO followed by a maintenance infusion.Adult maintenance infusion 25-75 mcg/kg/min IV/IO Pedi maintenance infusion 30-300 mcg/kg/min IV/IO

Trade – Dilantin Class – AnticonvulsantMOA – Depresses seizures by affecting the movement of sodium and calcium into neural tissue. Indication – Generalized tonic – clonic seizures.Contraindication – sinus bradycardia, sinoatrial block, second and third degree heart block, adam stokes syndrome, known sensitivity to hydantoins. Side effects – N/V, depression of cardiac conduction, sedation, nystagmus, tremors, ataxia, dysarthria, gingival hypertrophy, hirsutism, facial coarsening Dosing:Adult: 15-20mg/kg IV/IO ( not to exceed a push rate of 50mg/min)Pedi: 15-20mg/kg IV/IO ( at a rate of 1-3 mg/kg/min)

Trade – ALTEPLASE RECOMBINANT-TPAClass– Thrombolytic Agent MOA – Dissolves thrombi plugs in the coronary arteries and reestablishes blood flow.Indication – ST segment elevation greater then 1mm in 2 or more contiguous leads, New or presumed new left bundle branch block. Contraindications – ST segment depression, Cardiogenic shock, Recent major surgery, cerebrovascular disease, recent (within 10 days) GI bleeding, recent trauma, severe HTN Systolic greater then 180 diastolic greater then 110. High likely hood of left heart thrombus, acute pericarditis, severe renal or liver failure with bleeding complications, significant liver dysfunction, diabetic hemorrhagic retinopathy, septic thrombophlebitis, Patients older then 75, patients already taking Coumadin. Side effects – Bleeding, intracranial hemorrhage, stroke, cardiac arrhythmias, hypotension, bruisingDosingAdult Per medical direction.Pedi Not recommended 

Trade – Unfractionated Heparin Class – Anticoagulant MOA – Acts on antithrombin III to reduce the ability of the blood to form clots, thus preventing clot deposition in the coronary arteries. Indication – ACS, acute pulmonary embolism, DVTContraindication – Predisposed to bleeding, aortic aneurism, peptic ulcer. Dosing:AdultCardiac indications – 60 units/kgPulmonary embolism/ DVT – 80 units/kgPediCardiac indications – 75 units/kgPulmonary embolism/DVT 75 units/kg

Trade: Inderal Class: Beta Blocker MOA: Nonselective Beta antagonist that binds with both the beta1 and beta 2 receptors. Inhibits the strength of the hearts contractions, as well as decreases heart rate resulting in decreased cardiac O2 consumptionIndication: Angina, reentry SVT, Atrial Fibrillation, Atrial Flutter. Contraindication: Cardiogenic shock, Heart failure, AV block, bradycardia, pulmonary edema, sick sinus syndrome.Side effects:  Bradycardia, AV block, Bronchospasm, hypotension. Dosing:Adult: 1-3mg IV/IO Slow IVPPediatric: 0.01 to 0.1mg/kg slow IVP

Trade: NormodyneClass: Beta blocker MOA:  Binds with beta1, beta2 and Alpha1 receptors. Inhibits the strength of the hearts contractions, as well as heart rate. This results in decrease in cardiac Oxygen consumption. Indication: ACS, SVT, severe HTNContraindications: Hypotension, Cardiogenic shock, acute pulmonary edema, heart failure, severe bradycardia, Sick sinus syndrome, second or third degree heart block, bronchospasm. Side effects: Usually mild, Hypotensive symptoms, N/V, Bronchospasm, arrhythmia, bradycardia, AV blockDosing: Adult 10mg IV/IO Over 1-2mins may repeat every 10 mins to a max dose of 150mgPedi 0.4-1mg/kg per hour to a max dose of 3mg/kg per hour

WarfarinTrade: CoumadinUse: Anticoagulant Glipizide Trade: GlucotrolUse: Diabetes Clopidogrel bisulfate Trade: Plavix Use: Platelet inhibitor 

Trade: Pitocin Class: HormoneMOA: Increases Uterine Contractions Indications: Postpartum hemorrhage after infant and placental deliveryContraindications: Presence of a second fetus, unfavorable fetal position.Side effects:  Hypotension, Hypertension, tachycardia, arrhythmias, angina, seizures, N/V, uterine rupture, anaphylaxis.Dosing: IM: 3-10 units after delivery of placenta IV: 20-40 milliunits/min titrate to severity of bleeding.  

