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ASNSW Pharmacology > Adult Dose > Flashcards

Adult Dose Flashcards

1
Q

Adrenaline
Cardiac Arrest
>= 16
IV

A

Preparation: 1mg in 1ml ampoule (1:1,000)
1mg in 10ml ampoule (1:10,000)
Route: IV
Initial Dose: 1mg (1:10,000) bolus
Repeat: 2nd cycle (~ 4min)
Max Total: No Max

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2
Q

Adrenaline
Cardiac Arrest
>= 16
ETT

A

Preparation: 1mg in 1ml ampoule (1:1,000)
1mg in 10ml ampoule (1:10,000)
Route: ETT
Initial Dose: 3mg (1:1,000)
Repeat: 2nd cycle (~ 4min)
Max Total: 10mg
NB ETT Adrenaline must only be used if IV/IO access is unavailable.

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3
Q

Adrenaline
Life Threatening Asthma
>= 16
IM

A

Preparation: 1mg in 1ml ampoule (1:1,000)
1mg in 10ml ampoule (1:10,000)
Route: IM
Initial Dose: 500mcg (1:1,000) bolus into lateral thigh
Repeat: 5 min
Max Total: No Max

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4
Q

Adrenaline
Life Threatening Asthma
>= 16
IV

A

Indication: Unresponsive after 4x IM bolus injections.
Preparation: 1mg in 1ml ampoule (1:1,000)
1mg in 10ml ampoule (1:10,000)
Route: IV
Initial Dose: 50mcg (1:10,000) bolus
Repeat: 1 min
Max Total: No Max

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5
Q

Adrenaline
Severe/Life Threatening Anaphylaxis
>= 16
IM

A

Preparation: 1mg in 1ml ampoule (1:1,000)
1mg in 10ml ampoule (1:10,000)
Route: IM
Initial Dose: 500mcg (1:1,000) bolus into lateral thigh
Repeat: 5 min
Max Total: No Max

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6
Q

Adrenaline
Severe/Life Threatening Anaphylaxis
>= 16
INFUSION

A

Indication: Unresponsive after 4x IM bolus injections.
Preparation: 1mg in 1ml ampoule (1:1,000)
1mg in 10ml ampoule (1:10,000)
Route: Infusion
Initial Dose: 1mg (1:10,000) diluted in 90ml
compound sodium lactate via burette
with micro drip. Commence 5mcg/min
(30 drops/min)
Repeat: Titrate whilst indicated
Max Total: No Max

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7
Q

Adrenaline
Severe/Life Threatening Anaphylaxis
>= 16
NEB

A

Indication: Continuing signs of upper airway obstruction
post IM Adrenaline
Preparation: 1mg in 1ml ampoule (1:1,000)
1mg in 10ml ampoule (1:10,000)
Route: NEB
Initial Dose: 5mg (1: 1,000)
Repeat: 30 min
Max Total: No Max

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8
Q

Adrenaline
Bradycardia
>= 16

A

Preparation: 1mg in 1ml ampoule (1:1,000)
1mg in 10ml ampoule (1:10,000)
Route: IV
Initial Dose: 50mcg (1:10,000) bolus
Repeat: 1 min until PR > 40 and/or perfusion is
adequate or a continuous Adrenaline
infusion is running
Max Total: No Max

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9
Q

Adrenaline
Cardiogenic Shock
>= 16

A

Preparation: 1mg in 1ml ampoule (1:1,000)
1mg in 10ml ampoule (1:10,000)
Route: IV
Initial Dose: 50mcg (1:10,000)
Repeat: 1 min until systolic BP > 100mmHg or
Adrenaline infusion insitu
Max Total: No Max

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10
Q

Amiodarone
Cardiac Arrest
>= 16

A 
Preparation: 150mg in 3ml ampoule (50mg:1ml)
Route:           IV
Initial Dose:  300mg bolus
Repeat:         once 150mg
Max Total:     450mg
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11
Q

Amiodarone
Dysrhythmias - Tachycardia
>= 16

A 
Preparation: 150mg in 3ml ampoule (50mg:1ml)
Route:          IV
Initial Dose: 50mg bolus
Repeat:        3 min
Max Total:    300mg
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12
Q

Aspirin
Acute Coronary Syndrome
>= 16

A 
Preparation: 300mg tablet
Route:          PO
Initial Dose: 300mg chewed
Repeat:        Nil
Max Total:    300mg
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13
Q

Atropine
Bradycardia
>= 16
IV

A

Preparation: 600mcg in 1ml polyampoule (600mcg:1ml)
Diluted to 6ml (100mcg:1ml) with 5ml NaCl
Route: IV
Initial Dose: 600mcg undiluted bolus
Repeat: 1 min
Max Total: 3mg

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14
Q

Atropine
Bradycardia
>= 16
IM

A

Preparation: 600mcg in 1ml polyampoule (600mcg:1ml)
Diluted to 6ml (100mcg:1ml) with 5ml NaCl
Route: IM
Initial Dose: 600mcg undiluted bolus
Repeat: 3 min
Max Total: 3mg
NB Should only be used where IV access is not available

