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Flashcards

NZ Paramedic Pharmacology

Janelle Chambers First Aid Paramedic English 4.5Average rating 4.5 out of 5 (2 ratings) 125 cards

Cards in this deck (125)

  1. 1Adrenaline - Mechanism of ActionAdrenaline is a naturally occurring catecholamine in the body. It acts on Alpha and Beta receptors predominantly A1, B1 and B2.
    A1 - smooth muscle contraction, vasoconstriction, stimulation of glyconeogenesis and glycogenolysis.
    B1 - Increased Inotropy, Chronotropy, Dromotropy within the heart
    B2 - Smooth muscle relaxation, skeletal muscle vasodilation, bronchodilation and stabilisation of mast cells = reduced histamine release.
  2. 2Adrenaline - Indications for useCardiac Arrest
    Anaphylaxis
    Severe Asthma
    Moderate to Severe Stridor
    Clinically significant Epistaxis
    Clinically Significant wound bleeding
  3. 3Adrenaline - Contraindications and CautionsNo Contraindications
    Caution in Myocardial Ischaemia and Tachydysrhythmia
  4. 4Adrenaline - Adverse EffectsTachycardia
    Tachydysrhythmia
    Myocardial Ischaemia
    Ventricular Ectopy
    Hypertension
    Nausea and Vomiting
    Tremor, Anxiety, Sweating
    Hyperglycaemia
  5. 5Adrenaline - AdministrationTopical - dilute 1mg to 10ml, apply topically with direct pressure
    Intranasal - dilute 1mg to 10ml, 2ml into each nostril
    Nebulised - undiluted
    IM - undiluted
    IV - undiluted for cardiac arrest
  6. 6Adrenaline - DosesCardiac Arrest - 1mg every 3-5 minutes, children - children 0.05mg (5kg), 0.1mg (10kg), 0.2mg (20kg), 0.3mg (30kg), 0.4mg (40kg).
    Nebulised - 5mg
    IM - adults 0.5mg, children - same as Cardiac Arrest
  7. 7Amiodarone - Mechanism of ActionAmiodarone is a class III antidysrhythmic.
    It prolongs the action potential, reduces automaticity and prolongs refractory period.
    Reduced chronotropy, dromotropy and inotropy, sabilises SA and AV nodes.
    Small increase in coronary blood flow and reduced myocardial oxygen consumption
  8. 8Amiodarone - Indications for useCardiac Arrest
  9. 9Amiodarone - Contraindications and CautionsNone in Cardiac Arrest
  10. 10Amiodarone - Dose and AdministrationDose - 300mg IV, additional 150mg if VF or VT persists. Children - 25mg (5kg), 50mg (10kg), 100mg (20kg), 150mg (30kg), 200mg (40kg).
    Administration - Undiluted in Cardiac Arrest
  11. 11Amoxicillin/Clavulanic Acid - Mechanism of ActionAmoxicillin/clavulanic acid is a beta-lactam antibiotic with broad spectrum activity (gram negative, positive and some anaerobic bacteria)
    Amoxicillin is the active ingredient, part of penicillin class. It inhibits production of bacterial cell wall.
    Clavulanic acid inhibits beta-lactamase which is an enzyme some bacteria produce making them resistant to amoxicillin.
  12. 12Amoxicillin/clavulanic acid - Indications for useClinical diagnosis of meningococcal septicaemia
    Septic shock over 30 mins from hospital
    Cellulitis in patients being referred to primary care and they have a delay in seeing a doctor
  13. 13Amoxicillin/clavulanic acid - Contraindications and cautionsContraindications - Known severe allergy
    Known severe allergy to penicillins
    Anaphylaxis to beta-lactam antibiotics
    Cautions - None
  14. 14Amoxicillin/clavulanic acid - AdministrationIV - dissolve 1.2g using 5ml of 0.9% to dilute to 10ml (120mg/ml). Administer in a running line over 1-2 minutes.
    IM - Dissolve 1.2g using 2ml of 0.9%, shake well, administer into lateral thigh.
  15. 15Amoxicillin/clavulanic acid - DoseAdults - 1.2g
    Children - 150mg (5kg), 300mg (10kg), 600mg (20kg), 900mg (30kg), 1.2g (40kg).
  16. 16Aspirin - Mechanism of ActionAspirin is a Non-steroidal anti-inflammatory drug (NSAID).
    It has antiplatelet, antipyretic, anti-inflammatory, analgesic effects.
