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NUR5925 > - ALS DRUGS - > Flashcards

- ALS DRUGS - Flashcards

1
Q

State the action of Adrenaline

A
  • Stimulates alpha, beta 1&2 receptors resulting in cardiac stimulation. Acts on:
  • alpha (causing vasoconstriction)
  • beta 1 (causing increase in HR, increase in force of contractility)
  • beta 2 (causing bronchodilation)
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2
Q

List the indications for adrenaline in ALS

A
  • VF, pulseless VT, (after second shock, then every second loop) & PEA (initial then after every second loop
  • After atropine with bradyarrythmias
  • Severe hypotension
  • Anaphylaxis
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3
Q

Outline the adult dose of Adrenaline in ALS

A
  • 1mg in either 1:1,000 or 1:10,000 in arrest
  • 10mcg/kg for anaphylaxis
  • can also be nebulised, infusion, etc
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4
Q

Outline the paediatric dose of Adrenaline in PALS

A

10mcg/kg with a maximum dose of 1mg at a time

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5
Q

State the action of Amiodarone

A
  • Class III anti arrhythmic drug
  • prolongs phase 3 of the cardiac action potential (repolarization phase)
  • Has effects on sodium, potassium and calcium channels
  • This can slow cardiac tachyarrhythmias
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6
Q

List the indications for amiodarone in ALS

A
  • Pulseless VT and VF (3rd shock)

- Prophylaxis of re-current VF/VT

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7
Q

Outline the adult dose of amiodarone in ALS

A

Dose @ 3rd shock - 300 mg.

Optional does @ 5th+ shock - 150 mg could be considered or an infusion.

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8
Q

Outline the paediatric dose of amiodarone in PALS

A

5mg/kg

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9
Q

State the action of Lignocaine

A
  • acts as a sodium channel blocker

- acts in phase 0, preventing sodium influx and thus reducing occurrence of depolarization

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10
Q

List the indications for lignocaine in ALS

A
  • VF/pulseless VT as an alternative to amiodarone

- Prophylaxis in the setting of recurrent VF or VT.

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11
Q

Outline the adult dose of lignocaine in ALS

A

1mg/kg bolus dose

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12
Q

Outline the paediatric dose of lignocaine in PALS

A

1mg/kg bolus dose

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13
Q

State the action of Atropine

A
  • anticholinergic drug
  • increase in symathetic nervous response
  • increasing SA node automaticity and AV conduction
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14
Q

List the indications for atropine in ALS

A
  • bradyarrythmias
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15
Q

Outline the adult dose of atropine in ALS

A
  • 0.5 mg IV every 3-5 minutes as needed

- maximum total dosage that can be given is 3 mg

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16
Q

Outline the paediatric dose of atropine in PALS

A
  • Atropine 0.02 mg/kg

- may repeat once; maximum single dose, 0.5 mg

17
Q

List the indications for potassium in ALS

A

Persistent VF due to documented or suspected hypokalaemia

18
Q

Outline the adult dose of potassium in ALS

A

A bolus of 5 mmol

19
Q

Outline the paediatric dose of potassium in PALS

A
  • 0.03 - 0.07 mmol/kg

- administered over several minutes

20
Q

List the indications for magnesium in ALS

A
  • ventricular tachyarrythmias associated with hypomagnesaemia
21
Q

Outline the adult dose of magnesium in ALS

A
  • bolus of 5 mmol of magnesium

- followed by infusion of 20 mmol over 4 hours

22
Q

Outline the paediatric dose of magnesium in PALS

A
  • 0.1-0.2 mmol/kg bolus

- followed by an infusion of 0.3mmol/kg over 4 hours

23
Q

State the action of Calcium

A
  • Essential for normal muscle and nerve activity

- Increases myocardial excitability and contractility and peripheral resistance

24
Q

List the indications for calcium in ALS

A
  • Hyperkalaemia
  • Hypocalcaemia
  • Overdose of calcium-channel blocking drugs.
25
Q

Outline the adult dose of calcium in ALS

A
  • bolus of 5-10 mL of 10% calcium chloride or gluconate
26
Q

Outline the paediatric dose of calcium in PALS

A
  • 0.2mL/kg of 10% calcium chloride

- 0.7mL/kg of 10% calcium gluconate

27
Q

State the action of Sodium Bicarbonate

A
  • Sodium bicarbonate is an alkalising solution
  • which combines with hydrogen ions to form a weak carbonic acid
  • This breaks down to produce CO2 and H2O
  • reducing acidosis by acting as a buffer
28
Q

List the indications for sodium bicarbonate in ALS

A
  • Hyperkalaemia
  • Treatment of documented metabolic acidosis (buffer)
  • Overdose with tricyclic antidepressants
  • Protracted arrest (greater than 15 mins)
29
Q

Outline the adult dose of sodium bicarbonate in ALS

A

1mmol/kg, is initially given over 2-3 minutes, then as guided by arterial blood gases

30
Q

Outline the paediatric dose of sodium bicarbonate in PALS

A

0.5-1 mmol/kg

NUR5925 (27 decks)

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