Emergency Nursing Study Notes – Essential Medications

1. General Medication Safety Tips

• High-risk meds – use extra caution with:

  • Opioids

  • Anticoagulants (blood thinners)

  • Vasopressors

  • Antihypertensives (BP meds)

  • Benzodiazepines

  • Insulin

• Check allergies at first patient contact, even if EMR and handoff say “none.”

• Never give a med you don’t know. Look it up before pulling/administering.

• Remember the 6 Rights of medication administration (patient, drug, dose, route, time, reason).

• Protect your license:

  • Do not follow orders blindly.

  • Providers can make mistakes—verify doses/indications.

• Pharmacist = resource for med safety questions.

2. Vasopressors – Know These Well

Used for shock, severe hypotension:

• Epinephrine

• Norepinephrine

• Phenylephrine

• Vasopressin

• Dopamine

• Dobutamine

3. Antihypertensives (BP-lowering)

Used for hypertensive emergencies, chest pain, aortic dissections, etc.:

• Nitroglycerin

• Nicardipine

• Labetalol

• Hydralazine

• Enalapril (Vasotec)

• Nitroprusside

4. Heart Rate Control Medications

Used for tachyarrhythmias and rhythm control:

• Diltiazem

• Metoprolol

• Amiodarone

• Esmolol

5. Sedation & Analgesia for Intubated Patients

Prevent awareness and agitation while ventilated:

• Propofol

• Midazolam (Versed)

• Dexmedetomidine (Precedex)

• Fentanyl

6. Rapid Sequence Intubation (RSI) Medications

Induction agents:

• Etomidate

• Ketamine

• Propofol

• Midazolam (Versed)

Paralytics:

• Rocuronium

• Succinylcholine

• Vecuronium

7. Psychiatric & Sedation Medications

Used for agitation, psych emergencies, and chemical restraints:

• Haloperidol

• Olanzapine

• Risperidone

• Lorazepam (Ativan)

• Midazolam (Versed)

• Diphenhydramine

• Ketamine

8. Antidotes (Must-Master)

• Naloxone → opioid overdose

• Flumazenil → benzodiazepine overdose

• Protamine sulfate → heparin overdose

• Vitamin K → warfarin reversal

• Calcium gluconate → hyperkalemia, calcium channel blocker toxicity

• Glucagon → beta-blocker or CCB overdose

• Activated charcoal → select ingestions (time-dependent)

9. ACLS / Critical Care Medications

• Epinephrine

• Amiodarone

• Lidocaine

• Atropine

• Magnesium sulfate

• Calcium chloride

• Sodium bicarbonate

• Dopamine

10. Additional Key Medications to Know

• Thrombolytics: tPA, TNK

• Anticoagulants: Heparin

• Neuro/Seizure meds: Phenytoin (Dilantin), Phenobarbital, Pentobarbital

• Diuretics: Mannitol, Furosemide (Lasix)

• Respiratory: Albuterol

• Steroids: Dexamethasone, Prednisone

• GI meds: Protonix, GI cocktail

• Others: Aspirin, Adenosine, Meclizine

11. Clinical Communication Tip

• Some Hispanic patients may deny “chest pain” but report “chest pressure.”

• Always ask: “Do you have chest pain or chest pressure?”