8.4: Oral Medications

Acetylsalicylic Acid (Aspirin, ASA)

Classes: Platelet inhibitor (In the pre-hospital setting aspirin is only given for its platelet inhibitor properties.)

Mechanism of Action: Inhibits platelet aggregation for the life of the platelet (7-10 days) 

Onset: 5-30 minutes

Indications: Suspected acute coronary syndrome

Contraindications: Active GI bleeding, allergy, children

Dosage: 324 mg PO (4 baby chewable aspirin)

Route: Oral – instruct patient to chew tablets until fully dissolved

Note: Aspirin given at the onset of an acute MI reduces mortality. Aspirin is the most effective treatment paramedics/EMTs can offer. Don’t forget to give aspirin to patients with cardiac chest pain!

Glucose, Oral administration

Class: Carbohydrate

Mechanism of Action: Increases blood glucose in a hypoglycemic patient.

Onset: 5–30 minutes

Indications: Hypoglycemia in conscious, cooperative patient

Contraindications: Patients who cannot protect their airway.

Dosage:  1 tube PO (15-24 g). May repeat as needed.

Route: Oral – instruct patient to suck on glucose goo until fully dissolved in the mouth

Activated Charcoal

Class: Adsorbent

Mechanism of Action: Adsorbs toxin molecules to the outside surface of charcoal. The combined complex is then excreted from the body.

Indications: Selected ingestions. In most protocols, activated charcoal may be given for aspirin and acetaminophen ingestions < 2 hours. For all other ingestions, OLMC or poison center consultation is usually required.

Contraindications: Altered Mental Status (AMS)

Side Effects: Abdominal cramping, constipation

Dosage: 1 g/kg, max 50g, PO, supplied in bottles of 25-50 g in slurry with water or sorbitol

Route: Oral – instruct the patient to swallow as much of the dose as possible. Placing a straw at the back of the tongue will help with the taste.