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Paramedicine 🚑 > 3rd Year Drugs > Flashcards

3rd Year Drugs Flashcards

1
Q

Adrenaline - Anaphylaxis/Severe Asthma

A

1:1,000 - 1mg/1ml

IM - 500 mcg every 5 minutes

Contras: NONE

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2
Q

Adrenaline - Cardiac Arrest

A

1:1,000 - 1mg/1ml

IV/IO - 1mg in 1ml - every 3-5 minutes

CONTRAS: None

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3
Q

Adrenaline - ROSC

A

1:1,000 - 1mg/1ml

IV/IO - 50mcg - 0.5 -1ml

Add 9ml NaCl = 1mg in 10ml

As required, until BP >90mmHg

POST two 250ml saline boluses

CONTRAS: None

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4
Q

Amiodorone - cardiac arrest + refractory VF/VT (post 3 shocks)

A

150mg/3ml

IV/IO - 300mg - 6ml - no dilution

Single dose

CONTRAS:
None in this setting

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5
Q

Aspirin - ACS

A

PO - 300mg - single dose

CONTRAS:

Hypersensitivity to salicylates/aspirin, children under 12 years

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6
Q

Adrenaline - EpiPen

A

CONTRAS: None. But must not be used for Asthma

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7
Q

Atropine - Symptomatic bradycardia, organophosphate poisoning

A

1.2mg/1ml

IV - Symptomatic bradycardia - 600mcg (0.6mg) - 0.5ml - NO dilution - repeat 3-5 minutes (max 3mg)

IV - Organophosphate poisoning - 1-2mg -
10-20mls - Add 11ml NaCl = 1.2mg/12ml
Repeat every 5 minutes until Atropinisation

CONTRAS: Hypersensitivity, Third degree AV block, patients with cardiac transplant

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8
Q

Co-Phenylcaine - Epistaxis, oral haemorrhage, local pain (abrasions)

A

50mg/ml pump spray, 5mg dose per spray

IN/PO - 1 spray - 5mg - Repeat - 1-2 minutes, max 25mg

CONTRAS: Hypersensitivity to phenylephrine/lignocaine/other anaesthetics, pregnancy, children under 2 years

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9
Q

Fentanyl Citrate - 100mcg/2ml

IV dose

A

IV dose - Moderate to Severe pain

UNDER 70 years - Weight based

1mcg/kg (max 100mcg)
Add 8ml NaCl = 100mcg in 10 ml
Repeat 25mcg after 5 minutes

OVER 70 years - Weight based

0.5mcg/kg (max 50mcg)
Add 8ml NaCl to make 100mcg in 10ml
Repeat 25 mcg after 5 minutes

CONTRAS:
Hypersensitivity to Fentanyl, aged under 1 year (IV/IO)

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10
Q

Fentanyl - 450mcg/1.5ml

IN dose

A

Moderate to Severe pain

Prime atomiser first

Small/elderly/frail :
120mcg - 2 x 0.2ml
Repeat: 60mcg after 5 minutes

Adult :
180mcg - 3 x 0.2ml
Repeat: 60mcg after 5 minutes

CONTRAS:
Hypersensitivity to Fentanyl, occluded nasal passages of epistaxis (IN)

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11
Q

Glucagon - Hypoglycaemia - 3rd line agent

A

IM - 1mg/1ml

Repeat: after 5 minutes
Once only

CONTRAS: Pheochromocytoma, Hypersensitivity

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12
Q

Glucose 10% - Hypoglycaemia

1st line agent if unable to swallow

A

IV - 50mg in 500ml

Have bag insitu for immediate flush

10g/100ml - Repeat: every 5 minutes, as required

CONTRAS:
Not to be used if IV line is not patent

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13
Q

Glucose gel - 15mg sachet

A

PO - 1st line agent if can swallow

CONTRAS: None

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14
Q

GTN -

Chest pain

Cardiogenic APO/BO over 90mmHg

Autonomic Dysreflexia BP over 160mmHg

A

SL - 400mcg spray

Repeat: every 5 minutes, no max

CONTRAS:
Hypotension (under 90mmHg), hypersensitivity, use of erectile dysfunction meds in last 24 hours (Sildenafil, Vardenafil)

