15470298
Description
Flashcards by Janelle Chambers, updated more than 1 year ago
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Created by Janelle Chambers
over 5 years ago
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| Question | Answer |
| Adrenaline - Mechanism of Action | Adrenaline 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. |
| Adrenaline - Indications for use | Cardiac Arrest Anaphylaxis Severe Asthma Moderate to Severe Stridor Clinically significant Epistaxis Clinically Significant wound bleeding |
| Adrenaline - Contraindications and Cautions | No Contraindications Caution in Myocardial Ischaemia and Tachydysrhythmia |
| Adrenaline - Adverse Effects | Tachycardia Tachydysrhythmia Myocardial Ischaemia Ventricular Ectopy Hypertension Nausea and Vomiting Tremor, Anxiety, Sweating Hyperglycaemia |
| Adrenaline - Administration | Topical - 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 |
| Adrenaline - Doses | Cardiac 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 |
| Amiodarone - Mechanism of Action | Amiodarone 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 |
| Amiodarone - Indications for use | Cardiac Arrest |
| Amiodarone - Contraindications and Cautions | None in Cardiac Arrest |
| Amiodarone - Dose and Administration | Dose - 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 |
| Amoxicillin/Clavulanic Acid - Mechanism of Action | Amoxicillin/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. |
| Amoxicillin/clavulanic acid - Indications for use | Clinical 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 |
| Amoxicillin/clavulanic acid - Contraindications and cautions | Contraindications - Known severe allergy Known severe allergy to penicillins Anaphylaxis to beta-lactam antibiotics Cautions - None |
| Amoxicillin/clavulanic acid - Administration | IV - 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. |
| Amoxicillin/clavulanic acid - Dose | Adults - 1.2g Children - 150mg (5kg), 300mg (10kg), 600mg (20kg), 900mg (30kg), 1.2g (40kg). |
| Aspirin - Mechanism of Action | Aspirin 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 |
| Aspirin - Indications for use | Myocardial ischaemia |
| Aspirin - Contraindications and cautions | Contraindications - Known severe allergy Third trimester of pregnancy Cautions - Known bleeding disorder, clinically significant bleeding, known worsening of bronchospasm with NSAIDs |
| Aspirin - Adverse effects | Increased bleeding Chronic administration can cause gastrointestinal symptoms (indigestion, bleeding, ulceration). |
| Aspirin - Dose and Administration | 300mg dispersible (chewed or dissolved in water) |
| Fentanyl - Mechanism of Action | Fentanyl 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. |
| Fentanyl - Indications for use | Moderate to severe pain in patients who require intense pain relief for a short time (relocation). With clinically significant shock. If no IV access available. |
| Fentanyl - Contraindications and Cautions | Contraindications - 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) |
| Fentanyl - adverse reactions | Respiratory depression Bradycardia Hypotension Sedation Nausea and Vomiting Itching Euphoria |
| Fentanyl - Administration | IV - 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) |
| Fentanyl - Dose | IV - 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. |
| Gentamicin - Mechanism of Action | Gentamicin is an aminoglycoside antibiotic with broad activity against gram negative and some gram positive. It inhibits bacterial cell protein synthesis |
| Gentamicin - Indications for use | Septic Shock >30 minutes from hospital where the site of infection is known to be urinary, abdominal or unknown |
| Gentamicin - Contraindications and Cautions | Contraindications - Known severe allergy Pregnancy Cautions - None |
| Gentamicin - Administration | Administer 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 |
| Gentamicin - Dose | Adults - 240mg <60kg 320mg 60-80kg 400 >80kg Children - 30mg (5kg), 60mg (10kg), 120mg (20kg), 160mg (30kg), 240mg (40kg) |
| Gentamicin - Adverse effects | None if administering at appropriate rate Renal impairment with repeated doses Ototoxicity (damage to inner ear) if administered too rapidly or prolonged dosing. |
| Glucagon - Mechanism of Action | Glucagon is a natural occurring hormone produced by the pancreas. It increases blood glucose by stimulating glycogenolysis (breakdown of glycogen into glucose) in the liver |
| Glucagon - Indications for use | Hypoglycaemia where the patient cannot swallow and IV access is unavailable |
| Glucagon - Contraindications and Cautions | Contraindications - Known severe allergy Cautions - None |
| Glucagon - Dose and Administration | Dose - 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. |
| Glucose Gel - Mechanism of Action | Glucose 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. |
| Glucose gel - Indications for use | Hypoglycaemia where the patient is conscious enough to swallow |
| Glucose gel - Dose and Administration | 10-20g sachet, administer one sachet every 10 minutes if hypoglycaemia persists |
| Glyceral trinitrate (GTN) - Mechanism of Action | GTN 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. |
| GTN - Indications for use | Myocardial ischaemia Cardiogenic pulmonary oedema Hypertension associated with autonomic dysreflexia |
