CPG Pharmacology

Question 1

adrenaline

Answer 1

A naturally occurring alpha and beta adrenergic stimulant
Actions:
- Increases HR by increasing SA node firing rate (beta 1)
- Increases conduction velocity through the AV node (beta 1)
- Increases myocardial contractility (beta 1)
- Increases the irritability of the ventricles (beta 1)

Question 2

Aspirin

Answer 2

An analgesic, antipyretic, anti-inflammatory and antiplatelet aggregation agent.
Actions:
- To minimise platelet aggregation and thrombus formation in order to retard the progression of coronary artery thrombosis in ACS
- Inhibits synthesis of prostaglandins; anti-inflammatory actions

Question 3

ceftriaxone

Answer 3

cephalosporin antibiotic

Question 4

Dextrose 10%

Answer 4

A slightly hypertonic crystalloid solution. 
Composition:
- Sugar; 10% dextrose
- Water 
Actions:
- Provides a source of energy 
- Supplies body water

Question 5

Fentanyl

Answer 5

A synthetic opioid analgesic
Actions:
CNS effects
- Depression; leading to analgesia
- Respiratory depression; leading to apnoea
- Dependence (addiction)
Cardiovascular effects:
- Decrease condition velocity through the AV node

Question 6

Glucagon

Answer 6

A hormone normally secreted by the pancreas.
Actions:
- Causes an increase in blood glucose concentration by converting stored liver glycogen to glucose

Question 7

Glyceryl Trinitrate

Answer 7

Principally, a vascular smooth muscle relaxant.
Actions:
- Venous dilation promotes venous pooling and reduces venous return to the heart (reduces preload)
- Arterial dilation reduces systemic vascular resistance and arterial pressure (reduces afterload)
The effects of the above are:
- Reduced myocardial oxygen demand
- Reduced systolic, diastolic, and mean arterial blood pressure, whilst usually maintaining coronary perfusion pressure
- Mild collateral coronary arterial dilation may prove blood supply to ischaemic areas of myocardium
- Mild tachycardia secondary to slight fall in blood pressure
- Preterm labour: uterine quiescence in pregnancy

Question 8

Ipratropium Bromide

Answer 8

Anticholinergic bronchodilator
Actions:
- Allows bronchodilation by inhibiting cholinergic bronchomotor tone (I.e. blocks vagal reflexes which mediate bronchoconstriction)

Question 9

Ketamine

Answer 9

A rapid acting dissociative anaesthetic agent (primarily NMDA receptor antagonist)
Actions:
Produces a dissociative state characterised by:
- A trance-like state with eyes open but not responsive
- Nystagmus
- Profound analgesia
- Normal pharyngeal and laryngeal reflexes
- Normal or slightly enhanced skeletal muscle tone
- Occasionally a transient and minimal respiratory depression

Question 10

Lignocaine 1%

Answer 10

A local anaesthetic agent
Actions:
- Prevents initiation and transmission of nerve impulses causing local anaesthesia (1% solution)

Question 11

Methoxyflurane

Answer 11

Inhalational analgesic agent at low concentrations

Question 12

Midazolam

Answer 12

Short acting CNS depressant 
Actions:
- Anxiolytic 
- Sedative
- Anti-convulsant

Question 13

Misoprostol

Answer 13

A synthetic prostaglandin
Actions:
Enhances uterine contractions

Question 14

Morphine

Answer 14

An opioid analgesic 
Actions:
CNS effects:
- Depression (leading to analgesia) 
- Respiratory depression
- Depression of cough reflex
- Stimulation (changes of mood, euphoria or dysphoria, vomiting, pin-point pupils)
- Dependence (addiction) 
Cardiovascular effects:
- Vasodilation 
- Decreases conduction velocity through the AV node

Question 15

Naloxone

Answer 15

An opioid antagonist
Action:
- Prevents or reverses the effects of opioids

Question 16

Normal Saline

Answer 16

An isotonic crystalloid solution
Composition:
- Electrolytes (sodium and chloride in a similar concentration to thay of extracellular fluid)
Action:
- Increases the volume of the intravascular compartment

Question 17

Ondansetron

Answer 17

Anti-emetic
Action:
- 5HT3 antagonist which blocks receptors both centrally and peripherally

Question 18

Paracetamol

Answer 18

An analgesic and antipyretic agent
Actions:
- Exact mechanism of action unclear; thought to inhibit prostaglandin synthesis in the CNS

Question 19

Prochlorperazine

Answer 19

An anti-emetic.
Action:
- Acts on several central neuro-transmitter systems

Question 20

Salbutamol

Answer 20

A synthetic beta adrenergic stimulant with primarily beta 2 effects.
Action:
- Causes bronchodilation

Question 21

Water for injection

Answer 21

Water for injection is a clear, colourless, particle free, odourless, and tasteless liquid. It is sterile, with a pH of 5.6 to 7.7 and contains no antimicrobial agents