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Graduate Paramedic: Ambulance Tasmania > Basic Pharmacology (Indications, Contraindications, Dose) > Flashcards

Basic Pharmacology (Indications, Contraindications, Dose) Flashcards

1
Q

What are the Paramedic Indications for Adrenaline? (4)

A
  1. Cardiac Arrest
  2. Acute Bronchoconstriction (Asthma, altered conscious state, imminent or impending arrest)
  3. Anaphylaxis
  4. Upper Airway Obstruction (Paed.): Severe respiratory distress: increasing distress, agitation, cyanosis, marked respiratory effort (incl. upper airway oedema associated with anaphylaxis)
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2
Q

What are the Contraindications to Adrenaline?

A

Hypovolemic shock without adequate fluid replacement

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3
Q

What is the dose and route of Adrenaline for Cardiac Arrest?

A

1mg IV, repeat at 4 min intervals

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4
Q

What is the dose and route of Adrenaline for Acute Bronchoconstriction (Asthma, altered conscious state, imminent or impending arrest)

A

300mcg IM, repeatable at 20 mins

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5
Q

What is the dose and route of Adrenaline for Anaphylaxis?

A

500mcg IM, repeatable at 5 mins

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6
Q

What is the dose and route of Adrenaline for Upper Airway Obstruction (Paed.): Severe respiratory distress: increasing distress, agitation, cyanosis, marked respiratory effort (incl. upper airway oedema associated with anaphylaxis)?

A

5mg/5ml Neb.

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7
Q

What are the Paramedic indications for Normal Saline? (7)

A
  1. Cardiac Arrest
  2. Inadequate Perfusion (non-cardiogenic, non-hypovolemic) and (Associated with Hypovolemia)
  3. Burns
  4. Crush Syndrome
  5. Diving Emergencies
  6. Hypothermia/ cold exposure (moderate/ severe, <32 C, non-cardiac arrest)
  7. Glycaemic Emergencies (paed.) hyperglycemia BGL >12
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8
Q

What are the contraindications to Normal Saline?

A

Nil significant in paramedic indications

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9
Q

What is the dose and route of Normal Saline for Cardiac Arrest?

A

Non-traumatic TKVO IV

Traumatic up to 20ml/kg IV

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10
Q

What is the dose and route of Normal Saline for Inadequate Perfusion (non-cardiogenic, non-hypovolemic) (Sepsis)

A

up to 20ml/kg IV

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11
Q

What is the dose and route of Normal Saline for Inadequate Perfusion Associated with Hypovolemia

A

up to 20ml/kg IV

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12
Q

What is the dose and route of Normal Saline for Burns?

A

2ml / kg x %burn over the first 8 hrs

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13
Q

What is the dose and route of Normal Saline for Crush Syndrome?

A

500 ml IV prior to removal of crushing force. If inadequately perfused, manage as Inadequate perfusion associated with hypovolemia.

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14
Q

What is the dose and route of Normal Saline for Diving Emergencies?

A

1000ml IV, then medical consult

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15
Q

What is the dose and route of Normal Saline for Hypothermia/ cold exposure (moderate/ severe, <32 C, non-cardiac arrest)?

A

warmed 10ml/kg IV, repeatable to max 40ml/kg to maintain perfusion

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16
Q

What is the dose and route of Normal Saline for Glycaemic Emergencies (paed.) hyperglycemia BGL >12?

A

10ml/kg IV

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17
Q

What are the paramedic indications for Glyceryl Trinitrate (GTN)? (3)

A
  1. Acute Coronary Syndrome
  2. Pulmonary Oedema
  3. Autonomic Dysreflexia
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18
Q

What are the contraindications for Glyceryl Trinitrate (GTN)? (6)

A
  1. Known hypersensitivity
  2. Systolic BP <100mmHg (buccal/ sub-lingual) (120 IV)
  3. Sildenafil Citrate “VIAGRA” or Vardenafil “LEVITRA” administration in the previous 24hrs OR Tadalafil “CIALIS” administration in the previous 4 days (PDE5 inhibitors)
  4. Heart rate >150 or <50 (excluding autonomic dysreflexia)
  5. Ventricular Tachycardia
  6. Right Ventricular Infarct
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19
Q

What is the dose and route of Glyceryl Trinitrate (GTN) for Acute Coronary Syndrome?

A

400mcg buccal/ sub-lingual, repeatable at 5 mins until pain tolerable or onset of side effects

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20
Q

What is the dose and route of Glyceryl Trinitrate (GTN) for Pulmonary Oedema?

