Top Paramedicine Medications PDF

Top Paramedicine Medications Epinephrine Class: Catecholamine, sympathomimetic, alpha 1/ beta 1/beta 2 adrenergic agonist, histamine antagonist Indications: Anaphylaxis/allergic reaction Cardiac arrest (asystole, PEA, V fib, pulseless Vtach) Hemodynamically significant bradycardia/hypotension (not c...

Top Paramedicine Medications Epinephrine Class: Catecholamine, sympathomimetic, alpha 1/ beta 1/beta 2 adrenergic agonist, histamine antagonist Indications: Anaphylaxis/allergic reaction Cardiac arrest (asystole, PEA, V fib, pulseless Vtach) Hemodynamically significant bradycardia/hypotension (not caused by hypovolemia) Asthma, bronchospasm associated with emphysema and chronic bronchitis Mechanism of Action: Binds to alpha 1, beta 1, beta 2 adrenergic receptors Antagonizes histamine receptors Positive chronotropy, inotropy, and dromotropy Relaxes bronchial smooth muscle Increased blood pressure via vasoconstriction Reduction of swelling and blood vessel permeability Lidocaine Class: Antidysrhythmic, sodium channel blocker Indications: Ventricular tachycardia, pulseless V tach, ventricular fibrillation Premature ventricular complexes and couplets Monomorphic wide-complex tachycardia Mechanism of Action: Binds to sodium channels, blocking sodium ion flow Decreases ventricular excitability Increases threshold of ventricular fibrillation Suppresses ventricular ectopic activity Adenosine Class: Endogenous nucleotide, antidysrhythmic Indications: Supraventricular tachycardia Monomorphic wide complex tachycardia Mechanism of Action: Slows atrioventricular conduction, resulting in cardioversion Terminates reentry pathway Allows SA node to take over as primary pacemaker Amiodarone Class: Antidysrhythmic, sodium/potassium/calcium antagonist Indications: Ventricular dysrhythmias Ventricular tachycardia (with a pulse or pulseless) Ventricular fibrillation Wide complex tachycardia Mechanism of Action: Blocks sodium, potassium, and calcium channels Slows sinus rate, action potential, and repolarization Prolongs PR and QT segments Atropine Class: Anticholinergic, parasympathetolytic, antidote Indications: Hemodynamically significant bradycardia Cholinergic poisoning Mechanism of Action: Blocks acetylcholine on left vagus nerve from being released onto the SA node, thereby increasing heart rate by allowing the SA node to take over as the primary pacemaker. Blocks the release of 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 Class: Vasodilator, venodilator, anti-anginal, nitrate Indications: Chest pain and signs and symptoms associated with acute coronary syndromes Congestive heart failure in the presence of pulmonary edema Mechanism of Action: Vasodilates vessels in the coronary circulation and in bronchial and vascular smooth muscle Causes venodilation in the peripheral vasculature Decreases workload on the myocardium Decreases preload and afterload Decreases oxygen demand on the heart Contraindications: Systolic blood pressure below 100 ED drugs within the past 24 to 72 hours Use extreme caution in the presence of a confirmed right-sided myocardial infarction due to cavitation. Acetylsalicylic Acid (ASA) Class: Anti-platelet aggregate, NSAID Indications: Chest pain and signs and symptoms associated with acute coronary syndromes First line treatment of a confirmed myocardial infarction Mechanism of Action: Blocks thromboxane A2 formation Prevents blood clot formation Diltiazem Class: Antidysrhythmic, calcium channel blocker Indications: Atrial fibrillation, atrial flutter Second-line treatment for supraventricular tachycardia Mechanism of Action: Decreases extracellular calcium ion influx into the myocardium Negative inotropy and chronotropy Slows atrial and ventricular conduction Contraindications: Patients with WPW syndrome because it leaves only one pathway of conduction, leading to potentially fatal dysrhythmias. Magnesium Sulfate Class: Tocolytic, anti-inflammatory, electrolyte, calcium antagonist Indications: Pregnancy-induced hypertension (preeclampsia) Seizures in eclampsia Preterm labor Bronchospasm associated with asthma, chronic bronchitis Polymorphic V tach (torsades de pointes), refractory ventricular tachycardia and fibrillation Mechanism of Action: Relaxation of bronchial smooth muscle, uterus Blocks release of acetylcholine in myocardium which inhibits muscular excitability/ decreases ventricular irritability Antagonizes release of calcium on calcium receptors Ipratropium Bromide Class: Anticholinergic, bronchodilator Indications: Asthma, chronic bronchitis, emphysema, other reactive airway diseases Mechanism of Action: Blocks release of acetylcholine on bronchial smooth muscle Results in bronchodilation and drying of mucous membranes Albuterol Sulfate Class: Sympathomimetic, beta 2 adrenergic agonist, bronchodilator Indications: Asthma, chronic bronchitis, emphysema, reactive airway diseases, hyperkalemia Mechanism of Action: Binds to beta 2 adrenergic receptors in lungs Results in relaxation of bronchial smooth muscle and bronchodilation