Drug Cards: Prehospital Medications
Student study notes from paramedic coursework (2023 to 2024), not medical advice. Verify clinical values against current references and your local protocols.
Doses are general reference values recorded during paramedic training. They are not protocol: follow your local protocols and current drug references. New Jersey EMS doses and approved medications may differ.
EMS drug cards
Common medications in a prehospital context.
Bibliography
- Tucker, R. (2024). Lippincott Pocket Drug Guide for Nurses (Twelfth, North American Edition). Lippincott.
- Epocrates. (n.d.). Retrieved from https://www.epocrates.com/online/
Acetylsalicylic Acid
Generic Name:
Acetylsalicylic Acid
Trade Names:
Aspirin, Bayer, Ecotrin
Actions:
Aspirin is an antiplatelet agent and anti-inflammatory drug. It irreversibly inhibits cyclooxygenase (COX-1 and COX-2) enzymes, leading to decreased formation of prostaglandins and thromboxanes, which reduces inflammation, pain, and fever, and inhibits platelet aggregation.
Indications:
Acute coronary syndrome (ACS)
Secondary prevention of cardiovascular events
Contraindications:
Hypersensitivity to aspirin or other NSAIDs
Active peptic ulcer disease or gastrointestinal bleeding
Severe renal or hepatic impairment
Children and teenagers with viral infections (due to risk of Reye’s syndrome)
Dosage Range:
Cardiovascular: 81-325 mg once daily.
Routes of Administration:
Oral (tablets, chewable tablets)
Rectal (suppositories)
Adverse Reactions:
Gastrointestinal disturbances (nausea, dyspepsia, bleeding)
Increased risk of bleeding
Hypersensitivity reactions (asthma, anaphylaxis)
Reye’s syndrome in children with viral infections
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Activated Charcoal
Generic Name:
Activated Charcoal
Trade Names:
Actidose, CharcoalAid
Actions:
Activated charcoal is an adsorbent that binds to toxins in the gastrointestinal tract, preventing their absorption into the bloodstream.
Indications:
Treatment of acute oral poisoning or overdose of certain substances
Contraindications:
Unprotected airway (risk of aspiration)
Ingestion of corrosive agents, hydrocarbons, or heavy metals (ineffective and potentially harmful)
Gastrointestinal obstruction
Dosage Range:
Adults and Children: 25-100 grams as a single dose (typically 1 gram/kg).
Routes of Administration:
Oral (suspension)
Nasogastric tube (NG tube)
Adverse Reactions:
Gastrointestinal disturbances (nausea, vomiting, constipation)
Aspiration pneumonitis
Black stools
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Adenosine
Generic Name:
Adenosine
Trade Names:
Adenocard, Adenoscan
Actions:
Adenosine is an antiarrhythmic agent that slows conduction time through the AV node, restoring normal sinus rhythm in patients with paroxysmal supraventricular tachycardia (PSVT).
Indications:
Conversion of PSVT to sinus rhythm, including that associated with accessory bypass tracts (Wolff-Parkinson-White syndrome)
Contraindications:
Second- or third-degree AV block (except in patients with a functioning artificial pacemaker)
Sick sinus syndrome (except in patients with a functioning artificial pacemaker)
Hypersensitivity to adenosine
Dosage Range:
Adults: Initial dose: 6 mg rapid IV bolus. If not effective within 1-2 minutes, 12 mg rapid IV bolus. May repeat 12 mg dose if necessary.
Children: Initial dose: 0.05-0.1 mg/kg rapid IV bolus. May increase by 0.05-0.1 mg/kg every 1-2 minutes as needed. Maximum single dose: 0.3 mg/kg or 12 mg.
Routes of Administration:
Intravenous (IV)
Adverse Reactions:
Transient arrhythmias
Flushing
Dyspnea
Chest discomfort
Hypotension
Dizziness
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Albuterol
Generic Name:
Albuterol
Trade Names:
Ventolin, Proventil, ProAir
Actions:
Albuterol is a beta2-adrenergic agonist that relaxes bronchial smooth muscle by stimulating beta2 receptors, resulting in bronchodilation.
Indications:
Treatment or prevention of bronchospasm in patients with reversible obstructive airway disease (asthma, chronic obstructive pulmonary disease - COPD)
Prevention of exercise-induced bronchospasm
Contraindications:
Hypersensitivity to albuterol or any component of the formulation
Dosage Range:
Adults and Children (older than 4 yrs): 2.5 mg via nebulizer every 6-8 hours as needed. Inhalation (MDI): 1-2 puffs (90-180 mcg) every 4-6 hours as needed.
Children (<4 years): Dose individualized based on age and weight.
Routes of Administration:
Inhalation (MDI, nebulizer)
Oral (tablets, syrup)
Adverse Reactions:
Tremor
Nervousness
Tachycardia
Palpitations
Hypokalemia
Nausea
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Aminophylline
Generic Name:
Aminophylline
Trade Names:
Aminophylline
Actions:
Aminophylline is a bronchodilator that relaxes smooth muscles of the bronchial airways by inhibiting phosphodiesterase, leading to increased cyclic AMP levels.
Indications:
Treatment of symptoms and reversible airway obstruction due to asthma or other chronic lung diseases such as emphysema or chronic bronchitis
Contraindications:
Hypersensitivity to theophylline, ethylenediamine, or any component of the formulation
Active peptic ulcer disease
Seizure disorders (uncontrolled)
Dosage Range:
Adults: 380-760 mg/day divided every 6-8 hours (initial IV dose typically 5-6 mg/kg followed by maintenance).
Children: Dose individualized based on age and weight.
Routes of Administration:
Oral (tablets, syrup)
Intravenous (IV)
Adverse Reactions:
Nausea, vomiting
Headache
Insomnia
Tremors
Irritability
Tachycardia, arrhythmias
Seizures (overdose)
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Amiodarone
Generic Name:
Amiodarone
Trade Names:
Cordarone, Pacerone
Actions:
Amiodarone is an antiarrhythmic agent that prolongs phase 3 of the cardiac action potential. It affects sodium, potassium, and calcium channels and has alpha- and beta-adrenergic blocking properties.
Indications:
Treatment and prophylaxis of ventricular fibrillation (VF) and hemodynamically unstable ventricular tachycardia (VT)
Supraventricular arrhythmias, including atrial fibrillation
Contraindications:
Severe sinus-node dysfunction causing marked sinus bradycardia
Second- or third-degree AV block
Cardiogenic shock
Hypersensitivity to amiodarone or iodine
Dosage Range:
Adults: 150 mg IV over 10 minutes, followed by 360 mg IV over the next 6 hours, then 540 mg IV over 18 hours (loading dose). Maintenance: 0.5 mg/min IV infusion or 400-600 mg/day orally.