    Aspirin inhibits cyclooxygenase which reduces formation of prostaglandins and thromboxane = reduce formation of blood clots
  17. 17Aspirin - Indications for useMyocardial ischaemia
  18. 18Aspirin - Contraindications and cautionsContraindications - Known severe allergy
    Third trimester of pregnancy
    Cautions - Known bleeding disorder, clinically significant bleeding, known worsening of bronchospasm with NSAIDs
  19. 19Aspirin - Adverse effectsIncreased bleeding
    Chronic administration can cause gastrointestinal symptoms (indigestion, bleeding, ulceration).
  20. 20Aspirin - Dose and Administration300mg dispersible (chewed or dissolved in water)
  21. 21Fentanyl - Mechanism of ActionFentanyl is an opiate analgesic which binds to opiate receptors in the brain and spinal cord. Its predominant action is on mu receptors causing analgesia, respiratory depression, miosis, euphoria, reduced GI motility and physical dependence. It is also pharmacologically active on kappa and delta receptors to a lesser extent.
    Fentanyl does not stimulate as much histamine release as morphine so there is less effect on the cardiovascular system.
  22. 22Fentanyl - Indications for useModerate to severe pain in patients who require intense pain relief for a short time (relocation). With clinically significant shock. If no IV access available.
  23. 23Fentanyl - Contraindications and CautionsContraindications - Known severe allergy
    Unable to obey commands
    Current respiratory depression
    Cautions - Age less than 1 year
    High risk for respiratory depression (CORD, obesity)
    Labour (opiates cross the placenta)
  24. 24Fentanyl - adverse reactionsRespiratory depression
    Bradycardia
    Hypotension
    Sedation
    Nausea and Vomiting
    Itching
    Euphoria
  25. 25Fentanyl - AdministrationIV - dilute 100mcg to a total of 10ml (10mcg/ml)
    IN (children) - undiluted, half dose in 2x 1ml syringes, additional 0.1ml to fill atomiser, administer rapidly
    IN (adult) - undiluted, no need to add more to fill atomiser (insignificant amount)
  26. 26Fentanyl - DoseIV - 10 to 50 mcg every 3 to 5 minutes, lower end dose for small, frail or cardiovascularly unstable.
    Children - 2.5mcg (5kg), 5mcg (10kg), 10mcg (20kg), 15mcg (30kg), 20mcg (40kg)
    IN - 100mcg (<80kg), further 50mcg every 10 mins, 200mcg (>80kg), further 100mcg ever 10 mins
    Children - 10mcg (5kg) & 5mcg subsequent, 20mcg (10kg) & 10mcg , 40mcg (20kg) & 20mcg, 60mcg (30kg) & 30mcg, 80mcg (40kg) & 40mcg.
  27. 27Gentamicin - Mechanism of ActionGentamicin is an aminoglycoside antibiotic with broad activity against gram negative and some gram positive.
    It inhibits bacterial cell protein synthesis
  28. 28Gentamicin - Indications for useSeptic Shock >30 minutes from hospital where the site of infection is known to be urinary, abdominal or unknown
  29. 29Gentamicin - Contraindications and CautionsContraindications - Known severe allergy
    Pregnancy
    Cautions - None
  30. 30Gentamicin - AdministrationAdminister Amoxicillin/clavulanic acid first
    In a 1 litre bag of 0.9% (adults only) over 15-30 mins, a bag of 5% glucose (weight >20kg) 1-2 drops/sec over 15-30 mins, syringe via running line (usually children) diluted to 10ml and administer 1 ml every 2-3 minutes
  31. 31Gentamicin - DoseAdults - 240mg <60kg
    320mg 60-80kg
    400 >80kg
    Children - 30mg (5kg), 60mg (10kg), 120mg (20kg), 160mg (30kg), 240mg (40kg)
  32. 32Gentamicin - Adverse effectsNone if administering at appropriate rate
    Renal impairment with repeated doses
    Ototoxicity (damage to inner ear) if administered too rapidly or prolonged dosing.
  33. 33Glucagon - Mechanism of ActionGlucagon is a natural occurring hormone produced by the pancreas.
    It increases blood glucose by stimulating glycogenolysis (breakdown of glycogen into glucose) in the liver
  34. 34Glucagon - Indications for useHypoglycaemia where the patient cannot swallow and IV access is unavailable
  35. 35Glucagon - Contraindications and CautionsContraindications - Known severe allergy
    Cautions - None
  36. 36Glucagon - Dose and AdministrationDose - 1mg >5years
    0.5mg <5years
    Once only
    Administration - Dissolve the powder using the syringe provided in the kit, administer IM preferred in the lateral thigh.