| GTN - Contraindications | Systolic BP <100 Heart rate <40 Heart rate >130 or >150 in autonomic dysreflexia VT |
| GTN - cautions | STEMI with right side involvement Small, frail physiologically unstable pts Poor Perfusion Dysrhythmia Erectile dysfunction drugs used in last 24hrs Known Aortic or Mitral stenosis |
| GTN - dose | Myocardial 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. |
| GTN - Administration | Deliver 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 |
| GTN - Adverse effects | Hypotension Flushing Headache Tachycardia Light-headedness |
| Ibuprofen - Mechanism of Action | NSAID Inhibits prostaglandin production resulting in reduced inflammation and therefore reduced pain. |
| Ibuprofen - Indications for use | Mild to moderate pain relief particulary headache, soft tissue or musculoskeletal Can be used in combination with other pain relief for more severe pain |
| Ibuprofen - Contraindications and Cautions | Contraindications - 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 |
| Ibuprofen - Dose and Administration | Dose - 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) |
| Ibuprofen - adverse effects | Renal impairment Increased bleeding Gastrointestinal symptoms (chronic use) |
| Ipatropium - Mechanism of Action | Ipatropium is an anticholinergic agent with antimuscarinic activity. Blocks acetylcholine which is a neurotransmitter for the parasympathetic nervous system, resulting in bronchodilation |
| Ipratropium - Indications for use | Bronchospasm associated with Asthma or COPD Prominent Bronchospasm associated with smoke inhalation or airway burns |
| Ipratropium - Contraindications and cautions | Contraindicated in known severe allergy No Cautions |
| Ipratropium - Dose and Administration | Dose - 0.5mg once only for adults and children Administered via nebuliser in combination with Salbutamol |
| Ipratropium - Adverse effects | Tachycardia Dry mouth Blurred vision |
| 1% Lignocaine - Mechanism of action | Lignocaine 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 |
| 1% Lignocaine - indications for use | Subcutaneous injection prophylactically for pain associated with IV cannulation Subcutaneous injection for digital ring block analgesia. |
| 1% Lignocaine - Contraindications and cautions | Contraindicated in known severe allergy Caution in local infection at injection site |
| 1% Lignocaine - Dose and Administration | Maximum 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. |
| 1% Lignocaine - adverse effects | Stinging at time of injection (can warm it up in your hand or pocket to reduce this) |
| Loratadine - Mechanism of action | Loratadine is a non-sedating antihistamine It blocks peripheral histamine receptors, reduces effect of histamine which reduces itching and redness |
| Loratadine - Indications for use | Minor allergic reactions confined to skin involvement Prominent itch associated with anaphylaxis provided all systemic symptoms have resolved |
| Loratadine - Containdications and Cautions | Contraindicated in Known severe allergy Age less than 1 year Caution in Pregnancy (balance risk vs benefit) |
| Loratadine - Dose and Administration | Dose 10mg for adult or child >12 5mg for child 1-11years Administered PO, May be crushed in soft food (eg: Jam) |
| Methoxyflurane - Mechanism of action | Inhaled analgesic. Alters tissue excitability by reducing conduction at the gap junction, results in muscle relaxation and reduced pain sensation |
| Methoxyflurane - Indications for use | Moderate to severe pain |
| Methoxyflurane - Contraindications | Known severe allergy Known renal impairment Personal or family history of malignant hyperthermia Unable to obey commands Had methoxyflurane within last 7 days |
| Methoxyflurane - Cautions | Age >75 Pre-eclampsia Administration in a confined space |
| Methoxyflurane - Dose and Administration | Max 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 |
| Methoxyflurane - Adverse effects | Sedation Light-headedness Nausea Dislike of taste or smell |
| Midazolam - Mechanism of action | Midazolam is a benzodiazapine It enhances GABA (inhibitory neurotransmitter) at GABA receptors in the CNS resulting in anticonvulsant, sedation, amnesia, anxiolysis and muscle relaxation |
| Midazolam - indications for use | Prolonged seizures (IV and IM) Moderate aggitated delerium (IM) |
| Midazolam - Contraindications and Cautions | Contraindicated in known severe allergy Cautions - concurrent administration of opiates or ketamine Intoxication Elderly |
| Midazolam - Dose | IV - 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. |
| Midazolam - Administration | Midazolam 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 |
| Midazolam - Adverse effects | Sedation Respiratory depression Hypotension Amnesia |
| Morphine - Mechanism of action | Morphine 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) |
| Morphine - indications for use | Moderate to severe pain Cardiogenic pulmonary odema with severe anxiety / respiratory distress |
| Morphine - Contraindications and Cautions | Contraindications - 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) |
| Morphine - Dose | IV - 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 |
| Morphine - Administration | Morphine 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) |