Children: Dose individualized based on age and weight.
Routes of Administration:
Oral (tablets)
Intravenous (IV)
Adverse Reactions:
Hypotension
Bradycardia
Pulmonary toxicity
Hepatotoxicity
Thyroid dysfunction
Corneal microdeposits
Photosensitivity
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Lorazepam
Generic Name:
Lorazepam
Trade Names:
Ativan
Actions:
Lorazepam is a benzodiazepine that enhances the effect of the neurotransmitter GABA at the GABA-A receptor, leading to sedative, anxiolytic, anticonvulsant, and muscle relaxant properties.
Indications:
Anxiety disorders
Preoperative sedation
Status epilepticus
Contraindications:
Hypersensitivity to lorazepam or other benzodiazepines
Acute narrow-angle glaucoma
Severe respiratory insufficiency
Myasthenia gravis
Dosage Range:
Anxiety: 2-6 mg/day in divided doses.
Preoperative sedation: 0.05 mg/kg IM (usual range 2-4 mg).
Status epilepticus: 4 mg IV slow push. May repeat after 10-15 minutes if needed.
Routes of Administration:
Oral (tablets, solution)
Intramuscular (IM)
Intravenous (IV)
Adverse Reactions:
Sedation
Dizziness
Weakness
Unsteadiness
Respiratory depression
Paradoxical reactions (agitation, aggression)
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Atropine Sulfate
Generic Name:
Atropine Sulfate
Trade Names:
Atropine
Actions:
Atropine is an anticholinergic agent that inhibits the action of acetylcholine on muscarinic receptors, increasing heart rate and reducing secretions.
Indications:
Bradycardia (hemodynamically significant)
Organophosphate poisoning
Preoperative reduction of secretions
Contraindications:
Hypersensitivity to atropine or any component of the formulation
Glaucoma (narrow-angle)
Tachycardia due to cardiac insufficiency or thyrotoxicosis
Dosage Range:
Bradycardia: 0.5-1 mg IV every 3-5 minutes as needed. Maximum: 3 mg.
Organophosphate poisoning: 2-4 mg IV initially, then 2 mg every 5-10 minutes as needed.
Routes of Administration:
Intravenous (IV)
Intramuscular (IM)
Subcutaneous (Sub-Q)
Adverse Reactions:
Dry mouth
Blurred vision
Photophobia
Tachycardia
Urinary retention
Confusion
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Generic Name:
Bumetanide
Trade Names:
Bumex
Actions:
Bumetanide is a loop diuretic that inhibits the reabsorption of sodium and chloride in the ascending loop of Henle, leading to increased urine output.
Indications:
Edema associated with heart failure, liver cirrhosis, and renal disease
Contraindications:
Hypersensitivity to bumetanide or sulfonamides
Anuria
Severe electrolyte depletion
Dosage Range:
Adults: 0.5-2 mg orally once daily. May repeat every 4-5 hours up to a maximum of 10 mg/day.
Children: Dose individualized based on age and weight.
Routes of Administration:
Oral (tablets)
Intravenous (IV)
Intramuscular (IM)
Adverse Reactions:
Hypokalemia
Hyponatremia
Dehydration
Hypotension
Ototoxicity
Hyperuricemia
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Calcium Chloride
Generic Name:
Calcium Chloride
Trade Names:
Calcium Chloride
Actions:
Calcium chloride provides elemental calcium, which is necessary for the maintenance of the functional integrity of the nervous, muscular, and skeletal systems and cell membrane and capillary permeability.
Indications:
Hypocalcemia
Hyperkalemia
Hypermagnesemia
Calcium channel blocker overdose
Contraindications:
Hypercalcemia
Ventricular fibrillation
Digitalis toxicity
Dosage Range:
Adults: 500-1,000 mg IV over 5-10 minutes. May repeat as necessary.
Children: 20 mg/kg IV over 5-10 minutes. Maximum single dose: 1,000 mg.
Routes of Administration:
Intravenous (IV)
Adverse Reactions:
Hypercalcemia
Extravasation necrosis
Hypotension
Bradycardia
Nausea, vomiting
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Calcium Gluconate
Generic Name:
Calcium Gluconate
Trade Names:
Calcium Gluconate
Actions:
Calcium gluconate provides elemental calcium, which is necessary for the maintenance of the functional integrity of the nervous, muscular, and skeletal systems and cell membrane and capillary permeability.
Indications:
Hypocalcemia
Hyperkalemia
Hypermagnesemia
Calcium channel blocker overdose
Contraindications:
Hypercalcemia
Ventricular fibrillation
Digitalis toxicity
Dosage Range:
Adults: 1-3 grams IV over 5-10 minutes. May repeat as necessary.
Children: 60-100 mg/kg IV over 5-10 minutes. Maximum single dose: 3,000 mg.
Routes of Administration:
Intravenous (IV)
Adverse Reactions:
Hypercalcemia
Extravasation necrosis
Hypotension
Bradycardia
Nausea, vomiting
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Dexamethasone
Generic Name:
Dexamethasone Sodium Phosphate
Trade Names:
Decadron, DexPak
Actions:
Dexamethasone is a corticosteroid that prevents the release of substances in the body that cause inflammation. It suppresses the immune response and decreases edema and scar tissue formation.
Indications:
Allergic conditions
Asthma
Cerebral edema
Inflammatory conditions
Adrenal insufficiency
Management of acute and chronic inflammatory and autoimmune conditions
Contraindications:
Hypersensitivity to dexamethasone or any component of the formulation
Systemic fungal infections
Dosage Range:
Adults: 0.75-9 mg/day IV or IM in divided doses every 6-12 hours.
Children: 0.08-0.3 mg/kg/day IV or IM in divided doses every 6-12 hours.
Routes of Administration:
Oral (tablets, solution)
Intravenous (IV)
Intramuscular (IM)
Adverse Reactions:
Hyperglycemia
Increased risk of infection
Osteoporosis
Gastrointestinal disturbances
Mood changes
Hypertension
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Dextrose
Generic Name:
Dextrose
Trade Names:
Glucose, D50, D25, D10
Actions:
Dextrose is a simple sugar that provides a rapid increase in blood glucose levels. It is used to treat hypoglycemia and as a source of carbohydrate calories.
Indications:
Hypoglycemia
Nutritional support in patients unable to consume adequate oral intake
Contraindications:
Hyperglycemia
Diabetic coma (if no hypoglycemia is present)
Intra-cranial or intraspinal hemorrhage
Dosage Range:
Adults: 25-50 ml of 50% dextrose solution (D50) IV push.
Children: 0.5-1 g/kg of 25% dextrose solution (D25) IV push.
Infants: 0.2-0.5 g/kg of 10% dextrose solution (D10) IV push.
