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Histamine 2 Receptor Antagonists

• Medications reduce acid secretion in the stomach.
• They prevent histamine from stimulating receptor sites on parietal cells in the stomach.
• Aids in acid reduction and protect against ulcers and GI bleeding.
• Can be administered orally or intravenously.
• Examples: Fotod (pepid) and cadine (Tagamet).

Antiemetic Medications

• Used to treat nausea and vomiting, particularly in at-risk patients.
• Vomiting can worsen medical conditions, causing a Mallory-Weiss tear, raised cranial and intraocular pressure, pulmonary aspiration, and may be lethal if combined with activated charcoal aspiration.
• Promethazine (fenigrin) and Compazine have antiemetic and antipsychotic properties.
• Both can be given orally or intravenously, but IV administration has potential adverse effects.
• Promethazine should be diluted in a large syringe and administered slowly by IV as IM administration can cause tissue injury.
• Compazine can cause hypotension if administered rapidly; dystonic reactions are possible with both drugs and can be treated with IV badril.
• Adverse effects can include unusual muscle activity and patient discomfort.
• Enhance the effects of a at receptor sites in the upper GI tract, promoting gastric emptying
• Dystonic reactions are possible.

5-HT3 Receptor Antagonists

• These receptors play a role in activating the vomiting center in the brain
• Medications prevent certain mechanisms that induce vomiting, such as Zofran, kyril, and Enz.
• Available in oral and IV preparations.
• Adverse effects are generally minimal.

Hostin

• A synthetic version of the somatostatin hormone.
• Not routinely administered in the prehospital setting.
• Decreases the secretion of insulin, glucagon, growth hormones, and various other chemicals.
• Has potential uses but also has a wide variety of adverse effects.

Miscellaneous Medications

• An talo (antipyretic and mild analgesic):
  • Used as an adjunct to other analgesic medications.
  • Helps reduce discomfort by treating fever and preventing febrile seizures in pediatric patients.
  • Available in tablet, capsule, liquid, or rectal suppository form.
  • Oral administration should be avoided in patients with a high risk of seizure or airway compromise.
  • Rare adverse effects are possible; avoid toxicity from overdose.
  • Elevated levels can cause severe, fatal living damage.
• Calcium preparations:
  • Used as an antidote to calcium channel blocker overdose.
  • Used in the treatment of Mag sulfate toxicity and dysmas during severe hyperemia.
  • Used for calcium repletion in patients with hypocalcemia.
  • Used to prevent hypotension associated with IV Verapamil administration.
  • Not indicated for routine use during cardiac arrest resuscitation.
  • Available as calcium chloride or calcium gluconate, both administered as a slow IV infusion after dilution or irritation of the blood vessels occurs.
  • Monitor the IV catheter site carefully to avoid extravasation.
  • Should not be administered subcutaneously or intramuscularly.
  • Assess for compatibility with other medications.
• Dextrose:
  • Should be administered through a large-bore IV and continually monitoring for signs of infiltration.
  • Confirm IV placement with an adequate flush or free-flowing IV fluid before administering.
  • Used to treat hypoglycemia.
• Diphenhydramine (badil):
  • A competitive histamine one receptor antagonist, prevents receptor activation by histamine release.
  • Used for the treatment of anaphylaxis as well as sole treatment of a mild allergic or immune-mediated medication reaction
  • Used for mild sedative and antitussive purposes.
  • Treats dystonic reactions or extrapyramidal symptoms, helps with the drying of mucous membranes in patients with symptomatic rhinorrhea.
  • Typically administered IV or IM, but also available in capsule, taable, and liquid forms.
  • Adverse effects are generally limited to mild sedation, palpitations, or anxiety.
  • Toxicity and death are possible following overdose.
• Goon:
  • A naturally occurring peptide that is manufactured commercially.
  • Typically used for hypoglycemia when IV access is not available.
  • Can be given IM, with glucose production taking about 5 to 20 minutes following IV or 30 minutes following IM.
  • IV dextrus is preferred for hypoglycemia.
  • Helps increase heart rate and contractility following a beta-adrenergic antagonist overdose.
  • Used in the treatment of severe calcium channel blocker overdose.
  • May be administered when a foreign body or large food particle gets lodged in the esophagus to relax smooth muscle in the GI tract (after consultation with Medical Control).
• Toral:
  • Used as an alternative or adjunct to opiate analgesic medications.
  • An NSAID that inhibits progan synthesis.
  • Typically given IV or IM, although it is available orally.
  • Adverse effects include GI irritation and headache, and sometimes pain at the administration site (especially if given IM, feeling like a burning sensation).
  • Should not be given to patients who are susceptible to eye bleeding.
  • Commonly used in the hospital setting, especially for patients with abdominal pain or kidney stones where it can be more effective than morphine or finel.
• Magnesium Sulfate:
  • An IV electrolyte medication.
  • Used for the emergency treatment of torsades or other ventricular dysmas.
  • Used for correction of hypomagnesemia and the prevention or treatment of seizures in pregnant patients with preeclampsia or eclampsia and can be used for treatment of severe refractory asthma.
  • Replaces magnesium deficiencies in the body as well as relaxes smooth muscle tissues and is essential for the movement of other electrolytes.
  • Excessive doses can cause respiratory depression, decreased muscle tone, or loss of deep tendon reflexes.
  • Toxic effects are treated by discontinuing the infusion and administering an IV calcium preparation.
• Sodium Bicarb:
  • An alkalizing agent.
  • Used to raise blood pH in patients with severe metabolic acidosis.
  • Stabilizes profound hyperemia and provides cardiac cell membrane stabilization following a tricyclic antidepressant overdose.
  • Promotes urinary excretion of salicylic chemicals and certain tissue waste products.
  • Helps replace bicarbonate lost due to various medical conditions.
  • Administered as a rapid IV push or added to IV fluids for intermittent or continuous infusion.
  • Evaluate incompatibility when administered in the same IV tubing as other medications.
  • Effects of excessive administration include fluid volume overload, alkalosis, numerous electrolyte abnormalities, and cerebral and pulmonary edema.
• Tet:
  • A mild Opthalmic anesthetic.
  • Facilitates the flushing out of the eyes.
• Thiamine:
  • A commercial medication preparation of vitamin B.
  • Used to correct presumptive thyine deficiency before giving dextrose, especially in patients who are malnourished or consume alcohol on a long-term basis.
  • Deficiency can cause wory and copath and administered IV or deep IM with unlikely to have toxic or adverse effects when using therapeutic doses.