| back 1
Special Considerations:
- Draw blood sugar before administering.
- Do not
administer to patients with known CVA unless hypoglycemia
documented.
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Special Considerations:
- Short duration of anticonvulsant effect.
- Reduce dose
50% in elderly patient.
-
Pregnancy Safety: Category D
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front 3 Diphenhydramine hydrochloride (Benadryl) | back 3
Special Considerations:
- Not used in infants or in pregnancy: Category B.
- If
used in anaphylaxis, will be in conjunction with epinephrine,
steroids.
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front 4 Epinephrine (1:1000, 1:10,000) | back 4
Special Considerations:
-
Pregnancy Safety: Category C.
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front 5 Fentanyl citrate (Sublimaze) | back 5
Special Considerations:
-
Pregnancy Safety: Category C
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| back 6
Special Considerations:
- Ineffective if glycogen stores depleted.
-
Pregnancy Safety: Category C.
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front 7 Hydrocortisone sodium succinate (Cortef, Solu-Cortef) | back 7
Special Consideration:
- Protect medication from heat.
- Toxicity and side
effects with long-term use.
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front 8 Hydroxocobalamin (Vitamin B 12) *cyano-kit | back 8
Special Considerations:
-
Emergency Patient Management:
In
addition to [Rx], treatment of cyanide poisoning must include
immediate attention to airway patency, adequacy of oxygenation and
hydration, cardiovascular support, and management of any seizure
activity. Consideration should be given to decontamination measures
based on the route of exposure. -
Use with other cyanide antidotes:
Caution should be exercised when administering other cyanide
antidotes simultaneously with [Rx], as the safety of
co-administration has not been established. If a decision is made to
administer another cyanide antidote with [Rx], these drugs should
not be administered concurrently in the same IV line. -
Preparation of Solution for Infusion
Each 2.5 g vial of [Rx] for injection is to be reconstituted
with 100 mL of diluent (not provided with [Rx]) using the supplied
sterile transfer spike. The recommended diluent is 0.9% Sodium
Chloride injection (0.9% NaCl). Lactated Ringers injection and 5%
Dextrose injection (D5W) have also been found to be compatible with
[Rx] and may be used if 0.9% NaCl is not readily available. The line
on each vial label represents 100 mL volume of diluent. Following
the addition of diluent to the lyophilized powder, each vial should
be repeatedly inverted or rocked, not shaken, for at least 30
seconds prior to infusion. [Rx] solutions should be visually
inspected for particulate matter and color prior to administration.
If the reconstituted solution is not dark red or if particulate
matter is seen after the solution has been appropriately mixed, the
solution should be discarded. |
| back 9
Special Considerations:
- Use in caution in older patients due to a higher risk of renal
and fatal GI adverse reactions.
- Contraindicated for use
during pregnancy.
-
Pregnancy Safety: Category C.
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| back 10
Special Considerations:
- Inadvertent arterial injection may result in vasospasm and
gangrene.
- Expires in 6 weeks if not refrigerated.
-
Pregnancy Safety: Category D.
Note from Drug Control Program: Re: Storage of [Rx].
According to stability information, [Rx] injection requires
refrigeration and should be stored at 2 - 8º C (35 - 45º F). [Rx]
injection should be protected from light, which can be accomplished
by retaining the vial in the carton until ready for use. In
addition, freezing of the injection should be avoided. Ambulances
are required to ensure stability of all drug products stored on
site. Those ambulances unable to meet the above-mentioned storage
conditions should refrain from using [Rx]. For further information,
contact the Drug Control Program at (617) 983-6700 or the Office of
Emergency Medical Services at (617) 753-7300. |
front 11 Methylprednisolone sodium succinate (Solu-Medrol) | back 11
Special Consideration:
- Protect medication from heat.
- Toxicity and side
effects with long-term use.
|
| back 12
Special Considerations:
- Administer immediately prior to intubation procedure.
- Requires continuous monitoring of respiratory and cardiac
function.
-
Pregnancy Safety: Category D.
|
| back 13
Special Considerations:
- Seizures without causal relationship have been
reported.
- May not reverse hypotension.
- Use
caution when administering to narcotic addicts (violent behavior,
etc.).
- Pregnancy safety: category B.
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| back 14
Special Considerations:
-
Pregnancy Safety: Category B.
|
front 15 Pralidoxime chloride (2-PAM, Protopam) | back 15
Special Considerations:
- Treatment will be most effective if given within a few hours
after poisoning. Cardiac monitoring should be considered in all
cases of severe organophosphate poisoning.
-
Pregnancy Safety: unknown.
|
| back 16
Special Considerations:
- Must be mixed into an infusion bag, typically 100 mL of
NS.
- Use in pregnant and breastfeeding women should be clearly
indicated.
-
Pregnancy Safety: Category C
|