Routes of Administration:
Intravenous (IV)
Adverse Reactions:
Hyperglycemia
Phlebitis at injection site
Extravasation injury
Hypokalemia
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Diazepam
Generic Name:
Diazepam
Trade Names:
Valium
Actions:
Diazepam is a benzodiazepine that enhances the effect of the neurotransmitter GABA at the GABA-A receptor, leading to sedative, anxiolytic, anticonvulsant, and muscle relaxant properties.
Indications:
Anxiety disorders
Seizures (status epilepticus)
Muscle spasms
Alcohol withdrawal
Contraindications:
Hypersensitivity to diazepam or other benzodiazepines
Acute narrow-angle glaucoma
Severe respiratory insufficiency
Myasthenia gravis
Dosage Range:
Anxiety: 2-10 mg orally 2-4 times daily.
Seizures: 5-10 mg IV initially, may repeat every 10-15 minutes as needed. Maximum: 30 mg.
Muscle spasms: 2-10 mg orally 3-4 times daily.
Alcohol withdrawal: 10 mg orally 3-4 times during the first 24 hours, then 5 mg 3-4 times daily as needed.
Routes of Administration:
Oral (tablets, solution)
Intramuscular (IM)
Intravenous (IV)
Rectal (gel)
Adverse Reactions:
Sedation
Dizziness
Weakness
Unsteadiness
Respiratory depression
Paradoxical reactions (agitation, aggression)
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Diltiazem
Generic Name:
Diltiazem Hydrochloride
Trade Names:
Cardizem
Actions:
Diltiazem is a calcium channel blocker that inhibits the influx of calcium ions during membrane depolarization of cardiac and vascular smooth muscle. It decreases heart rate, myocardial contractility, and causes vasodilation.
Indications:
Hypertension
Angina pectoris
Atrial fibrillation or flutter
Paroxysmal supraventricular tachycardia (PSVT)
Contraindications:
Hypersensitivity to diltiazem
Severe hypotension
Second- or third-degree AV block
Sick sinus syndrome (without a pacemaker)
Acute myocardial infarction and pulmonary congestion
Dosage Range:
Hypertension: 180-360 mg/day orally in divided doses or once daily (extended-release).
Angina: 30-120 mg orally 3-4 times daily or 120-480 mg once daily (extended-release).
Atrial fibrillation/flutter: 0.25 mg/kg IV bolus over 2 minutes, then 5-15 mg/hour IV infusion.
Routes of Administration:
Oral (tablets, extended-release capsules)
Intravenous (IV)
Adverse Reactions:
Bradycardia
Hypotension
Peripheral edema
Dizziness
Headache
Gastrointestinal disturbances
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Diphenhydramine
Generic Name:
Diphenhydramine Hydrochloride
Trade Names:
Benadryl
Actions:
Diphenhydramine is an antihistamine that blocks H1 receptors, reducing the effects of histamine, such as vasodilation, increased vascular permeability, and smooth muscle contraction.
Indications:
Allergic reactions
Anaphylaxis
Insomnia
Motion sickness
Cough suppression
Contraindications:
Hypersensitivity to diphenhydramine or other antihistamines
Newborns or premature infants
Breastfeeding
Dosage Range:
Allergic reactions: 25-50 mg orally every 4-6 hours. Maximum: 300 mg/day.
Insomnia: 50 mg orally at bedtime.
Motion sickness: 25-50 mg orally 30 minutes before exposure, then every 4-6 hours as needed.
Cough: 25 mg orally every 4 hours. Maximum: 150 mg/day.
Routes of Administration:
Oral (tablets, capsules, liquid)
Intramuscular (IM)
Intravenous (IV)
Adverse Reactions:
Drowsiness
Dizziness
Dry mouth
Urinary retention
Constipation
Blurred vision
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Dobutamine
Generic Name:
Dobutamine Hydrochloride
Trade Names:
Dobutrex
Actions:
Dobutamine is a beta1-adrenergic agonist that increases cardiac contractility and stroke volume, leading to increased cardiac output without significantly increasing heart rate.
Indications:
Short-term treatment of cardiac decompensation due to depressed contractility from organic heart disease or cardiac surgery
Contraindications:
Hypersensitivity to dobutamine or any component of the formulation
Idiopathic hypertrophic subaortic stenosis
Dosage Range:
Adults and Children: 2-20 mcg/kg/min IV infusion, titrated to patient response. Maximum: 40 mcg/kg/min.
Routes of Administration:
Intravenous (IV)
Adverse Reactions:
Hypertension
Tachycardia
Arrhythmias
Angina
Hypotension (with excessive doses)
Nausea
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Dopamine
Generic Name:
Dopamine Hydrochloride
Trade Names:
Intropin
Actions:
Dopamine is an adrenergic agonist that stimulates dopaminergic, beta1-, and alpha-adrenergic receptors, leading to increased cardiac output, renal blood flow, and systemic vascular resistance depending on the dose.
Indications:
Treatment of hemodynamic imbalances in shock syndrome due to myocardial infarction, trauma, sepsis, open-heart surgery, and renal failure
Contraindications:
Pheochromocytoma
Uncorrected tachyarrhythmias
Hypersensitivity to dopamine or any component of the formulation
Dosage Range:
Adults and Children: 2-20 mcg/kg/min IV infusion, titrated to patient response. Maximum: 50 mcg/kg/min.
Routes of Administration:
Intravenous (IV)
Adverse Reactions:
Tachycardia
Arrhythmias
Hypertension
Vasoconstriction
Nausea, vomiting
Extravasation injury
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Epinephrine
Generic Name:
Epinephrine
Trade Names:
Adrenalin, EpiPen
Actions:
- Stimulates alpha and beta-adrenergic receptors
- Increases heart rate and cardiac output
- Causes bronchodilation and vasoconstriction
Indications:
- Anaphylaxis
- Severe asthma exacerbations
- Cardiac arrest (asystole, pulseless electrical activity, ventricular fibrillation, pulseless ventricular tachycardia)
Contraindications:
- None in the emergency setting
- Use with caution in patients with cardiovascular disease, hypertension, and hyperthyroidism
Dosage Range:
- Anaphylaxis: 0.3-0.5 mg intramuscular (IM) for adults; 0.01 mg/kg IM for children, max 0.3 mg
- Cardiac arrest: 1 mg intravenous (IV) or intraosseous (IO) every 3-5 minutes
Routes of Administration:
- Intramuscular (IM)
- Intravenous (IV)
- Intraosseous (IO)
- Subcutaneous (SC)
- Endotracheal (ET)
Adverse Reactions:
- Tachycardia
- Hypertension
- Palpitations
- Anxiety
- Tremors
- Headache
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Esmolol
Generic Name:
Esmolol
Trade Names:
Brevibloc
Actions:
Esmolol is a beta1-selective adrenergic blocker that decreases heart rate, myocardial contractility, and cardiac output.