Trade: Tenormin Class: Beta BlockerMOA: Inhibits the strength of the hearts contractions and heart rate, resulting in a decrease in cardiac oxygen consumption. Also saturates the beta receptors and inhibits dilation of bronchial smooth muscle. Indications: ACS, HTN, SVT, A-flutter, A-FibContraindications: Cardiogenic shock, AV block, bradycardia, use caution in hypotension, chronic lung disease ( asthma and COPD)Side effects: Bradycardia, bronchospasm, hypotension Dosing Adult: Oral dosing onlyPediatric: Not recommended 

Trade: LevophedClass: Adrenergic agonist, inotropic, vasopressor MOA: alpha 1, alpha 2, Beta 1 agonist. Primarily results in peripheral vasoconstriction resulting in increasing BP, and coronary blood flow. Beta adrenergic action produces inotropic stimulation of the heart and dilates coronary arteries.Indications: Cardiogenic Shock, septic shock, severe hypotension Contraindications: Patients taking MAOIs, use caution in hypovolemia Side Effects: Dizziness, anxiety, cardiac arrhythmias, dyspnea, asthma exacerbationDosing Adult: 2-4mcg/min IV/IO titrate to effect ( systolic BP greater then 80) Max dose is 30mcg/minPedi:  0.05 to 2mcg/kg/min IV/IO

Trade: DobutrexClass: Adrenergic agent, InotropicMOA: Increases myocardial contractility and stroke volume with minor chronotropic effects, resulting in increased cardiac outputIndication: CHF, Cardiogenic shockContraindications: Drug induced shock, Systolic pressure greater then 100, use caution in HTN, recent MI, Arrhythmias, hypovolemia Side effects: Tachycardia, PVC's, HTN, Hypotension, palpitations, arrhythmiasDosing:Adult: 2-20 mcg/kg/min IV/IOPedi: SAA

Trade: PrimacorClass: Inotropic / VasodilatorMOA: Positive inotropic drug and vasodilator with minimal chronotropic effects. Inhibits enzyme cAMP phosphodiesterase which results in an increased concentration of calcium inside the cardiac cell and results in better diastolic function and myocardial contractility. Indication: Cardiogenic shock, Heart failureContraindication: Valvular heart disease.Side effects: Cardiac arrhythmias, N/V, Hypotension Dosing:Adult: 50 Mcg/kg IV/IO over 10 minsPedi:SAA

Trade: IntropinClass: Vasopressor /Sympathomimetic MOA: Stimulates alpha and beta adrenergic receptors resulting in inotropy and increased cardiac output while maintaining dopaminergic induced vasodilatory effects.Indications: Hypotension and decreased cardiac output associated with cardiogenic shock and septic shock. Hypotension after ROSC. Symptomatic Bradycardia that doesn't respond to atropineContraindications: VF, VT, or other ventricular arrhythmiasSide effects : Tachycardia, arrhythmias, skin and soft tissue necrosis, severe HTN, angina, dyspnea, headache, N/VDosing Adults: 2-20 mcg/kg/min IV/IOPedi: SAA

meloxicam Trade: MobicUse: NSAIDibuprofenTrade: Advil Use: Pain, fever, arthritisinsulin glargineTrade: LantusUse: Diabetes Mellitus

Class: Electrolyte replacement /Alkalizing AgentMOA: Counteracts existing acidosisIndications: Acidosis, Drug intoxications (barbiturates, salicylates, methyl alcohol)Contraindications:  Metabolic alkalosis, hypocalcemiaSide effects: metabolic alkalosis, hypernatremia, injection site reaction, sodium and fluid retention, peripheral edema.Dosing Metabolic acidosis during cardiac arrest Adult:1 mEq/kg slow IV/IO may repeat at 0.5 mEq/kg in 10 minsPedi:SAA

