1. EMT Drugs

• Albuterol Class

  Beta 2 agonist - stimulates sympathetic nervous system receptors
• Albuterol MOA

  - Bronchial smooth-muscle relaxation

  - Peripheral arterial vasodilation in coronary, cerebral, & skeletal muscle circulation
• Albuterol Indications


  Tx of bronchospasm in pt w/ reversible obstructive airway disease (asthma/COPD)
• Albuterol Contraindications


  - Known sensitivity

  - Decreased mental status (unable to use SVN/MDI)
• Albuterol Dose

  SVN: 2.5mg in 3cc NS w/ O2 at 6-10lpm

  
  

  MDI: one puff
• Albuterol SE

  - Anxiety

  - Tremors

  - Tachycardia
• Aspirin (ASA) Class


  Platelet aggregation inhibitor; NSAID
• Aspirin MOA


  - Anti-platelet

  - Analgesia

  - Antipyretic
• Aspirin Indications

  - Chest pain/discomfort suggestive of Acute Coronary Syndrome (ACS)

  - Tx of minor arthritic pain

  - Tx of fever
• Aspirin Contraindications

  - Known sensitivity

  - Active GI bleed

  - Unable to control airway or chew/swallow
• Aspirin Dose


  160-325mg
• Aspirin Route


  PO, chew
• Aspirin SE

  - gastric irritation - N/V, heartburn

  - unpleasant taste

  - GI bleeding
• Naloxone HCl Class

  Opioid antagonist, antidote
• Naloxone HCl MOA

  - Competitive inhibitor at narcotic/opioid receptor

  - Reversal of CNS receptor respiratory depression caused by opioid drugs
• Naloxone HCl Indications

  - Known/suspected opioid OD causing respiratory depression requiring BVM

  - Coma of unknown origin
• Naloxone HCl Contraindications

  Known sensitivity
• Naloxone HCl Adult Dose

  - 0.4 - 2mg IM/IV/IO q5 min, max 10mg

  
  

  - 2mg IN: split dose (0.5mL) b/w nares

  Max dose per nare 1mg

  
  

  Max dose: 2mg per administration
• Naloxone HCl Ped Dose

  - 0.1mg/kg IM/IV/IO q2 min PRN, max 2mg

  
  

  IN: split dose (0.5mL) b/w nares

  Max dose per nare: 0.5mg

  
  

  Max 2mg per admin
• Naloxone HCl SE


  - Possibility of acute opioid withdrawal resulting in agitated pt

  - N/V

  - Return of respiratory depression, requiring redosing
• Nitroglycerin Class

  Nitrate, vasodilator
• Nitroglycerin MOA

  - Organic nitrate that relaxes smooth muscle of vasculature

  > Vasodilation primarily venous -> decreases preload/afterload -> decreases workload on the heart
• Nitroglycerin Indications

  - Chest pain/discomfort due to cardiac ischemia - angina pectoris
• Nitroglycerin Contraindications

  - Known sensitivity

  - SBP <90 mmHg, severe hypotension or uncorrected hypovolemia

  - Right ventricular myocardial infarction (req. 12-lead)

  - ED med use w/in 24-48 hrs

  - Unable to control airway (pill form)
• Nitroglycerin Dose

  0.4mg SL, repeat q3-5 min

  Max 3 doses
• Nitroglycerin SE

  - Hypotension

  - HA, lightheadedness
• Oral Glucose Class

  Carbohydrate, hyperglycemic
• Oral Glucose MOA

  Absorbed in GI tract and distributed to circulation to provide elevated circulating blood glucose levels
• Oral Glucose Indications


  - Signs of hypoglycemia BGL <70 mg/dL and AMS - Able to swallow (Conscious pt w/ intact gag reflex)
• Oral Glucose Contraindications

  - BGL >70 mg/dL

  - Decreased LOC

  - Unable to swallow (questionable gag reflex)
• Oral Glucose Dose

  - oral glucose: 40% - Jelly 31gm per tube delivers 20gm glucose

  
  

  >Adult: 20gm PO

  >Ped: 1gm PO
• Oral Glucose SE


  - bad taste

  - high BGL
• Oxygen Class

  Medical gas, naturally occurring atmospheric gas
• Oxygen MOA


  Facilitates aerobic metabolism & reverses hypoxemia
• Oxygen Indications

  - Confirmed / suspected hypoxemia

  - Ischemic chest pain

  - Respiratory compromise

  - Shock/traumatic injury
• Oxygen Contraindications

  BVM ventilation of newborn
• Oxygen Dose: NC


  1-6lpm
• Oxygen Dose: mask (simple/Venturi)


  1-8lpm
• Oxygen Dose: NRB


  8-15lpm
• Oxygen Dose: BVM


  15 lpm