Paramedic Drug Cards

Ketorolac

Trade: Toradol Class: NSAIDMOA: inhibits the production or prostaglandins in inflamed tissue, which decreases the responsiveness of pain receptors. Indications: Moderately severe acute painContraindications: Patients with a hx of peptic ulcer disease or GI bleed, patients with renal insufficiency, hypovolemic patients, 3rd trimester pregnancy, nursing mothers, allergy to other nsaids, stroke or head trauma, having surgery within the next 7 days.  Side effects:  headache, drowsiness, dizziness, abdominal pain, dyspepsia, N/V, Diarrhea.Dosing:Adult IV 30mgIM 60mg Senior (65 and older)/ Pediatric < 50kgsIV 15mgIM 30mg

Fentanyl

Trade: SublimazeClass: Narcotic Analgesic MOA: Binds to opiate receptors producing analgesia and euphoriaIndication: PainContraindication: Use caution in traumatic brain injury, Respiratory depression Side effects: Respiratory depression, apnea, hypotension, N/V, dizziness, sedation euphoria, Sinus bradycardia, sinus tachycardia, palpitations, HTN, diaphoresis, syncopeDosingAdult 50-100mcg IM/IVPedi 1-2mcg/kg IM/IV

Diazepam

Trade: Valium Class: BenzodiazepineMOA: Binds to the benzodiazepine receptor and enhances the effects of GABAIndications: Anxiety, Skeletal muscle relaxation, anticonvulsant Contraindications: Children younger then 6 months, acute angle glaucoma, CNS depression, alcohol intoxication. Side effects:  Respiratory depression, drowsiness, fatigue, headache, pain at the injection site, confusion, nausea, hypotension, cardiac arrest at high doses•Dosing:Adult: Anxiety: 2-10mg IV/IMSeizure: 5-10mg IV/IOPediatric:Anxiety: 0.2 – 0.3mg/kg IV/IMSeizure:  Older then 5 years: 1mg IV/IOOlder then 30 days less then 5 years: 0.2 to 0.5mg IV/IO                Neonate: 0.1-0.3mg/kg IV/IO

Morphine

Trade: MorphineClass: Opiate agonist/Narcotic Analgesic MOA: Binds to the opiate receptors. Reduces stimulation of the sympathetic nervous system caused by pain and anxiety. Reduction of sympathetic stimulation reduces heart rate, cardiac work, and myocardial O2 consumptionIndications: moderate to severe pain including chest pain associated with ACS, CHF, and pulmonary edema.Contraindications: Respiratory depression, shock.Side effects: Respiratory depression, hypotension, N/V, dizziness, lightheadedness, sedation, diaphoresis, euphoria, seizures, cardiac arrest, anaphylactoid reaction.Dosage:Adult  2-10mg IV/IO/IMPediatric < 110 lbs 0.025 – 0.2mg/kg IV/IO/IM

Carbamazepine

Trade: Tegretol Class:  Anticonvulsant MOA: Binds preferably to voltage gated Sodium channels in their inactive conformation, which prevents repetitive and sustained firing of an action potential.Indications: Partial and generalized tonic – clonic seizures Contraindications: AV Block, bundle branch block, agranulocytosis, bone marrow supression, monoamine oxidase inhibitor therapySide effects: Dizziness, drowsiness, ataxia, N/V, blurred vision, confusion, headache, transient diplopia, visual hallucinations, life threatening rashes.Dosing:Adult:200mg POPediatric:6-12 years old: 100mg PO        Less then 6: 10mg/kg PO