  37. 37Glucose Gel - Mechanism of ActionGlucose is a monosaccharide and is one of the preferred forms of energy for the cells. In this gel it is easily swallowed and rapidly absorbed.
  38. 38Glucose gel - Indications for useHypoglycaemia where the patient is conscious enough to swallow
  39. 39Glucose gel - Dose and Administration10-20g sachet, administer one sachet every 10 minutes if hypoglycaemia persists
  40. 40Glyceral trinitrate (GTN) - Mechanism of ActionGTN is a universal vasodilator. It acts on vascular smooth muscle causing vasodilation predominantly on veins.
    GTN converts to nitric oxide which relaxes smooth muscle cells and causes vasodilation.
    Vasodilation reduces venous return (preload), reduces cardiac output which reduces myocardial oxygen demand.
    Arterial dilation reduces peripheral resistance (afterload), reduces force required to eject blood, reduces oxygen demand.
    Dilation of coronary arteries increases coronary blood flow.
  41. 41GTN - Indications for useMyocardial ischaemia
    Cardiogenic pulmonary oedema
    Hypertension associated with autonomic dysreflexia
  42. 42GTN - ContraindicationsSystolic BP <100
    Heart rate <40
    Heart rate >130 or >150 in autonomic dysreflexia
    VT
  43. 43GTN - cautionsSTEMI with right side involvement
    Small, frail physiologically unstable pts
    Poor Perfusion
    Dysrhythmia
    Erectile dysfunction drugs used in last 24hrs
    Known Aortic or Mitral stenosis
  44. 44GTN - doseMyocardial Ischaemia - 0.4mg every 3 to 5 mins, increase to 10 mins if cautions.
    Cardiogenic Pulmonary oedema - 0.8mg every 3 to 5 mins, increase to 10 mins if cautions. Can increase dose and frequency if patient is not improving.
    Autonomic Dysreflexia - 0.4 to 0.8mg every 3 to 5 mins.
  45. 45GTN - AdministrationDeliver as sprays sublingually
    If delivered in presence of a caution:
    pt lying flat
    IV access
    Increase dosing interval
    Prepare to administer 0.9% if required
  46. 46GTN - Adverse effectsHypotension
    Flushing
    Headache
    Tachycardia
    Light-headedness
  47. 47Ibuprofen - Mechanism of ActionNSAID
    Inhibits prostaglandin production resulting in reduced inflammation and therefore reduced pain.
  48. 48Ibuprofen - Indications for useMild to moderate pain relief
    particulary headache, soft tissue or musculoskeletal
    Can be used in combination with other pain relief for more severe pain
  49. 49Ibuprofen - Contraindications and CautionsContraindications - Known severe allergy and third trimester
    Cautions -
    Ibuprofen in last 4 hours
    Abdominal pain, unwell/vomiting
    Age >75
    Dehydration or Shock
    Known renal impairment
    Known bleeding disorder
    Clinically significant bleeding
    Known worsening of Bronchospasm
    Taking warfarin
    Pregnancy
  50. 50Ibuprofen - Dose and AdministrationDose - 600mg > 80kg
    400mg < 80kg
    Child - N/A (5kg), 100mg (10kg, 20kg), 200mg (30kg), 300mg (40kg).
    Administration - PO, can crush tablets in soft food (eg: jam)
  51. 51Ibuprofen - adverse effectsRenal impairment
    Increased bleeding
    Gastrointestinal symptoms (chronic use)
  52. 52Ipatropium - Mechanism of ActionIpatropium is an anticholinergic agent with antimuscarinic activity.
    Blocks acetylcholine which is a neurotransmitter for the parasympathetic nervous system, resulting in bronchodilation
  53. 53Ipratropium - Indications for useBronchospasm associated with Asthma or COPD
    Prominent Bronchospasm associated with smoke inhalation or airway burns
  54. 54Ipratropium - Contraindications and cautionsContraindicated in known severe allergy
    No Cautions
  55. 55Ipratropium - Dose and AdministrationDose - 0.5mg once only for adults and children
    Administered via nebuliser in combination with Salbutamol
  56. 56Ipratropium - Adverse effectsTachycardia
    Dry mouth
    Blurred vision
  57. 571% Lignocaine - Mechanism of actionLignocaine is a local anaesthetic.
