Essential Emergency Medications: Clinical Reference

Nitroglycerin

Action: Vasodilator

Indication: Angina, hypertension, MI from cocaine, intoxication

Contraindications: Hypotension, severe bradycardia, increased ICP, intracranial bleeding, erectile dysfunction

Route: Sublingual tablet or spray

Side Effects: Headache, hypotension, lightheadedness

Dosage:

• Tab: 0.4 mg every 5 minutes (up to 3 doses)
• Spray: 0.4 mg every 5 minutes (up to 3 doses)

Albuterol

Action: Stimulates B2 receptors (Bronchodilator)

Indication: Asthma, bronchitis, COPD, bronchoconstriction

Contraindications: Angioedema, hypersensitivity

Route: Inhaled

Side Effects: Hyperglycemia, palpitations, anxiety, tremor, nausea/vomiting, epistaxis, headache

Dosage:

• Nebulizer: 2.5 mg every 20 minutes (max 3 doses)
• MDI: 4-8 puffs

Nitrous Oxide

Action: Inhaled anesthetic

Indication: Mild to severe pain

Contraindications: Head trauma, increased ICP, pneumothorax, COPD, hypoxic drive

Route: Inhaled

Side Effects: Delirium, hypoxia, respiratory depression

Dosage: 20%-50% concentration mixed with O2

Epinephrine

Action: Increases BP, increases HR, bronchodilation

Indication: Bronchospasm, allergic/anaphylactic reactions, cardiac arrest

Contraindications: Arrhythmia, hypertension, nervousness, chest pain, nausea/vomiting

Route: Intramuscular

Side Effects: Anxiety (shakes), headache, hypertension, nervousness, chest pain

Dosage: 1 mg (1:10,000 or 1:1,000)

Naloxone (Narcan)

Action: Binds with opioid receptors and blocks narcotic effects

Indication: Narcotic overdoses, narcotics used in anesthesia

Adverse Effects: Hyperglycemia, palpitations, anxiety, tremor, nausea/vomiting, epistaxis, headache

Contraindications: Angioedema, hypersensitivity

Route: Intranasal, intravenous, or intramuscular

Dosage: 0.4 mg - 2 mg

Sodium Bicarbonate

Action: Counteracts existing acidosis

Indication: Acidosis, drug intoxication, cardiac arrest

Adverse Effects: Metabolic alkalosis

Contraindications: Metabolic alkalosis

Dosage: 1 mEq/kg (pediatric and adult doses are the same)

Aspirin

Action: Prevents platelet formation

Indication: Fever, inflammation, angina, MI

Adverse Effects: Angioedema, bronchospasm, bleeding, stomach irritation, nausea/vomiting

Contraindications: GI bleeding, active ulcer disease, hemorrhagic stroke, bleeding disorders, children with flu/chickenpox

Dosage: 1 baby aspirin = 81 mg; adult dose = 4 baby aspirins (324 mg)