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Graduate Ambulance Paramedic > AV Pharmacology > Flashcards

AV Pharmacology Flashcards

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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
Q

Side effects of Ceftriaxone

A

Nausea, vomiting, skin rash

26
Q

Presentation of Dexamethasone

A

8 mg in 2 mL vial

27
Q

Actions of Dexamethasone

A
  • Relieves inflammatory reactions

- Provides immunosuppression

28
Q

Indications for Dexamethasone

A
  • Bronchospasm associated with acute respiratory distress not responsive to nebulised Salbutamol
  • Moderate to severe croup
  • Acute exacerbation of COPD
  • Adult stridor (non- FBAO)
29
Q

Contraindications for Dexamethasone

A

Hypersensitivity

30
Q

Precautions for Dexamethasone

A

Solutions which are not clear or are contaminated should be discarded (does not contain an antimicrobial agent)

31
Q

Onset, peak and duration of Dexamethasone IV

A

O: 30 - 60 mins
P: 2 hours
D: 36 - 72 hours

32
Q

Presentation of Dextrose 10%

A

25 g in 250 mL infusion pack

33
Q

Indications for Dextrose 10%

A

Diabetic hypoglycaemia (BGL <4 mmol/L) in pts with ACS who are unable to self-administer oral glucose

34
Q

Onset for Dextrose 10%

A

3 minutes

35
Q

Presentation of Fentanyl

A

100 mcg in 2 mL ampoule

250 mcg in 1 mL cartridge

36
Q

Actions of Fentanyl

A
  • CNS Depression, leading to analgesia
  • Respiratory depression
  • Decreases conduction velocity through the AV node
37
Q

Indications for Fentanyl

A
  • 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
Q

Contraindications for Fentanyl

A
  • Hypersensitivity

- Late second stage labour

39
Q

Precautions for Fentanyl

A
  • 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
Q

Side effects of Fentanyl

A
  • Respiratory depression
  • Apnoea
  • Rigidity of the diaphragm and intercostal muscles
  • Bradycardia
41
Q

Onset, peak and duration of Fentanyl

A

O: Immediate (IV), 2 mins (IN)
P: <5 mins
D: 30 - 60 mins

Graduate Ambulance Paramedic (11 decks)

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