Trade- XylocaineClass – Antiarrhythmic / NA+ blockerMOA – blocks sodium channels increasing the recovery period after repolarization. Suppresses automaticity in the His-Purkinje system and depolarization in the ventricles.Indication – Ventricular arrhythmiasContraindications - AV block, Bleeding, thrombocytopenia, Use caution in bradycardia, hypovolemia, cardiogenic shock, adams stokes syndrome, WPWSide effects – Toxicity ( signs may include anxiety, apprehension, euphoria, nervousness, disorientation, dizziness, blurred vision, facial paresthesias, tremors, hearing disturbances, slurred speech, seizures, sinus bradycardia.) Seizures without warning, cardiac arrhythmias, hypotension, cardiac arrest, pain at injection site. Dosing Pulseless v- tach and v-fibAdult: – 1-1.5mg/kg IV/IO may repeat at half the original dose (0.5 to 0.75mg/kg) every 5-10 mins to a max dose of 3mg/kg. Maintenance drip 1-4mg/minPedi:  1mg/kg IV/IO (max 100mg) Maintenance20-50 mcg/kg/minPerfusing ventricular rhythms Adult: 0.5-0.75mg/kg IV/IO repeat every 5-10mins to a max dose of 3mg/kgPedi: 1mg/kg IV/IO may repeat every 5-10 mins to a max of 3mg/kg

•Trade – Cordarone•Class – Antiarrhythmic•MOA - Acts directly on the myocardium to delay repolarization and increase the duration of action potential •Indications – Ventricular arrhythmias, second line for atrial rhythms.•Contraindications – Sick sinus syndrome, second and third degree heart block, cardiogenic shock, when episodes of bradycardia have cause syncope, sensitivity to benzyl alcohol and iodine.•Side effects – Burning at the IV site, hypotension, bradycardia. •DosingVentricular Fibrillation, and Pulseless Ventricular Tachycardia Adult: 300mg IV/IO followed by 150mg in 3-5 mins         1mg/min maintenance infusion after ROSCPedi: 5mg/kg max dose 300mg may repeat 5mg/kg up to 15mg/kgStable Wide Complex TachycardiaAdult: 150mg over 10 mins. Pedi: 5mg/kg IV/IO over 20-60 mins

Class- Antidote Description- Calcium chloride increases myocardial contractile force and increases ventricular automaticity.Indications-Hyperkalemia, hypocalcemia, hypermagnesemia, and calcium channel blocker toxicity.Contraindications-Ventricular fibrillation, hypercalcemia, and possible digitalis toxicity.Precautions- It may precipitate toxicity in patients taking digoxin. Ensure the IV line is in a large vein and flushed before using and after calciumDosing Adult Bradycardia of Suspected Hyperkalemia  Adult: 1G IV, IO over 5-10minsCardiac Arrest of Suspected HyperkalemiaAdult: 1G IV IOHyperkalemia Adult: 1G IV/IO may repeat after 5 mins

Trade – Adenocard Classification – Antiarrhythmic MOA– Slows the conduction of electrical impulses at the AV nodeIndication – SVTContraindications – Sick sinus syndrome, second or 3rd degree heart block, Poison/drug induced tachycardia, asthma, or bronchospasm Side Effects– Sense of impending doom, complaints of flushing, chest pressure, throat tightness, numbness, brief period of asystole after administration. Dosing Adult:  6mg rapid IV/IO followed by a rapid saline flush; If rhythm doesn't break in 1-2 minutes 2nd dose of 12mg RAPID IV/IO followed by saline flushPediatric:Greater than 110 pounds SAALess than 110 pounds initial dose 0.1mg/kg IV/IO (max 6mg)  Followed by a rapid saline flush second dose if rhythm persists or reoccurs 0.2mg/kg (max 12mg) followed by a rapid saline flush.