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15
Q

Heparin - 5000 units/5ml

Confirmed STEMI - going in to cath lab

A

IV - 5000 units/5ml

Single dose

CONTRAS:
Hypersensitivity to Heparin, presence of known haemorrhagic states

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16
Q

Ipratropium Bromide
Severe to life threatening asthma
Asthma/COPD

A

250mcg/1ml

NEB: 500mcg in 2ml
Combine with 5mg/2.5ml Salbutamol

MDI: 12 puffs. Repeat: Once only. 1 breath per puff

Contras: Hypersensitivity

17
Q

Ketamine - IV/IM

2nd line agent for traumatic pain following administration of 200mcg Fentanyl

1st line agent for sedation of combative TBI

A

200mg/2ml

Pain IV - 10mg/1ml. Add 18ml NaCl = 10mg/19ml?
Repeat: every 5 minutes

Pain IM: weight based.
1mg/kg - max 100mg.
Repeat: every 5 minutes

Sedation for TBI - IM: weight based.
2mg/kg - max 200mg.
Single dose.

CONTRAS:
Hypersensitivity, acute cardiovascular disease, active psychiatric condition, non traumatic pain (IM IV IO), aged under 12 months

18
Q

Ketamine - wafer

2nd line agent for moderate to severe acute pain when 1st line agent has failed

A

25mg wafer - SL

Dose: 50mg. Repeat: every 5 minutes. Max 125mg (4 tablets)

CONTRAS: under 12 years old

19
Q

Lignocaine

Local anaesthesia for IV cannulation - ID

Local anaesthesia for IO infusion - IO

A

1% - 20mg/2ml

ID for IV - 0.1mg - 0.1ml

IO - small adult: 20mg - 2ml
IO - adult: 40mg - 4ml

Use in second site if needed.

CONTRAS:
Hypersensitivity

20
Q

Methoxyflurane

FINISH

A

3ml - IH

Malignant hyperthermia
E
T
Hyperthermic
L
Altered conscious state
B
21
Q

Midazolam

Prolonged seizure activity - over 5 minutes

Sedation of disturbed/abnormal behaviour

A

15mg/3ml

IN: 5mg - 1ml.

IM: 5mg - 1ml.

IV: 2.5mg - 2.5ml. Add 12ml NaCl = 15mg in 15ml

ALL: Repeat every 5 minutes. Max dose 15mg

CONTRAS: Hypersensitivity

22
Q

Naloxone

Reversal of respiratory depression in suspected narcotic overdose

A

400mcg/1ml

IM: 400mcg/1ml.
Repeat every 5 minutes. Max 10mg.

IV: 400mcg/1ml
Repeat every 2 minutes. Max 10mg. 10mls titrated.
Add 9ml NaCl = 0.4mg in 10ml

CONTRAS:
None

23
Q

Ondansetron

Prophylaxis: spinal injury, eye injury

Moderate-Severe nausea

Active vomiting

A

4mg wafer
4mg/2ml vial

SL: 1 wafer.

IM: 2ml.

IV: slow push. Add 8ml NaCl = 4mg/10ml

ALL: Repeat once after 30 minutes

CONTRAS:
Hypersensitivity, children under 2 years of age.

24
Q

Paracetamol

Mild pain + headache

A

PO

500mg tablet.

1-2 tablets. Repeat after 4 hours.
Max dose 4g in 24 hours

CONTRAS:
Hypersensitivity, previous dode in last 4/24 or greater than 4g in 24 hours

25
Q

Salbutamol - MDI + NEB

Bronchospasm: Asthma, Anaphylaxis, non cardiac APO, bronchitis, smoke inhalation, COPD, salt water aspiration syndrome

A

5mg/2.5ml

MDI: 4 puffs. Repeat: every 4 minutes as required.

NEB: 5mg - 1 nebule. PRN - no max.

CONTRAS:
Hypersensitivity, cardiogenic APO, children under 12 months old

26
Q

Sodium Chloride - 0.9%
Ampoule 1000ml soft packs

Fluid Replacement Therapy

A

Hypovolaemic shock/Hyperosmolar Hyperglycaemic state - IV/IO:
20ml/kg at 250ml bolus - 250ml
PRN titrated

Hypovolaemic cardiac arrest: IV/IO - weight based.
20ml/kg.
Max 2 Litres. Once only. Max 2 Litres

ROSC: IV/IO
250ml - Repeat as required until BP over 100mmHg. Max 2 boluses prior to Adrenaline

CONTRAS: Severe Pulmonary Oedema

27
Q

Tranexamic Acid

Major trauma with uncontrolled excessive bleeding injury - under 3/24

A

1g/10ml

IV - 1g/10ml - slow push. Single dose

CONTRAS:
Hypersensitivity, injury time more than 3/24

Paramedicine 🚑 (6 decks)

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