Indications:
Supraventricular tachycardia (SVT)
Intraoperative and postoperative tachycardia and/or hypertension
Noncompensatory sinus tachycardia
Contraindications:
Severe sinus bradycardia
Heart block greater than first degree
Cardiogenic shock
Decompensated heart failure
Hypersensitivity to esmolol
Dosage Range:
Adults: Initial dose: 500 mcg/kg IV bolus over 1 minute, followed by an infusion of 50 mcg/kg/min. Maintenance infusion: 50-200 mcg/kg/min, titrated to response.
Children: Dose individualized based on age and weight.
Routes of Administration:
Intravenous (IV)
Adverse Reactions:
Hypotension
Bradycardia
Heart block
Bronchospasm
Dizziness
Nausea
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Etomidate
Generic Name:
Etomidate
Trade Names:
Amidate
Actions:
Etomidate is a short-acting non-barbiturate hypnotic used for induction of general anesthesia and sedation. It acts on the GABA-A receptors.
Indications:
Induction of general anesthesia
Procedural sedation
Contraindications:
Hypersensitivity to etomidate
Pregnancy (relative contraindication unless benefits outweigh risks)
Dosage Range:
Adults: 0.2-0.6 mg/kg IV over 30-60 seconds.
Children: 0.2-0.3 mg/kg IV over 30-60 seconds.
Routes of Administration:
Intravenous (IV)
Adverse Reactions:
Myoclonus
Adrenal suppression
Nausea, vomiting
Hypotension
Pain at injection site
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Fentanyl
Generic Name:
Fentanyl
Trade Names:
Sublimaze, Duragesic
Actions:
Fentanyl is a potent synthetic opioid analgesic that binds to the mu-opioid receptors, producing analgesia and sedation.
Indications:
Management of pain (severe)
Anesthesia adjunct
Procedural sedation
Contraindications:
Hypersensitivity to fentanyl or other opioids
Severe respiratory depression
Acute or severe asthma
Paralytic ileus
Dosage Range:
Adults (Pain management): 25-100 mcg IV/IM every 1-2 hours as needed.
Adults (Anesthesia): 50-100 mcg/kg IV.
Children: Dose individualized based on age and weight.
Routes of Administration:
Intravenous (IV)
Intramuscular (IM)
Transdermal (patch)
Transmucosal (lozenge)
Adverse Reactions:
Respiratory depression
Bradycardia
Hypotension
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Flumazenil
Generic Name:
Flumazenil
Trade Names:
Romazicon
Actions:
- Benzodiazepine receptor antagonist
- Reverses the sedative effects of benzodiazepines
Indications:
- Benzodiazepine overdose
- Reversal of benzodiazepine sedation
Contraindications:
- Known hypersensitivity to flumazenil or benzodiazepines
- Patients with seizures or head injury
Dosage Range:
- Initial dose: 0.2 mg IV over 15 seconds
- Additional doses: 0.3 mg IV, then 0.5 mg IV at 1-minute intervals if needed (maximum total dose: 3 mg)
Routes of Administration:
Adverse Reactions:
- Seizures
- Dizziness
- Nausea
- Vomiting
- Agitation
- Flushing
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Furosemide
Generic Name:
Furosemide
Trade Names:
Lasix
Actions:
- Inhibits reabsorption of sodium and chloride in the kidneys
- Promotes diuresis
Indications:
- Pulmonary edema
- Congestive heart failure
- Hypertension
Contraindications:
- Anuria
- Hypovolemia
- Electrolyte depletion
Dosage Range:
- 20-40 mg IV or IM, may be increased by 20 mg every 2 hours
Routes of Administration:
- Intravenous (IV)
- Intramuscular (IM)
Adverse Reactions:
- Hypotension
- Electrolyte imbalances
- Dehydration
- Renal dysfunction
- Ototoxicity (with rapid administration)
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Glucagon
Generic Name:
Glucagon
Trade Names:
GlucaGen
Actions:
- Stimulates hepatic glycogenolysis and gluconeogenesis
- Increases blood glucose levels
Indications:
- Hypoglycemia
- Beta-blocker overdose
- Calcium channel blocker overdose
Contraindications:
- Pheochromocytoma
- Insulinoma
- Known hypersensitivity
Dosage Range:
- Hypoglycemia: 1 mg IM or SC
- Overdose: 3-10 mg IV bolus followed by infusion
Routes of Administration:
- Intramuscular (IM)
- Subcutaneous (SC)
- Intravenous (IV)
Adverse Reactions:
- Nausea
- Vomiting
- Hypotension
- Tachycardia
- Allergic reactions
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Haloperidol
Generic Name:
Haloperidol
Trade Names:
Haldol
Actions:
- Dopamine receptor antagonist
- Antipsychotic effects
Indications:
- Acute psychosis
- Agitation
- Delirium
Contraindications:
- Severe CNS depression
- Parkinson’s disease
- Known hypersensitivity
Dosage Range:
- 2-5 mg IM, may repeat every 30-60 minutes
Routes of Administration:
- Intramuscular (IM)
- Intravenous (IV) (off-label use)
Adverse Reactions:
- Extrapyramidal symptoms
- Hypotension
- Tachycardia
- Drowsiness
- QT prolongation
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Heparin
Generic Name:
Heparin
Trade Names:
Hep-Lock
Actions:
- Anticoagulant
- Inhibits thrombin and factor Xa
Indications:
- Venous thromboembolism
- Pulmonary embolism
- Myocardial infarction
Contraindications:
- Active bleeding
- Severe thrombocytopenia
- History of heparin-induced thrombocytopenia
Dosage Range:
- Initial bolus: 60-80 units/kg IV
- Maintenance infusion: 12-18 units/kg/hour IV
Routes of Administration:
- Intravenous (IV)
- Subcutaneous (SC)
Adverse Reactions:
- Bleeding
- Thrombocytopenia
- Hypersensitivity reactions
- Osteoporosis (with long-term use)
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Insulin
Generic Name:
Insulin
Trade Names:
Humulin, Novolin
Actions:
- Lowers blood glucose levels by facilitating cellular uptake of glucose
- Inhibits hepatic glucose production
Indications:
- Diabetes mellitus
- Hyperglycemia
- Diabetic ketoacidosis
Contraindications:
- Hypoglycemia
- Known hypersensitivity
Dosage Range:
