Dextrose (D50, D25, D10)
Adverse Reactions:
- Extravagation leads to tissue necrosis.
- Warmth
- Pain
- Burning
- Thrombophlebitis
- Rhabdomyositis
Diazepam (Valium)
Adverse Reactions:
- Respiratory depression
- Hypotension
- Drowsiness
- Ataxia
- Reflex tachycardia
- Nausea
- Confusion
Diphenhydramine hydrochloride (Benadryl)
Adverse Reactions:
- Sedation
- Hypotension
- Seizures
- Visual disturbances
- Vomiting
- Palpitations/Dysrhythmias
- Dry mouth and throat
- Paradoxical CNS excitation in children
Epinephrine (1:1000, 1:10,000)
Adverse Reactions:
- Hypertension
- Dysrhythmias
- Pulmonary Edema
- Anxiety
- Psychomotor agitation
- Nausea
- Angina
- Headache
- Restlessness
Fentanyl citrate (Sublimaze)
Adverse Reactions:
- The most common serious adverse reactions reported to occur are respiratory depression, apnea, rigidity and bradycardia; if these remain untreated, respiratory arrest, circulatory depression or cardiac arrest could occur.
- Other adverse reactions that have been reported are hypertension, hypotension, dizziness, blurred vision, nausea, emesis, laryngospasm, chest wall rigidity and diaphoresis.
- It has been reported that secondary rebound respiratory depression may occasionally occur.
Patients should be monitored for this possibility and appropriate countermeasures taken as necessary.
Glucagon
Adverse Reactions:
- Nausea/Vomiting
- Tachycardia
- Hypertension
Hydrocortisone sodium succinate (Cortef, Solu-Cortef)
Adverse Reactions:
- Hypertension
- Sodium and water retention
- GI bleeding
- Trouble breathing
None from single dose.
Hydroxocobalamin (Vitamin B 12)
*cyano-kit
Adverse Reactions:
Serious adverse reactions include allergic reactions and increases in blood pressure. Use caution in the management of patients with known anaphylactic reactions to [drug] or cyanocobalamin. Consideration should be given to use of alternative therapies, if available.
Many patients with cyanide poisoning will be hypotensive; however, elevations in blood pressure have also been observed in known or suspected cyanide poisoning victims. Elevations in blood pressure (≥180 mmHg systolic or ≥110 mmHg diastolic) were observed in approximately 18% of healthy subjects (not exposed to cyanide) receiving 5g and 28% of subjects receiving 10 g. Increases in blood pressure were noted shortly after the infusions were started; the maximal increase in blood pressure was observed toward the end of the infusion. These elevations were generally transient and returned to baseline levels within 4 hours of dosing.
Ketamine (Ketalar)
Adverse Reactions:
- Hypertension
- Dysrhythmia
- Bronchodilation
- Respiratory depression
Lorazepam (Ativan)
Adverse Reactions:
- Respiratory depression/Apnea
- Drowsiness/Sedation
- Ataxia/Psychomotor impairment
- Confusion/Delirium
- Restlessness
- Hypotension
- Bradycardia
Methylprednisolone sodium succinate (Solu-Medrol)
Adverse Reactions:
- Hypertension
- Sodium and water retention
- GI bleeding
- Trouble breathing
None from single dose.
Midazolam (Versed)
Adverse Reactions:
- Hypotension
- Respiratory depression/arrest
- Hiccup
- Cough
- Over-sedation
- Nausea/vomiting
- Injection site pain
- Headache
- Blurred vision
Naloxone (Narcan)
Adverse Reactions:
Withdrawal symptoms in the addicted patient.
- Tachycardia
- Hypertension
- Dysrhythmias
- Nausea
- Vomiting
- Diaphoresis
Ondansetron (Zofran)
Adverse Reactions:
- Headache
- Drowsiness
- Pruritus
- Prolonged QT
- Acute dystonic reactions
Pralidoxime chloride (2-PAM, Protopam)
Adverse Reactions:
- Dizziness
- Blurred vision
- Diplopia
- Headache
- Drowsiness
- Nausea
- Tachycardia
- Hyperventilation
- Muscular weakness
- Excitement and manic behavior
Tranexamic acid (TXA)
Adverse Reactions:
- Fatigue
- Headache
- Abdominal pain
- Anemia
- DVT, PE, other thromboembolic disorder.
- Rapid infusion may cause hypotension.