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CCP > CCP drugs > Flashcards

CCP drugs Flashcards

1
Q

Adenosine MOA

A

Nucleoside that depresses conduction through AV node which interrupts re-entry circuits that may restore sinus rhythm in pts with SVT

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2
Q

Adenosine indications

A

pt > 12 years with SVT and a rate > 150 and; moderate compromise, mild compromise if known to be responsive to adenosine

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3
Q

Adenosine contraindications

A

Known severe allergy

Known sick sinus syndrome without internal pacemaker

2nd or 3rd degree block without internal pacemaker

Heart transplant without internal pacemaker

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4
Q

Adenosine cautions

A

Asthma/CORD: may precipitate bronchospasm and should be withheld if pt has had recurrent life-threatening bronchospasm or is currently experiencing exacerbation of Asthma/CORD.

WPW syndrome if rhythm possibly fast AF - in this setting risk of causing VF

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5
Q

Adenosine dose

A

6 mg, 2nd dose 12 mg if rhythm fails to revert

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6
Q

Adenosine administration

A

fast push IV with 20 ml flush

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7
Q

Adenosine common adverdse effects

A

Bradycardia

SOB

Light headed

Nausea and flushing

Chest tigthness

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8
Q

Adenosine preparation

A

ampoule 6 mg in 2 ml

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9
Q

Adenosine onset and duration

A

Onset: 5-10 secs

DOA: 10-20 secs

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10
Q

Amiodarone MOA

A

Class III antidysrhythmic that prolongs the action potential and refractory period od atrial, nodal and ventrcular tissues reducing abnormal conduction, reducing HR and stabilising SA and AV nodes

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11
Q

Amiodarone Indications

A

Cardiac arrect with VT or VF at any time

Adults - sustained VT

Adults with moderate compromise from fast AF or fast atrial flutter

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12
Q

Amiodarone contraindications

A

Known severe allergy

Known severe allergy iodine

VT secondary to tricyclic antidepressant OD

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13
Q

Amiodarone cautions

A

*None in cardiac arrest

Poor perfusion or signs of low CO

Hypotension

AF secondary to sepsis

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14
Q

Amiodarone dose

A

CA - 300 mg IV push, 2nd dose if persistant VF/VT 15 mins after 1st dose 150 mg

Tachydysrhythmia - 300 mg IV infusion over 30 mins, 2nd dose can be given over 30 mins 150 mg infusion

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15
Q

Amiodarone administration

A

CA - IV push

VT/AF/Aflutter 300 mg IV infusion over 30 mins, add to 100 ml 5% glucose. Further 150mg over 30 mins if rate remains above 120 BPM

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16
Q

Amiodarone adverse effects

A

Hypotension

light headed

Bradydysrhythmia

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17
Q

Amiodarone onset/duration

A

Onset 5-10 mins

DOA 1-4 hrs

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18
Q

Amiodarone preparation

A

ampoule 150 mg in 3 ml

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19
Q

Atropine MOA

A

Anticholinergic that blocks muscarinic AcH receptors causing vagal inhibition

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20
Q

Atropine indications

A

Adults with bradycardia, particularly if the rhythm is narrow complex

Organophosphate poisoning

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21
Q

Atropine contraindications

A

Known severe allergy

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22
Q

Atropine cautions

A

Myocardial Ischaemia. Atropine will increase myocardial oxygen consumption.

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23
Q

Atropine dose

A

0.6 mg IV, repeat as required without maximum dose if bradycardia is responsive to atropine

Repeated and escalating doses will likely be required for organophosphate poisoning

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24
Q

Atropine administration

A

Undilute as rapid IV bolus

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25
Q

Atropine onset and duration

A

onset - 5-10 secs

DOA 15-60 mins

26
Q

Atropine preparation

A

Ampoule 0.6 mg in 1 ml

27
Q

Magnesium sulphate MOA

A

Reduces bronchial smooth muscle contraction causing bronchodilation

28
Q

Magnesium sulphate indications

A

Bronchospasm secondary to severe or immediately life threatening asthma
Bronchospasm secondary to severe COPD or imminent respiratory arrest from COPD

