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hudfgbhsdjhadoj; > Drug Formulary > Flashcards

Drug Formulary Flashcards

Drug; Indications, Route, Dose, Side Effects, Contradictions, Cautions, Children

1
Q

What Should Be Asked And Recorded On The Cas Card if giving drugs

Acronym

A

S.A.M.P.L.E
S: Symptoms
A: Allergy (To This Drug, Other)
M: Medications
P: Past Medical History
L: Last Meal
E: Events (Leading To Illness/Injury)

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2
Q

What Should Be Cheacked With a 2nd Cas Carer when giving drugs

9 Things

A

1: Drug Name
2: Correct Drug
3: Expiry Date
4: Packaging Intact/Drug Uncontamanated
5: Dose Administerd
6: Route Of Administration
7: Indications
8: Contraindications (Including Allergies)
9: Record on Cas Card (Drug, Dose, Route, Time Administerd, Intials)

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3
Q

Adrenaline: Indications

A

Life-Threarening Allergic reaction, With breathing Difficulty or shock
Life-Threating Asthma with failing ventilation and ddeterioration dispite nebuliser

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4
Q

Adrenaline: Route

A

Intramuscular

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5
Q

Adrenaline: Dose (Adult)

A
  • If avalible use patients own auto-Injector
  • Team issue auto-injector
  • 0.5mg (0.5ml of 1:1000) -This is half of 1ml ampoule
  • Repeat after 5 minutes if necessary
  • Seek medical advicr after 2 doses
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6
Q

Adrenaline: Side Effects

A
  • Anxiety
  • Tremor
  • Fast Heart Rate
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7
Q

Adrenaline: Contradictions

A

NONE

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8
Q

Adrenaline: Cautions

A

NONE

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9
Q

Adrenaline: Use In Children

A
  • 12-17 Adult Dose
  • 6-11 Team issue Pediactric auto injector
  • 6-11 0.3mg (0.3mg of 1:1000)
  • SPECIAL Circumstance: 0-5 0.15ml or patient own auto-injector
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10
Q

Aspirin: Indications

A

Suspected Myocardial Infarction (MI/Heart Attack)

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11
Q

Aspin: Indications

A

Suspected MI/Heart Attack

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12
Q

Aspirin: Route

A

Oral - chewed / soluble

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13
Q

Aspirin: Adult Dose

A

300mg tablet
In suspected MI give regardless of any taken previously that day

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14
Q

Aspirin: Side Effects

A

None

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15
Q

Aspirin: Contradictions

A

Allergy to Aspirin or other anti-inflammatory medication (NSAID, E.g. ibuprofen)
Suspected Stroke
Know Active bleeding in guy

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16
Q

Aspirin: cautions

A

MI: give to patients with history of ulcers or indigestion unless guy bleeding (e.g. vomiting blood)

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17
Q

Aspirin: Child does

A

Do not use if under 16

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18
Q

Co-amoxiclav: Indications

A

Open Fracture or heavily contaminated wound. Greater than 1h from hospital (at time of injury)

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19
Q

Co-amoxiclav: Route

A

Oral - Do not crush

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20
Q

Co-amoxiclav: Adult Dose

A

2x250/125 mg tablets
Once only

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21
Q

Co-amoxiclav: Side Effects

A

Allergic reaction
Nausea/ vomiting

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22
Q

Co-amoxiclav: contradictions

A

Allergy to Penicillin
History of jaundice

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23
Q

Co-amoxiclav: Cautions

A

None

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24
Q

Co-amoxiclav: Children

A

Seek medical advice
12-17 1x 250/125mg tablet
6-11 1x 250/125mg tablet if able to swallow whole

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25
Q

Diamorphine (Intranasal): Indications

A

Moderate to severe pain (6-10)
Suspected myocardial infarction (MI/Heart Attack) pian score 4 or above

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26
Q

Diamorphine (Intranasal): Route

A

Intranasal CIA atomiser

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27
Q

Diamorphine (Intranasal): Adult Dose

A

Refer to diamorphine protocol
5mg/1ml full dose OR 2.5mg/0.5ml half dose
Maximum of 3 full doses at 15min intervals
If possible draw up 2nd dose ready to go

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28
Q

Diamorphine (Intranasal): Side Effects

A

Known allergy/hypersensitivity to opioids
Head injury
Conscious level P or U GCS<10
Injury or Active bleeding in nose
Chest injury with with oxygen sats of <94%
Respiratory depression (Adult <10pm Child <20pm)
Signs of shock

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29
Q

Diamorphine (Intranasal): Cautious

A

Seek medical advice with;
Chest injury
Bleeding without shock
Head injury
Altered consciousness
Pregnant
Elderly
Taking other opioids

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30
Q

Diamorphine (Intranasal): use in children

A

Seek medical advice
Not if under 7

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31
Q

Diamorphine (Intranasal): additional equipment

A

BVM & Naloxone

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32
Q

Entonox: Indications

A

Pain above 4
Labour pains

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33
Q

Entonox: Route

A

Inhale with normal breathing

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34
Q

Entonox: Adult Dose

A

Controlled by patient
May take 5-10 minutes for maximum effect

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35
Q

Entonox: Side effects

A

Dizziness
Euphoria
Nausea

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36
Q

Entonox: Contradictions

A

Patient unable to self administrator
Head injury with reduced consciousness
Chest injury with possibility or pneumothorax
Diving in the past 24hours