    It blocks the initiation and transmission of nerve impulses by blocking the movement of sodium ions across the nerve cell membrane
  58. 581% Lignocaine - indications for useSubcutaneous injection prophylactically for pain associated with IV cannulation
    Subcutaneous injection for digital ring block analgesia.
  59. 591% Lignocaine - Contraindications and cautionsContraindicated in known severe allergy
    Caution in local infection at injection site
  60. 601% Lignocaine - Dose and AdministrationMaximum of 20ml, may be repeated after 1 hour.
    Children - max 1.5ml (5kg),3ml (10kg), 6ml (20kg), 9ml (30kg), 12ml (40kg).
    Administer SC, for IV administer at the site of cannulation, raise a bleb, wait 1 minute.
    For ring block, administer 1-2ml into tissue on either side of the web space.
  61. 611% Lignocaine - adverse effectsStinging at time of injection (can warm it up in your hand or pocket to reduce this)
  62. 62Loratadine - Mechanism of actionLoratadine is a non-sedating antihistamine
    It blocks peripheral histamine receptors, reduces effect of histamine which reduces itching and redness
  63. 63Loratadine - Indications for useMinor allergic reactions confined to skin involvement
    Prominent itch associated with anaphylaxis provided all systemic symptoms have resolved
  64. 64Loratadine - Containdications and CautionsContraindicated in Known severe allergy
    Age less than 1 year
    Caution in Pregnancy (balance risk vs benefit)
  65. 65Loratadine - Dose and AdministrationDose 10mg for adult or child >12
    5mg for child 1-11years
    Administered PO, May be crushed in soft food (eg: Jam)
  66. 66Methoxyflurane - Mechanism of actionInhaled analgesic. Alters tissue excitability by reducing conduction at the gap junction, results in muscle relaxation and reduced pain sensation
  67. 67Methoxyflurane - Indications for useModerate to severe pain
  68. 68Methoxyflurane - ContraindicationsKnown severe allergy
    Known renal impairment
    Personal or family history of malignant hyperthermia
    Unable to obey commands
    Had methoxyflurane within last 7 days
  69. 69Methoxyflurane - CautionsAge >75
    Pre-eclampsia
    Administration in a confined space
  70. 70Methoxyflurane - Dose and AdministrationMax 6ml (2 doses) >12years
    Max 3ml (one dose) <12 years
    Self administered, inhaled in and out through the mouthpiece to limit exposure to ambulance personnel
  71. 71Methoxyflurane - Adverse effectsSedation
    Light-headedness
    Nausea
    Dislike of taste or smell
  72. 72Midazolam - Mechanism of actionMidazolam is a benzodiazapine
    It enhances GABA (inhibitory neurotransmitter) at GABA receptors in the CNS resulting in anticonvulsant, sedation, amnesia, anxiolysis and muscle relaxation
  73. 73Midazolam - indications for useProlonged seizures (IV and IM)
    Moderate aggitated delerium (IM)
  74. 74Midazolam - Contraindications and CautionsContraindicated in known severe allergy
    Cautions - concurrent administration of opiates or ketamine
    Intoxication
    Elderly
  75. 75Midazolam - DoseIV - 5mg adults (reduced to 2-3mg if small, frail or physiologically unstable)
    Children - 0.5mg, 1mg, 2mg, 3mg, 4mg
    IM - 10mg adults (reduced to 5mg if small, frail or physiologically unstable)
    Children - 1mg, 2mg, 4mg, 6mg, 8mg
    Limit to 2 doses max via either route.
  76. 76Midazolam - AdministrationMidazolam comes in 15mg/3ml
    IV - dilute 2ml up to 10ml with 0.9% (1mg/ml), administer as bolus.
    IM - administer undiluted, later thigh is preferred
  77. 77Midazolam - Adverse effectsSedation
    Respiratory depression
    Hypotension
    Amnesia
  78. 78Morphine - Mechanism of actionMorphine is an opiate analgesic
    It binds to opiate receptors in the CNS.
    Main effect is on mu receptors but also has effect on delta and kappa receptors.