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15
Q

Atropine
Organophosphate Poisoning
>= 16
IV

A

Indication: PR<80/min and/or
SBP <80mmHg and/or
[+] secretions/crackles or chest crepitation.
Preparation: 600mcg in 1ml polyampoule (600mcg:1ml)
Diluted to 6ml (100mcg:1ml) with 5ml NaCl
Route: IV
Initial Dose: 600mcg undiluted bolus
Repeat: 1 min
Max Total: No Max

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16
Q

Atropine
Organophosphate Poisoning
>= 16
IM

A

Indication: PR<80/min and/or
SBP <80mmHg and/or
[+] secretions/crackles or chest crepitation.
Preparation: 600mcg in 1ml polyampoule (600mcg:1ml)
Diluted to 6ml (100mcg:1ml) with 5ml NaCl
Route: IM
Initial Dose: 2mg undiluted bolus
Repeat: 3 min
Max Total: No Max
NB Should only be used where IV access is not available

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17
Q

Atropine
Nerve Agent Poisoning
>= 16
IV

A

Indication: ALL ages: Mild nerve agent poisoning
symptoms.
>=6yrs: Moderate - Severe Nerve Agent
poisoning symptoms unresponsive to
maximum dose of Pralidoxime
Chloride/Atropine Autoinjector
and/or Pralidoxime Chloride/Atropine
Autoinjector is not available.
Preparation: 600mcg in 1ml polyampoule (600mcg:1ml)
Diluted to 6ml (100mcg:1ml) with 5ml NaCl
Route: IV
Initial Dose: 600mcg undiluted bolus
Repeat: 1 min
Max Total: No Max

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18
Q

Atropine
Nerve Agent Poisoning
>= 16
IM

A

Indication: ALL ages: Mild nerve agent poisoning
symptoms.
>=6yrs: Moderate - Severe Nerve Agent
poisoning symptoms unresponsive to
maximum dose of Pralidoxime
Chloride/Atropine Autoinjector
and/or Pralidoxime Chloride/Atropine
Autoinjector is not available.
Preparation: 600mcg in 1ml polyampoule (600mcg:1ml)
Diluted to 6ml (100mcg:1ml) with 5ml NaCl
Route: IM
Initial Dose: 2mg undiluted bolus
Repeat: 3 min
Max Total: No Max
NB Should only be used where IV access is not available

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19
Q

Benzyl Penicillin
Meningococcal Septicaemia
>= 10

A

Preparation: 600mg as powder.
IV / IO dissolve 600mg in 10ml NaCl
IM dissolve 600mg in 2ml NaCl
Route: IV / IO / IM
Initial Dose: 1200mg
Repeat: Nil
Max Total: 1200mg

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20
Q

Calcium Gluconate
Hyperkalaemia
>= 16

A 
Preparation: 2.2mmol in 10ml ampoule (~1g per 10ml)
Route:           IV
Initial Dose:  1g over 2 min
Repeat:         5 min
Max Total:     3g
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21
Q

Clopidogrel
Cardiac Reperfusion - PHT
>=18 - <75

A 
Preparation: 75mg tablet
Route:           PO
Initial Dose:  300mg (4x tablets)
Repeat:         Nil
Max Total:     300mg
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22
Q

Clopidogrel
Cardiac Reperfusion - PHT
>75

A 
Preparation: 75mg tablet
Route:           PO
Initial Dose:  75mg
Repeat:         Nil
Max Total:     75mg
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23
Q 
Compound Sodium Lactate
Dehydration
ALL ages
Pump set: >=16
Autostart Burette + Pump set: <16
A 
Preparation: 500ml bag
Route:           IV/IO
Initial Dose:  10ml/kg bolus
Repeat:         No Repeat
Max Total:     10ml/kg
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24
Q 
Compound Sodium Lactate
Crush Injuries & Trapped/Hyperkalaemia/Hyperglycaemia
ALL ages
Pump set: >=16
Autostart Burette + Pump set: <16
A 
Preparation: 500ml bag
Route:           IV/IO
Initial Dose:  10ml/kg bolus
Repeat:         whilst indicated
Max Total:     No Max
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25
Q

Compound Sodium Lactate
Traumatic Hypovolaemia
>=16
Pump set

A

Indication: 1. Non Head Injured: Absence of a radial
pulse
2. Head Injured: SBP < 100mmHg
3. Penetrating trauma decreased LOC
and/or absent radial pulse.
Preparation: 500ml bag
Route: IV
Initial Dose: 250ml bolus
Repeat: 250ml until radial pulse restored (Non Head
Injured) or SBP > 100mmHg (Head Injured)
Max Total: No Max

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26
Q

Compound Sodium Lactate
Traumatic Cardiac Arrest
>=16
Pump set

A

Indication: Traumatic cardiac arrest with no palpable
central pulse (carotid or femoral)
Preparation: 500ml bag
Route: IV/IO
Initial Dose: 250ml bolus
Repeat: whilst indicated
Max Total: 1000ml

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27
Q 
Compound Sodium Lactate
Medical Hypoperfusion/Hypovolaemia
ALL ages
Pump set: >=16
Autostart Burette + Pump set: <16
A

