Paramedic Drug Cards

Trade: Morphine
Class: Opiate agonist/Narcotic Analgesic 
MOA: Binds to the opiate receptors. Reduces stimulation of the sympathetic nervous system caused by pain and anxiety. Reduction of sympathetic stimulation reduces heart rate, cardiac work, and myocardial O2 consumption
Indications: moderate to severe pain including chest pain associated with ACS, CHF, and pulmonary edema.
Contraindications: Respiratory depression, shock.
Side effects: Respiratory depression, hypotension, N/V, dizziness, lightheadedness, sedation, diaphoresis, euphoria, seizures, cardiac arrest, anaphylactoid reaction.
Dosage:
Adult  
2-10mg IV/IO/IM
Pediatric 
< 110 lbs 0.025 – 0.2mg/kg IV/IO/IM

Trade: Sublimaze
Class: Narcotic Analgesic 
MOA: Binds to opiate receptors producing analgesia and euphoria
Indication: Pain
Contraindication: Use caution in traumatic brain injury, Respiratory depression 
Side effects: Respiratory depression, apnea, hypotension, N/V, dizziness, sedation euphoria, Sinus bradycardia, sinus tachycardia, palpitations, HTN, diaphoresis, syncope
Dosing
Adult 
50-100mcg IM/IV

Pedi 
1-2mcg/kg IM/IV

Trade: Valium 
Class: Benzodiazepine
MOA: Binds to the benzodiazepine receptor and enhances the effects of GABA
Indications: Anxiety, Skeletal muscle relaxation, anticonvulsant 
Contraindications: Children younger then 6 months, acute angle glaucoma, CNS depression, alcohol intoxication. 
Side effects:  Respiratory depression, drowsiness, fatigue, headache, pain at the injection site, confusion, nausea, hypotension, cardiac arrest at high doses
•Dosing:
Adult: 
Anxiety: 2-10mg IV/IM
Seizure: 5-10mg IV/IO
Pediatric:
Anxiety: 0.2 – 0.3mg/kg IV/IM
Seizure:  Older then 5 years: 1mg IV/IO
Older then 30 days less then 5 years: 0.2 to 0.5mg IV/IO
                Neonate: 0.1-0.3mg/kg IV/IO

Trade: Tegretol 
Class:  Anticonvulsant 
MOA: Binds preferably to voltage gated Sodium channels in their inactive conformation, which prevents repetitive and sustained firing of an action potential.
Indications: Partial and generalized tonic – clonic seizures 
Contraindications: AV Block, bundle branch block, agranulocytosis, bone marrow supression, monoamine oxidase inhibitor therapy
Side effects: Dizziness, drowsiness, ataxia, N/V, blurred vision, confusion, headache, transient diplopia, visual hallucinations, life threatening rashes.
Dosing:
Adult:
200mg PO
Pediatric:
6-12 years old: 100mg PO
        Less then 6: 10mg/kg PO

Trade: Toradol 
Class: NSAID
MOA: inhibits the production or prostaglandins in inflamed tissue, which decreases the responsiveness of pain receptors. 
Indications: Moderately severe acute pain
Contraindications: Patients with a hx of peptic ulcer disease or GI bleed, patients with renal insufficiency, hypovolemic patients, 3rd trimester pregnancy, nursing mothers, allergy to other nsaids, stroke or head trauma, having surgery within the next 7 days.  
Side effects:  headache, drowsiness, dizziness, abdominal pain, dyspepsia, N/V, Diarrhea.
Dosing:
Adult 
IV 30mg
IM 60mg 
Senior (65 and older)/ Pediatric < 50kgs
IV 15mg
IM 30mg