- Varies by type and patient needs; commonly, 0.1 units/kg/hour IV infusion for DKA
Routes of Administration:
- Subcutaneous (SC)
- Intravenous (IV)
- Intramuscular (IM)
Adverse Reactions:
- Hypoglycemia
- Hypokalemia
- Injection site reactions
- Allergic reactions
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Ipecac
Generic Name:
Ipecac
Trade Names:
Ipecac Syrup
Actions:
- Induces vomiting by irritating the gastric mucosa and stimulating the vomiting center in the brain
Indications:
- Induced vomiting in poisoning (rarely used now)
Contraindications:
- Ingestion of corrosive substances
- Ingestion of hydrocarbons
- Unconsciousness or reduced consciousness
Dosage Range:
- 15-30 mL orally, followed by 240 mL of water
Routes of Administration:
Adverse Reactions:
- Prolonged vomiting
- Diarrhea
- Aspiration pneumonia
- Electrolyte imbalances
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Ipratropium
Generic Name:
Ipratropium
Trade Names:
Atrovent
Actions:
- Anticholinergic bronchodilator
- Inhibits vagally mediated reflexes by antagonizing acetylcholine
Indications:
- Bronchospasm associated with chronic obstructive pulmonary disease (COPD)
- Asthma (in combination with beta-agonists)
Contraindications:
- Known hypersensitivity to ipratropium or atropine
Dosage Range:
- 0.5 mg nebulized every 6-8 hours
Routes of Administration:
- Inhalation (nebulizer or metered-dose inhaler)
Adverse Reactions:
- Dry mouth
- Cough
- Nervousness
- Dizziness
- Palpitations
*[top](#drug-cards-prehospital-medications)*
Isoproterenol
Generic Name:
Isoproterenol
Trade Names:
Isuprel
Actions:
- Beta-adrenergic agonist
- Increases heart rate, contractility, and bronchodilation
Indications:
- Bradycardia
- Heart block
- Asthma (rarely used)
Contraindications:
- Tachyarrhythmias
- Digitalis-induced tachycardia
Dosage Range:
- Bradycardia: 2-10 mcg/min IV infusion
Routes of Administration:
Adverse Reactions:
- Tachycardia
- Palpitations
- Headache
- Tremors
- Hypotension
*[top](#drug-cards-prehospital-medications)*
Ketamine
Generic Name:
Ketamine
Trade Names:
Ketalar
Actions:
- NMDA receptor antagonist
- Provides dissociative anesthesia and analgesia
Indications:
- Procedural sedation
- Pain management
- Rapid sequence intubation
Contraindications:
- Known hypersensitivity
- Conditions where significant hypertension would be hazardous
Dosage Range:
- Procedural sedation: 1-2 mg/kg IV bolus
- Pain management: 0.1-0.3 mg/kg IV bolus or infusion
Routes of Administration:
- Intravenous (IV)
- Intramuscular (IM)
Adverse Reactions:
- Emergence reactions (hallucinations, delirium)
- Hypertension
- Tachycardia
- Increased intracranial pressure
- Nausea
*[top](#drug-cards-prehospital-medications)*
Labetalol
Generic Name:
Labetalol
Trade Names:
Normodyne, Trandate
Actions:
- Alpha and beta-adrenergic blocker
- Lowers blood pressure without significant heart rate reduction
Indications:
- Hypertensive emergencies
- Severe hypertension
Contraindications:
- Bronchial asthma
- Severe bradycardia
- Heart block greater than first degree
- Cardiogenic shock
Dosage Range:
- Hypertensive emergency: 20 mg IV bolus, followed by 40-80 mg IV every 10 minutes as needed (max 300 mg)
- Continuous infusion: 1-2 mg/min IV
Routes of Administration:
Adverse Reactions:
- Hypotension
- Bradycardia
- Dizziness
- Nausea
- Fatigue
*[top](#drug-cards-prehospital-medications)*
Lidocaine
Generic Name:
Lidocaine
Trade Names:
Xylocaine
Actions:
- Sodium channel blocker
- Local anesthetic and antiarrhythmic
Indications:
- Ventricular arrhythmias (ventricular tachycardia, ventricular fibrillation)
- Local anesthesia
Contraindications:
- Adams-Stokes syndrome
- Wolff-Parkinson-White syndrome
- Severe heart block without pacemaker
Dosage Range:
- Cardiac arrest: 1-1.5 mg/kg IV bolus, followed by 0.5-0.75 mg/kg every 5-10 minutes (max 3 mg/kg)
- Maintenance infusion: 1-4 mg/min IV
Routes of Administration:
- Intravenous (IV)
- Intramuscular (IM)
- Subcutaneous (SC)
- Topical
Adverse Reactions:
- Drowsiness
- Dizziness
- Confusion
- Seizures
- Hypotension
*[top](#drug-cards-prehospital-medications)*
Magnesium
Generic Name:
Magnesium sulfate
Trade Names:
None
Actions:
- Essential electrolyte
- Anticonvulsant in eclampsia
- Antiarrhythmic
Indications:
- Torsades de pointes
- Eclampsia
- Hypomagnesemia
- Severe asthma exacerbation
Contraindications:
- Heart block
- Myocardial damage
- Hypermagnesemia
Dosage Range:
- Torsades de pointes: 1-2 g IV over 15 minutes
- Eclampsia: 4-6 g IV over 20-30 minutes, then 1-2 g/hour IV infusion
Routes of Administration:
- Intravenous (IV)
- Intramuscular (IM)
Adverse Reactions:
- Hypotension
- Flushing
- Drowsiness
- Respiratory depression
- Arrhythmias
*[top](#drug-cards-prehospital-medications)*
Methylprednisolone
Generic Name:
Methylprednisolone
Trade Names:
Solu-Medrol
Actions:
- Glucocorticoid
- Anti-inflammatory and immunosuppressive effects
Indications:
- Severe allergic reactions
- Asthma exacerbations
- Chronic obstructive pulmonary disease (COPD) exacerbations
- Spinal cord injury
Contraindications:
- Systemic fungal infections
- Known hypersensitivity
Dosage Range:
- Asthma/COPD: 40-125 mg IV
- Spinal cord injury: 30 mg/kg IV over 15 minutes, then 5.4 mg/kg/hour for 23 hours
Routes of Administration:
- Intravenous (IV)
- Intramuscular (IM)
Adverse Reactions:
- Hyperglycemia
- Hypertension
- Fluid retention
- Immunosuppression
- Gastrointestinal bleeding
*[top](#drug-cards-prehospital-medications)*
Metoprolol
Generic Name:
Metoprolol
Trade Names:
Lopressor, Toprol-XL
Actions:
- Beta-adrenergic blocker
- Reduces heart rate, cardiac output, and blood pressure
Indications:
