Drug notecards for paramedic NREMT study guide

A selection of notecards to study for the NREMT. Including uses, dosages, routes of admin, complications.

1. Adenosine
Generic: Adenocard
Classification: Anti-dysrhythmic
Indic: SVT
Adult: 6mg + 12mg + 12mg IVP
Peds: below 50kg 0.05-0.1mg/kg IVP
Protocols: 5022 A&P, 5023 A&P
Contra: 2
nd/
3
rd
AV block, VTACH, asthma (relative)
Effects: slows/blocks conduction through AV node, "resets the heart"
Side Effects: AV block, asystole, dysrhythmias, chest pressure, dizziness,
flushing, nausea, SOB
Notes: record EKG while giving to determine underlying rhythm, onset
very quick, effects may be more pronounced in patients on dipyridamole,
effects may be weakened on patients taking theophylline, not indicated
for aflutter or afib, if no effect likely to be VT.
Valium
Generic: Diazepam
Classification: benzodiazepine
Indic: generalized seizures, status epilepticus, combative patients
Adult: seizure/sedation 0.1mg/kg IV/IO every 5min 0.3mg/kg max vertigo
5mg IV/IO
Peds: seizure 0.3mg/kg IV/IO or 0.5mg/kg rectally every 5 min 0.6mg/kg
max sedation 0.1mg/kg IV/IO every 5min 0.3mg/kg max
Protocols: 7007, 7010, 8001, 8083, 3080, 4002, 5021A, 5022A&P,
5023A&P
Contra: respiratory depression, hypotension (relative)
Effects: suppresses spread of seizure activity through the motor cortex,
skeletal muscle relaxant, reduces anxiety and causes sedation
Side Effects: hypotension, respiratory depression
Notes: Intramuscular should be avoided as it leads to widely variable
absorption
Fentanyl
Classification: opioid analgesic
Indic: moderate/severe pain, premed for cardioversion or
transcutaneous pacing
Adult: 1mcg/kg IV/IO 100mcg/dose max repeat half dose every 5min
3mcg/kg max
Peds: 1mcg/kg IV/IO may repeat half dose every 5min 3mcg/kg max
Protocols: 6003, 6071, 5001
Contra: no absolute, relative head injury, acute stroke, pre-existing
respiratory or CNS depression
Effects: binds to CNS opioid receptors for producing analgesia and
sedation
Side Effects: respiratory or CNS depression, itchiness, bradycardia,
nausea, vomiting, muscular rigidity in high doses
Amiodarone
Generic: Coradone
Classification: Antidysrhthmic
Indic: vfib, vtach, rapid afib, rapid aflutter, SVT
Adult: VF/pulselessVT 300mg IVP +150mg @10min, recurrent VF/VT 1mg/min IV/IO
max 6 hours, wide complex vtach 150mg/100cc over 10 min may repeat dose once
after 10min or 1mg/min IV/IO, narrow complex tach 5 mg/kg IV over 20-60min
Peds: VF/pulselessVT 5mg/kg up to 300mg IVP, narrow or wide complex tach 5m/kg
IV over 60min
Protocols: 3031A, 3050A, 3080, 5022A&P, 5023A&P
Contra: bradycardia, 2
nd
& 3
rd
degree AV block, cardiogenic shock (relative),
suspected AAA (relative)
Effects: alpha and beta adrenergic inhibiting, increases PR and QT intervals,
decreases PVR
Side Effects: hypotension, bradycardia, asystole, pulseless electrical activity, serious
CNS eye lung liver and skin toxicity possible
Notes: avoid using both amiodarone and procainamide