Indication: 1. >= 2 key signs of shock
2. meningococcal disease
3. suspected sepsis patient with
hypotension
4. moderate to severe anaphylaxis with
signs of shock
Preparation: 500ml bag
Route: IV/IO
Initial Dose: 20ml/kg bolus
Repeat: whilst indicated
Max Total: No Max

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28
Q 
Compound Sodium Lactate
Trauma in Pregnancy
ALL ages
Pump set: >=16
Autostart Burette + Pump set: <16
A

Indication: Trauma + 1 or more key signs of shock
Preparation: 500ml bag
Route: IV/IO
Initial Dose: 250ml bolus
Repeat: 250ml to maintain SBP > 90mmHg
Max Total: No Max

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29
Q

Compound Sodium Lactate
Cardiogenic Shock
>=16
Pump set

A

Indication: Haemodynamic compromise and
SBP < 90mmHg
Preparation: 500ml bag
Route: IV
Initial Dose: 10ml/kg bolus
Repeat: Once - 10ml/kg per hr if indicated AND no
response to Adrenaline infusion
Max Total: 20ml/kg

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30
Q 
Compound Sodium Lactate
Burns
ALL ages
Pump set: >=16
Autostart Burette + Pump set: <16
A

Indication: >20% TBSA in patients >=16
>10% TBSA in patients <16
Preparation: 500ml bag
Route: IV/IO
Initial Dose: 10ml/kg bolus
Repeat: 10ml/kg per hour
Max Total: No Max

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31
Q

Droperidol
Behavioural Disturbance - all indications
>=14 - < 65

A 
Indication:     >=14 yrs
Preparation: 10mg in 2ml vial
Route:           IM/IV
Initial Dose:  10mg bolus
Repeat:         Once after 15 min
Max Total:     20mg
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32
Q

Droperidol
Palliative Care
>= 16

A 
Indication:     Palliative care patient with nausea and 
                      vomiting
Preparation: 10mg in 2ml vial
Route:           SC
Initial Dose:  0.5mg
Repeat:         8hrs
Max Total:     3mg in 24hrs
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33
Q

Enoxaparin Sodium
Cardiac Reperfusion - PHT
>=18 - <75

A

Preparation: 60mg (0.6ml) pre-filled orange syringe
100mg (1ml) pre-filled black syringe
Initial Dose: Discard 30mg (0.3ml) and attach NaCl
0.9% primed microbore extension set prior
to administering the remaining 30mg (0.3ml)
IV as a bolus and flush with 30ml NaCl 0.9%.
To be administered 15min after
Tenectaplase.
2nd Dose: Weight adjusted 1mg/kg SC
(to a max of 100mg) administered 15 min
after the 1st dose of Enoxaparin Sodium.

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34
Q

Enoxaparin Sodium
Cardiac Reperfusion - PHT
>=75

A

Preparation: 60mg (0.6ml) pre-filled orange syringe
100mg (1ml) pre-filled black syringe
Initial Dose: No IV dose
2nd Dose: Weight adjusted 0.75mg/kg SC
(to a max of 75mg) administered 15 min
after the 1st dose of Enoxaparin Sodium.

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35
Q

Fentanyl
Pain Management
>=16

A

Preparation: 450mcg (1.5ml) sealed vial
Route: IN
Initial Dose: 240mcg undiluted
1. 120mcg (0.4ml) - patient receives 90mcg
2. 90mcg (0.3ml) - patient receives 90mcg
3. 60mcg (0.2ml) - patient receives 60mcg
Repeat: 60mcg (0.2ml) undilted every 5min while
indicated
Max Total: No Max

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36
Q

Fentanyl
Pain Management
>=65 and/or limited physiological reserves

A

Preparation: 450mcg (1.5ml) sealed vial
Route: IN
Initial Dose: 120mcg undiluted
1. 90mcg (0.3ml) - patient receives 60mcg
2. 60mcg (0.2ml) - patient receives 60mcg
Repeat: 30mcg (0.1ml) undilted every 5min while
indicated
Max Total: No Max

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37
Q

Fexofenadine
Allergic Reactions
>=12

A 
Preparation: 180mg tablet
Route:           PO
Initial Dose:  180mg
Repeat:         Nil
Max Total:     180mg
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38
Q

Frusemide
Cardiogenic Pulmonary Oedema
>=16 Not taking oral diuretics

A 
Preparation: 40mg (4ml) ampoule
Route:           IV/IM
Initial Dose:  40mg
Repeat:         Once after 10min
Max Total:     80mg
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39
Q

Frusemide
Cardiogenic Pulmonary Oedema
>=16 Taking oral diuretics

A 
Preparation: 40mg (4ml) ampoule
Route:           IV/IM
Initial Dose:  80mg
Repeat:         Once after 10min
Max Total:     160mg
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40
Q

Glucagon
Hypoglycaemia
>=16

A

Indication: BGL <4mmol and
[-] LOC and
unable to be cannulated for glucose 10%
Preparation: 1mg vial and syringe containing 1ml of sterile
water. Dissolve glucagon powder by adding
the entire contents of the syringe to the vial
containing the glucagon. Solution must be
prepared immediately prior to use.
Route: SC/IM
Initial Dose: 1mg
Repeat: Nil
Max Total: 1mg