| Morphine - adverse effects | Respiratory depression Hypotension Sedation Nausea and vomiting Histamine release = itching |
| Naloxone - Mechanism of Action | Naloxone 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. |
| Naloxone - Indications for use | Suspected opiate poisoning with significantly impaired level of consciousness or significantly impaired breathing. Excess adverse effects from opiate administration. |
| Naloxone - Contraindications and Cautions | Contraindications - known severe allergy Cautions - Chronic opiate use (adverse psychological effects from withdrawl) |
| Naloxone - Dose and Administration | IV - 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 |
| Naloxone - adverse effects | Sweating Tachycardia Hypertension |
| Olanzapine - Mechanism of action | Olanzapine 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. |
| Olanzapine - Indications for use | Mild aggitated delerium |
| Olanzapine - Contraindications and Cautions | Contraindicated in Known severe allergy Age less than 12 years Cautions in pregnancy and the elderly |
| Olanzapine - Dose and Administration | Dose - 10mg >80kg 5mg <80kg Repeat once after 20 minutes Administer PO, dispersable tablet, can be dissolved in liquid (water, tea, coffee) |
| Ondansetron - Mechanism of action | Ondansetron is an anti-emetic It blocks serotonin receptors in the brain and gastrointestinal tract resulting in a reduction of nausea and vomiting |
| Ondansetron - Indications for use | Clinically significant nausea and/or vomiting |
| Ondansetron - Contraindications and Cautions | Contraindicated in known severe allergy Age < 1 year Caution in Known prolonged QT syndrome |
| Ondansetron - Dose and Administration | Oral (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 |
| Ondansetron - Adverse effects | Headache Flushing Metallic taste |
| Oxytocin - Mechanism of Action | Oxytocin 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. |
| Oxytocin - Indications for use | Following normal birth Postpartum haemorrhage |
| Oxytocin - Contraindications and Cautions | Contraindicated in known severe allergy No Cautions |
| Oxytocin - Dose and Administration | Dose - 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 |
| Oxytocin - Adverse effects | Abdominal cramping Tachycardia Flushing |
| Paracetamol - Mechanism of Action | Inhibits prostaglandin production in the CNS resulting in a reduction in pain and fever. |
| Paracetamol - Indications for use | Mild to moderate pain Can be used in combination with other pain relief. Can be given for fever > 39 degrees and causing discomfort |
| Paracetamol - Contraindications and Cautions | Contraindicated in Known severe allergy Current paracetamol poisoning Caution - paracetamol in the last 4 hours Abdominal pain, unwell or vomiting Known severe liver disease |
| Paracetamol - Dose and Administration | Dose - 1.5g >80kg 1g <80kg Children (syrup) - 100mg, 200mg, 400mg, 600mg, 800mg Children (tablets) - 500mg (30kg), 750mg (40kg) |
| Prednisone - Mechanism of Action | Prednisone 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. |
| Prednisone - Indications for use | Bronchospasm associated with Asthma or COPD Prominent rash associated with Anaphylaxis provided systemic signs have resolved Minor allergy associated with rash |
| Prednisone - Contraindications and Cautions | Contraindicated in known severe allergy Age < 1 year Caution in age < 5 years (unless clear history or previously received oral steroids) |
| Prednisone - Dose and Administration | Adult - 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. |
| Prednisone - Adverse effects | Bitter taste Fatigue Sodium and water retention Gastrointestinal reflux |
| Salbutamol - Mechanism of Action | Salbutamol 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 |
| Salbutamol - Indications for use | Bronchospasm associated with Asthma and COPD Prominent bronchospasm associated with smoke inhalation and airway burns |
| Salbutamol - Contraindications and Cautions | Contraindicated in known severe allergy No Cautions |
| Salbutamol - Dose and Administration | 5mg Nebulised undiluted, initally combined with ipratropium then on its own thereafter. |
| Salbutamol - Adverse effects | Tremor and tachycardia |
| Sodium Valproate - Mechanism of action | Valproate is the active ingredient Valproate is an anticonvulsant, it blocks sodium channels and enhances the inhibitory neurotransmitter GABA at GABA receptors in the CNS |
| Sodium Valproate - Indications for use | Status epilepticus that does not respond to 2 doses of midazolam |
| Sodium Valproate - Contraindications and Cautions | Contraindicated in known severe allergy No Cautions |
| Sodium Valproate - Dose and Administration | 1200mg 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. |
| Tramadol - Mechanism of action | Tramadol is an analgesic. It acts on the CNS by binding to mu opiate receptors and inhibiting re-uptake of noradrenaline and serotonin |
| Tramadol - Indications for use | Moderate pain, can be used in combination with other pain relief |
| Tramadol - Contraindications and Cautions | Contraindicated 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 |
| Tramadol - Dose and Administration | 50mg >12 years old Administer PO |
| Tramadol - Adverse effects | Nausea / vomiting Light-headedness, feeling unusual Sedation Dry mouth |
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