special considerations

activated charcoal

will NOT adsorb all toxins such as cyanide, lithium, iron, led or arsenic

albuterol

may be antagonized by beta blockers

albuterol

may potentiate diuretic induced hypokalemia

albuterol

anti-depressants may potentiate the effects on the vasculature

calcium chloride

antidote for calcium channel blocker overdose

dextrose 50%

can cause severe neurological symptoms (Wernicke's encephalopathy) in
thiamine deficient patients

digoxin

toxicity S/S: visual disturbances such as blurred vision or seeing
everything with a yellow or green tint or experiencing a halo effect

dobutamine

incompatible with sodium bicarbonate

racemic epinephrine

may have a rebound effect after medication wears off

flumazenil

will not antagonize opioid analgesics, barbituates or ethanol

flumazenil

IV/IO push given over 30 seconds
doses given at 1 minute intervals

flumazenil

antidote for benzodiazepines

glucagon

antidote for beta blockers

diphenhydramine

antidote for haloperidol

ketamine

consider using a small amount of benzodiazepines to reduce
hallucinations and combativeness

methylprednisolone

will cross the placenta and may cause fetal injury/demise

midazolam

never administer by rapid IV push

naloxone

works on: morphine, fentanyl, heroin, dilaudid, methadone, Demerol,
Percodan, Percocet, codeine, stadol, talwin, nubain, Darvon, Norco,
vicodin, Tylenol 3

phenytoin

must be given with normal saline ONLY!
may precipitate with other solutions

prednisone

will cross the placenta and may cause fetal injury/demise with long
term use

sodium bicarbonate

must ventilate patient following administration

sodium bicarbonate

will react with amines (epinephrine) and cause precipitation of line
in concurrent use...ALWAYS FLUSH IV LINE