emergency drugs .pptx
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emergency medicine contain all type of emergency drugs which mainly used in emergency condition.
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emergency drugs .pptx
- 1. EMERGENCY DRUGS PRESENTED BY – HARSHIKA S. TEMBHURNE MSC 1ST YEAR , SCON , PUNE .
- 2. Introduction • • Emergency medicine is the medical specialty dedicated to the diagnosis and treatment of unforeseen illness or injury. • Emergency drugs are those chemical entities used in patients during life threatening conditions so that the symptoms can be controlled and life can be saved.
- 3. Purpose of Emergency Drugs • • To provide initial treatment for broad spectrum of illness • and injuries, most of which may be life threatening. • • To control the symptoms of patient. • • To save the life of the Patient. • • To reach the Site of action a soon as possible • • To normalize the vital body function. • • To diverge the patient the from the possible risk.
- 4. Drug Dosage Calculations • Desired dose − Quantity of a medication that is to be administered • Concentration − Amount of medication that is present in vial • Volume − Amount of fluid medication is dissolved in • Yield − The amount of drug in 1 mL
- 5. Activated Charcoal (EZ-Char, Actidose, Liqui-Char) • Mechanism of action − Absorbs toxic substances from the gastrointestinal tract • Indications − Most oral poisonings/ medication overdoses • Contraindications − Oral administration to comatose patients • Adverse reactions − If aspirated, can induce fatal form of pneumonitis − Bowel obstruction • Considerations − Mix contents well before administration. − Does not absorb cyanide, lithium, iron, lead, or arsenic
- 6. Adenosine (Adenocard) • Mechanism of action − Slows conduction through the AV node − Can interrupt reentrant pathways − The drug of choice for reentry SVT • Indications − Most forms of stable narrow-complex SVT • Contraindications − Bronchoconstrictive or bronchospastic lung disease • Adverse reactions − Generally short duration and mild • Considerations − Evaluate elderly for signs of dehydration
- 7. Albuterol (Proventil, Ventolin) • Mechanism of action − Results in smooth- muscle relaxation in the bronchial tree • Indications − Treatment of bronchospasm in patients with COPD/asthma) • Contraindications − Hypersensitivity reactions to albuterol • Adverse reactions − Often dose-related and include headache, fatigue, lightheadedness, irritability, restlessness • Considerations − Pregnancy safety: Category C − May precipitate angina pectoris and dysrhythmias
- 8. Aspirin (ASA, Bayer, Ecotrin, St. Joseph, and Others) • Mechanism of action − Prevents platelets from clumping together and forming emboli • Indications − New onset chest pain suggestive of acute myocardial infarction • Contraindications − Relatively contraindicated in patients with active ulcer disease or asthma • Adverse reactions − Bronchospasm, anaphylaxis, wheezing in allergic patients, prolonged bleeding • Considerations − Pregnancy safety: Category D − Not recommended in pediatric population
- 9. Atropine Sulfate • Mechanism of action − Increases heart rate in life-threatening bradydysrhythmias • Indications − Hemodynamically unstable bradycardia • Contraindications − Tachycardia, hypersensitivity • Adverse reactions − Drowsiness, confusion, headache, tachycardia, palpitations • Considerations − Pregnancy safety: Category C − Moderate doses may cause pupillary dilation.
- 10. Bumetanide (Bumex) • Mechanism of action − Inhibits the reabsorption of sodium and chloride in the ascending limb of the loop of Henle • Indications − Pulmonary edema, congestive heart failure • Contraindications − Hypersensitivity to bumetanide or sulfonamides • Adverse reactions − Dizziness, headache, orthostatic hypotension • Considerations − Pregnancy safety: Category C
- 11. Calcium Gluconate • Mechanism of action − Counteracts the toxicity of hyperkalemia • Indications − Hyperkalemia, hypocalcemia • Contraindications − Ventricular fibrillation, digitalis toxicity, hypercalcemia • Adverse reactions − Syncope, cardiac arrest, dysrhythmia, bradycardia • Considerations − Pregnancy safety: Category C − Do not administer by IM or SQ
- 12. Dexamethasone Sodium Phosphate (Decadron) • Mechanism of action − Suppresses acute and chronic inflammation • Indications − Anaphylaxis, asthma, spinal cord injury • Contraindications − Hypersensitivity, use caution in suspected systemic sepsis • Adverse reactions − Headache, restlessness, euphoria, psychoses • Considerations − Pregnancy safety: Category C − Protect medication from heat. Toxicity and side effects occur with long-term use.
- 13. Dextrose • Mechanism of action − Rapidly increases serum glucose levels • Indications − Hypoglycemia, altered level of consciousness • Contraindications − Intracranial hemorrhage • Adverse reactions − Cerebral hemorrhage − Cerebral ischemia − Pulmonary edema • Considerations − Pregnancy safety: Category C
- 14. Diazepam (Valium and Others) • Mechanism of action − Raises the seizure threshold; induces amnesia and sedation • Indications − Acute anxiety states and agitation, acute alcohol withdrawal • Contraindications − Hypersensitivity, narrow-angle glaucoma • Adverse reactions − Dizziness, drowsiness, confusion, headache • Considerations − Pregnancy safety: Category D − Short duration for anticonvulsant effect − Reduce dose by 50% in elderly patients.
