- Medication allergy/exposure
- Past history of reactions
- Past medical history
- Ace inhibitors
- Involuntary muscle contractions of the face, neck, chest, back and pelvis
- Deviated pupils
- Swollen tongue
- Acute Extrapyrmadial Reaction
DO NOT use this order if chest pain is thought to be cardiac in origin
- Ativan 1-2 mg IV/IO; may repeat to a max of 4mg
- Normal Saline up to a 1,000 mL to reverse the signs of hypotension.
- Wait 10-15 mintues after Benadryl before administering Ativan
- Patients hemodynamically unstable refractory to IV fluids request an order for Epinephrine 1:10,000 0.5 - 1 mL IV/IO.
Common medication groups that cause dystonic reactions include:
- antipsychotics: Zyprexa (Olanzapine), Haloperidol (Haldol), Alprazolam, (Xanax), Fluphenazine (Prolixin), Thorazine (Chlorpromazine), Ziprasidone (Geodon)
- antimetics: Compazine (Prochlorperazine), Promethazine (Phenergan), Hydroxyzine (Vistaril), Metoclopramide (Reglan).