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37
Q

Entonox: Cautions

A

Store cylinder horizontal and >10c for 24h+
Consider other analgesic in cold
Mix before administration

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38
Q

Entonox: use with children

A

Seek advice
Same dose as adults

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39
Q

Fentanyl (Lozenge): Indications

A

6-10 on pain score
Suspected MI/Heart attack with pain 4+

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40
Q

Fentanyl (Lozenge): Route

A

Oromucoeal Lozenge, patient to rub on inside of cheek for 15min

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41
Q

Fentanyl (Lozenge): Adult Dose

A

Refer to fentanyl protocol
800 micrograms
Maximum cumulative dose of 1600

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42
Q

Fentanyl (Lozenge): side effects

A

Respiratory depression
Nausea vomiting drowsiness hypotension

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43
Q

Fentanyl (Lozenge): contraindications

A

Known allergy/hypersensitive to morphine
Patient taking any anti depressants
Head injury
Reduced consciousness
Injury or bleeding to mouth
Chest injury with oxygen saturation<94% with O2 therapy
Respiratory depression (adult<10 child <20
Shock

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44
Q

Fentanyl (Lozenge) : cautions

A

Seek medical advice with;
Chest injury
Bleeding without shock
Head injury
Altered consciousness
Pregnant
Elderly
Taking other opioids

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45
Q

Fentanyl (children)

A

Not for use if u18

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46
Q

When using fentanyl what must be to hand

A

BVM and Naloxone

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47
Q

Glucose Gel: Indications

A

Hypoglycemia (blood glocouse<4 mmol) in conscious patient
Exhaustion Hypothermia

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48
Q

Glucose Gel: Route

A

Oral

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49
Q

Glucose Gel: adult dose

A

10-20 grams - reassess after 5 min
Check after 5 min aim for >5 mmol/L

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50
Q

Glucose Gel: side effects

A

None

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51
Q

Glucose Gel: contraindications

A

None

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52
Q

Glucose Gel: Cautions

A

In unconscious rub onto gums

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53
Q

Glucose Gel: children

A

As per adult seek medical advice

54
Q

Glyceryl Trinitrate: Indications

A

Cardiac chest pain in suspected angina or MI

55
Q

Glyceryl Trinitrate: Route

A

Sub-lingual spray under tongue and close mouth
Sit patient down

56
Q

Glyceryl Trinitrate: Adult Dose

A

400-800 micrograms 1-2 sprays
Can be repeated after 5-10 min if bp remains >90 mmHg / radial pulse present
No maximum dose
Considering one dose if risk of low blood pressure

57
Q

Glyceryl Trinitrate: side effects

A

Headaches and facial flushing
Dizziness
Hypotension

58
Q

Glyceryl Trinitrate: contradictions

A

Hypotension<90mmHg or absent radial pulse
Hypovolemia
Chest pain due to trauma
Head injury
Viagra or drugs ending in fil in past 24 hours

59
Q

Glyceryl Trinitrate: Cautions

A

Can be used with opioids however may exacerbate hypotension

60
Q

Glyceryl Trinitrate: use in children

A

Not for under 18

61
Q

Ibuprofen: indications

A

Pain 1-6
Soft tissue injury
Severe pain when used with other analgesic

62
Q

Ibuprofen: route

A

Oral

63
Q

Ibuprofen: adult dose

A

400mg (2 x 200mg)
Maximum 3 doses in 24h

64
Q

Ibuprofen: side effects

A

Gastrointestinal bleeding
Can exacerbate asthma

65
Q

Ibuprofen: contradictions

A

Known allergy to anti-inflammatory medication Inc Aspirin
Shocked trauma patients
Kidney disease
Dehydration
Severe indigestion or history of bleeding from ulcer in gut
Pregnancy
If taking anti-coagulant e.g. warfarin, apixaban

66
Q

Ibuprofen: cautions

A

Asthma (most will know if they can take nsaids)
Over 65 and not used to taking

67
Q

Ibuprofen: children

A

Seek medical advice
12< as adult
7-11 200mg max 3 in 24h

68
Q

Ipratropium Bromide: indications

A

Acute severe asthma attack (second line)

69
Q

Ipratropium Bromide: route

A

Nebulised

70
Q

Ipratropium Bromide: adult dose

A

500 micrograms (2x 250mg /1ml nebules
Add to salbutamol in nebuliser for first dose in life threatening

71
Q

Ipratropium Bromide: side effects

A

Headaches
Nausea
Dry mouth
Fast heart rate

72
Q

Ipratropium Bromide: contradictions

A

None in emergency

73
Q

Ipratropium Bromide: cautions

A

None in emergency

74
Q

Ipratropium Bromide: use on children

A

Seek advice
6-17 250 micrograms (1x nebul)