- Hypertension
- Angina
- Myocardial infarction
- Tachyarrhythmias
Contraindications:
- Severe bradycardia
- Heart block greater than first degree
- Cardiogenic shock
- Decompensated heart failure
Dosage Range:
- Hypertension/Angina: 50-100 mg orally daily or in divided doses
- Myocardial infarction: 5 mg IV every 2 minutes for 3 doses, then 50 mg orally every 6 hours
Routes of Administration:
- Oral (PO)
- Intravenous (IV)
Adverse Reactions:
- Bradycardia
- Hypotension
- Dizziness
- Fatigue
- Bronchospasm
*[top](#drug-cards-prehospital-medications)*
Midazolam
Generic Name:
Midazolam
Trade Names:
Versed
Actions:
- Benzodiazepine
- Sedative, anxiolytic, and amnesic effects
Indications:
- Procedural sedation
- Seizure control
- Induction of anesthesia
Contraindications:
- Severe respiratory depression
- Acute narrow-angle glaucoma
- Known hypersensitivity
Dosage Range:
- Procedural sedation: 1-2.5 mg IV bolus, titrate to effect
- Seizure control: 0.2 mg/kg IM or IN (max 10 mg)
Routes of Administration:
- Intravenous (IV)
- Intramuscular (IM)
- Intranasal (IN)
- Oral (PO)
Adverse Reactions:
- Respiratory depression
- Hypotension
- Amnesia
- Drowsiness
- Paradoxical reactions (agitation, aggression)
*[top](#drug-cards-prehospital-medications)*
Morphine
Generic Name:
Morphine
Trade Names:
MS Contin, Roxanol
Actions:
- Opioid agonist
- Analgesic and sedative effects
Indications:
- Severe pain
- Acute myocardial infarction
- Pulmonary edema
Contraindications:
- Respiratory depression
- Acute or severe asthma
- Paralytic ileus
- Known hypersensitivity
Dosage Range:
- Pain: 2.5-10 mg IV every 2-6 hours as needed
- Myocardial infarction: 2-4 mg IV, then 2-8 mg IV every 5-15 minutes
Routes of Administration:
- Intravenous (IV)
- Intramuscular (IM)
- Subcutaneous (SC)
- Oral (PO)
Adverse Reactions:
- Respiratory depression
- Hypotension
- Nausea
- Vomiting
- Constipation
- Drowsiness
*[top](#drug-cards-prehospital-medications)*
Nalbuphine
Generic Name:
Nalbuphine
Trade Names:
Nubain
Actions:
- Mixed opioid agonist-antagonist
- Provides analgesia with lower risk of respiratory depression
Indications:
- Moderate to severe pain
- Preoperative and postoperative analgesia
Contraindications:
- Known hypersensitivity to nalbuphine or other opioids
Dosage Range:
- 10-20 mg IV/IM/SC every 3-6 hours as needed
Routes of Administration:
- Intravenous (IV)
- Intramuscular (IM)
- Subcutaneous (SC)
Adverse Reactions:
- Sedation
- Nausea
- Vomiting
- Dizziness
- Sweating
- Respiratory depression (less common)
*[top](#drug-cards-prehospital-medications)*
Nalmefene
Generic Name:
Nalmefene
Trade Names:
Revex
Actions:
- Opioid receptor antagonist
- Reverses opioid effects, including respiratory depression
Indications:
- Opioid overdose
- Reversal of opioid-induced respiratory depression
Contraindications:
Dosage Range:
- Initial dose: 0.5 mg IV, repeat as needed (max 1.5 mg)
Routes of Administration:
- Intravenous (IV)
- Intramuscular (IM)
- Subcutaneous (SC)
Adverse Reactions:
- Nausea
- Vomiting
- Tachycardia
- Hypertension
- Sweating
- Withdrawal symptoms in opioid-dependent patients
*[top](#drug-cards-prehospital-medications)*
Naloxone
Generic Name:
Naloxone
Trade Names:
Narcan
Actions:
- Opioid receptor antagonist
- Reverses opioid effects, including respiratory depression
Indications:
- Opioid overdose
- Reversal of opioid-induced respiratory depression
Contraindications:
Dosage Range:
- Initial dose: 0.4-2 mg IV/IM/SC, repeat every 2-3 minutes as needed (max 10 mg)
- Intranasal: 2 mg, repeat as needed
Routes of Administration:
- Intravenous (IV)
- Intramuscular (IM)
- Subcutaneous (SC)
- Intranasal (IN)
Adverse Reactions:
- Nausea
- Vomiting
- Tachycardia
- Hypertension
- Sweating
- Withdrawal symptoms in opioid-dependent patients
*[top](#drug-cards-prehospital-medications)*
Nitroglycerin
Generic Name:
Nitroglycerin
Trade Names:
Nitrostat, Nitro-Bid, Nitrolingual
Actions:
- Vasodilator
- Decreases preload and afterload
- Reduces myocardial oxygen demand
Indications:
- Angina pectoris
- Myocardial infarction
- Congestive heart failure
- Hypertensive emergencies
Contraindications:
- Hypotension
- Severe bradycardia or tachycardia
- Use of phosphodiesterase inhibitors (e.g., sildenafil) within 24-48 hours
- Increased intracranial pressure
Dosage Range:
- Sublingual: 0.3-0.6 mg every 5 minutes (max 3 doses)
- IV infusion: 5-200 mcg/min, titrated to effect
Routes of Administration:
- Sublingual (SL)
- Intravenous (IV)
- Transdermal (TD)
Adverse Reactions:
- Headache
- Hypotension
- Dizziness
- Flushing
- Reflex tachycardia
*[top](#drug-cards-prehospital-medications)*
Oxygen
Generic Name:
Oxygen
Trade Names:
None
Actions:
- Increases arterial oxygen tension and hemoglobin saturation
- Improves tissue oxygenation
Indications:
- Hypoxemia
- Respiratory distress
- Carbon monoxide poisoning
- Cardiac arrest
Contraindications:
- None in emergency settings
- Caution in patients with chronic obstructive pulmonary disease (COPD)
Dosage Range:
- 1-15 L/min via nasal cannula, face mask, or non-rebreather mask
- 15-25 L/min via bag-valve mask or CPAP
Routes of Administration:
Adverse Reactions:
- Oxygen toxicity (with prolonged high concentrations)
- Dry mucous membranes
- Retrolental fibroplasia in neonates (with prolonged high concentrations)
*[top](#drug-cards-prehospital-medications)*
Phenylephrine
Generic Name:
Phenylephrine
Trade Names:
Neo-Synephrine
Actions:
- Alpha-adrenergic agonist
- Vasoconstriction and increased blood pressure
Indications:
- Hypotension
- Nasal congestion
- Shock
Contraindications:
- Severe hypertension
- Ventricular tachycardia
- Narrow-angle glaucoma
Dosage Range:
