emergency drugs .pptx

emergency medicine contain all type of emergency drugs which mainly used in emergency condition.

1. EMERGENCY DRUGS PRESENTED BY – HARSHIKA S. TEMBHURNE MSC 1 ST YEAR , SCON , PUNE .

2. Introduction  Emergency medicine is the medical specialty dedicated to the diagnosis and treatment of unforeseen illness or injury.  Emergency drugs are those chemical entities used in patients during life threatening conditions so that the symptoms can be controlled and life can be saved.

3. Purpose of Emergency Drugs • To provide initial treatment for broad spectrum of illness and injuries, most of which may be life threatening. • To control the symptoms of patient. • To save the life of the Patient. • To reach the Site of action a soon as possible • To normalize the vital body function. • To diverge the patient the from the possible risk.

4. Drug Dosage Calculations Desired dose Quantity of a medication that is to be administered Concentration Amount of medication that is present in vial Volume Amount of fluid medication is dissolved in Yield The amount of drug in 1 mL

5. Activated Charcoal (EZ-Char, Actidose , Liqui-Char) Mechanism of action Absorbs toxic substances from the gastrointestinal tract Indications Most oral poisonings/ medication overdoses Contraindications Oral administration to comatose patients Adverse reactions If aspirated, can induce fatal form of pneumonitis Bowel obstruction Considerations Mix contents well before administration. Does not absorb cyanide, lithium, iron, lead, or arsenic

6. Adenosine ( Adenocard ) Mechanism of action Slows conduction through the AV node Can interrupt reentrant pathways The drug of choice for reentry SVT Indications Most forms of stable narrow-complex SVT Contraindications Bronchoconstrictive or bronchospastic lung disease Adverse reactions Generally short duration and mild Considerations Evaluate elderly for signs of dehydration

7. Albuterol (Proventil, Ventolin) Mechanism of action Results in smooth-muscle relaxation in the bronchial tree Indications Treatment of bronchospasm in patients with COPD/asthma) Contraindications Hypersensitivity reactions to albuterol Adverse reactions Often dose-related and include headache, fatigue, lightheadedness, irritability, restlessness Considerations Pregnancy safety: Category C May precipitate angina pectoris and dysrhythmias

8. Aspirin (ASA, Bayer, Ecotrin, St. Joseph, and Others) Mechanism of action Prevents platelets from clumping together and forming emboli Indications New onset chest pain suggestive of acute myocardial infarction Contraindications Relatively contraindicated in patients with active ulcer disease or asthma Adverse reactions Bronchospasm, anaphylaxis, wheezing in allergic patients, prolonged bleeding Considerations Pregnancy safety: Category D Not recommended in pediatric population

9. Atropine Sulfate Mechanism of action Increases heart rate in life-threatening bradydysrhythmias Indications Hemodynamically unstable bradycardia Contraindications Tachycardia, hypersensitivity Adverse reactions Drowsiness, confusion, headache, tachycardia, palpitations Considerations Pregnancy safety: Category C Moderate doses may cause pupillary dilation.

10. Bumetanide (Bumex) Mechanism of action Inhibits the reabsorption of sodium and chloride in the ascending limb of the loop of Henle Indications Pulmonary edema, congestive heart failure Contraindications Hypersensitivity to bumetanide or sulfonamides Adverse reactions Dizziness, headache, orthostatic hypotension Considerations Pregnancy safety: Category C

11. Calcium Gluconate Mechanism of action Counteracts the toxicity of hyperkalemia Indications Hyperkalemia, hypocalcemia Contraindications Ventricular fibrillation, digitalis toxicity, hypercalcemia Adverse reactions Syncope, cardiac arrest, dysrhythmia, bradycardia Considerations Pregnancy safety: Category C Do not administer by IM or SQ

12. Dexamethasone Sodium Phosphate (Decadron) Mechanism of action Suppresses acute and chronic inflammation Indications Anaphylaxis, asthma, spinal cord injury Contraindications Hypersensitivity, use caution in suspected systemic sepsis Adverse reactions Headache, restlessness, euphoria, psychoses Considerations Pregnancy safety: Category C Protect medication from heat. Toxicity and side effects occur with long-term use.

13. Dextrose Mechanism of action Rapidly increases serum glucose levels Indications Hypoglycemia, altered level of consciousness Contraindications Intracranial hemorrhage Adverse reactions Cerebral hemorrhage Cerebral ischemia Pulmonary edema Considerations Pregnancy safety: Category C

14. Diazepam (Valium and Others) Mechanism of action Raises the seizure threshold; induces amnesia and sedation Indications Acute anxiety states and agitation, acute alcohol withdrawal Contraindications Hypersensitivity, narrow-angle glaucoma Adverse reactions Dizziness, drowsiness, confusion, headache Considerations Pregnancy safety: Category D Short duration for anticonvulsant effect Reduce dose by 50% in elderly patients.

