Respiratory Drugs

You should be somewhat familiar of drugs listed in blue for casual conversation.  (Have an ideal what it is and does)

Text in RED a medic should be gained knowledge.

Drug Name Another Trade or Generic Name Indication

Class

 Single Dose Max Dose

Unique Information
albuterol Proventil Bronchospasm in reversible airway diseases. Sympathomimetic B2 MDI: 1-2 inhalations of  90mcg. Neb: 2.5mg/3mL 3 to 4 doses per day. Minimum 5 minutes between doses.
Salbutamol Ventolin Bronchospasm in reversible airway diseases. Sympathomimetic B2 MDI: 1-2 inhalations 90mcg per spray.  Neb: 2.5mg in 2.5mL saline   Note the different Neb mL compared to 3mL with albuterol.
terbutaline Brethine Bronchospasm in reversible airway diseases. Sympathomimetic 0.25mg SQ Repeat one in 20 minutes Used to induce Pre-term labor
Aminophylline   Brochial Asthma, CHF Pulmonary edema Xanthine bronchodilator 250-500mg on 90ML of D5W over 20-30 minutes   Smooth muscle relaxant with mild diuretic properties.
ipratopium Atrovent Persistent bronchospasm, COPD Anticholinergic MDI: 1-2 inhalations.  Neb: 500mcg   Always use after the beta agonist drug. Dries respiratory tract secretions.
metaproternol Alupent Bronchial asthma, reversible bronchospasm, COPD Sympathomimetic B2 selective MDI: 2-3 inhalations - 2 minutes between inhalations. Neb: 0.2-.03mL in 2-3mL saline. 12 inhalations per day.  
EPI Racemic microNEFRIN Bronchial asthma, croup, laryngeal edema. Sympathomimetic Neb: 0.25-0.75mL in 2 mL saline. Only one dose in pre-hospital setting Used mostly on children.

Intubation/sedative/paralytic Drugs

Drug Name Another Trade or Generic Name Indication

Class

 Single Dose Max Dose

Unique Information
midazolam Versed Premedication for tracheal intubation, cardioversion, or painful procedures Tranquilizer (benzodiazepine) 1-2.5mg slow IV over 2-3 minutes. Elderly: 0.5mg slow IV max 1.5mg/2minutes.    
etomidate Amidate Premedication for tracheal intubation or cardioversion. Sedative/hypnotic Adult: 0.3mg/kg IV over 30-60 seconds.    
succinylcholine Anectine Facilitate intubation. muscle relaxation. Neuromuscluar blocking agent 0.3-1.5mg/kg (25to100mg) IV over 10-30 seconds.   Not used with narrow-angle glaucoma
vecuronium Norcuron Skeletal muscle relaxant. ETT intubation Neuromuscular blocker .08-.01mg/kg Paralysis occurs within 1 min and lasts for 30 minutes.

Pain Medication

Drug Name Another Trade or Generic Name Indication

Class

 Single Dose Max Dose

Unique Information
Demoral meperidine CNS depressant.  Moderate to severe pain Narcotic 50 mg IM or 25-50mg IV   Pt. gets a natural high.
nalbuphine Nubain CNS depressant - moderate to severe pain Synthetic analgesic 5-10 mg IV, IM   Narcan will reveres.
nitrous oxide Nitronox CNS depressant for pain Gas Self administered with 50% O2 and 50% nitrous oxide. laughing gas.

Steroids

Drug Name Another Trade or Generic Name Indication

Class

 Single Dose Max Dose

Unique Information
Dexamethasone Decadron, Hexadrol Decrease cerebral edema, anti-inflammatory, suppress immune response in allergic reactions. Steroid 4-24 mg IV Some doses go up to 100mg. Rare. Onset is 2-6 hours.
methylprednisone Solu-Medrol Anti inflammatory, allergic reactions Steroid 125-250mg IV, IM   Onset 2-6 hours.  Must be reconstituted.
mannitol Osmotrol Decrease cellular edema, Increase urinary output.  Head injuries. Osmotic Diuretic 0.5-1g/kg IV slow. Will crystallize at low temperatures.

