50 Drugs: Every Emergency Physician Should Know
50 Drugs: Every Emergency Physician Should Know
50 Drugs: Every Emergency Physician Should Know
50DRUGS
Thanks for using this guide. Please note that this is not meant to represent
every drug an EP should know. This is simply a quick guide to many of the
common and life saving drugs that we use every day. It does not include
antibiotics and it does not include many important pediatric drugs. Use this
with care and remember that every patient does not weigh 70kg.
Enjoy
Steven Elsbecker D.O. and Aryan Rahbar PharmD
AAEM/RSA-0115-459
EVERY EMERGENCY
PHYSICIAN SHOULD KNOW
2015 American Academy of Emergency Medicine Resident and Student Association (AAEM/RSA)
Special thanks to the University of Nevada Department of Emergency Medicine for their assistance with the flashcards.
These materials are intended to provide assistance to the user as a reference tool. While every effort has been made
to ensure the accuracy of the recommendations made herein, these materials are not intended to be a substitute for
professional medical advice or treatment or the exercise of professional judgment in any given situation. Rather,
these materials are intended only for general informational purposes. They reflect the best judgment of the editors
and contributors as of the date of this publication and are subject to change. The content set forth in these materials
should not be construed as the sole basis for the users own medical judgments or decisions.
UNDER NO CIRCUMSTANCES WILL AAEM, AAEM/RSA, ITS AFFILIATES OR ANY OF THEIR RESPECTIVE
DIRECTORS, OFFICERS, MEMBERS, EMPLOYEES OR AGENTS, OR OTHERWISE ANY EDITOR OR CONTRIBUTOR
TO THESE MATERIALS BE RESPONSIBLE OR LIABLE TO ANY USER OR OTHER ENTITY FOR ANY DIRECT,
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FAILURE TO PERFORM BY AAEM, AAEM/RSA, ITS AFFILIATES OR ANY EDITOR OR CONTRIBUTOR HERETO.
Acetylcysteine - Mucomyst
Card 1 of 50
MOA: replenishes glutathione stores, serves as glutathione substitute, and enhances sulfate
conjugation of acetaminophen (Tylenol)
PO Dose: 140 mg/kg x 1, then 70 mg/kg q 4 hours x 17 doses (72 hours total)
IV Dose: 150 mg/kg in 200ml D5W over 1 hour, 50 mg/kg in 500ml D5W over 4 hours,
100 mg/kg in 1 liter D5W over 16 hours (21 total hours, may need to continue until LFTs and
APAP level normalize)
Emergent Indications: acetaminophen (Tylenol) overdose
Where youll get in Trouble: hypersensitivity reaction (stop infusion, switch to PO or slow
infusion rate), while rare, you can also see hypersensitivity with PO as well, Preg B
Adenosine - Adenocard/Adenoscan
Card 2 of 50
Card 3 of 50
Amiodarone - Pacerone
Card 4 of 50
MOA: blocks K efflux (Class III antidysrhythmic); also has Na channel blocking (class I),
beta blocking (class II), and Ca channel blocking (class IV) properties
Dose: Pulseless VF/VT: 300mg IV rapid push followed by 150mg IV rapid push if necessary at
next pulse check
Stable wide complex tachycardias: 150mg IV over 10 minutes, followed by infusion of
1mg/min x 6hours, then 0.5 mg/min thereafter
Emergent Indications: pulseless VF/VT, Wide complex tachydysrhythmias
Where youll get in Trouble: Causes hypotension, prodysrhythmic, Preg D
Atropine - AtroPen
MOA: direct anticholinergic
Dose: Organophosphate/carbamate toxicity: 1-6 mg IV q 3-5 minutes PRN, until dry
secretions (can double dose each time until adequate response achieved)
Peds Bradycardia: 0.02 mg/kg IVx1; 0.5 mg maximum single dose; 1 mg max
cumulative dose
Adult bradycardia: 0.5 mg IV, 3 mg max cumulative dose
Emergent Indications: Organophosphate/carbamate toxicity, bradycardia
Where youll get in Trouble: hyperthermic patients, tachydysrhythmias, Preg C
Card 5 of 50
Calcium Gluconate/Chloride
Card 6 of 50
Diazepam - Valium
Card 7 of 50
Diltiazem - Cardizem
MOA: inhibits calcium influx in myocardium > vascular smooth muscle;
prolongs AV nodal conduction
Dose: 0.25 mg/kg IV x1; may give 0.35 mg/kg IV x1 after 15 minutes;
continuous infusion 5-15 mg/hr
Emergent Indications: stable Afib with RVR, stable SVT
Where youll get in Trouble: iatrogenic hypotension, bradycardia, Preg C
Card 8 of 50
Dobutamine
Card 9 of 50
Dopamine
Card 10 of 50
Droperidol - Inapsine
Card 11 of 50
Card 12 of 50
Enoxaparin - Lovenox
Card 13 of 50
Esmolol - Brevibloc
Card 14 of 50
Esomeprazole - Nexium
MOA: inhibits parietal cell hydrogen-potassium ATPase (PPI)
Dose: 80 mg IV bolus followed by 8 mg/hour
Emergent Indications: Upper GI bleed (non-variceal)
Where youll get in Trouble: fairly benign when used acutely, Preg B