29
Q

Magnesium sulphate contraindication

A

known severe allergy

30
Q

Magnesium sulphate cautions

A

Hypotension - vasodilator which may make hypotension worse

31
Q

Magnesium sulphate dose

A

10 mmol, second dose if transport time is longer than 30 mins and not improving

32
Q

Magnesium sulphate administration

A

Add to 100 ml 5% glucose and give as infusion over 15 mins

Dilute to 10 ml with NaCl and give 1 ml every 1-2 mins through running IV

33
Q

Magnesium sulphate onset/duration

A

Onset 5-10 mins

DOA 30-60 mins

34
Q

Magnesium sulphate preparation

A

ampoule 10 mmol in 5 ml

35
Q

Metaraminol MOA

A

Alpha receptor agonist causing peripheral vasoconstriction

36
Q

Metaraminol indications

A

Hypotension in the setting of septic shock, post CA, cardiogenic shock, severe TBI, neurogenic shock, RSI and post intubation

37
Q

Metaraminol contraindications

A

known severe allergy

38
Q

Metaraminol dose

A

Titrate to effect - 0.5 mg-1 mg every 5-10 mins

39
Q

Metaraminol administration

A

Draw up into 10 mg in 10 ml

40
Q

Metaraminol preparation

A

ampoule 10 mg in 1 ml

41
Q

Metaraminol onset/duration

A

onset 1-2 mins

DOA 10-15 mins

42
Q

Rocuronium MOA

A

Neuromuscular blocker which antagonises nicotinic acetylcholine receptors at the neuromuscular junction

43
Q

Rocuronium indications

A

RSI, post intubation provided ETT position confirmed with capnography

44
Q

Rocuronium contraindications

A

Known severe allergy, ETT not confirmed by capnography

45
Q

Rocuronium cautions

A

Predicted difficult intubation, chronic muscle weakness (HALVE DOSE), adult with poor prognosis post cardiac arrest

46
Q

Rocuronium dose

A

RSI <70 kg 150 mg, 70-90 kg 150 mg, >90 kg 200 mg

Post intubation - ≤80 kg 50 mg, >80 kg 100 mg

47
Q

Rocuronium onset and duration

A

onset 30-60 secs, duration 30-60 mins

48
Q

Rocuronium preparation

A

Ampoule 50mg in 5 ml

49
Q

Rocuronium administration

A

IV undiluted as a bolus

50
Q

Rocuronium storage

A

If not refrigerated it loses 5-10% activity per month, once in kits it must be dated 8 weeks post removal from fridge

51
Q

Rocuronium vs suxamethonium

A

Rocuronium antagonist which blocks acetylcholine at neuromuscular junction - no stimulation prior to blockade = no fasciculations

Suxamethonium is an acetylcholine agonist which binds to receptors and keeps the channels open - stimulates receptor so will see fasciculations

52
Q

Ripovacaine 0.75% MOA

A

local anaesthetic which blocks the initiation and transmission of nerve impulses by blocking the movement of sodium ions across the nerve cell membrane

53
Q

Ripovacaine 0.75% indications

A
  • FI blocks - severe pain with obvious NOF or proximal femur fracture where pain is not adequately controlled with opiates and transport time is > 30mins (including extrication time)
  • Ring blocks - isolated injuries to digits with moderate to severe pain and transport time is > 60 mins
54
Q

Ripovacaine 0.75% contraindications

A

Known severe allergy, infection at site of injection, *for FI block - previous surgery in the groin, age < 12 years

55
Q

Ripovacaine 0.75% dose

A

FI blocks: ADMINISTER BLOCK ONCE ONLY

> 60 kg 40 ml of 0.375% (20ml of 0.75% diluted to 40ml)

<60 kg 30 ml of 0.375% (15 ml of 0.75% diluted to 30 ml)

Ring blocks:

1-2 ml of 0.75% into tissue either side of digit. If more than 20 ml is required dilute to 0.375%

56
Q

Ripovacaine 0.75% preparation

A

ampoule 150 mg in 20 ml

57
Q

Ripovacaine 0.75% onset and duration

A

Onset 5-10 mins, duration 1-2 hrs

58
Q

Metaraminol cautions

A

Bradycardia, may make bradycardia worse from decreased release of endogenous adrenaline. Consider adrenaline if hypotensive and bradycardic

59
Q

Ketamine for dissociation dose

A

1 mg/kg up to 100 mg IV, repeat once after 5 mins

60
Q

Ketamine for agitated delirium

A

IV 1 mg/kg (up to 100 mg), repeat every 5 mins
IM 5mg/kg rounded up to the nearest 100 mg, (up to 400mg), repeat once only after 20 mins

61
Q

Midazolam for agitated delirium

A

2-3 mg IV every 5 mins as required

62
Q

Midazolam for pain/adjunct

A

Indicated when pain is spasmodic, or anxiety related and opiate/ketamine is not appropriate
0.5-1 mg IV every 10 mins as required

CCP (2 decks)

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