top 10 meds.docx

Top 10 Paramedicine medications Epinephrine is a sympathomimetic- an alpha 1, beta 1, beta 2 adrenergic agonist, bronchidilator and histamine antagonist. Epinephrine is indicated for anaphylaxis/allergic reaction, cardiac arrest, asystole, PEA, V fib, pulseless Vtach, hemodynamically significant bra...

Top 10 Paramedicine medications Epinephrine is a sympathomimetic- an alpha 1, beta 1, beta 2 adrenergic agonist, bronchidilator and histamine antagonist. Epinephrine is indicated for anaphylaxis/allergic reaction, cardiac arrest, asystole, PEA, V fib, pulseless Vtach, hemodynamically significant bradycardia/ hypotension not caused by hypovelemia, asthma, bronchospasm associated with emphysema and chronic bronchitis. Epinephrine binds to alpha 1, beta 1 and beta 2 adrenergic receptors and antagonizes histamine receptors, causing positive chronotropy, inotropy and dromotropy, relaxing bronchial smooth muscle, increasing blood pressure via vasoconstriction, preload and afterload in the myocardium and also reduces swelling. Lidocaine is an antidysrhythmic that binds to sodium channels, which blocks the flow of sodium ions, thus decreasing ventricular excitability in ventricular dysrhythmias, increasing the threshold of ventricular fibrillation, and suppressing ventricular ectopic activity. It is indicated for ventricular tachycardia, pulseless V tach, ventricular fibrillation and premature ventricular complexes and couplets. It can be used as a maintenance infusion as well for the above mentioned indications and is also indicated for monomorphic wide-complex tachycardia. Adenosine is an endogenous nucleotide and an antidysrhythmic. It is indicated for supraventricular tachycardia and monomorphic wide complex tachycardia. It works by slowing down atrioventricular conduction, resulting in cardioversion. By slowing down atrioventricular conduction, the reentry pathway becomes terminated, resulting in the SA node taking over electrical conduction as the primary pacemaker. Amiodarone is an antidysrhthmic indicated for ventricular dysrhythmias including ventricular tachycardia with a pulse, pulseless vtach, ventricular fibrillation and wide complex tachycardia. It works by blocking sodium, potassium and calcium channels in the heart. This slows the sinus rate, action potential and repolarization, prolonging the PR and QT segment. Atropine is an anticholinergic, parasympathetolytic and an antidote that is indicated for hemodynamically significant bradycardia and cholinergic poisoning. Atropine blocks acetylcholine on the left vagus nerve from being released onto the SA node, thereby increasing the heart rate by allowing the SA node to take over as the primary pacemaker. It also blocks acetylcholine on various end organs and target tissues such as the eyes, lungs, GI organs etc, reversing signs and symptoms of organophosphate, carbamate and nerve gas exposure. Nitroglycerin is a vasodilator, venodilator, anti-anginal and a nitrate. Nitro works by vasodilating vessels in the coronary circulation and in bronchial and vascular smooth muscle, causing venodilation in the peripheral vasculature, decreasing the workload on the myocardium. It also decreases preload, afterload and oxygen demand on the heart. Nitroglycerin is indicated for chest pain and signs / symptoms associated with acute coronary syndromes and congestive heart failure in the presence of pulmonary edema. Nitro has contraindications of a systolic blood pressure below 100, ED drugs within the past 24 to 48 hours and should be used with caution in the presence of a confirmed right-sided myocardial infarction due to cavitation. Acetylsalicylic acid/ASA is an anti-platelet aggregate and a non steroidal anti-inflammatory indicated for chest pain and signs and symptoms associated with acute coronary syndromes. It works by blocking thromboxane A2 formation which in turn stops the creation of future blood clots. It is the first line of treatment for a confirmed myocardial infarction. Diltiazem is an antidysrhythmic and a calcium channel blocker indicated for atrial fibrillation, atrial flutter and is a second line treatment for supraventricular tachycardia refractory to adenosine. Diltiazem decreases extra cellular calcium ion influx into the myocardium, causing negative inotropy and chronotropy, slows atrial and ventricular conduction and decreases the sinus rate and ventricular rate in afib and a flutter. Diltiazem is contraindicated with patients with wpw syndrome because it leaves only one pathway of conduction, leading to potentially fatal dysrhythmias. Magnesium sulfate is a tocolytic, anti-inflammatory and electrolyte. It is indicated for pregnancy induced hypertension in preeclampsia, seizures in eclampsia, preterm labor, bronchospasm associated with asthma, chronic bronchitis and other reactive airway disease, polymorphic V tach(torsaids de points), ventricular tachycardia and ventricular fibrillation refractory to lidocaine and amiodarone in cardiac arrest. Magnesium works by relaxing bronchial smooth muscle, the uterus and blocking the release of acetylcholine in the myocardium which inhibits muscular excitability/decreases ventricular irritability, and antagonizes the release of calcium on calcium receptors, raising the threshold of seizures. Ipratropium bromide is an anticholinergic and a bronchodilator. It is indicated for asthma, chronic bronchitis, emphysema and other reactive airway diseases. It works by blocking the release of acetylcholine on bronchial smooth muscle, resulting in dilation of the larger airways/bronchodilation and the drying out of mucous membranes in the lungs. Albuterol sulfate is a sympathomimetic, beta 2 adrenergic agonist and a bronchodilator. It is indicated for asthma, chronic bronchitis, emphysema and other reactive airway diseases. It works by binding to beta 2 adrenergic receptors in the lungs- resulting in the relaxation of bronchial smooth muscle and bronchodilation.