Drug Protocols

[Statua]

Citizen Hospital

Protocols for Drug Administration

Terms
Indications: Any reason required to administer the drug
Contraindications: Any reason to prevent you from administering the drug.
Onset: Time it takes for the drug to start working
Peak Effectiveness: Time it takes for drug to work at full effect
Duration: How long the drug will last

Acetaminophen (aka Tylenol or Paracetamol)
Mild painkiller. Fever control.

Spoiler for Hiden:

Indications: Mild to moderate pain, fever

Contraindications: None

Side Effects: None

Dose and Administration: 650mg Orally every 4 hours.

Duration of Action:
-onset: 30 minutes
-peak effectiveness: variable
-duration: 4 hours

Acetylsalicyclic Acid (aka ASA or Aspirin)
Anti-inflammatory, Prevents clotting

Spoiler for Hiden:

Indications: chest pain suggestive of MI

Contraindications: Internal bleeding

Side Effects: heartburn, nausea & vomiting, wheezing in allergic patients, prolonged bleeding

Dose and Administration: 160mg chewed orally once

Duration of Action:
-onset: 30-45 minutes
-peak effectiveness: variable
-duration: 7-10 days

Amiodarone (aka Cordarone)
Reverses abnormal heart rhythms such as v-fib

Spoiler for Hiden:

Indications: patient with no vital signs and either v-fib or v-tach

Contraindications: Hypothermic cardiac arrest, renal failure, 2nd or 3rd degree heart block, hypotension, bradycardia

Side Effects: hypotension, bradycardia, nausea, fever

Dose and Administration: 300mg initial slow IV push, 150mg second slow IV dose after 10 minutes if indicated

Duration of Action:
-onset: 5-15 minutes
-peak effectiveness: variable
-duration: variable

Atropine
Increases slow heart rate

Spoiler for Hiden:

Indications: asystole, pulseless electrical activity, shocky bradycardia, nerve gas exposure

Contraindications: trauma or hypothermic cardiac arrest, tachycardia

Side Effects: headache, dizziness, nausea & vomiting, tachycardia, flushed hot dry skin

Dose and Administration: 1mg IV push every 3-5 minutes up to a max of 3mg

Duration of Action:
-onset: immediate
-peak effectiveness: 1-2 minutes
-duration: 2-6 hours

D50W (Dextrose)
Brings up blood sugars

Spoiler for Hiden:

Indications: Blood sugar below 4 mmol/L

Contraindications: Hyperglycemia

Side Effects: warmth, pain, burning, tissue death if leaked out of the vein

Dose and Administration: 25g slow IV push, may be repeated once after 5 minutes if BGL >4mmol/L

Duration of Action:
-onset: <1 minute
-peak effectiveness: variable
-duration: variable

Dimenhydrinate (aka Gravol)
Decreases nausea and vomiting

Spoiler for Hiden:

Indications: symptomatic relief of nausea and vomiting

Contraindications: Hypertension

Side Effects: sedation, hypotension, seizures, hallucinations, vomiting, dry mouth and throat

Dose and Administration: 25-50mg IM, IV, or Orally

Duration of Action:
-onset: 15-30 minutes
-peak effectiveness: 1 hour
-duration: 3-12 hours

Diphenhydramine (aka Benadryl)
Blocks allergic reactions

Spoiler for Hiden:

Indications: relief of allergies, anaphylaxis, motion sickness

Contraindications: hypertension

Side Effects: sedation, hypotension, seizures, hallucinations, vomiting, dry mouth and throat

Dose and Administration: 25-50mg IM, IV, or Orally

Duration of Action:
-onset: 15-30 minutes
-peak effectiveness: 1 hour
-duration: 3-12 hours

Epinephrine (aka Adrenaline or EpiPen)
Opens up airways, increases heart rate and blood pressure

Spoiler for Hiden:

Indications: absent vitals with v-fib or v-tach, asystole without death determination, PEA, severe bronchospasm, anaphylaxis

Contraindications: hypothermic cardiac arrest, hypertension, pulmonary edema, hypovolemic shock,

Side Effects: hypertension, pulmonary edema, anxiety, nausea, chest pain, headache

Dose and Administration: Cardiac Arrest: 1mg IV push every 3-5 minutes. Anaphylaxis: 0.3mg IM

Duration of Action:
-onset: immediate
-peak effectiveness: within minutes
-duration: several minutes