    Results in analgesia, respiratory depression, miosis, euphoria, reduced GI motility and physical dependence (mu)
  79. 79Morphine - indications for useModerate to severe pain
    Cardiogenic pulmonary odema with severe anxiety / respiratory distress
  80. 80Morphine - Contraindications and CautionsContraindications - Known severe allergy, Unable to obey commands, Current respiratory depression
    Cautions - Age <1year, High risk of respiratory depression (CORD, Obesity), Labour (opiates cross the placenta)
  81. 81Morphine - DoseIV - 1 to 5mg every 3 to 5 mins (lower end if small, frail or physiologically unstable)
    Children - 0.25mg, 0.5mg, 1mg, 1.5mg, 2mg
    IM - 5 to 10mg, repeated once after 10mins (lower end if small, frail or physiologically unstable)
    Children - 1mg, 2mg, 4mg, 6mg, 8mg
    CPO - 1 to 2mg IV sparingly
  82. 82Morphine - AdministrationMorphine comes in 10mg/1ml ampoules
    IV - dilute to 10ml using 0.9% (1mg/ml) administer as a bolus
    IM - undiluted, lateral thigh preferred
    don't use this route if patient is shocked, IN fentanyl preferred (can follow after 2x IM doses), Can give IV if access gained after (with caution)
  83. 83Morphine - adverse effectsRespiratory depression
    Hypotension
    Sedation
    Nausea and vomiting
    Histamine release = itching
  84. 84Naloxone - Mechanism of ActionNaloxone is a competitive opiate receptor antagonist, it blocks opiate receptors therefore reversing effects of opiates. In high concentrations it will displace opiate agonists from receptors.
  85. 85Naloxone - Indications for useSuspected opiate poisoning with significantly impaired level of consciousness or significantly impaired breathing.
    Excess adverse effects from opiate administration.
  86. 86Naloxone - Contraindications and CautionsContraindications - known severe allergy
    Cautions - Chronic opiate use (adverse psychological effects from withdrawl)
  87. 87Naloxone - Dose and AdministrationIV - 0.1 to 0.4mg every 3 to 5 mins
    Children - 0.05mg, 0.1mg, 0.2mg, 0.3mg, 0.4mg
    IM - 0.8mg repeated every 10 minutes
    Children - 0.1mg, 0.2mg, 0.4mg, 0.6mg, 0.8mg
    Administration is preferred IV, dilute to total of 4ml (0.1mg/ml), minimum dose to produce improvement
    IM administered undiluted
  88. 88Naloxone - adverse effectsSweating
    Tachycardia
    Hypertension
  89. 89Olanzapine - Mechanism of actionOlanzapine is an atypical anti-psychotic
    Binds to multiple different receptors in the brain (alpha 1, dopamine, histamine H1, muscarinic, and serotonin type 2). Relieves both positive and negative symptoms.
    Results in a reduction in agitation, sedation, anxiolysis and stabilisation of mood.
  90. 90Olanzapine - Indications for useMild aggitated delerium
  91. 91Olanzapine - Contraindications and CautionsContraindicated in Known severe allergy
    Age less than 12 years
    Cautions in pregnancy and the elderly
  92. 92Olanzapine - Dose and AdministrationDose - 10mg >80kg
    5mg <80kg
    Repeat once after 20 minutes
    Administer PO, dispersable tablet, can be dissolved in liquid (water, tea, coffee)
  93. 93Ondansetron - Mechanism of actionOndansetron is an anti-emetic
    It blocks serotonin receptors in the brain and gastrointestinal tract resulting in a reduction of nausea and vomiting
  94. 94Ondansetron - Indications for useClinically significant nausea and/or vomiting
  95. 95Ondansetron - Contraindications and CautionsContraindicated in known severe allergy
    Age < 1 year
    Caution in Known prolonged QT syndrome
  96. 96Ondansetron - Dose and AdministrationOral (wafers) - 8mg >12 years
    Children - N/A, 2mg, 4mg, 6mg, 8mg
    IV/IM - 4mg >12 years
    Children - N/A, 1mg, 2mg, 3mg, 4mg
    Can administer 2x IV/IM doses in addition to one PO dose
  97. 97Ondansetron - Adverse effectsHeadache
    Flushing
    Metallic taste
  98. 98Oxytocin - Mechanism of ActionOxytocin is a synthetic version of a naturally occurring hormone released from the pituitary gland.
    It stimulates oxytocin receptors causing an increase in sodium permeability in uterine smooth muscle cells. Resulting in increased frequency and amplitude of uterine contractions, leading to reduction of blood loss.
  99. 99Oxytocin - Indications for useFollowing normal birth
    Postpartum haemorrhage
  100. 100Oxytocin - Contraindications and CautionsContraindicated in known severe allergy
    No Cautions
  101. 101Oxytocin - Dose and AdministrationDose - 10 units IM
    Administer undiluted, preferred lateral thigh.
    In normal birth, after the last baby.
