Medication Formulary - emt.emszone.com

1 Medication Formulary Contents Reference for Medication Listings Activated Charcoal (Liqui-Char). Albuterol (Proventil, Ventolin). Aspirin Epinephrine (Adrenalin). Levalbuterol (Xopenex). Metaproterenol 5% (Alupent). Nitroglycerin (Nitrostat, Tridil, and others). Oral Glucose (Insta-Glucose). Oxygen MARK 1 or NAAK Kit Atropine Sulfate Pralidoxime Chloride (2-PAM Chloride, Protopam). 2 Medication Formulary Title Goes Here and I need Reference for Medication Listings the longest title Name of Medication (Other Common Names). Class How the Medication is categorized as compared to other medications. This is usually done by grouping those medications with similar characteristics, traits, or primary components. Mechanism of action The manner of combination of parts, processes, etc., which form a common function. Indications A circumstance that points to or shows the cause, pathology, treatment, or issue of an attack of disease; that which points out; that which serves as a guide or warning.

2 Contraindications Any condition, especially any condition of disease, which renders some particular line of treatment improper or undesirable. Adverse reactions This is an abnormal or harmful effect to an organism caused by exposure to a chemical. It is indicated by some result such as death, a change in food or water consumption, altered body and organ weights, altered enzyme levels, or visible illness. An effect may be classed as adverse if it causes functional or anatomic damage, causes irreversible change in the homeostasis of the organism, or increases the suscep- tibility of the organism to other chemical or biologic stress. A nonadverse effect will usually be reversed when the organism is no longer being exposed to the chemical. Drug interactions This refers to any potential effects that a Medication may have when administered in conjunction or in the presence of another Medication already in the patient's system, a Medication delivery device, or fluid.

3 How supplied This is how the manufacturer packages the Medication for distribution and sale. Typical methods of packaging are prefilled sy- ringes, vials, or ampules. Dosage and administration This is the typical or average volume of the Medication that is to be administered to the patient and the route of intro- duction of the Medication to the patient. Duration of action Three values are given; (1) Onset: the estimated amount of time it will take for the Medication to enter the body/system and begin to take effect, (2) Peak effect: the estimated amount of time it will take for the Medication to have its greatest effect on the patient/system and (3) Duration: the estimated amount of time that the Medication will have any effect on the patient/system. Special considerations Additional pertinent information concerning a Medication . Activated Charcoal (Liqui-Char). Class Adsorbent. How supplied 25 g (black powder)/125-mL bottle (200 mg/mL); 50 g Mechanism of action Adsorbs toxic substances from the gastrointesti- (black powder)/250-mL bottle (200 mg/mL).

4 Nal tract; onset of action is immediate. Dosage and administration Note: if not in premixed slurry, dilute with Indications Most oral poisonings and Medication overdoses; can be 1 part charcoal/4 parts water. Adult: 1 2 g/kg PO or via NGT. Pediat- used after evacuation of poisons. ric: 1 2 g/kg PO or via NGT. Contraindications Oral administration to comatose patient; after inges- Duration of action Depends on gastrointestinal function; will act until tion of corrosives, caustics, or petroleum distillates (ineffective and may excreted. induce vomiting); simultaneous administration with other oral drugs. Special considerations Often used in conjunction with magnesium ci- Adverse reactions May induce nausea and vomiting; may cause consti- trate. Must be stored in a closed container. Does not adsorb cyanide, pation; may cause black stools. lithium, iron, lead, or arsenic. Drug interactions Bonds with and generally inactivates whatever it is mixed with, eg, syrup of ipecac.

5 Albuterol (Proventil, Ventolin). Class Sympathomimetic, bronchodilator. How supplied Solution for aerosolization: (5 mg/mL). Metered Mechanism of action Elective beta-2 agonist that stimulates adrenergic dose inhaler: 90 g/metered spray (17-g canister with 200 inhala- receptors of the sympathomimetic nervous system resulting in smooth tions). Syrup: 2 mg/5 mL. muscle relaxation in the bronchial tree and peripheral vasculature. Dosage and administration Adult: Administer mg ( mL of Indications Treatment of bronchospasm in patients with reversible solution) added to 2 mL normal saline for inhalation by nebulizer obstructive airway disease (COPD/asthma). Prevention of exercise- treatment and administer over 10 15 minutes. MDI: 1 2 inhalations induced bronchospasm. (90 180 g). Five minutes between inhalations. Pediatric: (between Contraindications Known prior hypersensitivity reactions to albuterol.)

