Core Paramedic Medications

Cards · 60

Epinephrine (Cardiac Arrest)

1 mg (1:10,000) IV/IO push every 3-5 minutes

Epinephrine (Anaphylaxis)

0.3-0.5 mg (1:1,000) IM into the anterolateral thigh every 5-15 minutes

Amiodarone (Cardiac Arrest - Pulseless VT/VF)

First dose: 300 mg IV/IO push; Second dose: 150 mg IV/IO push

Amiodarone (Stable Wide-Complex Tachycardia)

150 mg IV/IO infused over 10 minutes

Lidocaine (Cardiac Arrest - Pulseless VT/VF)

First dose: 1.0-1.5 mg/kg IV/IO; Repeat dose: 0.5-0.75 mg/kg every 5-10 minutes (max 3 mg/kg)

Atropine Sulfate (Symptomatic Bradycardia)

1 mg IV/IO push every 3-5 minutes (maximum total dose 3 mg)

Adenosine (Stable SVT)

Initial dose: 6 mg rapid IV push followed by immediate 20 mL saline flush; Second dose: 12 mg if needed

Diltiazem (Cardizem - Rapid Atrial Fibrillation/Flutter)

0.25 mg/kg IV slow push over 2 minutes; repeat at 0.35 mg/kg after 15 minutes if needed

Aspirin (Acute Coronary Syndrome)

162-324 mg chewable PO (non-enteric coated)

Nitroglycerin (Angina / ACS)

0.4 mg sublingual (tablet or spray) every 5 minutes (max 3 doses, systolic BP > 90-100 mmHg)

Morphine Sulfate (Severe Ischemic Pain)

2-4 mg slow IV push every 5-15 minutes titrated to pain and blood pressure

Fentanyl (Acute Pain Management)

50-100 mcg (or 1 mcg/kg) slow IV/IO/IM/IN push, titrated every 5-10 minutes

Naloxone (Opioid Overdose)

0.4-2 mg IV/IO/IM/SC or 2-4 mg IN, titrated to restore adequate respirations

Albuterol (Bronchospasm / Asthma)

2.5 mg in 3 mL normal saline via nebulizer over 5-15 minutes

Ipratropium Bromide (Atrovent - Bronchospasm)

0.5 mg in 2.5 mL normal saline via nebulizer (often combined with albuterol)

Methylprednisolone (Solu-Medrol - Severe Asthma/COPD)

125 mg slow IV/IO push over 2 minutes

Dexamethasone (Decadron - Airway Inflammation)

8-16 mg IV, IO, or IM push

Magnesium Sulfate (Torsades de Pointes)

1-2 g diluted in 10 mL D5W/NS IV/IO push over 1-2 minutes

Magnesium Sulfate (Severe Refractory Asthma)

2 g diluted in 100 mL IV piggyback infused over 15-20 minutes

Magnesium Sulfate (Eclampsia / Severe Pre-eclampsia)

4-6 g IV loading dose in 100 mL over 15-20 minutes, followed by 1-2 g/hr continuous infusion

Dextrose 10% (D10W - Hypoglycemia)

125-250 mL (12.5-25 g) IV/IO rapid infusion, re-evaluating blood glucose

Dextrose 50% (D50W - Hypoglycemia)

25 g (50 mL of 50% solution) slow IV/IO push

Glucagon (Hypoglycemia without IV access)

1 mg IM or SC (reconstituted powder)

Glucagon (Beta-Blocker Overdose)

3-5 mg slow IV push over 2-3 minutes, followed by an infusion of 2-5 mg/hr

Oral Glucose (Hypoglycemia - Conscious Adult)

15-25 g orally/buccal (1 tube of gel)

Midazolam (Versed - Active Seizure)

5-10 mg IM/IN, or 2-5 mg slow IV/IO push titrated to seizure cessation

Lorazepam (Ativan - Active Seizure)

2-4 mg slow IV/IO/IM push over 2 minutes

Diazepam (Valium - Active Seizure)

5-10 mg slow IV push over 2 minutes (or 0.2 mg/kg rectally)

Ondansetron (Zofran - Nausea and Vomiting)

4 mg slow IV/IO push over 2-5 minutes or 4 mg ODT (oral dissolving tablet)

Promethazine (Phenergan - Severe Nausea)

12.5-25 mg deep IM or slow IV diluted in 10-20 mL normal saline (administered with caution)

Metoclopramide (Reglan - Nausea / Migraine)