- IV bolus: 100-200 mcg every 10-15 minutes as needed
- IV infusion: 0.2-0.5 mcg/kg/min, titrated to effect
Routes of Administration:
- Intravenous (IV)
- Intranasal
Adverse Reactions:
- Hypertension
- Reflex bradycardia
- Headache
- Nausea
- Restlessness
*[top](#drug-cards-prehospital-medications)*
Procainamide
Generic Name:
Procainamide
Trade Names:
Pronestyl
Actions:
- Sodium channel blocker
- Slows conduction and prolongs repolarization
Indications:
- Ventricular arrhythmias
- Supraventricular tachycardia (SVT)
- Atrial fibrillation with rapid ventricular response (off-label)
Contraindications:
- Second or third-degree heart block without pacemaker
- Systemic lupus erythematosus (SLE)
- Torsades de pointes
Dosage Range:
- Loading dose: 15-17 mg/kg IV over 25-30 minutes
- Maintenance infusion: 1-4 mg/min IV
Routes of Administration:
- Intravenous (IV)
- Intramuscular (IM)
Adverse Reactions:
- Hypotension
- Bradycardia
- QT prolongation
- Lupus-like syndrome
- Agranulocytosis
*[top](#drug-cards-prehospital-medications)*
Reglan
Generic Name:
Metoclopramide
Trade Names:
Reglan
Actions:
- Dopamine receptor antagonist
- Enhances gastrointestinal motility
- Antiemetic
Indications:
- Nausea and vomiting
- Gastroparesis
- Gastroesophageal reflux disease (GERD)
Contraindications:
- Gastrointestinal obstruction or perforation
- Pheochromocytoma
- Seizure disorders
Dosage Range:
- 10-20 mg IV/IM every 6-8 hours as needed
Routes of Administration:
- Intravenous (IV)
- Intramuscular (IM)
- Oral (PO)
Adverse Reactions:
- Drowsiness
- Extrapyramidal symptoms
- Diarrhea
- Restlessness
- Hypertension
*[top](#drug-cards-prehospital-medications)*
Ringers Solution
Generic Name:
Ringer’s lactate solution
Trade Names:
None
Actions:
- Isotonic crystalloid solution
- Restores fluid and electrolyte balance
Indications:
- Hypovolemia
- Dehydration
- Burns
Contraindications:
- Hyperkalemia
- Severe liver disease
- Metabolic or respiratory alkalosis
Dosage Range:
- Depends on patient condition and fluid deficit
Routes of Administration:
Adverse Reactions:
- Fluid overload
- Hyperkalemia
- Metabolic alkalosis
*[top](#drug-cards-prehospital-medications)*
Rocuronium
Generic Name:
Rocuronium
Trade Names:
Zemuron
Actions:
- Non-depolarizing neuromuscular blocker
- Causes skeletal muscle relaxation
Indications:
- Rapid sequence intubation
- Muscle relaxation during surgery
Contraindications:
Dosage Range:
- Rapid sequence intubation: 0.6-1.2 mg/kg IV bolus
Routes of Administration:
Adverse Reactions:
- Hypotension
- Tachycardia
- Prolonged neuromuscular blockade
- Bronchospasm
- Allergic reactions
*[top](#drug-cards-prehospital-medications)*
Normal Saline
Generic Name:
0.9% Sodium chloride solution
Trade Names:
Normal Saline
Actions:
- Isotonic crystalloid solution
- Restores fluid and electrolyte balance
Indications:
- Hypovolemia
- Dehydration
- Diluent for medications
Contraindications:
- Congestive heart failure (relative contraindication)
- Severe renal impairment (relative contraindication)
Dosage Range:
- Depends on patient condition and fluid deficit
Routes of Administration:
Adverse Reactions:
- Fluid overload
- Hypernatremia
- Metabolic acidosis (with large volumes)
*[top](#drug-cards-prehospital-medications)*
Sodium Bicarbonate
Generic Name:
Sodium bicarbonate
Trade Names:
None
Actions:
- Alkalinizing agent
- Neutralizes acid
Indications:
- Metabolic acidosis
- Tricyclic antidepressant overdose
- Hyperkalemia
Contraindications:
- Metabolic or respiratory alkalosis
- Hypocalcemia
Dosage Range:
- Metabolic acidosis: 1 mEq/kg IV bolus, then 0.5-1 mEq/kg every 10 minutes as needed
- Overdose: 1-2 mEq/kg IV bolus
Routes of Administration:
Adverse Reactions:
- Metabolic alkalosis
- Hypernatremia
- Hypocalcemia
- Tissue necrosis (if extravasation occurs)
*[top](#drug-cards-prehospital-medications)*
Solu-Cortef
Generic Name:
Hydrocortisone sodium succinate
Trade Names:
Solu-Cortef
Actions:
- Glucocorticoid
- Anti-inflammatory and immunosuppressive effects
Indications:
- Adrenal insufficiency
- Severe allergic reactions
- Asthma exacerbations
- Shock
Contraindications:
- Systemic fungal infections
- Known hypersensitivity
Dosage Range:
- Adrenal crisis: 100 mg IV bolus, followed by 50 mg IV every 6 hours
- Severe allergic reactions: 100-500 mg IV bolus
Routes of Administration:
- Intravenous (IV)
- Intramuscular (IM)
Adverse Reactions:
- Hyperglycemia
- Hypertension
- Fluid retention
- Immunosuppression
- Gastrointestinal bleeding
*[top](#drug-cards-prehospital-medications)*
Succinylcholine
Generic Name:
Succinylcholine
Trade Names:
Anectine, Quelicin
Actions:
- Depolarizing neuromuscular blocker
- Causes skeletal muscle paralysis
Indications:
- Rapid sequence intubation
- Muscle relaxation during surgery
Contraindications:
- Malignant hyperthermia
- Hyperkalemia
- Penetrating eye injuries
- Known hypersensitivity
Dosage Range:
- Rapid sequence intubation: 1-2 mg/kg IV bolus
Routes of Administration:
- Intravenous (IV)
- Intramuscular (IM)
Adverse Reactions:
- Hyperkalemia
- Malignant hyperthermia
- Increased intraocular pressure
- Prolonged apnea
- Muscle fasciculations
*[top](#drug-cards-prehospital-medications)*
Terbutaline
Generic Name:
Terbutaline
Trade Names:
Brethine
Actions:
- Beta-adrenergic agonist
- Bronchodilation and tocolysis
Indications:
- Asthma exacerbations
- Preterm labor (off-label)
Contraindications:
- Severe hypertension
- Tachyarrhythmias
- Known hypersensitivity
Dosage Range:
- Asthma: 0.25 mg SC, repeat in 15-30 minutes if needed (max 0.5 mg in 4 hours)
Routes of Administration:
- Subcutaneous (SC)
- Intravenous (IV)
- Oral (PO)
Adverse Reactions:
- Tachycardia