15. Digoxin (Lanoxin) Mechanism of action Increases force of myocardial contraction Indications Congestive heart failure, reentry SVTs, ventricular rate control in atrial flutter and atrial fibrillation Contraindications Ventricular fibrillation, ventricular tachycardia, digitalis toxicity Adverse reactions Fatigue, headache, blurred yellow or green vision, seizures Considerations Pregnancy safety: Category C Patient receiving IV digoxin must be on a monitor

16. Diphenhydramine (Benadryl) Mechanism of action Blocks cellular histamine receptors Indications Symptomatic relief of allergies, allergic reactions, and anaphylaxis Contraindications Asthma, glaucoma, pregnancy, hypertension Adverse reactions Drowsiness, sedation, seizures Considerations Pregnancy safety: Category B Not used in infants

17. Dobutamine Hydrochloride ( Dobutrex ) Mechanism of action Increased myocardial contractility, stroke volume, and increased cardiac output Indications Cardiogenic shock, CHF Contraindications Tachydysrhythmias, severe hypotension Adverse reactions Headache, dyspnea, tachycardia, hypertension, chest pain Considerations Pregnancy safety: Category B Monitor blood pressure closely.

18. Dopamine Hydrochloride ( Intropin ) Mechanism of action Increases myocardial contractility and stroke volume Indications Cardiogenic and septic shock, hypotension with low cardiac output states Contraindications Hypovolemic shock, pheochromocytoma, tachydysrhythmias Adverse reactions Headache, anxiety, dyspnea, dysrhythmias Considerations Pregnancy safety: Category C Effects are dose-dependent

19. Epinephrine (Adrenalin) Mechanism of action Blocks histamine receptors Indications Cardiac arrest, symptomatic bradycardia Contraindications Hypertension, hypothermia, pulmonary edema Adverse reactions Nervousness, restlessness, headache, tremor Considerations Pregnancy safety: Category C May cause syncope in asthmatic children

20. Epinephrine Racemic ( Micronefrin ) Mechanism of action Reduces airway resistance Indications Bronchial asthma, prevention of bronchospasm, croup Contraindications Hypertension, underlying cardiovascular disease, epiglottitis Adverse reactions Headache, anxiety, fear, nervousness, respiratory weakness Considerations May cause tachycardia and other dysrhythmias Monitor vital signs.

21. Fosphenytoin ( Cerebyx ) Mechanism of action Elevates the excitability threshold of the cell, reducing its response to stimuli Indications Status epilepticus, seizure disorder Contraindications Bradycardia, Adams-Stokes syndrome, second- or third-degree AV blocks Adverse reactions Severe hypotension, bradycardia, dysrhythmias Considerations Pregnancy safety: Category D Use with caution in patients with hepatic and renal impairment and diabetic, elderly, and debilitated patients.

22. Furosemide (Lasix) Mechanism of action Causes increased urine output Indications CHF, pulmonary edema, hypertensive crisis Contraindications Hypovolemia, anuria, hypotension Adverse reactions Dizziness, headache, ECG changes, weakness Considerations Pregnancy safety: Category C Ototoxicity, deafness, and projectile vomiting can occur with rapid administration.

23. Heparin Sodium Mechanism of action Affects clotting factors IX, XI, XII, plasmin; does not lyse existing clots Indications Acute myocardial infarction, prophylaxis and treatment of thromboembolic disorders Contraindications Hypersensitivity, active bleeding Adverse reactions Pain, anaphylaxis, shock, hematuria Considerations Pregnancy safety: Category C Heparin does not lyse existing clots.

24. Hydrocortisone Sodium Succinate ( Solu-Cortef ) Mechanism of action Anti-inflammatory; immunosuppressive with salt-retaining actions Indications Shock due to acute adrenocortical insufficiency, anaphylaxis, asthma, and COPD Contraindications Systemic fungal infections, premature infants Adverse reactions Headache, vertigo, pulmonary tuberculosis Considerations Pregnancy safety: Category C May be used in status asthmaticus as a second-line drug

25. Lidocaine Hydrochloride (Xylocaine) Mechanism of action Decreases automaticity Indications Alternative to amiodarone in cardiac arrest from ventricular tachycardia Contraindications Hypersensitivity, second- or third-degree AV block in the absence of an artificial pacemaker Adverse reactions Anxiety, drowsiness, confusion, seizures Considerations Apnea induced with succinylcholine may be prolonged with high doses of lidocaine. Exceedingly high doses can result in coma or death.