- 15. Digoxin (Lanoxin) • Mechanism of action − Increases force of myocardial contraction • Indications − Congestive heart failure, reentry SVTs, ventricular rate control in atrial flutter and atrial fibrillation • Contraindications − Ventricular fibrillation, ventricular tachycardia, digitalis toxicity • Adverse reactions − Fatigue, headache, blurred yellow or green vision, seizures • Considerations − Pregnancy safety: Category C − Patient receiving IV digoxin must be on a monitor
- 16. Diphenhydramine (Benadryl) • Mechanism of action − Blocks cellular histamine receptors • Indications − Symptomatic relief of allergies, allergic reactions, and anaphylaxis • Contraindications − Asthma, glaucoma, pregnancy, hypertension • Adverse reactions − Drowsiness, sedation, seizures • Considerations − Pregnancy safety: Category B − Not used in infants
- 17. Dobutamine Hydrochloride (Dobutrex) • Mechanism of action − Increased myocardial contractility, stroke volume, and increased cardiac output • Indications − Cardiogenic shock, CHF • Contraindications − Tachydysrhythmias, severe hypotension • Adverse reactions − Headache, dyspnea, tachycardia, hypertension, chest pain • Considerations − Pregnancy safety: Category B − Monitor blood pressure closely.
- 18. Dopamine Hydrochloride (Intropin) • Mechanism of action − Increases myocardial contractility and stroke volume • Indications − Cardiogenic and septic shock, hypotension with low cardiac output states • Contraindications − Hypovolemic shock, pheochromocytoma, tachydysrhythmias • Adverse reactions − Headache, anxiety, dyspnea, dysrhythmias • Considerations − Pregnancy safety: Category C − Effects are dose- dependent
- 19. Epinephrine (Adrenalin) • Mechanism of action − Blocks histamine receptors • Indications − Cardiac arrest, symptomatic bradycardia • Contraindications − Hypertension, hypothermia, pulmonary edema • Adverse reactions − Nervousness, restlessness, headache, tremor • Considerations − Pregnancy safety: Category C − May cause syncope in asthmatic children
- 20. Epinephrine Racemic (Micronefrin) • Mechanism of action − Reduces airway resistance • Indications − Bronchial asthma, prevention of bronchospasm, croup • Contraindications − Hypertension, underlying cardiovascular disease, epiglottitis • Adverse reactions − Headache, anxiety, fear, nervousness, respiratory weakness • Considerations − May cause tachycardia and other dysrhythmias − Monitor vital signs.
- 21. Fosphenytoin (Cerebyx) • Mechanism of action − Elevates the excitability threshold of the cell, reducing its response to stimuli • Indications − Status epilepticus, seizure disorder • Contraindications − Bradycardia, Adams- Stokes syndrome, second- or third- degree AV blocks • Adverse reactions − Severe hypotension, bradycardia, dysrhythmias • Considerations − Pregnancy safety: Category D − Use with caution in patients with hepatic and renal impairment and diabetic, elderly, and debilitated patients.
- 22. Furosemide (Lasix) • Mechanism of action − Causes increased urine output • Indications − CHF, pulmonary edema, hypertensive crisis • Contraindications − Hypovolemia, anuria, hypotension • Adverse reactions − Dizziness, headache, ECG changes, weakness • Considerations − Pregnancy safety: Category C − Ototoxicity, deafness, and projectile vomiting can occur with rapid administration.
- 23. Heparin Sodium • Mechanism of action − Affects clotting factors IX, XI, XII, plasmin; does not lyse existing clots • Indications − Acute myocardial infarction, prophylaxis and treatment of thromboembolic disorders • Contraindications − Hypersensitivity, active bleeding • Adverse reactions − Pain, anaphylaxis, shock, hematuria • Considerations − Pregnancy safety: Category C − Heparin does not lyse existing clots.
- 24. Hydrocortisone Sodium Succinate (Solu-Cortef) • Mechanism of action − Anti-inflammatory; immunosuppressive with salt-retaining actions • Indications − Shock due to acute adrenocortical insufficiency, anaphylaxis, asthma, and COPD • Contraindications − Systemic fungal infections, premature infants • Adverse reactions − Headache, vertigo, pulmonary tuberculosis • Considerations − Pregnancy safety: Category C − May be used in status asthmaticus as a second-line drug
- 25. Lidocaine Hydrochloride (Xylocaine) • Mechanism of action − Decreases automaticity • Indications − Alternative to amiodarone in cardiac arrest from ventricular tachycardia • Contraindications − Hypersensitivity, second- or third- degree AV block in the absence of an artificial pacemaker • Adverse reactions − Anxiety, drowsiness, confusion, seizures • Considerations − Apnea induced with succinylcholine may be prolonged with high doses of lidocaine. − Exceedingly high doses can result in coma or death.
