Pharmacology
Activated Charcoal (actidose with sorbitol)
Action-Adsorbs toxic substances in the digestive tract.
Indicacations- Most oral poisonings overdose
Contraindications- Decreased level of consciousness; overdose of corrosives, caustics, or petroleum substances
Routes-PO
Side Effects- Nausea, vomiting, constipation, black stools
Interactions-Bonds with and inactive most medications/ substances in the digestive tract
Adult Dose- 1-2g/kg
Administration Concerns-stains (protect patient and provider clothing); do not give when giving other PO medication.
Aspirin (Bayer)
Action-Anti-inflammatory agent and anti-fever agent; prevents platelets from clumping, thereby decreasing formation of new clots.
Indications- Relief of mild pain, headache, muscle aches; chest pain of cardiac origin.
Contraindications-Hypersentivity, recent bleeding
Routes- PO
Side effects- Nausea, vomiting, stomach pain,bleeding, allergic reactions
Adult Dose- 160 to 325mg; t60- 325mg chewable tablets for chest pain
Administration Concerns- Do not administer for pain caused by trauma or fevers in children; patients with chest pain must be able to chew tablets.
Common fast-acting MDI medications (albuterol[Proventil], Ventolin
Action- Stimulates nervous system, causing brochodilation
Indications- Asthma/ difficulty breathing with wheezing
Contraindications- Hypersensivity; tachycardia(relative) chest pain of cardiac origin.
Sifde effects- Hypertension, tachycardia, anxiety, restlessness
Routes- Inhalation
Interactions- Increases effects of other nervous system stimulants.
Adult Dose- 1-2 inhalations; wait 5 mins. before repeating dose
Administration Concerns- patient must inhale all medication in one breath; coach patient to hold breath for 5 seconds after inhalation.
Epinephrine (EpiPen)
Action-Stimulates nervous system, causing brochodilation
Indications- Anaphylactic reaction
Contraindications- chest pain of cardiac origin; hypothermia; hypertension
Routes- IM
Side Effects- Hypertension, tachycardia, anxiety, restlessness
Interactions- increases effects of other nervous system stimulants.
Adult dose- 0.3 mg for Adult; 0.15 mg for children
Administration concerns- Medication will last approximately 5mins; do not repeat dose; ensure ALS is en route for continuing treatment.
Naloxone (Narcan, EVZIO autoinjector)
Action- Reverses respiratory depression secondary to opioid overdose.
Indications- Opioid posoning
Contraindications-Hypersensitivity
Routes- IM,IN
Side Effects- Nausea, vomiting
Interactions- Additional doses may be required for severe opioid overdoses
Adult Dose- 0.4 mg auto-injector; 2 mg IN
Administration Concerns- patients may wake up combative
Nitroglycerin (Nitrostat, Nitromist)
Action- Dilates blood vessels
Indications- Chest pain of cardiac origin
Contraindications- Hypotension; use of sildenafil (Viagra) or another treatment for erectile dysfunction within the previous 24hrs; head injury
Routes- Sl tablet or spray
Side Effects- Headache, burning under tongue, hypotension, nausea
Interactions- Increases dilating effects of other blood vessel-dilating medications
Adult Dose- 0.3 to 0.4 mg SL; ).4 mg spray
Administration Concerns- Ensure ALS is en route
Oral glucose (Glutose)
Action- When absorbed, provides glucose for cell use.
Indications- Low blood glucose (hypoglycemia)
Contraindications- Decreased level of consciousness; nausea; vomiting
Routes- PO
Side Effects- Nausea, vomiting
Adult Dose- None
Administration Concerns- Patient must be awake, have control of airway, and be able to follow commands
Oxygen (no trade name)
Action- Reverses hypoxia; provides oxygen to be absorbed by lungs
Indications- Hypoxia or suspected hypoxia
Contraindications-Very rarely used in patients with COPD; do not use near open flames, as oxygen will support comustion
Routes- Inhalation
Side Effects-Decreased respiratory effort in rare cases in patients with COPD
Interactions- Can support combstion
Adult Dose- use oxygen delivery devices to administer 28 % to 100% oxygen
Administration Concerns- No open flames nearby; do not withhold oxygen from patients in respiratory distress
Acetaminophen (Tylenol)
Action- Analgesic and fever reducer
Indications- Relief of mild pain or fever, headache, muscke aches
Contraindications- Hypersentivity
Routes- PO
Side effects- allergic reaction
Interaction- Take caution to avoid potential overdosing. Many OTC medications contain Acetaminophen
Adult Dose- 500 to 1,000 mg every 4 hours as needed; dose is weiht-based for children
Administration Concerns- Weight of child more important than age
Diphenhydramine (Benadryl)
Antihistamine (blocks histamine)
Mild Allergic reactiosn
Asthma; glaucoma; pregnancy; hypertension; infants
PO
Sleepiness(although can stimulate children), dry mouth and theoat.
Do not take with alcohol or MAO inhibitors (a type of psychiatric medication
25 to 50 mg
Can use in severe allergic reaction; however epinephrine is administered first
Ibuprofen
Nonsteroidal antiflammatory drug that reduces inflammation and fever; analgesic
Mild pain or fever, headache, muscle aches
Hypersensitivity
PO
Nausea, vomiting, stomach pain, bleeding, allergic reactions
Do not take with aspirin
200 to 400 mg every 4 to 6 hours; dose is weight-based in children
Do not takw for pain caused by trauma, weight of child is more important than age
The six rights of medications
Right patient
Right medication
Right Dose
Right route
Right Time
Right Documentation