O. MEDICATION/IV GUIDE Acetaminophen (Tylenol) .................................................................................................................. O-2 Adenosine (Adenocard) ................................................................................................................... O-3 Afrin ................................................................................................................................................. O-4 Albuterol .......................................................................................................................................... O-5 Amiodarone (Cordarone) .................................................................................................................. O-7 Aspirin (Chewable) ........................................................................................................................... O-8 Atropine ........................................................................................................................................... O-9 Calcium Chloride 10% ................................................................................................................... O-11 Calcium Gluconate 10% .................................................................................................................. O-12 Cyanokit (Hydroxocobalamin) ........................................................................................................ O-13 Dexamethasone (Decadron) ............................................................................................................. O-15 Dextrose 5% (D5W), 10% (D10W), 25% (D25W) and 50% (D50W) ............................................... O-16 Diazepam (Valium) ......................................................................................................................... O-17 Diltiazem (Cardizem) ...................................................................................................................... O-19 Diphenhydramine (Benadryl) ........................................................................................................ O-20 Dopamine ....................................................................................................................................... O-21 Epinephrine (Adrenalin) ................................................................................................................ O-23 Etomidate (Amidate) ....................................................................................................................... O-26 Fentanyl (Sublimaze) ...................................................................................................................... O-27 Glucagon ........................................................................................................................................ O-28 Glucose, Oral ................................................................................................................................. O-29 Ibuprofen .......................................................................................................................................... O-30 Ipratropium Bromide (Atrovent) ..................................................................................................... O-31 Ketamine (Ketalar) ........................................................................................................................... O-32 Lactated Ringer’s (LR) .................................................................................................................... O-33 Lidocaine 2% ................................................................................................................................. O-34 Magnesium Sulfate ........................................................................................................................ O-36 Mark I/DuoDote (NAAK) ............................................................................................................... O-38 Methylprednisolone (Solu-Medrol) ................................................................................................ O-39 Midazolam (Versed) ....................................................................................................................... O-40 Morphine Sulfate ........................................................................................................................... O-42 Naloxone (Narcan) ......................................................................................................................... O-44 Nitroglycerin ................................................................................................................................... O-46 Nitrous Oxide (Nitronox) ................................................................................................................ O-48 Ondansetron (Zofran) ..................................................................................................................... O-49 Oxygen ........................................................................................................................................... O-50 Pralidoxime Chloride (2-PAM Chloride) ....................................................................................... O-51 Rocuronium (Zemuron) .................................................................................................................. O-52 Sodium Bicarbonate ....................................................................................................................... O-53 Sodium Chloride 0.9% (Normal Saline) (NS) ............................................................................... O-54 Succinylcholine (Anectine) ............................................................................................................ O-55 Vecuronium (Norcuron) .................................................................................................................. O-56 Xylocaine 2% Jelly ........................................................................................................................ O-57 O-1 ACETAMINOPHEN (TYLENOL) CLASSIFICATION 1. Antipyretic. 2. Analgesic. ACTION 1. Inhibits prostaglandin in CNS to reduce fever. 2. Blocks pain impulses. ONSET OF ACTION 1. PO and PR: 10-30 minutes. DURATION OF ACTION 1. PO and PR: 3-4 hours. INDICATION 1. Fever. 2. Pain management. CONTRAINDICATION 1. Hypersensitivity. 2. Severe liver disease. USE WITH CAUTION 1. Anemia. 2. Liver disease. 3. Renal disease. DOSAGE AND ADMINISTRATION 1. Adult: 500-1000 mg orally. 2. Pediatric: 15 mg/kg orally or by rectal suppository. ADVERSE REACTION 1. Nausea, Vomiting, Rash. REFERENCE IN PROTOCOL 1. Medical Emergencies (Febrile pediatric patient). 2. Pain Management. O-2 ADENOSINE (ADENOCARD) CLASSIFICATION 1. Antiarrhythmic. ACTION 1. Acts on AV node to slow conduction. May inhibit reentry pathways. ONSET OF ACTION 1. Immediate. DURATION OF ACTION 1. Less than one minute. INDICATION 1. Conversion of stable narrow complex SVT to sinus rhythm. 2. Conversion of unstable narrow complex reentry tachycardia to sinus rhythm. 3. Regular and monomorphic wide complex tachycardia, thought to be or previously defined to be reentry SVT. CONTRAINDICATION 1. Second and third degree heart blocks, sick sinus syndrome, unless patient has a pacemaker. 2. Hypersensitivity to adenosine. USE WITH CAUTION 1. May produce TRANSIENT first, second, and third degree blocks or asystole for 10-15 seconds. 2. Asystolic pause may be longer in patients taking Tegretol (carbamazepine) or Persantine (dipyridamole). 3. Patients taking theophylline or caffeine may require higher doses. 4. Patients with asthma may experience bronchoconstriction. 5. May be used with wide QRS complex SVT at direction of Base Station. Its use may cause acceleration of the rate. 6. It is ineffective in atrial fibrillation or flutter, and ventricular tachycardia. DOSAGE AND ADMINISTRATION 1. Adult: 6 mg by rapid IV push over 1-3 seconds followed by a rapid NS flush of 20 mL, then elevate extremity. If no response within 1-2 minutes, give 12 mg by same method as before. 2. Pediatric: 0.1 mg/kg up to 6 mg rapid IV push over 1-3 seconds followed by a rapid NS flush of 5-10 mL. If no response within 1-2 minutes, give 0.2 mg/kg up to 12 mg by the same method as before. 3. Place IV in antecubital for best absorption using at least an 18 gauge catheter. ADVERSE REACTION 1. Common but transient: Asystole, Bradycardia (temporary), Hypotension, Chest pain, Flushing, Dyspnea, Apprehension, Back/neck pain, Blurred vision, Burning sensation, Dizziness, Numbness, Tingling in arms, Sweating, Palpitations, Nausea. REFERENCE IN PROTOCOL 1. Cardiac Emergencies (see AHA handbook). 2. Pediatric Cardiac Arrest Guide (Appendix K). O-3 AFRIN CLASSIFICATION 1. Adrenergic sympathomimetic. ACTION 1. Unknown. Causes vasoconstriction of the smaller arterioles in the nasal passages which lasts up to 12 hours. ONSET OF ACTION 1. Less than 5 minutes. DURATION OF ACTION 1. Less than 12 hours. INDICATION 1. Preparation for nasotracheal intubation. 2. Control of epistaxis. CONTRAINDICATION 1. Known hypersensitivity to medication. USE WITH CAUTION 1. Not recommended for children < 6 years old. DOSAGE AND ADMINISTRATION 1. Adult and Pediatric > 6 years old: 2-3 sprays in each nostril. 2. Pediatric < 6 years old: none. ADVERSE REACTION 1. Headache, Drowsiness, Insomnia, Palpitations, Hypertension, Rebound nasal congestion or irritation. 2. Burning, Stinging or