2. Solumedrol
Generic: Methylprednisolone
Classification: anti-inflammatory glucocorticoid
Indic: anaphylaxis/severe allergic reaction, asthma/COPD exacerbation,
irritant/allergic bronchospasm, severe adrenal insufficiency
Adult: 125 mg IVP
Peds: 2mg/kg IVP
Protocols: 4011, 4022
Contra: hypersensitivity, caution with GI bleeding, diabetes mellitus and
severe infection
Effects: anti-inflammatory, immune suppression, decreases swelling and
mucous production in airways
Side Effects: seizure, hypertension, sodium and water retention,
hypokalemia, euphoria
Notes: effects due to altering protein so onset takes hours after admin
Cardizem
Generic: cardiazem, diltiozem
Classification: calcium channel blocker
Indic: rate control in afib and SVT
Adult: 15-20mg (0.25mg/kg) IV/IO over 1-2min + 20-25mg (0.35mg/kg)
after 15min
Protocols: 5022A
Contra: wide complex QRS, (relative) recent use of beta blockers and
hypotension
Effects: inhibits influx of calcium ions during depolarization of cardiac
and vascular smooth muscle, slows conduction though the SA and AV
node
Side Effects: hypotension, heart block
Ativan
Generic: Lorazepam
Classification: benzodiazepines
Indic: major motor seizures, status epilepticus, sedation, skeletal muscle
spasm, acute anxiety states, combative behavior
Adult: sedation/seizure 0.1mg/kg IV/IO/IN every 5min max 2mg/dose until
max of 4 mg, nausea/vomiting with vertigo 1mg IV/IO slowly
Peds: seizure 0.1mg/kg IV/IO/IN every 5min max 2mg/dose until max of 4 mg
Protocols: 1000, 3080, 4002, 5021A, 5022A&P, 5023A&P, 7007, 7010, 8001,
8083
Contra: (relative) respiratory depression, hypotension, ETOH or other
sedative drugs, pregnancy, hypersensitivity
Effects: binds to GABA receptors in CNS causing depression of RAS and spinal
nerves, short term sedation, amnesia to events while drug is active, anti-
convulsant
Side Effects: respiratory depression, hypotension
Atropine
Classification: anticholinergic, antiparasympathetic, antimuscarinic
Indic: symptomatic bradycardia especially sinus bradycardia, organophosphate
poisoning
Adult: brady 0.5mg IV/IO every 3-5 not to exceed 0.03mg/kg max 3mg,
organophosphate 2-6mg IM with pralidoxime no max
Peds: brady 0.02mg/kg IV/IO min 0.1mg max single dose 1mg + same dose every
5 min max total dose 0.03mg/kg
Protocols: 8083, 3031A&P, 3032, 5021A&P
Contra: (relative) glaucoma, myasthenia gravis, pyloric stenosis, prostatic
hypertrophy
Effects: blocks acetylcholine receptor sites (anti-cholinergic), decreased vagal
tone, increases SA and AV nodal conduction, dries secretions
Side Effects: pupil dilation, blurred vision, dry mouth, tachycardia, urinary
retention
Notes: usually not effective for Mobitz II or 3
rd
degree block, not effective in
heart transplant

3. Versed
Generic: Midazolam
Classification: benzodiazepines
Indic: sedation, agitation, seizure, alcohol withdrawal
Adult: sedation 1mg IV/IO every 5min to desired effect max 0.1mg/kg, agitation 1-
2mg IV/IO or 2-5mg IM/IN every 5min as needed max 0.1mg/kg, seizure 1-5mg
IV/IO/IN/IM every 5min as needed max 0.1mg/kg, vertigo 1mg IV/IO/IM/IN (requires
command)
Peds: sedation 0.025-0.05mg/kg IV/IO every 5min max 0.1mg/kg, seizure 0.1mg/kg
IV/IO/IN (0.15mg/kg IM) every 5min as needed
Protocols: 3080, 4002, 5021A, 5022A&P, 5023A&P, 7007, 7010, 8001, 8083
Contra: hypersensitivity, acute or untreated glaucoma, (relative) hypotension, shock,
CNS depression, recent use of sedation, renal failure, pregnancy
Effects: binds to GABA receptors in CNS causing depression of RAS and spinal nerves,
short term sedation, amnesia to events while drug is active, anti-convulsant
Side Effects: respiratory depression, cardiac dysrhythmia, hypotension
Notes: decrease dose if systolic <100, repeat dose requires command
Zofran
Generic: Ondansetron
Classification: antiemetic, selective 5-HT3 receptor antagonist
Indic: nausea, vomiting
Adult: 4mg slow IV/IO over 2min, 4-8mg IM
Peds: 0.15mg/kg IV/IO max dose 4mg over 2min, 4-8mg IM,
Protocols: 7010
Contra: hypersensitivity
Effects: prevents nausea and vomiting
Side Effects: tremor, restlessness, paranoia dystonia
Benadryl
Generic: Diphenhydramine
Classification: antihistamine
Indic: anaphylaxis, allergic reactions, dystonic reactions, nausea, vomiting,
pruritic dermatitis, motion sickness
Adult: 25-50mg IV/IO/IM/PO
Peds: 1mg/kg IV/IO/PO max 50mg
Protocols: 8031, 4011
Contra: nursing mothers, (relative) other use of CNS depressants, narrow
angle glaucoma
Effects: blocks H1 histamine receptors, inhibits dystonic reactions
Side Effects: dry mouth, tachycardia, sedation, urinary retention
D50
Dextrose, can be in D25/D10 forms
Classification: caloric agent
Indic: hypoglycemia
Adult: 25g (50ccD50 100ccD25) IV/IO
Peds: newborn 5ml/kg D10, <13 2ml/kg D25, ≥13 1ml/kg D50
Protocols: 6081, 7002A&P, 7006, 7007, 3031P, 3080
Contra: (relative) stroke, MI, cardiac arrest
Effects: immediate source of glucose
Side Effects: none
Notes: causes local tissue necrosis if IV infiltrates