Trade – Calcium Gluconate Class – Electrolyte solution MOA – Counteracts the toxicity of hyperkalemia by stabilizing the membrane of the cardiac cells, reducing the likelihood of fibrillation Indication – Hyperkalemia, hypocalcemia, hypermagnesemia Contraindications - VF, Dig toxicity, hypercalcemia Side effects – soft tissue necrosis, hypotension, bradycardia ( if administered rapidly)Dosing Adult: 500 to 1000mg IV/IO (packaged as 100mg/ml) administer 1-1.5 ml/min max dose 3G IV/IO Pedi: 60-100ml/kg IV/IO slowly over a 5-10 minute period maximum dose 3G IV/IO

Trade– Lopressor, Toprol XLClass– Beta Blocker ( Class II antiarrhythmic) MOA– Inhibits the strength of the hearts contraction as well as the heart rateIndication– ACS, HTN, SVT, atrial flutter, Afib, thyrotoxicosis Contraindications– Cardiogenic Shock, AV Block, BradycardiaSide effects – Tiredness, dizziness, diarrhea, heart block, bradycardia, bronchospasm, drop in blood pressure.Dosing Adult: 5mg slow IV/IO over 2 minute period, Repeat at 5 minute intervals as necessary up to 15mgPediatric: Not Recommended 

Trade – Cardizem Class – Calcium channel Blocker ( class IV antiarrhythmic) MOA – Blocks Calcium from moving into the heart muscle cell, which prolongs the conduction of electrical impulses through the AV node Indication – Rapid atrial fibrillation Contraindications – Hypotension, Heart block, heart failure Side effects – Flushing, headache, bradycardia, hypotension, heart block, myocardial depression, severe AV block, at high doses cardiac arrest Dosing Adult: 0.25mg/kg IV/IO 2nd dose of 0.35mg/kg IV/IOPediatric: Not recommended 

Class – Anticholinergic MOA – Competes reversibly with ACH at the site of the muscarinic receptor. Indication – Symptomatic Bradycardia, asystole or PEA, Nerve agent exposure or organophosphate poisoning.Contraindications – Acute MI, Myasthenia Gravis, GI obstruction, closed angle glaucoma, known sensitivity to atropine, belladonna alkaloids, or sulfites. Atropine may not be effective on second degree type 2 and 3rd degree heart blocks.Side effects – decreased secretions resulting in dry mouth and hot skin, intense facial flushing, blurred vision or dilation of the pupils with photophobia, tachycardia and restlessness. Atropine may cause paradoxical bradycardia if the dose administered is too low or if it is administered too slowly. Dosing Symptomatic Bradycardia Adult: 0.5mg IV/IO every 3-5 minutes to a maximum dose of 3mgPediatric: 0.02mg/kg  IV/IO up to a total dose of 2mg  Nerve Agent or Organophosphate Poisoning Adult: 1-6mg IV/IM repeat every 5 minutes until symptoms dissipate Pediatric: 0.05mg/kg IV/IM every 10 – 30 minutes until symptoms dissipate 

Trade – OsmitrolClass – Osmotic DiureticMOA – Facilitates the flow of fluid out of tissues including the brain and into interstitial fluid and blood, this causes dehydration of the brain which results in decreased swelling. Reabsorption by the kidneys is limited so increased urine output takes placeIndications – increased ICPContraindications- Active intracranial bleeding, heart failure, pulmonary edema, severe dehydration, use caution with hypovolemia and renal failure.Side effects – Pulmonary edema, headache, blurred vision, dizziness, seizures, hypovolemia, nausea/vomiting, diarrhea, electrolyte imbalance, hypotension/HTN, sinus tachycardia, PVCs, angina, phlebitis DosageAdult: 0.25-1g/kgPediatric: SAA

Trade – DecadronClass – Corticosteroid MOA – Reduces inflammation by multiple mechanismsIndication – Asthma, airway edema, acute mountain sickness, cerebral edema and multiple medical conditions requiring anti-inflammatory Contraindications – Fungal infection, use caution in active infections, renal disease, penetrating spinal cord injury.Side effects – Depression, euphoria, headache, restlessness, HTN, Bradycardia, Nausea/vomiting, swelling, diarrhea, weakness, fluid retention, paresthesias DoseAdult: 10mg IV/PO