Diabetic / Hypoglycemia

Drug Name Another Trade or Generic Name Indication

Class

 Single Dose Max Dose

Unique Information
Glucagon Glucagen Causes breakdown of glycogen to glucose.  Elevate blood glucose levels using stored fats. Calcium channel blocker/Beta blocker toxicity reversal Hormone (antihypoglycemic agent) 0.5-1mg IM Repeat in 7-10 minutes. If you cannot get IV to give Dextrose 50% give Glucagon IM.
Thiamine Vitamin B1 Allows breakdown of glucose Vitamin 100mg IV/IM   Should not be used as part of the coma cocktail.
Insulin Humilin, Novolin, Itetin Causes uptake of glucose by cells. Hormone 10-25 units IV/SQ Dose is based on blood sugar levels. In EMS we never treat a patient with insulin.

Overdose Medications

Drug Name Another Trade or Generic Name Indication

Class

 Single Dose Max Dose

Unique Information
activate charcoal generic only Oral poisoning, medication overdose Absorbent 1g/kg PO. May repeat one if vomiting after first dose. If ipecac is administered wait 10 minutes to administer charcoal.
ipecac generic Irritates the enteric tract Emetic 30mL in 8 oz glass of water   Not used if strong acids, petroleum.
diphenhydramine Benadryl Moderate to severe allergic reactions Antihistamine 25-50mg deep IM or IV ever 6-8 hours.   Pedi dose is 2-5mg/kg
Amyl Nitrite none Removes cyanide poisoning (bitter almond) via complex mechanism Nitrate Crush ampule inhalant hold under nose inhale for 30 seconds. Repeat as needed. Works for about 20 minutes.
sodium nitrite Coverts hemoglobin to methemoglobin for treating cyanide poisoning. Nitrate / cyanide antidote 300mg IV 1/2 original dose every 30 minutes. Hypotension common with rapid administration.

Vaso Dilators / BP MEDS

Drug Name Another Trade or Generic Name Indication

Class

 Single Dose Max Dose

Unique Information
nifedapine Procardia Smooth muscle relaxed, Severe hypertension Calcium channel blocker 10mg sub lingual.  Puncture capsule squirt under tongue then swallow.   Major delay hypotension possible.
nitro paste Nitro-Bid Smooth muscle relaxant Antianginal 0.5 to 1 inch topical paste Works fast use gloves.  Clean off pt not just wipe off.  Monitor BP constantly.  Works fast.

Brain Drugs / Seizure Drugs

Drug Name Another Trade or Generic Name Indication

Class

 Single Dose Max Dose

Unique Information
haloperidol Haldol Blocks dopamine in brain responsible for mood. Major tranquilizer 2-5mg IM   Should not be administered in presence of other sedatives like phenergan.
phenobarbitol Luminal Suppressed spread of seizure activity through brain. Barbituate 100-250mg IV Slow   Can cause tissue necrosis if infiltrated.
phenytoin Dilantin Seizures Anticonvulsant, antidysrthythmic Seizure: 150-250mg. Digitalis toxicity: 100mg over 5 minutes.   Can help cardiac rhythms due to digitalis toxicity.  Tachycardias.

Blood Thinners / Clot Busters

Drug Name Another Trade or Generic Name Indication

Class

 Single Dose Max Dose

Unique Information
tissue plasminogen activator tPA, Activase

Dissolves blood clots

 Fibrinolytic Front load 15mg IV over 1-2 minutes.  Then 50mg over first hour and 35mg over the second hour.  Total dose of 100mg Only one FDA approved for brain.
retaplase Retavase AMI, Dissolves blood clots Fibrinolytic 10 units IV over 2 minutes.  Repeat in 30 minutes (until 20 units give)    
streptokinase Strepase Dissolves blood clots Fibrinolytic 1.5 million units over 1 hour   Ineffective to give again within 12 months of first exposure.
antistreplase Eminase Dissolves blood clots Fibrinolytic 30 units slow IV over 2-5 minutes    
Enoxaparin Lovenox Effective anticoagulant Anticoagulation 0.5-1mg/kg SQ will see in ICU rotations.   Used to prevent clots after certain procedures or to prevent deep vein thrombosis. Or possible MI in conjunction with ASA.
Heparin warfarin Inhibits thrombin complex. (clotting) Anticoagulant 5000 units followed by maintenance.  IV    

Other

Drug Name Another Trade or Generic Name Indication

Class

 Single Dose Max Dose

Unique Information
Zofran ondansetron Chemotherapy nausea, pre/post op nausea Antiemetic  selective antagonist of the serotonin receptor 4-8mg IV 30mg for some chemo pts. Works fast and acts as a sedative also.
oxytocin Pitocin Uterine contraction Hormone 10-20 units in 500mL  

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