Card 15 of 50
Etomidate - Amidate
Card 16 of 50
Fentanyl - Sublimaze
Card 17 of 50
Fomepizole - Antizol
Card 18 of 50
Fosphenytoin - Cerebyx
MOA: stabilizes voltage dependent neuronal Na channels to stop seizure activity
Dose: 15-20 mg/kg IV loading dose administered at 150 mg/min
Emergent Indications: status epilepticus
Where youll get in Trouble: rapid administration can cause hypotension or
dysrhythmias, give with patient on monitor, Preg D
Card 19 of 50
Furosemide - Lasix
Card 20 of 50
MOA: inhibits Na and Cl reabsorption in distal renal tubule and ascending loop of Henle
Dose: usual dose in ED 20-40 mg IV, reassess, increase to desired effect
(maximum single dose 200mg)
Emergent Indications: pulmonary edema, CHF exacerbation, hyperkalemia
(if making urine)
Where youll get in Trouble: volume depletion, hypokalemia, metabolic alkalosis,
ototoxicity, Preg C
Glucagon - GlucaGen
Card 21 of 50
Haloperidol - Haldol
Card 22 of 50
Heparin
Card 23 of 50
MOA: binds to antithrombin III thereby potentiating inactivation of thrombin and factors
IX, Xa, XI, XII; prevents fibrinogen fibrin; preferential inactivation of thrombin over other
clotting factors
Dose: Venous thromboembolism: 80 units/kg IV x 1, then 18 units/kg/hour
ACS or Afib: 60 units/kg IV x 1, then 12 units/kg/hr
Emergent Indications: thromboembolism; ACS (enoxaparin preferred for NSTEMI)
Where youll get in Trouble: bleeding (protamine may be given for reversal), dosing
errors, Preg C
Hydrocortisone - SoluCortef
Card 24 of 50
Hydromorphone - Dilaudid
Card 25 of 50
Insulin Regular
Card 26 of 50
Ketamine - Ketalar
MOA: Acts on cortex and limbic system, NMDA receptor antagonist
Dose: Subdissociative: 0.1-0.5 mg/kg IV
Procedural sedation: 0.5-1 mg/kg IV
RSI induction: 2 mg/kg IV
Emergent Indications: analgesia, sedation, RSI induction
Where youll get in Trouble: emergence reactions (treat with benzos or barbs),
laryngospasm, IOP increase, ICP increase, tachycardia, hypertension, Preg D
Card 27 of 50
Labetolol - Trandate
Card 28 of 50
Lorazepam - Ativan
Card 29 of 50
Magnesium Sulfate
Card 30 of 50
Mannitol - Osmitrol
MOA: osmotic diuretic
Dose: 1 gram/kg IV x 1
Emergent Indications: elevated ICP, impending herniation
Where youll get into trouble: may cause dehydration, osmotic nephrosis
Card 31 of 50
Methohexital - Brevital
Card 32 of 50
MOA: produces cortical and cerebellar sedation, hypnosis (ultra short-acting barbiturate)
Dose: 1mg/kg IV, then 0.5 mg/kg q 2-5 minutes PRN
Emergent Indications: procedural sedation
Where youll get in Trouble: laryngospasm (give more brevital), respiratory depression,
hypotension, Preg B
Methylprednisolone - SoluMedrol
MOA: multiple gluco and mineralocorticoid effects
Dose: Asthma: 1mg/kg IV
Hypersensitivity reaction: 1 mg/kg IV
PCP PNA: 30mg IV BID x 5 days followed by a gradual taper
Emergent Indications: severe asthma, PCP PNA with elevated A-a gradient or
PaO2 < 70 mmHg, acute hypersensitivity reaction
Where youll get in Trouble: immunosuppresion, hyperglycemia, Preg C
Card 33 of 50
Metoclopramide - Reglan
Card 34 of 50
Midazolam - Versed
Card 35 of 50
Morphine sulfate
Card 36 of 50
Nimodipine - Nimotop
MOA: Ca channel blocker that is selective for cerebral arteries
Dose: 60 mg PO qh4
Emergent Indications: SAH
Where youll get in Trouble: hypotension although this is minimized due to its
selectivity, Preg C
Card 37 of 50
Nitroglycerin
Card 38 of 50
Nitroprusside - Nipride
Card 39 of 50
Norepinephrine - Levophed
Card 40 of 50
Octreotide - Sandostatin
Card 41 of 50
MOA: vasoconstricts vessels (more selective for GI vessels), reduces portal vessel pressure
Dose: Bleeding esophageal varices: 50 mcg IV bolus, then 50 mcg/hour IV
Sulfonylurea toxicity: 50 mcg SQ q 6 hours PRN
Emergent Indications: bleeding esophageal varices, sulfonlyurea overdose
Where youll get in Trouble: Precipitated biliary dz, Preg B
Olanzapine Zyprexa
Card 42 of 50
Ondansetron - Zofran
MOA: antagonizes serotonin 5-HT3 receptors, centrally acting antiemetic
Dose: usual dose 4-8 mg IV q 4-6 hours PRN
Emergent Indications: vomiting prevention and treatment
Where youll get in Trouble: QT prolongation, torsades (rare), Preg B
Card 43 of 50
Phenobarbital
Card 44 of 50
Prednisone
Card 45 of 50
Propofol - Diprivan
Card 46 of 50
Protamine sulfate
Card 47 of 50
Rocuronium
MOA: non-depolarizing neuromuscular agent
Dose: 1mg/kg IV
Emergent Indications: RSI paralysis
Where youll get in Trouble: prolonged paralysis, Preg B
Card 48 of 50
Sodium Bicarbonate
Card 49 of 50
Succinylcholine
Card 50 of 50