A

400mcg Buccal/ Sub-lingual, repeatable at 5 mins until relief of symptoms

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21
Q

What is the dose and route of Glyceryl Trinitrate (GTN) for Autonomic Dysreflexia?

A

400mcg buccal/ sub-lingual if SBP >160. repeatable at 10 mins until resolution of symptoms, development of side effects of SBP <160.

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22
Q

What are the paramedic indications for Aspirin?

A
  1. Acute Coronary Syndrome
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23
Q

What are the contraindications to Aspirin? (5)

A
  1. Hypersensitivity to Aspirin/ Salicylates
  2. Actively bleeding peptic ulcers
  3. Bleeding disorders
  4. Suspected dissecting aortic aneurysm
  5. Chest pain associated with psychostimulant overdose if BP >160
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24
Q

What is the route and dose for Aspirin?

A

300mg oral (chewable)

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25
Q

What are the paramedic indications for Fentanyl?

A
  1. Pain Relief (Moderate - Severe pain)
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26
Q

What are the contraindications of fentanyl? (4)

A
  1. Known hypersensitivity
  2. Active labour
  3. Epistaxis or occluded nasal passages (IN)
  4. Patients <1 year old
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27
Q

What is the route and dose of fentanyl?

A
  1. up to 0.5 mcg/kg IV/IO (max 50mcg) repeatable at no less than 5 mins to max dose of 200 mcg. (consider reduced dose for patients over 65 y.o.)
  2. 100 mcg IN (50 mcg if >65), repeat 50 mcg after no less than 5 mins, to max dose 400 mcg.
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28
Q

What are the paramedic indications of Morphine?

A
  1. Pain Management (Moderate - Severe pain)
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29
Q

What are the contraindications to Morphine? (2)

A
  1. Known hypersensitivity

2. Labour

30
Q

What is the dose and route for Morphine?

A

Up to 0.05 mg/kg IV/IO (max 5mg). Repeat after no less than 5 mins to max dose 20mg. Consider reduced dose for patients over 65 y.o.

31
Q

What are the paramedic indications for Methoxyflurane?

A
  1. Pain relief (moderate - severe pain)
32
Q

What are the contraindications of methoxyflurane? (4)

A
  1. Pre-existing renal disease/ renal impairment
  2. Concurrent use of tetracycline antibiotics
  3. Exceeding a total dose of 6ml in 24 hrs or 15ml in seven day period
  4. Family history of anaesthetic induced malignant hyperthermia
33
Q

What is the dose and route of Methoxyflurane?

A

3ml inhaled, repeatable to max of 6ml

34
Q

What are the Paramedic Indications for Salbutamol?

A 
Acute Bronchoconstriction (Asthma, COPD - mild, moderate, severe) 
\+ Severe allergic reactions and smoke inhalation
35
Q

What are the contraindications to Salbutamol?

A

Nil significant for indications

36
Q

What is the dose and route for Salbutamol?

A
  1. 6 puffs pMDI and spacer, repeatable at 5 mins

2. 10mg/5ml neb, repeatable 5mg/2.5ml at 5 mins

37
Q

What are the paramedic indications for Ipratropium Bromide?

A

Acute Bronchoconstriction.
Asthma - severe
COPD - mild, moderate, severe

38
Q

What are the contraindications for Ipratropium Bromide?

A

Known hypersensitivity to atropine or its derivatives

39
Q

What is the dose and route for Ipratropium Bromide?

A
  1. 8 puffs pMDI and spacer

2. 500mcg/ 2ml Neb

40
Q

What are the paramedic indications for Metoclopramide?

A

Nausea and Vomiting (associated with narcotic pain relief or hx of migraine)

41
Q

What are the contraindications to Metoclopramide? (3)

A
  1. GIT haemorrhage, obstruction or perforation
  2. Known sensitivity or intolerance
  3. <16 y.o.
42
Q

What is the dose and route of Metoclopramide?

A

10mg IV/IM repeatable at 10 mins to max dose of 20mg

43
Q

What are the paramedic indications for Prochlorperazine?

A

Nausea and Vomiting:

  1. treatment or prophylaxis for motion sickness, penetrating eye injury, planned aeromedical evacuation.
  2. vertigo, nausea or vomiting associated with migraine, labyrinthitis or Meniere’s syndrome
  3. known allergy or contraindication to Metoclopramide
44
Q

What are the contraindications of Prochlorperazine? (4)

A
  1. Circulatory collapse
  2. CNS depression
  3. Hypersensitivity
  4. < 2 y.o.
45
Q

What is the dose and route for Prochlorperazine?

46
Q

What are the paramedic indications for Ondansetron?