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41
Q

Glucagon
Anaphylaxis
>=16

A

Indication: Persistent hypovolaemia post administration
of compound sodium lactate.
Preparation: 1mg vial and syringe containing 1ml of sterile
water. Dissolve glucagon powder by adding
the entire contents of the syringe to the vial
containing the glucagon. Solution must be
prepared immediately prior to use.
Route: IV
Initial Dose: 2mg
Repeat: Nil
Max Total: 2mg

42
Q

Glucose 10%
Hypoglycaemia
>=10

A 
Indication:    BGL <4mmol and [-] LOC
Preparation: Glucose 10% - 50g per 500ml bag
Route:           IV/IO
Initial Dose:  15g (150ml) bolus
Repeat:         whilst indicated
Max Total:     No Max
43
Q

Glucose Gel

>=1

A

Indication: >28 days of age with BGL <4mmol and
conscious and able to swallow.
Preparation: 15g glucose in a 37.5g tube containing
glucose gel 40%
Route: PO
Initial Dose: 15g bolus
Repeat: 15min
Max Total: 30g

44
Q

Glyceryl Trinitrate
Acute Coronary Syndrom/Cardiogenic Pulmonary Oedema
>=16

A 
Preparation: 300mcg tablet
Route:           PO
Initial Dose:  600mcg
Repeat:         5 min
Max Total:     1.8mg
45
Q

Glyceryl Trinitrate
Autonomic Dysreflexia
>=16

A 
Preparation:  300mcg tablet
Route:            PO
Initial Dose:   300mcg
Repeat:          5 min
Max Total:      900mcg
46
Q

Hydrocortisone
Adrenal Crisis
>=16

A

Indication: Symptomatic patients with Adrenal
Insufficiency. Patients with existing Dr or
hospital care plan should be administered
the dose state on the plan.
Preparation: 100mg vial reconstituted with 2ml NaCl
(50mg:1ml)
Route: IM/IV
Initial Dose: 100mg bolus
Repeat: Nil
Max Total: 100mg

47
Q

Hydrocortisone
Asthma/Anaphylaxis/COPD Exacerbation
>=16

A

Indication: >= 6yrs
moderate - severe/life threatening Asthma.
Anaphylaxis patients with persistent
wheeze post salbutamol.
Preparation: 100mg vial reconstituted with 2ml NaCl
(50mg:1ml)
Route: IM/IV
Initial Dose: 100mg bolus
Repeat: Nil
Max Total: 100mg

48
Q

Ibuprofen
Pain Management
>=12

A 
Preparation:  200mg tablet
Route:            PO
Initial Dose:   200-400mg 
                       Max dose: 400mg
Repeat:          4-6hrs
Max Total:      1.2g in 24 hrs
49
Q

Influenza Vaccine
Influenza prophylaxis
>=16

A 
Indication:    Prophylaxis for staff during influenza 
                      pandemic
Preparation:  0.5ml pre-filled syringe
Route:            IM
Initial Dose:   0.5ml bolus
Repeat:          Nil
Max Total:      0.5ml
50
Q

Ipratropium Bromide
Asthma/COPD
>=6

A

Indication: Moderate - Severe/Life threatening asthma
and symptomatic patients with COPD
Preparation: 500mcg in 1ml nebule
Route: NEB
Initial Dose: 500mcg mixed with Salbutamol
Repeat: Once
Max Total: 1mg

51
Q

Ketamine
Pain Management/Behavioural Disturbance
>=14 - <65
IV

A

Preparation: 200mg in a 2ml vial: diluted to 20ml
(10mg:1ml) with 18ml NaCl
Route: IV
Initial Dose: 0.25mg/kg diluted bolus
(max bolus: 30mg)
Repeat: 3-5min
May be repeated 60min after last
administration
Max Total: 200mg

52
Q

Ketamine
Pain Management/Behavioural Disturbance
>=14 - <65
IM

A 
Preparation: 200mg in a 2ml vial
Route:           IM
Initial Dose:  1mg/kg undiluted bolus
                      (max bolus: 100mg)
Repeat:         10min
                      May be repeated 60min after last 
                      administration.
Max Total:     2mg/kg up to 200mg
53
Q

Ketamine
Pain Management/Behavioural Disturbance
>=65
IV

A

Preparation: 200mg in a 2ml vial: diluted to 20ml
(10mg:1ml) with 18ml NaCl
Route: IV
Initial Dose: 0.125mg/kg diluted bolus
(max bolus: 15mg)
May be repeated 60min after last
administration.
Repeat: 3-5 min
Max Total: 100mg

54
Q

Ketamine
Pain Management/Behavioural Disturbance
>=65
IM

A 
Preparation: 200mg in a 2ml vial
Route:           IM
Initial Dose:  0.5mg/kg undiluted bolus
                      (max bolus: 50mg)
Repeat:         10 min
                      May be repeated 60min after last 
                      administration
Max Total:     1mg/kg up to 100mg
55
Q

Ketamine

CPR Induced Consciousness

A

Indication: CPR induced consciousness with the
exception of minor isolated movements
interfering with resuscitation
Preparation: 200mg in a 2ml vial: diluted to 20ml
(10mg:1ml) with 18ml NaCl
Route: IV
Initial Dose: 20mg bolus diluted dose
Repeat: 3 min
Max Total: 100mg