4. Narcan
Generic: Naloxone
Classification: opioid antagonist
Indic: opiate overdose
Adult: 2mg IV/IM/SC/ET/IN
Peds: <5 or 20kg 0.1mg/kg IV/IM/SC/ET, >5 or 20kg 2mg IV/IM/SC/ET
Protocols: 3031A&P, 4001, 4002, 6003, 7002A&P
Contra: (relative) hypersensitivity
Effects: reverses effects of most narcotics
Side Effects: acute narcotic withdrawal, hypertension, irritability, nausea,
vomiting, tachycardia
Notes: does not reverse benzo OD
Nitro
Generic: Nitroglycerin, Nitro-Bid, Nitrostat
Classification: nitrates
Indic: angina pectoris, heart failure with increased blood pressure
Adult: angina 1 metered dose SL every 5min max 3, PE SBP>160 2
metered doses SL every 3-5min, PE SBP 100-160 1 metered dose every 3-
5min
Protocols: 5001, 5002, 9001
Contra: head trauma, hypertrophic cardiomyopathy, (relative) glaucoma,
hypotension, erectile dysfunction meds within 48 hours
Effects: dilated coronary and systemic arteries
Side Effects: dizziness, headache, hypotension
Albuterol
Generic: Proventil, Ventolin
Classification: Adrenergic B2 agonist, bronchodilator
Indic: asthma, bronchospasms
Adult/Peds: 2.5mg Neb
Protocols: 4011, 4022, 4023P
Contra: Tachydysrhythmias
Effects: bronchodilates. by acting on B2 receptors in lungs, relaxes
smooth muscle
Side Effects: tachycardia, palpitations
Calcium Chloride
Classification: electrolyte supplement
Indic: symptomatic hyperkalemia with cardiac conduction effects,
hyperkalemic cardiac arrest, crush syndrome, calcium channel blocker
overdose
Adult: 1g (10cc of 10%sol) slow IV/IO push repeat as needed
Peds: 0.2ml/kg of 10%sol up to 1g slow IV/IO push repeat as needed
Protocols: 6004, 8031, 5023A&P
Contra: digoxin toxicity, (relative) hyperglycemia
Effects: stabilizes cardiac tissue to effects of high potassium
Side Effects: cardiac arrhythmias, flushing/burning sensation of skin,
nausea, vomiting
Notes: do not admin with sodium bicarb as it may crystallize in the IV line