6 The ages of 2 and 12) Administer mg ( mL of solution). Tachycardia arrhythmias, especially those caused by digitalis. Syner- added to 2 mL normal saline for inhalation by nebulizer treatment gistic with other sympathomimetics. and administer over 10 15 minutes. May repeat every 20 minutes, up Adverse reactions Often dose-related and include restlessness, to three times. tremors, dizziness, palpitations, tachycardia, nervousness, peripheral Duration of action Onset in 5 15 minutes with peak effect in 30 min- vasodilatation, nausea, vomiting, hyperglycemia, increased blood utes to 2 hours and duration of 3 4 hours. pressure, and paradoxical bronchospasm. Special considerations Pregnancy safety: Category C. Antagonized Drug interactions Tricyclic antidepressants may potentiate vasculature by beta-blockers (eg, Inderal, Lopressor). May precipitate angina effects. Beta-blockers are antagonistic.

7 May potentiate hypokalemia pectoris and arrhythmias. Should only be administered by inhalation caused by diuretics. methodology in prehospital management. section3 Medication Formulary XX. Aspirin Class Platelet inhibitor, anti-inflammatory agent. Drug interactions Use with caution in patients allergic to NSAIDs. Mechanism of action Prostaglandin inhibition. How supplied 81-mg, 160-mg, or 325-mg tablets (chewable and Indications New onset chest pain suggestive of acute myocardial standard). infarction. Signs and symptoms suggestive of recent cerebrovascular Dosage and administration 160 mg to 325 mg PO (chewed if pos- accident. sible). Contraindications Hypersensitivity. Relatively contraindicated in pa- Duration of action Onset: 30 45 minutes. Peak effect: variable. Dura- tients with active ulcer disease or asthma. tion: variable. Adverse reactions Heartburn, GI bleeding, prolonged bleeding, nau- Special considerations Pregnancy safety: Category D.

8 Not recom- 26 Respiratory Emergencies mended in pediatric population. sea, and vomiting. Wheezing in allergic patients. 27 Cardiovascular Epinephrine (Adrenalin). Emergencies 28. Class Neurologic Emergencies Sympathomimetic. Mechanism of action Direct-acting alpha- and beta-agonist. Alpha: of 1:10,000) IV/IO over 5 minutes. Cardiac arrest: IV/IO dose: 1 mg (10 mL of 1:10,000 solution) every 3 5 minutes during resuscita- 29 Endocrine Emergencies vasoconstriction. Beta-1: positive inotropic, chronotropic, and dromotropic effects. Beta-2: bronchial smooth muscle relaxation and tion. Follow each dose with 20 mL flush and elevate arm for 10 to 20 seconds after dose. Higher dose: Higher doses (up to mg/kg). 30 Cardiac Allergic dilation of skeletal vasculature. Indications Reactions arrest (V-fib/pulseless V-tach, asystole, PEA), may be used for specific indications (beta-blocker or calcium channel blocker overdose).

9 Continuous infusion: Add 1 mg (1 mL of 1:1,000. 31. solution) to 500 mL normal saline or D W. Initial infusion rate of 1. Gastrointestinal Emergencies symptomatic bradycardia as an alternative infusion to dopamine, severe hypotension secondary to bradycardia when atropine and g/min 5. titrated to effect (typical dose: 2 10 g/min). Endotracheal (ET) dose: 2 mg diluted in 10 mL normal saline. Profound 32. transcutaneous pacing are unsuccessful, allergic reactions, anaphy- laxis, Renal and Urologic Emergencies asthma. bradycardia or hypotension: 2 10 g/min; titrate to patient response. Pediatric: Mild allergic reactions and asthma: mg/kg ( mL/. 33 Toxicology: Contraindications Hypertension, hypothermia, pulmonary edema, myocardial ischemia, hypovolemic shock. Substance Abuse kg) and Poisoning of 1:1,000 solution SC (maximum of mL). Cardiac arrest: Adverse reactions Hypertension, tachycardia, arrhythmias, pulmo- IV/IO dose: mg/kg ( mL/kg) of 1:10,000 solution every 3 5.

10 34. nary Hematologic edema, Emergencies anxiety, restlessness, psychomotor headache, angina. agitation, nausea, minutes during arrest. All endotracheal (ET) doses: mg/kg ( mL/kg) of 1:1,000 solution. Symptomatic bradycardia: IV/IO dose: 35 Environmental Drug interactions Emergencies Potentiates other sympathomimetics, deactivated by alkaline solutions (ie, sodium bicarbonate), monamine oxidase mg/kg ( mL/kg) of 1:10,000 solution. Continuous IV/IO. infusion: Begin with rapid infusion, then titrate to response. Typical 36. inhibitors (MAOIs). effects. Infectious may potentiateand Communicable effects, beta-blockers may blunt initial infusion: 1 g/min. Higher doses may be effective. Diseases Duration of action Onset: immediate. Peak effect: minutes. Duration: 37 Behavioral several minutes. How supplied 1:1,000 solution: ampules Emergencies and vials containing 1 mg/. mL. 1:10,000 solution: prefilled syringes containing 1 mg in 10 mL Special considerations Pregnancy safety: Category C.