56
Q

Lignocaine
VF or Pulseless VT and Torsades de Pointes
>=16

A

Indication: VF, pulseless VT unresponsive to
Amiodarone
Torsades de Pointes
Preparation: 2% - 100mg (5ml) polyampoule (IV use only)
Route: IV
Initial Dose: 100mg bolus
Repeat: Once
Max Total: 200mg

57
Q

Lignocaine
Post Intraosseous Procedure Pain
>=16

A

Indication: Localised pain post intraosseous insertion.
Allow 1 min for effect once Lignocaine
introduced into medullary space
Preparation: 2% - 100mg (5ml) polyampoule
(IV use only)
Route: IO
Initial Dose: 40mg slow infusion
Repeat: Nil
Max Total: 40mg

58
Q

Lignocaine
Local Anaesthesia prior to cannulation
ALL ages

A

Preparation: 1% - 20mg (2ml) ampoule
(local anaesthesia only)
Route: SC
Initial Dose: small amount until skin is slightly raised

59
Q

Methoxyflurane
Pain Management
>=1

A

Indication: 1. Mild pain >= 1 to < 12 yrs
2. > 1 where paramedic is not authorised to
administer an opioid or an opioid is
contraindicated, ineffective or refused.
3. Multiple …NOT FINISHED !!!!!
Preparation: 3ml bottle with external inhaler
Route: INH
Initial Dose: 3ml via inhaler
Repeat: Once
Max Total: 6ml in 24hrs, 15ml in 7 days

60
Q

Metoclopramide
Nausea, Vomiting & Eye Injuries
>=16

A

Indication: 1. Severe nausea and/or active vomiting
where Ondansetron is contraindicated or
ineffective after 10min.
2. Suspected penetrating eye injury where
Ondansetron in contraindicated or
ineffective after 10min.
Preparation: 10mg (1ml) ampoule
Route: IM/IV
Initial Dose: 10mg bolus
Repeat: Nil
Max Total: 10mg

61
Q

Midazolam
Post Ketamine Administration
>=14

A

Indication: Patients experiencing distressing
psychological reactions post Ketamine
administration who are unresponsive to
reassurance.
Preparation: 5mg (1ml) ampoule
Dilution: 5mg (1ml) diluted with 4ml NaCl to
5ml (1mg:1ml)
Route: IV
Initial Dose: 0.5 - 1mg diluted bolus
Repeat: Nil
Max Total: 0.5 - 1mg

62
Q

Midazolam
Limb realignment and/or difficult extrication
>=10 - <65

A

Indication: To facilitate limb realignment and/or difficult
extrication post analgesia to provide
effective pain management at rest for the
patient.
Preparation: 5mg (1ml) ampoule
Dilution: 5mg (1ml) diluted with 4ml NaCl to
5ml (1mg:1ml)
Route: IV
Initial Dose: 1mg diluted bolus
Repeat: 3min
Max Total: 5mg

63
Q

Midazolam
Seizures
>=16
IM

A 
Preparation: 5mg (1ml) ampoule
Route:           IM
Initial Dose:  5mg undiluted bolus
Repeat:         5min
Max Total:     15mg
64
Q

Midazolam
Seizures
>=16
IV

A 
Preparation: 5mg (1ml) ampoule
                      Dilution: 5mg (1ml) diluted with 4ml NaCl to 
                      5ml (1mg:1ml)
Route:           IV
Initial Dose:  2.5mg diluted slow bolus
Repeat:         5min
Max Total:     15mg
65
Q

Midazolam
Behavioural Disturbance
>=14 - <65
IM

A

Indication: 1. Non head injured: Droperidol ineffective
15min AFTER the maximum total dose or is
contraindicated.
2. Acute traumatic brain injured patients
where Ketamine is ineffective or
contraindicated.
3. Authorised to administer a single dose
between initial and repeat doses of
Droperidol (MH28, MH6) ONLY if the
patient is PHYSICALLY aggressive.
Preparation: 5mg (1ml) ampoule
Route: IM
Initial Dose: 5 - 10mg undiluted bolus
Repeat: 5min
Max Total: 15mg

66
Q

Midazolam
Behavioural Disturbance
>=14 - <65
IV

A

Indication: 1. Non head injured: Droperidol ineffective
15min AFTER the maximum total dose or is
contraindicated.
2. Acute traumatic brain injured patients
where Ketamine is ineffective or
contraindicated.
3. Authorised to administer a single dose
between initial and repeat doses of
Droperidol (MH28, MH6) ONLY if the
patient is PHYSICALLY aggressive.
Preparation: 5mg (1ml) ampoule
Dilution: 5mg (1ml) diluted with 4ml NaCl to
5ml (1mg:1ml)
Route: IV
Initial Dose: 2.5mg diluted slow bolus
Repeat: 3min
Max Total: 15mg