A

Nausea and vomiting:

associated with

  1. cardiac chest pain
  2. secondary to cytotoxic drug use
  3. severe gastroenteritis
  4. previously diagnosed migraine

prophylaxis for

  1. motion sickness
  2. planned aeromedical evacuation
  3. suspected spinal injury
  4. eye trauma
47
Q

What are the contraindications for Ondansetron? (2)

A
  1. Known hypersensitivity

2. < 2 y.o.

48
Q

what is the dose and route of ondansetron?

A

4mg IV/IM repeatable at 10 mins (if symptomatic) to max dose 8mg

49
Q

What are the paramedic indications for Oral Glucose paste?

A

Glycemic emergencies (hypoglycaemia, <4 mmol/l) in patients who are conscious and able to self administer

50
Q

What are the contraindications to oral glucose paste?

A

Nil significant in indications

51
Q

What is the dose and route for oral glucose paste?

52
Q

What are the paramedic indications for Glucose 10%?

A

Glycemic Emergencies (hypoglycaemia, >4 mmol/l) in patients with altered conscious state who are unable to self-administer oral glucose

53
Q

What are the contraindications for glucose 10%?

A

Nil significant in indications

54
Q

What is the route and dose of glucose 10%?

A

15gm/150ml IV, titrated to response with 10ml normal saline flush. repeat 10mg/100ml at 5 mins until GCS 15 or BGL >4mmol/l

55
Q

What are the paramedic indications for Glucagon?

A

Glycemic Emergencies (hypoglycaemia, BGL <4 mmol/l) in patients with altered conscious state and unable to self-administer oral glucose paste

56
Q

What are the contraindications of glucagon?

A

nil significant in indications

57
Q

What is the dose and route of glucagon?

A

1mg (1 IU) IM

58
Q

What are the paramedic indications of Midazolam?

A

Continuous or recurrent seizures

59
Q

What are the contraindications to Midazolam?

A

Known hypersensitivity to benzodiazepines

60
Q

What is the dose and route for midazolam?

A
  1. > 60 y.o. 0.05mg/kg IM (max single dose 10mg) repeatable (once) at 10 mins if seizure activity continues. (max dose 20mg)
  2. <60 y.o. 0.1mg/kg IM (max single dose 10mg) repeatable (once) at 10 mins if seizure activity continues (max dose 20mg)
61
Q

What are the paramedic indications for Ceftriaxone?

A

Meningococcal Septicaemia

62
Q

What are the contraindications of Ceftriaxone?

A

allergy to cephalosporin antibiotics

63
Q

what is the dose and route of Ceftriaxone?

A
  1. 2gm IV. Dilute each 1gm with 10ml normal saline (to make 10ml). Administer each gm slowly over 2 mins.
  2. 2gm IM. Dilute each 1gm with 1% Lignocaine HCL to make 4ml.
64
Q

What are the paramedic indications for Naloxone?

A

Management of overdose: altered conscious state and respiratory depression secondary to admin of narcotic or related drugs

65
Q

What are the contraindications to Naloxone?

A

nil for this indication

66
Q

What is the dose and route of naloxone administration?

A
  1. Partial reversal: 100mcg IV bolus, repeated every 1 min to response (max dose 2mg)
  2. Complete reversal: 800mcg IM, repeat 800mcg IV/IM at 5mins then 400mcg further 5 mins (max dose 2mg)
67
Q

What are the paramedic indications for diazepam?

A

Acute Behavioural Disturbance (SAT 1)

68
Q

What are the contraindications for Diazepam? (2)

A
  1. Known allergy or adverse reaction to benzodiazepines

2. Myasthenia gravis

69
Q

What is the dose and route for Diazepam?

A
  1. <60 y.o. 10mg oral
  2. > 60 y.o. 5mg oral
    repeatable at 60 mins to max dose 40mg
70
Q

What are the paramedic indications for Droperidol?

A

Acute Behavioural Disturbance (SAT +2 or +3)

71
Q

What are the contraindications for Droperidol? (3)

A
  1. Known allergy or adverse reaction (including previous dystonic reaction
  2. Parkinson’s disease
  3. <8 y.o.
72
Q

What is the dose and route for droperidol?

A
  1. 5mg IV, repeatable at 10 mins (max dose 10mg for >60y.o. or <50kg and 20mg other patients)
  2. > 60 y.o. or <50kg: 5mg IM, repeatable at 15 mins to max dose 10mg
  3. <60 y.o. and >50kg: 10mg IM, repeatable at 15
    mins to max dose 20mg

Graduate Paramedic: Ambulance Tasmania (3 decks)

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