- Tremors
- Nervousness
- Nausea
- Hypertension
*[top](#drug-cards-prehospital-medications)*
Thiamine
Generic Name:
Thiamine (Vitamin B1)
Trade Names:
None
Actions:
- Coenzyme in carbohydrate metabolism
- Prevents and treats thiamine deficiency
Indications:
- Wernicke’s encephalopathy
- Beriberi
- Thiamine deficiency
- Alcohol withdrawal syndrome
Contraindications:
- None in emergency settings
Dosage Range:
Routes of Administration:
- Intravenous (IV)
- Intramuscular (IM)
Adverse Reactions:
- Hypersensitivity reactions (rare)
- Hypotension (with rapid IV administration)
*[top](#drug-cards-prehospital-medications)*
TXA
Generic Name:
Tranexamic acid
Trade Names:
Cyklokapron
Actions:
- Antifibrinolytic
- Inhibits the breakdown of fibrin clots
Indications:
- Severe bleeding (trauma, surgery)
- Menorrhagia (off-label)
Contraindications:
- Active intravascular clotting
- Severe renal impairment
- Known hypersensitivity
Dosage Range:
- Trauma: 1 g IV over 10 minutes, followed by 1 g IV over 8 hours
Routes of Administration:
Adverse Reactions:
- Nausea
- Vomiting
- Diarrhea
- Hypotension (with rapid IV administration)
- Thromboembolic events (rare)
*[top](#drug-cards-prehospital-medications)*
Vasopressin
Generic Name:
Vasopressin
Trade Names:
Pitressin
Actions:
- Antidiuretic hormone
- Vasoconstriction and increased water reabsorption
Indications:
- Vasodilatory shock
- Cardiac arrest (alternative to epinephrine)
- Diabetes insipidus
Contraindications:
- Chronic nephritis with nitrogen retention
- Known hypersensitivity
Dosage Range:
- Cardiac arrest: 40 units IV once (may replace first or second dose of epinephrine)
- Vasodilatory shock: 0.01-0.04 units/min IV infusion
Routes of Administration:
- Intravenous (IV)
- Intramuscular (IM)
Adverse Reactions:
- Hypertension
- Bradycardia
- Arrhythmias
- Ischemia
- Water intoxication
*[top](#drug-cards-prehospital-medications)*
*[top](#drug-cards-prehospital-medications)*
Vecuronium
Generic Name:
Vecuronium
Trade Names:
Norcuron
Actions:
- Non-depolarizing neuromuscular blocker
- Causes skeletal muscle relaxation
Indications:
- Rapid sequence intubation
- Muscle relaxation during surgery
Contraindications:
Dosage Range:
- Rapid sequence intubation: 0.1 mg/kg IV bolus
- Maintenance: 0.01-0.05 mg/kg IV bolus as needed
Routes of Administration:
Adverse Reactions:
- Prolonged neuromuscular blockade
- Hypotension
- Bradycardia
- Allergic reactions
- Bronchospasm
*[top](#drug-cards-prehospital-medications)*
Verapamil
Generic Name:
Verapamil
Trade Names:
Calan, Isoptin
Actions:
- Calcium channel blocker
- Slows AV node conduction, reduces heart rate, and dilates coronary arteries
Indications:
- Supraventricular tachycardia (SVT)
- Atrial fibrillation/flutter with rapid ventricular response
- Hypertension
Contraindications:
- Severe hypotension
- Cardiogenic shock
- Heart block greater than first degree
- Severe heart failure
Dosage Range:
- SVT: 2.5-5 mg IV over 2 minutes, may repeat with 5-10 mg IV after 15-30 minutes (max 20 mg)
- Hypertension: 80-120 mg orally three times daily
Routes of Administration:
- Intravenous (IV)
- Oral (PO)
Adverse Reactions:
- Hypotension
- Bradycardia
- Dizziness
- Headache
- Constipation
*[top](#drug-cards-prehospital-medications)*
Xylocaine
Generic Name:
Lidocaine
Trade Names:
Xylocaine
Actions:
- Sodium channel blocker
- Local anesthetic and antiarrhythmic
Indications:
- Ventricular arrhythmias (ventricular tachycardia, ventricular fibrillation)
- Local anesthesia
Contraindications:
- Adams-Stokes syndrome
- Wolff-Parkinson-White syndrome
- Severe heart block without pacemaker
Dosage Range:
- Cardiac arrest: 1-1.5 mg/kg IV bolus, followed by 0.5-0.75 mg/kg every 5-10 minutes (max 3 mg/kg)
- Maintenance infusion: 1-4 mg/min IV
Routes of Administration:
- Intravenous (IV)
- Intramuscular (IM)
- Subcutaneous (SC)
- Topical
Adverse Reactions:
- Drowsiness
- Dizziness
- Confusion
- Seizures
- Hypotension
*[top](#drug-cards-prehospital-medications)*
Zofran
Generic Name:
Ondansetron
Trade Names:
Zofran
Actions:
- Serotonin (5-HT3) receptor antagonist
- Antiemetic
Indications:
- Nausea and vomiting (chemotherapy, radiation, postoperative)
Contraindications:
Dosage Range:
- 4-8 mg IV/IM/PO every 6-8 hours as needed
Routes of Administration:
- Intravenous (IV)
- Intramuscular (IM)
- Oral (PO)
Adverse Reactions:
- Headache
- Dizziness
- Constipation
- QT prolongation
- Diarrhea
*[top](#drug-cards-prehospital-medications)*
Cyanokit
Generic Name:
Hydroxocobalamin
Trade Names:
CYANOKIT
Actions:
- Binds cyanide ions to form cyanocobalamin (vitamin B12), which is then excreted in urine
- Antidote for cyanide poisoning
Indications:
Contraindications:
Dosage Range:
- Initial dose: 5 g IV over 15 minutes
- Additional dose: 5 g IV over 15 minutes to 2 hours if needed (max 10 g)
Routes of Administration:
Adverse Reactions:
- Red discoloration of skin, urine, and mucous membranes
- Hypertension
- Nausea
- Headache
- Injection site reactions
*[top](#drug-cards-prehospital-medications)*
Pralidoxime
Generic Name:
Pralidoxime chloride (Mark-1 kit)
Trade Names:
2-PAM, Protopam
Actions:
- Reactivates cholinesterase inhibited by organophosphates
- Restores normal neuromuscular function
Indications:
- Organophosphate poisoning
- Nerve agent exposure
Contraindications:
- Myasthenia gravis (relative contraindication)
Dosage Range:
- Initial dose: 1-2 g IV over 15-30 minutes
- Maintenance: 500 mg IV every 4-6 hours as needed
Routes of Administration:
- Intravenous (IV)
- Intramuscular (IM)
Adverse Reactions:
- Dizziness
- Blurred vision
- Hypertension
- Nausea
- Tachycardia
*[top](#drug-cards-prehospital-medications)*