5. Epi 1:10,000
Generic: Epinephrine
Classification: alpha and beta adrenergic agonists
Indic: cardiac arrest, anaphylaxis, bronchospasm, shock
Adult: cardiac arrest IV/IO 1mg every 3-5 min ETT 2mg,
Peds: cardiac arrest IV/IO 0.01mg/kg every 3-5min, symptomatic
bradycardia IV/IO 0.01mg/kg every 3-5min
Protocols: 6002, 7005, 3031A&P, 3032, 3033, 3050A, 3080, 4011, 4022,
4023P, 5012A&P, 411
Contra: (relative) coronary artery disease, hypertension, tachycardia
Effects: stimulates alpha and beta adrenergic receptors, increases heart
rate and myocardial contractility, vasoconstriction, inhibits release of
anaphylactic mediators
Side Effects: hypertension, palpitations, tachyarrhythmia's, tremors
Epi 1:1,000
Generic: Epinephrine
Classification: alpha and beta adrenergic agonists
Indic: cardiac arrest, anaphylaxis, bronchospasm, shock
Adult: profound bradycardia/hypertension epi infusion0.1-0.5mcg/kg/min
titrated until SBP>90, anaphylaxis 0.3mg IM repeat as necessary
Peds: cardiac arrest ETT 0.1mg/kg, croup/stridor 5ml via neb, anaphylaxis
0.01mg/kg IM max 0.3mg
Protocols: 6002, 7005, 3031A&P, 3032, 3033, 3050A, 3080, 4011, 4022,
4023P, 5012A&P, 411
Contra: (relative) coronary artery disease, hypertension, tachycardia
Effects: stimulates alpha and beta adrenergic receptors, increases heart
rate and myocardial contractility, vasoconstriction, inhibits release of
anaphylactic mediators
Side Effects: hypertension, palpitations, tachyarrhythmia's, tremors
Dobutamine
Generic: Dobutrex
Classfication: vasopressors
Indi: cardiogenic shock
Adult: 5-20mcg/kg/min infusion
Peds: 5-20mcg/kg/min infusion
Protocols: 5002
Contra: idiopathic, hypertrophic subaortic stenosis (IHSS), (relative)
uncorrected hypovolemia, MI
Effects: increases cardiac contractility, vasodilation effects
Side Effects: tachyarrhythmia's, hypotension, angina
Notes: do not exceed 20mcg/kg/min unless by command, if SBP<70 use
dopamine
Verapamil
Generic: Calan, isoptin, verelan, covera
Classification: calcium channel blocker
Indic: SVT, afib/aflutter to control rate
Adult: 2.5mg IV/IO over 2min repeat in 15min
Protocols: 5022A
Contra: Wolff-Parkinson-White (WPW) Syndrome or other bypass tract,
AV block, cardiogenic shock, wide complex tachycardia unless known
AF/SVT
Effects: calcium channel blocker, delays impulse though AV node, dilates
coronary and systemic arteries
Side Effects: bradycardia, AV blockade, CHF, severe hypotension,
dizziness/headache

6. Sodium Thiosulfate
Classification: antidote, antineoplastic adjunct
Indic: acute cyanide poisoning
Adult: 12.5g (50ml) over 1-2min may give half a dose 5-10min later if
symptoms persist
Peds: 1.6ml/kg to max of 50ml over 3-5min may give half a dose 5-10min
later if symptoms persist
Protocols: 8031, 8081
Contra: none
Effects: accelerates the conversion of cyanide to the non-toxic
thiocyanate, excreted by the kidneys
Side Effects: none significant
Procan
Generic: Procainamide, Pronestyl
Classification: antiarrhythmic agent
Indic: vtach, SVT (including AF) wide complex and wolf-parkinson-white
Adult: 20-50mg/min IV until arrhythmia is suppressed, hypotension
ensues or the QRS complex is prolonged by 50% max dose is 17mg/kg, or
100mg IV every 5min until arrhythmia is controlled, maintence infusion
rate is 1-4mg/min
Protocols: 3031A&P, 5022P, 5023P
Contra: 2
nd
and 3
rd
degree block, torsade’s de pointes, hypersensitivity,
lupus
Effects: class 1a antiarrhythmic, decreases conduction and impulse
generation in atria, AV node and ventricles
Side Effects: hypotension, cardiac rhythm and conduction disturbances
Oxytocin
Generic: Pitocin
Classification: polypeptide hormone
Indic: post-partum hemorrhage
Adult: 10-20units/1000mlNSS IV/IO at wide open, 10 units IM
Protocols: 7087
Contra: ensure baby and placenta have been delivered and there is no
additional fetus
Effects: causes contraction of the uterine smooth muscle and lactation,
used to induce labor and controlling hemorrhage post-delivery
Side Effects: hypertension, cardiac arrhythmia, coma/subarachnoid
hemorrhage, nausea, vomiting, uterine rupture and internal bleeding,
retinal hemorrhage, arrhythmias, convulsions
Enalapril
Generic: Enalaprilat, Vasotec
Classification: Angiotensin converting enzyme (ACE)
Indic: treatment of acute severe heart failure not responsive to NTG or
unable to give NTG such as on CPAP, treatment of severe hypertension
Adult: 0.625-1.25mg IV/IO
Protocols: 5002
Contra: history of ACE inhibitor associated hereditary or idiopathic
angioedema, pregnancy
Effects: ACE inhibitor, vasodilation
Side Effects: severe hypotension, angioedema/anaphylaxis,
hyperkalemia/renal failure, fetal death/malformations, headache/nausea
Notes: may increase lithium levels