10 mg slow IV push over 1-2 minutes or IM

Diphenhydramine (Benadryl - Allergic Reaction)

25-50 mg deep IM or slow IV/IO push

Sodium Bicarbonate (Severe Acidosis / TCA Overdose)

1 mEq/kg IV/IO rapid bolus, repeat at 0.5 mEq/kg every 10 minutes as indicated by QRS width

Calcium Chloride (Hyperkalemia / Calcium Channel Blocker Toxicity)

500-1000 mg (5-10 mL of 10% solution) slow IV/IO push over 5-10 minutes

Calcium Gluconate (Hyperkalemia)

1-2 g (10-20 mL of 10% solution) slow IV/IO push over 5-10 minutes

Norepinephrine (Levophed - Cardiogenic/Septic Shock)

2-12 mcg/min IV/IO continuous infusion titrated to mean arterial pressure ≥ 65 mmHg

Dopamine (Cardiogenic Shock / Symptomatic Bradycardia)

5-20 mcg/kg/min IV/IO continuous infusion, titrated to patient hemodynamics

Epinephrine (Push-Dose Epinephrine - Hypotension)

5-20 mcg (0.5-2 mL of 10 mcg/mL solution) IV/IO every 2-5 minutes

Ketamine (Dissociative Induction / RSI)

1.5-2 mg/kg IV/IO push or 3-4 mg/kg IM

Ketamine (Analgesia)

0.1-0.3 mg/kg IV/IO slow infusion over 10-15 minutes or 0.5 mg/kg IN

Ketamine (Excited Delirium / Chemical Restraint)

4-5 mg/kg IM or 1-2 mg/kg IV/IO

Etomidate (Amidate - RSI Sedation Induction)

0.3 mg/kg IV/IO rapid push

Propofol (RSI / Post-Intubation Sedation)

Induction: 1.5-2.5 mg/kg IV push; Maintenance: 5-50 mcg/kg/min infusion

Succinylcholine (Anectine - RSI Paralytic)

1.5-2.0 mg/kg rapid IV/IO push

Rocuronium (Zemuron - RSI Paralytic)

1.0-1.2 mg/kg rapid IV/IO push

Vecuronium (Norcuron - RSI Paralytic / Post-Intubation)

0.1 mg/kg IV/IO push

Tranexamic Acid (TXA - Severe Hemorrhagic Shock)

1 g mixed in 100 mL NS or D5W infused IV/IO over 10 minutes within 3 hours of injury

Hydralazine (Hypertensive Crisis in Pregnancy)

5-10 mg slow IV push over 2 minutes; repeat in 20 minutes if needed

Labetalol (Hypertensive Emergency / Severe Pre-eclampsia)

10-20 mg slow IV push over 2 minutes; may double every 10 minutes (max 300 mg)

Oxytocin (Pitocin - Postpartum Hemorrhage)

10 units IM, or 10-40 units diluted in 1,000 mL crystalloid infused IV at 200-500 mL/hr

Activated Charcoal (Acute Toxic Ingestion)

1 g/kg (typically 50-100 g) PO or via nasogastric tube within 1 hour of ingestion

Hydroxocobalamin (Cyanokit - Cyanide Poisoning)

5 g IV infusion over 15 minutes; a second 5 g dose may be infused over 15 minutes to 2 hours

Atropine Sulfate (Organophosphate / Nerve Agent Poisoning)

2-4 mg IV/IM every 3-5 minutes until tracheobronchial secretions clear

Pralidoxime (2-PAM - Organophosphate Poisoning)

1-2 g IV/IO mixed in 100 mL saline infused over 15-30 minutes, or 1-2 g IM

Flumazenil (Romazicon - Benzodiazepine Reversal)

0.2 mg slow IV push over 30 seconds; repeat with 0.3-0.5 mg every minute up to 1 mg total (use with caution)

Haloperidol (Haldol - Acute Psychosis / Agitation)

2.5-10 mg IM or slow IV push

Droperidol (Inapsine - Severe Agitation / Nausea)

2.5-5 mg IM or slow IV push

Acetaminophen (Tylenol - Mild-Moderate Pain / Fever)

650-1000 mg PO or 1000 mg IV infusion over 15 minutes

Ketorolac (Toradol - Moderate-Severe Musculoskeletal/Renal Colic Pain)

15 mg IV push or 30 mg IM (single dose)

Nitrous Oxide (50:50 Entonox/Nitronox - Acute Pain)

Self-administered by the patient via demand valve mask or mouthpiece