67
Q

Midazolam
Behavioural Disturbance
>65
IM

A

Indication: 1. Non head injured: Droperidol ineffective
15min AFTER the maximum total dose or is
contraindicated.
2. Acute traumatic brain injured patients
where Ketamine is ineffective or
contraindicated.
3. Authorised to administer a single dose
between initial and repeat doses of
Droperidol (MH28, MH6) ONLY if the
patient is PHYSICALLY aggressive.
Preparation: 5mg (1ml) ampoule
Route: IM
Initial Dose: 2.5 - 5mg undiluted bolus
Repeat: 5min
Max Total: 7.5mg

68
Q

Midazolam
Behavioural Disturbance
>65
IV

A

Indication: 1. Non head injured: Droperidol ineffective
15min AFTER the maximum total dose or is
contraindicated.
2. Acute traumatic brain injured patients
where Ketamine is ineffective or
contraindicated.
3. Authorised to administer a single dose
between initial and repeat doses of
Droperidol (MH28, MH6) ONLY if the
patient is PHYSICALLY aggressive.
Preparation: 5mg (1ml) ampoule
Dilution: 5mg (1ml) diluted with 4ml NaCl to
5ml (1mg:1ml)
Route: IV
Initial Dose: 1.25mg diluted slow bolus
Repeat: 5min
Max Total: 7.5mg

69
Q

Midazolam
Distress/Pain post TCP initial and capture
>=16

A

Indication: Distress/Pain post initiation of TCP
Preparation: 5mg (1ml) ampoule
Dilution: 5mg (1ml) diluted with 4ml NaCl to
5ml (1mg:1ml)
Route: IV
Initial Dose: 1mg diluted bolus
Repeat: 3min
IV regimen may be repeated 20min post last
administration
Max Total: 5mg

70
Q

Midazolam

Palliative Care

A

Indication: Palliative care patients with agitation/anxiety
caused by pain and/or
tachypnoea/dyspnoea.
Preparation: 5mg (1ml) ampoule
Route: SC
Initial Dose: 2.5mg - 5mg undiluted bolus
Repeat: Nil
Max Total: 2.5 - 5mg

71
Q

Midazolam
ROSC or Post intubation/SGA sedation
>=16
IM

A

Indication: ROSC or Post Intubation/SGA sedation
Preparation: 5mg (1ml) ampoule
10mg (2ml) Midazolam mixed with 10mg (1ml)
Morphine and diluted with 7ml NaCl 0.9% to
10ml total volume.
Morphine/Midazolam solution:
1ml = 1mg Midazolam + 1mg Morphine
Route: IM
Initial Dose: 5ml Morphine/Midazolam solution bolus if IV
not available.
Repeat: 15min
Max Total: 15ml

72
Q

Midazolam
ROSC or Post intubation/SGA sedation
>=16
IV

A

Indication: ROSC or Post Intubation/SGA sedation
Preparation: 5mg (1ml) ampoule
10mg (2ml) Midazolam mixed with 10mg (1ml)
Morphine and diluted with 7ml NaCl 0.9% to
10ml total volume.
Morphine/Midazolam solution:
1ml = 1mg Midazolam + 1mg Morphine
Route: IV
Initial Dose: 2.5ml Morphine/Midazolam solution bolus
Repeat: 3min
IV regimen for Post Intubation/SGA sedation
may be repeated 20min after the last
administration.
Max Total: 15ml

73
Q

Morphine
Palliative Care
>=16
SC

A

Indication: Palliative care patients with pain and/or
tachypnoea/dyspnoea
Preparation: 10mg (1ml) ampoule
Route: SC
Initial Dose: 2.5mg - 5mg undiluted bolus
Repeat: Nil
Max Total: 2.5 - 5mg

74
Q

Morphine
Pain Management
>=16 - <65
IV

A

Indication: Pain Management
Preparation: 10mg (1ml) ampoule
10mg (1ml) diluted with 9ml NaCl 0.9% to a
total volume of 10ml (1mg:1ml)
Route: IV
Initial Dose: 2.5 - 5mg diluted bolus
Repeat: 5min
IV regimen may be repeated 30min post
last administration.
Max Total: 0.5mg/kg

75
Q

Morphine
Pain Management
>=16 - <65
IM/SC

A 
Indication:     Pain Management
                      IM Morphine should only be used where IV 
                      access or IN Fentanyl is not available.
Preparation: 10mg (1ml) ampoule
Route:           IM/SC
Initial Dose:  5 - 10mg undiluted bolus
Repeat:         15min
Max Total:     2 doses
76
Q

Morphine
Pain Management
>65
IV

A

Indication: Pain Management
Preparation: 10mg (1ml) ampoule
10mg (1ml) diluted with 9ml NaCl 0.9% to a
total volume of 10ml (1mg:1ml)
Route: IV
Initial Dose: 1.25 - 2.5mg diluted bolus
Repeat: 5min
Max Total: 0.25mg/kg

77
Q

Morphine
Pain Management
>65
IM/SC

A 
Indication:    Pain Management
                      IM Morphine should only be used where IV 
                      access or IN Fentanyl is not available.
Preparation: 10mg (1ml) ampoule
Route:           IM/SC
Initial Dose:  2.5 - 5mg undiluted bolus
Repeat:         15min
Max Total:     2 doses
78
Q