7. Captopril
Classification: ACE inhibitor
Indic: acute heart failure with hypertension
Adult: 25mg sublingual
Protocols: 5002
Contra: history of ACE inhibitor associated angioedema
Effects: decreases afterload (myocardial work), ACE inhibitor –
suppression of rennin-angiotensin-aldosterone system
Side Effects: rash, fever, arthralgia, hypotension, persistent
nonproductive cough, anaphylactoid reactions, angioedema
Activated Charcoal
Generic: Actidose-Aqua
Classification: poison antidote
Indic: Poisoning, overdose
Adult: 25-50g
Peds: 1g/kg
Protocols: 8031
Contra: unconsciousness, cyanide poisoning, acids or alkaline ingestion,
absent bowel sounds
Effects: binds to poisons/ toxins and increases absorption in GI tract
Side Effects: black stool, vomiting, pulmonary aspiration
Aspirin
Classification: non-steroidal anti-inflammatory drug
Indic: myocardial infarction, chest pain
Adult: 4 baby ASA (81mg each)
Protocols: 9001, 5001, 901
Contra: hypersensitivity, (relative) active bleeding condition or ulcer,
pregnancy
Effects: inhibits platelet aggregation by blocking formation of
thromboxane A2, reduces mortality due to MI, reduces non-fatal re-
infarction
Side Effects: heartburn, indigestion, nausea
Glucagon
Classification: hormone
Indic: hypoglycemia and no IV access
Adult: hypoglycemia 1mg IM/IN, calcium channel blocker or beta blocker
overdose 3-10mg IV/IO, refractory allergic reaction 1-4mg IVP
Peds: hypoglycemia <5 or 20kg 0.1mg/kg IM/IN, calcium channel blocker
overdose 0.05mg/kg IV/IO
Protocols: 4011, 5021A&P, 5023A&P, 7002A&P, 7007, 8031
Contra: hypersensitivity, (relative) known pancreatic or adrenal gland
tumor
Effects: promotes breakdown of hepatic glycogen to glucose, bypasses
blocked beta receptors to stimulate heart rate and contractility
Side Effects: nausea, vomiting, urticaria

8. Tylenol
Generic: Acetaminophen
Classification: non-opioid analgesic
Indic: pain control, fever
Adult: 15-20mg not to exceed 1000mg PO
Peds: 10-15 mg/kg PO/Rectal
Protocols: 1000, 6003, 7007
Contra: known allergy, liver/renal disease
Effects: may block peripheral pain impulses, inhibits prostaglandins (helps
control fever)
Side Effects: GI bleeding, renal failure, seizures
Sodium Bicarbonate
Classification: electrolyte agent and alkalizer
Indic: tricyclic antidepressant (TCA) or aspirin overdose, hyperkalemia,
metabolic acidosis, cyanide poisoning
Adult: 1mEq/kg IV may give multiple doses
Peds: 1mEq/kg IV may give multiple doses
Protocols: 3031A&P, 5023A&P, 6004, 8031, 8081
Contra: (relative) hypoglycemia, pulmonary edema
Effects: buffers acid in blood causing pH to rise, antagonizes sodium
channel blockade in TCA overdoses, promotes diffusion out of the body
tissues and urinary excretion of aspirin
Side Effects: dysrhythmias secondary to potassium effects, pulmonary
edema
Dopamine
Generic: Intropin
Classification: sympathomimetic
Indic: cardiogenic shock, neurogenic shock, sepsis, refractory hypotension
after fluid admin, symptomatic bradycardia
Adult/Peds: 5-20mcg/kg/min infusion (titrate to BP)
Protocols: 6002, 7005, 3080, 5002, 5021A&P
Contra: (relative) tachydysrhythmias, acute coronary syndrome,
inadequate volume resuscitation
Effects: stimulates alpha, beta and dopamine receptors depending on
dose, increases cardiac output and systemic arterial pressure, dilates
vessels to brain heart and kidneys, constricts most systemic vasculature,
increases heart rate and myocardial contractility
Side Effects: angina, ectopy/tachydysrhthmias, headache
Notes: do not exceed 20mcg/kg/min without command, with cardiogenic
shock with SBP>70 use dobutamine
Magnesium Sulfate
Classification: mineral/electrolyte
Indic: preeclampsia, eclampsia, asthma ventricular arrhythmias (torsade’s
de pointes)
Adult: cardiac arrest 2g IVP, vtach 1-2g IV over 5-20min, asthma 1-2g IV
over 5-20min, preeclampsia 4g IV over 20min, eclampsia 1g/min IVP until
seizure stops max 4g
Peds: cardiac arrest 20-50mg/kg IVP/IO
Protocols: 3031A&P, 4022
Contra: (relative) active labor, heart block, hypocalcemia, renal failure
Effects: affects myocardial impulse formation and conduction time,
relaxes smooth muscle
Side Effects: bradycardia, hyperreflexia, hypotension, respiratory
depression
Notes: preferred med for patients with torsade’s de pointe

