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.