Furosemide (aka Lasix)
Reverses fluid buildup in the lungs caused by heart failure

Spoiler for Hiden:

Indications: shortness of breath with crackles in both lungs, pulmonary edema

Contraindications: hypotension, hypovolemia

Side Effects: dry mouth, may make hypovolemia or hyperglycemia worse

Dose and Administration: 40mg IV Bolus

Duration of Action:
-onset: 5 minutes
-peak effectiveness: 30 minutes
-duration: 4-6 hours

Glucagon
Helps raise blood sugars

Spoiler for Hiden:

Indications: hypoglycemia

Contraindications: hyperglycemia, known adrenal tumor

Side Effects: tachycardia, hypertension

Dose and Administration: 1mg IM

Duration of Action:
-onset: 1 minute
-peak effectiveness: 30 minutes
-duration: 60-90 minutes

Oral Glucose
Tube of pure glucose to raise blood sugars

Spoiler for Hiden:

Indications: hypoglycemia

Contraindications: decreased LOC, no gag reflex, nausea, vomiting, hyperglycemia

Side Effects: nausea and vomiting

Dose and Administration: 50 grams bucally

Duration of Action:
-onset: immediate
-peak effectiveness: variable
-duration: variable

Heparin
Clot busting drug.

Spoiler for Hiden:

Indications: blood clot occluding a blood vessel

Contraindications: Hemorrhaging

Side Effects: bleeding, inability to clot

Dose and Administration: 60-80 units/kg IV loading dose, 14-18 units/kg IV infused per hour

Duration of Action:
-onset: immediate
-peak effectiveness: variable
-duration: 4 hours after last dose

Lorazepam (aka Ativan)
Sedative

Spoiler for Hiden:

Indications: seizure lasting longer then 5 minutes, severe anxiety, other sedation needs

Contraindications: hypersensitivity, coma, shock, suspected drug abuse

Side Effects: respiratory depression, drowsiness, sedation, confusion, restlessness, hypotension, bradycardia

Dose and Administration: 2mg IM. Repeat after 15 minutes if symptoms persist

Duration of Action:
-onset: 1-5 minutes
-peak effectiveness: variable
-duration: 6-8 hours

Morphene
Analgesic

Spoiler for Hiden:

Indications: pain control

Contraindications: undiagnosed head injury, shock, respiratory depression, hypotension, hypovolemia, decreased LOC

Side Effects: respiratory depression, hypotension, decreased LOC, nausea, vomiting, bradycardia, tachycardia, euphoria, bronchospasm, dry mouth

Dose and Administration: 2mg slow IV every 5 minutes as needed up to 10mg

Duration of Action:
-onset: immediate
-peak effectiveness: 20 minutes
-duration: 2-7 hours

Naloxone (aka Narcan)
Reverses effects of opiates such as morphine, codeine, and heroin

Spoiler for Hiden:

Indications: opiate overdose, unconsciousness of unknown origin

Contraindications: None

Side Effects: withdrawal symptoms ina ddicts, tachycardia, hypertension, nausea, vomiting, diaphoresis

Dose and Administration: 0.4mg IV, IM, or SC every 3-5 minutes as necessary up to 2mg

Duration of Action:
-onset: 2 minutes or less
-peak effectiveness: variable
-duration: 30-81 minutes

Nitroglycerine (aka Nitro)
Dilates blood vessels

Spoiler for Hiden:

Indications: chest pain indicative of ischemia, hypertension, congestive heart failure

Contraindications: hypotension, use of viagra within 24 hours or cialis within 72 hours, intracranial bleed, head injury

Side Effects: headache, hypotension, fainting, tachycardia, nausea, vomiting, diaphoresis

Dose and Administration: 0.3mg Sublingually every 5 minutes as necessary up to 0.9mg

Duration of Action:
-onset: 1-3 minutes
-peak effectiveness: 5-10 minutes
-duration: 20-30 minutes

Salbutamol (aka Ventolin)
Relaxes airways

Spoiler for Hiden:

Indications: bronchospasm (wheezing, respiratory distress, and feeling of "can't breathe")

Contraindications: None

Side Effects: Dizziness, tachycardia, nervousness, nausea, vomiting, increased blood pressure, synergistic with epinephrine

Dose and Administration: 2.5mg via Nebulizer every 15 minutes as necessary

Duration of Action:
-onset: 5-15 minutes
-peak effectiveness: 60-90 minutes
-duration: 3-6 hours