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Graduate Ambulance Paramedic > AV Pharmacology > Flashcards

AV Pharmacology Flashcards

1
Q

Contraindications for Aspirin

A
  • Hypersensitivity to aspirin/salicyates
  • Actively bleeding peptic ulcers
  • Bleeding disorders
  • Suspected dissecting aortic aneurysm
  • Chest pain associated with psychostimulant OD if SBP >160mmHg
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2
Q

Precautions for Aspirin

A
  • Peptic ulcer
  • Asthma
  • Patients on anticoagulants
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3
Q

Side effects of Aspirin

A

Heartburn, nausea, GI bleeding, increased bleeding time, hypersensitivity reactions

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4
Q

Indications for GTN

A
  • Chest pain with ACS
  • Acute LVF
  • Hypertension associated with ACS
  • Autonomic dysreflexia
  • Preterm labour (consult)
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5
Q

Actions for GTN

A
  • Venous dilatation promotes venous pooling and reduced venous return to the heart, reducing preload
  • Arterial dilatation reduces systemic vascular resistance and arterial pressure, reducing afterload
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6
Q

Contraindications for GTN

A
  • Known hypersensitivity
  • SBP <110mmHg (tablet)
  • SBP <90mmHg (patch)
  • Sildenafil (Viagra) or Vardenafil (Levitra) in previous 24/24 or Taladafil (Cialis) in previous 4/7
  • HR >150bpm
  • Bradycardia <50bpm (ex. Autonomic Dysreflexia)
  • VT
  • Inferior STEMI with SBP <160mmHg
  • Right ventricular MI
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7
Q

Precautions for GTN

A
  • No previous administration
  • Elderly patients
  • Recent MI
  • Concurrent use with other tocolytics (labor suppressants)
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8
Q

Side effects for GTN

A
  • Tachycardia
  • Hypotension
  • Headache
  • Skin flushing (uncommon)
  • Bradycardia (occasionally)
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9
Q

Onset, peak and duration for S/L GTN

A

O: 30 seconds - 1 minute
P: 5 - 10 minutes
D: 15 - 30 minutes

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10
Q

Onset and peak for transdermal GTN

A

O: Up to 30 minutes
P: 2 hours

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11
Q

Actions for Adrenaline

A
  • Increases HR by increasing SA node firing rate (B1)
  • Increases conduction velocity through AV node (B1)
  • Increases myocardial contractility (B1)
  • Increases irritability of the ventricles (B1)
  • Causes bronchodilatation (B2)
  • Causes peripheral vasoconstriction (A)
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12
Q

Indications for Adrenaline

A
  • Cardiac arrest
  • Inadequate perfusion
  • Bradycardia w/ poor perfusion
  • Anaphylaxis
  • Severe asthma (imminent life threat not responding to nebulised therapy, or unconscious with no BP)
  • Croup
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13
Q

Contraindications for Adrenaline

A

Hypovolaemic shock without adequate fluid replacement

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14
Q

Precautions for Adrenaline

A
  • Elderly/frail patients
  • Pts with cardiovascular disease
  • Pts on MAO inhibitors
  • Pts on beta blockers (higher doses may be required)
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15
Q

Side effects for Adrenaline

A
  • Tachycardia
  • Supraventricular & ventricular arrythmias
  • Hypertension
  • Pupillary dilatation
  • May increase size of MI
  • Feeling of anxiety/palpitaions in the conscious pt
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16
Q

Onset, peak and duration for IV Adrenaline

A

O: 30 sec
P: 3 - 5 mins
D: 5 - 10 mins

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17
Q

Onset, peak and duration for IM Adrenaline

A

O: 30 - 90 sec
P: 4 - 10 mins
D: 5 - 10 mins

18
Q

Presentation of Adrenaline

A

1 mg in 1 mL ampoule

1 mg in 10 mL ampoule

19
Q

Presentation of Aspirin

A

300 mg chewable tablet

20
Q

Presentation of GTN

A

0.3 mg tablet

50 mg transdermal patch (0.4 mg/hr)

21
Q

Presentation and preparation of Ceftriaxone

A

1 g sterile powder in glass vial, diluted w/:

  • 10 mL Water for Injection (IV)
  • 3.5 mL Lignocaine 1% to make 4 mL (IM)
22
Q

Indications for Ceftriaxone

A
  • Suspected meningococcal septicaemia

- Severe sepsis (consult only)

23
Q

Contraindications for Ceftriaxone

A

Allergy to cephalosporin antibiotics

24
Q

Precautions for Ceftriaxone

A

Allergy to penicillin antibiotics

25
Side effects of Ceftriaxone
Nausea, vomiting, skin rash
26
Presentation of Dexamethasone
8 mg in 2 mL vial
27
Actions of Dexamethasone
- Relieves inflammatory reactions | - Provides immunosuppression
28
Indications for Dexamethasone
- Bronchospasm associated with acute respiratory distress not responsive to nebulised Salbutamol - Moderate to severe croup - Acute exacerbation of COPD - Adult stridor (non- FBAO)
29
Contraindications for Dexamethasone
Hypersensitivity
30
Precautions for Dexamethasone
Solutions which are not clear or are contaminated should be discarded (does not contain an antimicrobial agent)
31
Onset, peak and duration of Dexamethasone IV
O: 30 - 60 mins P: 2 hours D: 36 - 72 hours
32
Presentation of Dextrose 10%
25 g in 250 mL infusion pack
33
Indications for Dextrose 10%
Diabetic hypoglycaemia (BGL <4 mmol/L) in pts with ACS who are unable to self-administer oral glucose
34
Onset for Dextrose 10%
3 minutes
35
Presentation of Fentanyl
100 mcg in 2 mL ampoule | 250 mcg in 1 mL cartridge
36
Actions of Fentanyl
- CNS Depression, leading to analgesia - Respiratory depression - Decreases conduction velocity through the AV node
37
Indications for Fentanyl
- Sedation to facilitate/maintain intubation - Sedation to facilitiate transthoracic pacing - Sedation to facilitate syncronised cardioversion - CPR interfering patient - Analgesia, if: - - C/I to Morphine - - Short duration of action desirable - - Hypotension - - Nausea and/or vomiting - - Severe headache
38
Contraindications for Fentanyl
- Hypersensitivity | - Late second stage labour
39
Precautions for Fentanyl
- Elderly/frail - Impaired hepatic function - Respiratory depression (eg COPD) - Current asthma - Patients on MAO inhibitors - Known addiction - Rhinitis, rhinorrhea or facial trauma (IN route)
40
Side effects of Fentanyl
- Respiratory depression - Apnoea - Rigidity of the diaphragm and intercostal muscles - Bradycardia
41
Onset, peak and duration of Fentanyl
O: Immediate (IV), 2 mins (IN) P: <5 mins D: 30 - 60 mins

Graduate Ambulance Paramedic (11 decks)

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