- 26. Lorazepam (Ativan) • Mechanism of action − Anxiolytic, anticonvulsant, and sedative effect • Indications − Initial control of status epilepticus or severe recurrent seizures • Contraindications − Acute narrow-angle glaucoma, coma, shock • Adverse reactions − Dizziness, drowsiness, CNS depression, headache • Considerations − Pregnancy safety: Category D − Monitor respiratory rate and blood pressure during administration.
- 27. Mannitol (Osmitrol) • Mechanism of action − Decreases cerebral edema and intracranial pressure • Indications − Cerebral edema • Contraindications − Hypotension, pulmonary edema, severe dehydration, intracranial bleeding, CHF • Adverse reactions − Headache, confusion, seizures, pulmonary edema • Considerations − Pregnancy safety: Category C − May crystallize at low temperatures; store at room temperature − Have ventilatory support available.
- 28. Methylprednisolone Sodium Succinate (Solu-Medrol) • Mechanism of action − Suppresses acute and chronic inflammation • Indications − Acute spinal cord trauma, anaphylaxis, bronchodilator for unresponsive asthma • Contraindications − Premature infants, systemic fungal infections • Adverse reactions − Depression, euphoria, headache, restlessness, seizure • Considerations − Pregnancy safety: Category C − Not effective if time of spinal cord injury greater than 8 hours
- 29. Midazolam Hydrochloride (Versed) • Mechanism of action − Causes sedative, anxiolytic, amnesic, and hypnotic effects • Indications − Sedation for medical procedures • Contraindications − Acute narrow-angle glaucoma, shock, coma, alcohol intoxication • Adverse reactions − Headache, somnolence, respiratory depression • Considerations − Pregnancy safety: Category D − Administer immediately prior to intubation procedure.
- 30. Naloxone Hydrochloride (Narcan) • Mechanism of action − Reverses respiratory depression secondary to opiate drugs • Indications − Opiate overdose, complete or partial reversal of central nervous system and respiratory depression induced by opioids • Contraindications − Use with caution in narcotic-dependent patients • Adverse reactions − Restlessness, seizures, dyspnea, pulmonary • Considerations − Pregnancy safety: Category C
- 31. Nitroglycerin (Nitrostat, Nitro-Bid, Tridil) • Mechanism of action − Smooth muscle relaxant acting on vasculature, bronchial, uterine, intestinal smooth muscle • Indications − Acute angina pectoris, ischemic chest pain • Contraindications − Hypotension, hypovolemia, intracranial bleeding or head injury • Adverse reactions − Headache, dizziness, weakness, reflex tachycardia • Considerations − Pregnancy safety: Category C − Hypotension more common in the elderly
- 32. Phenytoin (Dilantin) • Mechanism of action − Promotes sodium efflux from neurons • Indications − Prophylaxis and treatment of major motor seizures • Contraindications − Hypersensitivity, bradycardia • Adverse reactions − Ataxia, agitation, dizziness, headache, drowsiness • Considerations − Pregnancy safety: Category D − Carefully monitor vital signs.
- 33. Propofol (Diprivan) • Mechanism of action − Produces rapid and brief state of general anesthesia • Indications − Anesthesia induction/ maintenance, sedation for mechanically ventilated patients • Contraindications − Hypovolemia, known sensitivity • Adverse reactions − Seizure, apnea, dysrhythmias, asystole, hypotension, hypertension • Considerations − Pregnancy safety: Category B − Avoid rapid administration in elderly patients to avoid hypotension and airway obstruction.
- 34. Sodium Bicarbonate • Mechanism of action − Buffers metabolic acidosis and lactic acid buildup • Indications − Metabolic acidosis during cardiac arrest, tricyclic antidepressant, aspirin • Contraindications − Metabolic/respiratory alkalosis, hypokalemia, electrolyte imbalance • Adverse reactions − Hypernatremia, metabolic alkalosis, tissue sloughing, cellulitis • Considerations − Pregnancy safety: Category C − Repeat as needed in tricyclic antidepressant overdose until QRS narrows
- 35. Sodium Nitrate • Mechanism of action − Reacts with hemoglobin to form methemoglobin, which reacts with cyanide • Indications − Cyanide poisoning • Contraindications − None in the emergency setting • Adverse reactions − Hypotension, tachycardia, fainting, nausea, vomiting • Considerations − Pregnancy safety: Category C − Potent vasodilator causes significant hypotension if given too rapidly
- 36. Summary • Paramedics are required to know the names, class, mechanism of action, adverse reactions and side effects, interactions, indications, contraindications, complications, routes of administration, dose, and specific administration considerations for many emergency medications and intravenous fluids. • Individual states have the authority to include additional medications, which may be taught by your local training agency.
- 37. CONCLUSION • I conclude that because of paramedics must make quick decisions about when to administer medications, what medications to administer, and when administering certain medications would be harmful to the patient, it is critically important they develop a solid understanding of the information in this chapter and stay up to date on the latest pharmacologic information.
- 38. BIBLIOGRAPHY