Morphine
Distress/Pain post TCP initiation and capture
>=16

A

Indication: Distress/Pain post initiation of TCP
Preparation: 10mg (1ml) ampoule
10mg (1ml) diluted with 9ml NaCl 0.9% to a
total volume of 10ml (1mg:1ml)
Route: IV
Initial Dose: 2.5mg diluted bolus
Repeat: 2-5min
IV regimen may be repeated 20min post
last administration.
Max Total: 15mg

79
Q

Morphine
ROSC or Post Intubation/SGA sedation
>=16
IV

A

Indication: ROSC or Post Intubation/SGA sedation
Preparation: 10mg (1ml) ampoule
10mg (2ml) Midazolam mixed with 10mg (1ml)
Morphine and diluted with 7ml NaCl 0.9% to
10ml total volume.
Morphine/Midazolam solution:
1ml = 1mg Midazolam + 1mg Morphine
Route: IV
Initial Dose: 2.5ml Morphine/Midazolam solution bolus
Repeat: 3min
IV regimen may be repeated 20min post
last administration.
Max Total: 15ml

80
Q

Morphine
ROSC or Post Intubation/SGA sedation
>=16
IM

A

Indication: ROSC or Post Intubation/SGA sedation
Preparation: 10mg (1ml) ampoule
10mg (2ml) Midazolam mixed with 10mg (1ml)
Morphine and diluted with 7ml NaCl 0.9% to
10ml total volume.
Morphine/Midazolam solution:
1ml = 1mg Midazolam + 1mg Morphine
Route: IM
Initial Dose: 5ml Morphine/Midazolam solution bolus IF
IV not available.
Repeat: 15min
Max Total: 15ml

81
Q

Naloxone
Opioid Overdose
>=16
IV

A 
Preparation: 400mcg (1ml) ampoule
                     400mcg (1ml) diluted to 4ml with 3ml of NaCl 
                     0.9% (100mcg:1ml)
Route:          IV
Initial Dose: 100mcg diluted bolus
Repeat:        2min
Max Total:    2mg
82
Q

Naloxone
Opioid Overdose
>=16
IM

A 
Preparation: 400mcg (1ml) ampoule
Route:           IM
Initial Dose:  400mcg undiluted bolus
Repeat:         2min
Max Total:     2mg
83
Q

Naloxone
Etorphine or Buprenorphine Overdose
>=16
IM/IV

A 
Preparation: 400mcg (1ml) ampoule
                     400mcg (1ml) diluted to 4ml with 3ml of NaCl 
                     0.9% (100mcg:1ml)
Route:          IM/IV
Initial Dose: 2mg undiluted bolus
Repeat:        5min
Max Total:    No Max
84
Q

Ondansetron
Nausea & Vomiting/Eye Injuries
>=8

A 
Preparation: 4mg (2ml) ampoule
Route:           IM/IV
Initial Dose:  4mg bolus
Repeat:         Nil
Max Total:     4mg
85
Q

Oxygen

A

Preparation: White cylinders with white markings on the
shoulders containing 490L or 1500L of
100% medical oxygen.
Supplemental O2 is required for all patients with SpO2 <=94% on room air, with the exception of the conditions below, and should be titrated to meet the targeted outcomes.

86
Q

Oxygen
Respiratory Distress
Hypoxia
Acute Coronary Syndrome

A

Targeted Outcome: Maintain SpO2% >= 94 - 98%

87
Q

Oxygen

Chronic Obstructive Pulmonary Disease

A

Targeted Outcome: Maintain SpO2% >= 88 - 92%

88
Q 
Oxygen
   Cardiac/Respiratory Arrest
   Carbon Monoxide Poisoning
   Cyanide Poisoning
   Diving Emergencies
   Prolapsed Umbilical Cord
A

Targeted Outcome: 100% Oxygen delivery

89
Q

Oxygen

Cardiogenic Pulmonary Oedema

A

Targeted Outcome: 100% Oxygen delivery via IPPV

90
Q

Oxytocin
Maternal Postpartum Care
ALL ages
IM

A 
Indication:     Prophylaxis post childbirth - ensure ALL 
                      foetuses have been delivered prior to 
                      administration.
Preparation: 10 IU (1ml) ampoule
Route:           IM
Initial Dose:  10 IU
Repeat:         Nil
Max Total:     10 IU
91
Q

Oxytocin
Postpartum Haemorrhage
ALL ages
IM

A

Indication: Prophylaxis post childbirth - ensure ALL
foetuses have been delivered prior to
administration.
Preparation: 10 IU (1ml) ampoule
Route: IM
Initial Dose: IM bolus followed by Oxytocin infusion.
Repeat: Nil
Max Total: 10 IU

92
Q

Oxytocin
Postpartum Haemorrhage
ALL ages
INF

A

Indication: Prophylaxis post childbirth - ensure ALL
foetuses have been delivered prior to
administration.
Preparation: 10 IU (1ml) Oxytocin diluted to 60ml with
59ml NaCl 0.9% via burette with microdrip
(1 IU:6ml).
Route: INF
Initial Dose: 60 drops/min (10 IU/hr)
Repeat: Once
Max Total: 20 IU over 2 hrs

