Common drugs used in the Emergency Room

Common drugs used in the Emergency Room

Lidocaine

Lidocaine has 2 uses: It is a local anesthetic when injected subcutaneously (and it can be used
for a nerve block). It is also an antidysrhythmic drug when injected IV used to treat cardiac
dysrhythmias. Anesthetic preparations come in 2 forms: with and without epinephrine. The
epinephrine is added to reduce absorption and prolong the effect

Epinephrine

Epinephrine is a natural substance produced by the adrenal gland _ adrenaline
Epinephrine is used in emergencies to stimulate the heart or to dilate the bronchial tree. Its use is
limited by cardiac side effects. It is also mixed with lidocaine to prolong lidocaine’s effect and to
control bleeding

Furosemide _Lasix

Lasix is a diuretic, which is given IV or PO, which causes the patient to produce more urine. This
is often given to reduce the fluid overload in patients with congestive heart failure ( CHF) or
hypertension

Diazepam_Valium

Diazepam is a benzodiazepine that is used both as a powerful sedative and as an anticonvulsant
for patients with seizures. You will see it used for alcohol withdrawal, cocaine toxicity
and status epilepticus (i.e. uncontrolled seizures). Diazepam may produce respiratory depression


Haloperidol _Haldol

Haldol is a antipsychotic with powerful sedative properties. It is often used for patients who are
acting in a psychotic manner. It should not be used to treat alcohol withdrawal or cocaince toxicity
In sufficient quantities it will render the patient unconscious


Atropine

Atropine is used for several purposes, including inducing the heart to beat faster (i.e
chronotropy) as well as an antidote for certain organophosphate poisonings. It is sometimes
used as a drug for patients with severe asthma. It can also be dripped into the eyes to produce
dilation of the pupil (although this is a different formulation). Can also be used to dry up respiratory
secretions during procedures

Heparin

Heparin is an anticoagulant used to prevent blood from clotting. It is used in patients suspected
of having a myocardial infarction and to prep the syringe for an arterial-blood-gas for the same
reason

Phenobarbital

Phenobarbital is a barbiturate which is used either as a sedative and/or anticonvulsant
medication

Pentobarbital

Similar to phenobarbital but much faster acting and with a duration of effect. It is used as an
anticonvulsant medication and to treat severe alcohol withdrawal. Often used in a continuous
drip for patients who continue to seize

Methylprednisolone _Solumedrol

Solu-medrol is a long acting corticosteroid. It is often used to prevent the recurrence of
anaphylaxis after the epinephrine has worn off and for patients with asthma. It has a half-life of
around 6 hours

Albuterol _Proventil

Albuterol is a bronchodilator, used in a nebulizer for asthma patients. Typically a drop (0.5 mg
of albuterol is suspended in saline and nebulized with oxygen. Often referred to as “how many
nebs the patient got”


Ketorolac _Toradol

Ketorolac is a powerful NSAID, used for severe headaches, musculo-skeletal pain, kidney
stones and inflammation

Morphine Sulfate

Morphine is a powerful opiate (derived from opium and similar to heroin that is used as a pain killer
i.e. analgesic. However, as a side effect it can suppress respirations
.
Naloxone _Narcan

Narcan is the antidote to opioids such as heroin or morphine. It is very rapidly acting and
competes with the opioid for the opioid receptor. Be careful when administering this drug, as it
may cause withdrawal in opioid tolerant patients

Prednisone

Prednisone is a corticosteroid that is given for asthma and as an anti-inflammatory. A side effect
of prolonged use is Cushing’s syndrome and often you may see tremors

Dopamine

Dopamine is a mild pressor agent, which is administered IV to produce vasoconstriction and raise a
patient’s blood presure

Phenytoin _Dilantin

Dilantin is an anticonvulsant. As a side effect, when administered too fast, it can induce
hypotension

Streptokinase

Streptokinase is a thrombolytic made by Streptococcus bacteria
which dissolves clots, similar to tPA (although through a different mechanism

Diltiazem_Cardizem

Diltiazem is a calcium channel blocker used to slow the heart down in patients with certain
types of tachycardias such as atrial fibrillation

Metoprolol

Metoprolol is a beta-blocker which is used to slow down the heart and lower blood-pressure.
These drugs are not typically used in asthmatics, as they can induce bronchoconstriction

Atenolol

Atenolol is a beta-blocker similar to metoprolol

Adenosine

Adenosine (the A of ATP fame) is used as an antidysrhythmic to break certain cardiac
dysrhythmias; it is often used in patients with supraventricular tachycardia. The half life of the drug
is only a few seconds, and can often induce non-pathologic asystole (flat line on an EKG) for a few
seconds

Digoxin

Digoxin (a derivative of the Foxglove plant) is a cardiac drug used to slow conduction through
the heart, especially in cases of atrial-fibrillation. As a side effect it can produce various
dysrhythmias including ventricular fibrillation and aystole

Pepcid

Pepcid is a systemic antacid (H2 blocker) which takes 30-45 minutes to take effect, but lasts for
several hours. Similar to ranitidine (Zantac) and cimetidine (Tagamet

NS

NS stands for Normal Saline, which is 0.9% Sodium Chloride, and is the usual fluid given to a
patient who needs fluid due to dehydration. It is approximately isotonic

LR

LR stands for Lactated Ringers, which is Normal Saline with other electrolytes. Due to the
presence of the other electrolytes, there is a limit to how much can be administered within a
specific period of time

D5, D10, D25 and D50

The D stands for Dextrose, which is a stable form of glucose. This solution is given IV to give
the patient glucose. This is never given IM, as high concentrations of glucose cause tissue death
outside the vasculature