    If postpartum haemorrhage occurs after, another 10 units should be administered
  102. 102Oxytocin - Adverse effectsAbdominal cramping
    Tachycardia
    Flushing
  103. 103Paracetamol - Mechanism of ActionInhibits prostaglandin production in the CNS resulting in a reduction in pain and fever.
  104. 104Paracetamol - Indications for useMild to moderate pain
    Can be used in combination with other pain relief.
    Can be given for fever > 39 degrees and causing discomfort
  105. 105Paracetamol - Contraindications and CautionsContraindicated in Known severe allergy
    Current paracetamol poisoning
    Caution - paracetamol in the last 4 hours
    Abdominal pain, unwell or vomiting
    Known severe liver disease
  106. 106Paracetamol - Dose and AdministrationDose - 1.5g >80kg
    1g <80kg
    Children (syrup) - 100mg, 200mg, 400mg, 600mg, 800mg
    Children (tablets) - 500mg (30kg), 750mg (40kg)
  107. 107Prednisone - Mechanism of ActionPrednisone is a corticosteroid with anti-inflammatory and immunosuppressant actions.
    It inhibits the production of inflammatory mediators including prostaglandins and leukotrienes resulting in a reduction in inflammatory and immune responses.
  108. 108Prednisone - Indications for useBronchospasm associated with Asthma or COPD
    Prominent rash associated with Anaphylaxis provided systemic signs have resolved
    Minor allergy associated with rash
  109. 109Prednisone - Contraindications and CautionsContraindicated in known severe allergy
    Age < 1 year
    Caution in age < 5 years (unless clear history or previously received oral steroids)
  110. 110Prednisone - Dose and AdministrationAdult - 40mg PO
    Children - N/A, N/A, 20mg, 30mg, 40mg
    Do not administer if pt is taking prednisone already at an equal or higher dose.
    Do not crush as the bitter taste may cause vomiting.
  111. 111Prednisone - Adverse effectsBitter taste
    Fatigue
    Sodium and water retention
    Gastrointestinal reflux
  112. 112Salbutamol - Mechanism of ActionSalbutamol is a B2 selective bronchodilator
    It stimulates beta 2 receptors in the lungs and lesser effect on beta 1 receptors in the heart.
    It It causes relaxation of bronchial smooth muscle causing bronchodilation and the relief of bronchospasm
  113. 113Salbutamol - Indications for useBronchospasm associated with Asthma and COPD
    Prominent bronchospasm associated with smoke inhalation and airway burns
  114. 114Salbutamol - Contraindications and CautionsContraindicated in known severe allergy
    No Cautions
  115. 115Salbutamol - Dose and Administration5mg Nebulised undiluted, initally combined with ipratropium then on its own thereafter.
  116. 116Salbutamol - Adverse effectsTremor and tachycardia
  117. 117Sodium Valproate - Mechanism of actionValproate is the active ingredient
    Valproate is an anticonvulsant, it blocks sodium channels and enhances the inhibitory neurotransmitter GABA at GABA receptors in the CNS
  118. 118Sodium Valproate - Indications for useStatus epilepticus that does not respond to 2 doses of midazolam
  119. 119Sodium Valproate - Contraindications and CautionsContraindicated in known severe allergy
    No Cautions
  120. 120Sodium Valproate - Dose and Administration1200mg for adults
    Children - 150mg, 300mg, 600mg, 800mg, 1200mg
    Adminster IV over 10 - 15 mins, preferably in a running line.
    Dissolve the ampoule using 4ml 0.9%, dilute up to 10ml if needed and administer 1ml every 1-2 mins.
  121. 121Tramadol - Mechanism of actionTramadol is an analgesic. It acts on the CNS by binding to mu opiate receptors and inhibiting re-uptake of noradrenaline and serotonin
  122. 122Tramadol - Indications for useModerate pain, can be used in combination with other pain relief
  123. 123Tramadol - Contraindications and CautionsContraindicated in known severe allergy
    Age less than 12 years
    Cautions - tramadol in last 4 hours
    Abdominal pain, unwell and vomiting
    Age > 75 years
    Confusion
    Pregnancy
  124. 124Tramadol - Dose and Administration50mg >12 years old
    Administer PO
  125. 125Tramadol - Adverse effectsNausea / vomiting
    Light-headedness, feeling unusual
    Sedation
    Dry mouth

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Description
Pharmacology of Medicines within Paramedic Scope of practice based on St John Ambulance NZ CPGs
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