Trade – Dextrose (D50, D25, D10)Class – Antihypoglycemic MOA – Increases blood glucose concentrationsIndications – Hypoglycemia Contraindications – Intracranial and instraspinal hemorrhage, delirium tremens. Side effects – Hyperglycemia, warmth, burning from IV infusion. Concentrated solutions may cause pain and thrombosis of peripheral veins. Dosing –Hyperkalemia: Adult: 25G of dextrose 50% IV,IOPedi: 0.5 – 1G/kg IV/IOHypoglycemia: Adult: 10-25g dextrose 50% IVPedi: Older then 2 years 2ml/kg of Dextrose 50%Pedi under years old: 2-4 ml/kg of Dextrose 10%

Bupropion Trade: Wellbutrin Use: Antidepressant PotassiumTrade: K-DurUse: Hypokalemia CarvedilolTrade: CoregUse: HTN

Fluticasone Trade: FlonaseUse: Allergies AlprazolamTrade: XanaxUse: Anxiety, Panic disorderTrazodone hydrochlorideTrade: DesyrelUse: Depression

Trade – BreviblocClass– Beta BlockerMOA– Inhibits the strength of the hearts contractions, as well as heart rate. Indication – ACS, MI, acute HTN, Supraventricular tachyarrhythmiasContraindications – COPD, Acute Bronchospasm, Bradycardia, Advanced Heart blocks, cardiogenic shock, Pulmonary Edema, Side Effects – Hypotension, sinus bradycardia, AV block, Cardiac arrest, nausea/vomiting, hypoglycemia, injection site reactionDosageAdult: 500mcg/kg IV/IO over 1 minute Pedi: 500mcg/kg IV/IO over 1 minute 

Trade – GlucagonClass – HormoneMOA – Converts glycogen to glucoseIndication – hypoglycemia, beta blocker overdoseContraindications – Pheochromocytoma, Insulinoma Side effects – Nausea/vomiting, rebound hyperglycemia, hypotension, sinus tachycardiaDosagesHypoglycemiaAdult: 1mg IM, IV, IO, SQPedi: Less than 44 lbs – 0.5mg IM, IV, IO, SqBeta Blocker/CCB OverdoseAdult: 3-10mg IV, IO

Trade – BrethineClass– Adrenergic agent MOA – Stimulates B2 receptor producing relaxation of bronchial smooth muscle and bronchodilation. Indication – prevention and reversal of bronchospasm  Contraindications – known sensitivity to sympathomimeticsSide Effects – Cardiac arrhythmias, arrhythmia exacerbation, angina, anxiety, headache, tremor, palpitations, dizzinessDosagesAdult: 0.25mg SQ every 20 minutes for up to 3 dosesPedi:  0.005 to 0.01 mg/kg SQ every 20 mins for up to 3 doses

Trade – ZofranClass – Antiemetic MOA – Binds and blocks a receptor for the brain chemical serotonin Indication – Prevention and treatment of nausea and vomitingContraindication – Use caution in hypokalemia, hypomagnesemia, cardiac arrhythmias Side Effects – headache, fatigue, diarrhea, dizziness, hypotension/HTN, Prolonged PR and QT intervals, Widened QRS, Bradycardia, tachycardia, syncope. DosageAdult: 4– 8mg IV, IO, POPedi: (2-16 years) 0.15 mg/kg IV,IO ( max dose 16mg)

Trade – Solu MedrolClass – CorticosteroidMOA – Reduces inflammation by multiple mechanismsIndications – Anaphylaxis, Asthma, COPDContraindications – Cushing Syndrome, Fungal infection, HTN, seizures, CHF, Penetrating spinal cord injuries, Renal diseaseSide effects – depression, euphoria, headache, restlessness, HTN, Bradycardia, nausea/vomiting, swelling, diarrhea, weakness, fluid retention, paresthesiaDosage:Asthma and COPDAdult: 40-80mg/day IV Pedi: 1mg/kg (up to 60) IV/IO per dayAnaphylactic ShockAdult: 0.5 – 1mg/kg IV Pedi: SAA