93
Q

Paracetamol
Pain Management/Febrile patients
>=12

A

Indication: Mild pain.
Antipyretic in patients with temp>=38.5C.
Preparation: 500mg tablet
Route: PO
Initial Dose: 500mg - 1g (max 1g per dose)
Repeat: 4hrs
Max Total: 4g in 24hrs

94
Q

Pralidoxime Chloride/Atropine
Moderate Nerve Agent Poisoning
>=16

A

Preparation: Auto-injector contains a sterile solution of
Atropine (2.1mg/0.7ml) and a sterile solution
of Pralidoxime Chloride (600mg/2ml) in two
separate internal chambers.
Route: IM
Initial Dose: One injection into mid-lateral thigh
Repeat: 15min (2 injections)
Max Total: 3 injections
NB max dose and pt still symptomatic admin Atropine

95
Q

Pralidoxime Chloride/Atropine
Severe Nerve Agent Poisoning
>=16

A

Preparation: Auto-injector contains a sterile solution of
Atropine (2.1mg/0.7ml) and a sterile solution
of Pralidoxime Chloride (600mg/2ml) in two
separate internal chambers.
Route: IM
Initial Dose: 3x injections into mid-lateral thigh in rapid
succession.
Repeat: Nil
Max Total: 3 injections
NB max dose and pt still symptomatic admin Atropine

96
Q

Salbutamol
Asthma/Anaphylaxis/COPD/Palliative Care
>=5
NEB

A

Indications: Asthma - moderate to severe/life
threatening.
Anaphylaxis - bronchospasm
COPD - symptomatic patients with COPD
Palliative Care - Dyspnoea/Tachypnoea
Preparation: 5mg (2.5ml) nebule
Route: NEB
Initial Dose: 5mg
Repeat: whilst indicated
Max Total: No Max

97
Q 
Salbutamol
Mild - Moderate: 
   Asthma/Anaphylaxis/COPD/Palliative Care
>=5
CFC-Free Inhaler
A

Indication: In circumstances where O2 and
nebulised Salbutamol are not available.
Preparation: 100mcg per actuation
Route: CFC-Free Inhaler
Initial Dose: 4-12 puffs
Repeat: whilst indicated
Max Total: No Max

98
Q 
Salbutamol
Severe/Life Threatening: 
   Asthma/Anaphylaxis/COPD/Palliative Care
>=5
CFC-Free Inhaler
A

Indication: In circumstances where O2 and
nebulised Salbutamol are not available.
Preparation: 100mcg per actuation
Route: CFC-Free Inhaler
Initial Dose: 12 puffs
Repeat: whilst indicated
Max Total: No Max

99
Q

Sodium Bicarbonate
Hyperkalaemia/Tricyclic Antidepressant OD
ALL ages

A

Indications: 1. Actual or suspected Hyperkalaemia with
progression of ECG changes (T waves
becoming tall and peaked, P wave
disappearing, QRS widening. Presence
of a sine wave pattern and
Asystole/VT/VF).
2. Tricyclic OD with conduction delay (wide
QRS complex) presenting with shock,
coma or convulsions.
Preparation: 8.4% 100ml (1mmol:1ml) bottle
Route: IV
Initial Dose: 1mmol/kg bolus (max bolus:100mmol)
Repeat: Nil
Max Total: 1mmol/kg (up to 100mmol)

NB Sodium Bicarbonate and Calcium Gluconate precipitate when mixed together. Flush the line between administration of these medications.

100
Q

Tenecteplase
Cardiac Reperfusion - PHT
>=18 - <75

A

Indication: Confirmed ST Elevation Myocardial
Infarction.
Preparation: 50mg vial and syringe containing 10ml
sterile water.
Reconstitute by adding the sterile water to
the Tenecteplase powder in the vial.
The solution must be prepared immediately
prior to use.
Avoid foaming the solution.
Route: IV
Initial Dose: Weight adjusted dose (see table). Bolus to a
max of 50mg administered 15min prior to
the first does of Enoxaparin Sodium.
Repeat: No repeat
Max Total: One dose maximum
NB DO NOT administer through a line that may have
contained Glucose.
Flush with 10ml NaCl 0.9% prior to administering
Tenecteplase.
Flush with 30ml NaCl 0.9% between administering
Tenecteplase and Enoxaparin Sodium.

101
Q

Tenecteplase
Cardiac Reperfusion - PHT
>75

A

Indication: Confirmed ST Elevation Myocardial
Infarction.
Preparation: 50mg vial and syringe containing 10ml
sterile water.
Reconstitute by adding the sterile water to
the Tenecteplase powder in the vial.
The solution must be prepared immediately
prior to use.
Avoid foaming the solution.
Route: IV
Initial Dose: Weight adjusted dose (see table). Bolus to a
max of 25mg administered 15min prior to
the first does of Enoxaparin Sodium.
Repeat: No repeat
Max Total: One dose maximum
NB DO NOT administer through a line that may have
contained Glucose.
Flush with 10ml NaCl 0.9% prior to administering
Tenecteplase.
Flush with 30ml NaCl 0.9% between administering
Tenecteplase and Enoxaparin Sodium.

ASNSW Pharmacology (8 decks)

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