9. Etomidate
Classification: anesthetic agent
Indic: brief profound sedation
Adult: 0.3mg/kg IV/IO max 30mg
Protocols: 4002
Contra: (relative) severe infection, renal insufficiency
Effects: short acting sedative with rapid onset, minimal cardiac and
respiratory depressive effects, no histamine release
Side Effects: myoclonic skeletal muscle movement, tonic movements,
short duration apnea, hyper or hypoventilation, laryngospasm, hyper or
hypotension, tachy or bradycardia, arrhythmias, decreased adrenal
function
Lidocaine
Generic: Xylocaine
Classification: antiarrhythmic
Indic: ventricular arrhythmias
Adult: VF/VT 1-1.5mg/kg IV/IO may repeat dose, refractory VF 1-1.5mg/kg
IV/IO can repeat 0.75mg/kg IV/IO every 5-10min max 3mg/kg, IV
infusion/drip 2-4mg/min, ETT admin double the IV dose, local anesthesia for
IO 20-40mg
Peds: VF/VT 1mg/kg IV/IO or 2mg/kg ET repeated to max 3mg/kg, IV
infusion/drip 20-50mcg/kg/min IV infusion, ETT admin 2-3mg/kg, local
anesthesia for IO 0.5mg/kg
Protocols: 1000, 3031A&P, 3032, 4001, 5023A&P, 7007
Contra: idioventricular rhythms, 2
nd
or 3
rd
degree AV block, (relative)
bradycardia
Effects: suppresses ventricular ectopy, elevates threshold for ventricular
fibrillation, suppresses reentry arrhythmias
Side Effects: arrhythmias, hypotension, irritability, muscle twitching
Morphine
Classification: opioid agonist
Indic: pain management, pulmonary edema, procedural sedation
Adult: chest pain or Pulmonary edema 2-4mg IV, pain 3-5mg IV titrated to
effect, procedural sedation 3-5mg IV
Peds: contact medical command
Protocols: 5001, 5002, 6003, 6071
Contra: (relative) asthma, COPD, diarrhea secondary to poisoning, head
injury, hypotension, hypovolemia, respiratory depression
Effects: binds to opiate receptors, peripheral vasodilation
Side Effects: bradycardia, hypotension, nausea, vomiting, respiratory
depression
Nitrous
Classification: dissociative class of intoxicants
Indic: pain of musculoskeletal origin, burns, suspected ischemic chest
pain, states of severe anxiety including hyperventilation
Adult/Peds: blend 50% nitrous oxide and 50% oxygen self admin through
modified demand valve
Protocols: 6003, 6071
Contra: patients who cannot understand verbal instructions, alcohol or
drug use, head injury or altered mental status, (relative) COPD that can’t
tolerate 50% O2
Effects: CNS depressant with analgesic properties, effects go away 2-5min
after stopping, treats pain good for trauma, increases blood oxygen level
Side Effects: dizziness, lightheadedness, altered mental state,
hallucinations, nausea, vomiting

10. Ipratropium Bromide
Classification: bronchodilator
Indic: bronchospasm, dyspnea associated with chronic obstructive
pulmonary disease (emphysema and chronic bronchitis)
Adult: 500mcg in 2.5ml NSS via neb
Peds: 250mcg in 2.5ml NSS via neb
Protocols: 4022, 421
Contra: hypersensitivity
Effects: Parasympatholytic agent antagonizes the action of acetylcholine
Side Effects: coughing, sputum increased, dizziness, tremor, nervousness