26. Lorazepam (Ativan) Mechanism of action Anxiolytic, anticonvulsant, and sedative effect Indications Initial control of status epilepticus or severe recurrent seizures Contraindications Acute narrow-angle glaucoma, coma, shock Adverse reactions Dizziness, drowsiness, CNS depression, headache Considerations Pregnancy safety: Category D Monitor respiratory rate and blood pressure during administration.

27. Mannitol ( Osmitrol ) Mechanism of action Decreases cerebral edema and intracranial pressure Indications Cerebral edema Contraindications Hypotension, pulmonary edema, severe dehydration, intracranial bleeding, CHF Adverse reactions Headache, confusion, seizures, pulmonary edema Considerations Pregnancy safety: Category C May crystallize at low temperatures; store at room temperature Have ventilatory support available.

28. Methylprednisolone Sodium Succinate ( Solu -Medrol) Mechanism of action Suppresses acute and chronic inflammation Indications Acute spinal cord trauma, anaphylaxis, bronchodilator for unresponsive asthma Contraindications Premature infants, systemic fungal infections Adverse reactions Depression, euphoria, headache, restlessness, seizure Considerations Pregnancy safety: Category C Not effective if time of spinal cord injury greater than 8 hours

29. Midazolam Hydrochloride (Versed) Mechanism of action Causes sedative, anxiolytic, amnesic, and hypnotic effects Indications Sedation for medical procedures Contraindications Acute narrow-angle glaucoma, shock, coma, alcohol intoxication Adverse reactions Headache, somnolence, respiratory depression Considerations Pregnancy safety: Category D Administer immediately prior to intubation procedure.

30. Naloxone Hydrochloride (Narcan) Mechanism of action Reverses respiratory depression secondary to opiate drugs Indications Opiate overdose, complete or partial reversal of central nervous system and respiratory depression induced by opioids Contraindications Use with caution in narcotic-dependent patients Adverse reactions Restlessness, seizures, dyspnea, pulmonary Considerations Pregnancy safety: Category C

31. Nitroglycerin (Nitrostat, Nitro-Bid, Tridil ) Mechanism of action Smooth muscle relaxant acting on vasculature, bronchial, uterine, intestinal smooth muscle Indications Acute angina pectoris, ischemic chest pain Contraindications Hypotension, hypovolemia, intracranial bleeding or head injury Adverse reactions Headache, dizziness, weakness, reflex tachycardia Considerations Pregnancy safety: Category C Hypotension more common in the elderly

32. Phenytoin (Dilantin) Mechanism of action Promotes sodium efflux from neurons Indications Prophylaxis and treatment of major motor seizures Contraindications Hypersensitivity, bradycardia Adverse reactions Ataxia, agitation, dizziness, headache, drowsiness Considerations Pregnancy safety: Category D Carefully monitor vital signs.

33. Propofol ( Diprivan ) Mechanism of action Produces rapid and brief state of general anesthesia Indications Anesthesia induction/ maintenance, sedation for mechanically ventilated patients Contraindications Hypovolemia, known sensitivity Adverse reactions Seizure, apnea, dysrhythmias, asystole, hypotension, hypertension Considerations Pregnancy safety: Category B Avoid rapid administration in elderly patients to avoid hypotension and airway obstruction.

34. Sodium Bicarbonate Mechanism of action Buffers metabolic acidosis and lactic acid buildup Indications Metabolic acidosis during cardiac arrest, tricyclic antidepressant, aspirin Contraindications Metabolic/respiratory alkalosis, hypokalemia, electrolyte imbalance Adverse reactions Hypernatremia, metabolic alkalosis, tissue sloughing, cellulitis Considerations Pregnancy safety: Category C Repeat as needed in tricyclic antidepressant overdose until QRS narrows

35. Sodium Nitrate Mechanism of action Reacts with hemoglobin to form methemoglobin, which reacts with cyanide Indications Cyanide poisoning Contraindications None in the emergency setting Adverse reactions Hypotension, tachycardia, fainting, nausea, vomiting Considerations Pregnancy safety: Category C Potent vasodilator causes significant hypotension if given too rapidly

36. Summary Paramedics are required to know the names, class, mechanism of action, adverse reactions and side effects, interactions, indications, contraindications, complications, routes of administration, dose, and specific administration considerations for many emergency medications and intravenous fluids. Individual states have the authority to include additional medications, which may be taught by your local training agency.

37. CONCLUSION I conclude that b ecause of paramedics must make quick decisions about when to administer medications, what medications to administer, and when administering certain medications would be harmful to the patient, it is critically important they develop a solid understanding of the information in this chapter and stay up to date on the latest pharmacologic information.

38. BIBLIOGRAPHY