75
Q

Midazolam: Indications

A

Any seizure+5 min and still fitting
3 or more in 1h and currently convulsing
Any after head injury

76
Q

Midazolam: route

A

Intranasal via atomiser
Buccal via syringe

77
Q

Midazolam: adult dose

A

Refer to protocol
10mg/2ml (1ml per nostril or buccal 1ml each side between cheek and gum)
Repeat after 10 if still fitting
Seek medical advice

78
Q

Midazolam: side effects

A

Respiratory depression
Droziness dizzyness

79
Q

Midazolam: Contradictions

A

Known allergy

80
Q

Midazolam: Cautions

A

New onset must be referred to hospital
Known advised to seek follow up

81
Q

Midazolam: children

A

Refer to protocol get advice
Not for under 5

82
Q

Naloxone: Indications

A

Known or suspected opioid overdose, causing respiratory or cardiovascular depression or reduced GCS
Administer is resps <10pm or GCS <10

83
Q

Naloxone: Route

A

Atomiser
Ensure adequate oxygenation ventilation via BVM

84
Q

Naloxone: adult dose

A

Refer to protocol
400mg/1ml 200mg per nostril
Is no response repeat every 3 min up to 4 times and seek advice

85
Q

Naloxone: side effects

A

Return of pain
Nausea, vomiting, tachycardia
Acute withdrawal in addicts

86
Q

Naloxone: contradictions

A

None

87
Q

Naloxone: cautions

A

Duration is short lived resp and cardio depression may recur and be fatal
Dose may need repeating until breathing normal and conscious

88
Q

Naloxone: children

A

Refer to protocol
Get advice
Dose same as adult

89
Q

Ondanseton: indications

A

Nausea and vomiting

90
Q

Ondanseton: route

A

Oral tablet or film “melt”

91
Q

Ondanseton: adult dose

A

4mg can repeat after 30min
Maximum dose 8mg

92
Q

Ondanseton: side effects

A

Rare after 1 dose

93
Q

Ondanseton: contradictions

A

Known sensitivity

94
Q

Ondanseton: cautions

A

None in acute situation

95
Q

Ondanseton: children

A

Seek advice
12-17 as adult
<12 do not give

96
Q

Oxygen: indications

A

All seriously ill or injured
Oxygen sats <94%

97
Q

Oxygen: route

A

Inhaled

98
Q

Oxygen: adult dose

A

10-15lpm via non rebreather mask
6-8lpm via nebuliser for asthma

99
Q

Oxygen: side effects/cautions

A

Risk of fire
Patients with COPD chronic obstructive pulmonary disease require observation (aim for SpO2 88%-92%

100
Q

Oxygen: contradictions

A

Patients with; heart attack, chest pain , stroke , heat exhaustion UNLESS OXYGEN SATURATION <94%

101
Q

Oxygen: children

A

As adult get advice

102
Q

Paracetamol: indications

A

1-6 on pain scale
Use alongside other analgesic using analgesic ladder

103
Q

Paracetamol: route

A

Oral

104
Q

Paracetamol: adult dose

A

1 gram (2 x 500mg tablets)
Can repeat after 4 h
16 + AND >50kg maximum dose 4 grams on 24h

105
Q

Paracetamol: side effects

A

None in acute situation

106
Q

Paracetamol: contradictions

A

Known allergy
Taken in the last 4 hours
Maximum dose taken

107
Q

Paracetamol: cautions

A

Adults <50kg half dose

108
Q

Paracetamol: children

A

Seek advice
Check dosage

109
Q

Prochlorperazine: Indications

A

Nausea or vomiting

110
Q

Prochlorperazine: route

A

Buccal (place high between upper lip and gum)

111
Q

Prochlorperazine: adult dose

A

6mg (2 X3 mg tablets every 2 hours)
Maximum 18mg (6x tablets)

112
Q

Side effects: dystonia, abnormal muscle spasms
Rarely respiratory depression

A
113
Q

Prochlorperazine: contradictions

A

Reduced consciousness

114
Q

Prochlorperazine: cautions

A

History of dystonia
Epilepsy
Elderly

115
Q

Prochlorperazine: children

A

12-18 start with 3mg give further 3mg if persists
Not for under 12

116
Q

Salbutamol (via inhaler): Indications

A

Asthma where patient has forgotten medication

117
Q

Salbutamol (via inhaler): route

A

Inhaled, preferably with spacer

118
Q

Salbutamol (via inhaler): adult dose

A

2-10 puffs - each puff inhaled separately
Give nebulised if severe

119
Q

Salbutamol (via inhaler): side effects

A

Tremor, fast pulse, headache

120
Q

Salbutamol (via inhaler): contradictions

A

Non in acute asthma

121
Q

Salbutamol (via inhaler): cautions

A

None in acute asthma

122
Q

Salbutamol (via inhaler): children

A

Seek advice
As per adult

123
Q

Salbutamol (nebuliser): Indications

A

Asthma with no response to inhaler
Wheeze associated with ; allergy , anaphylaxis, smoke inhalation

124
Q

Salbutamol (nebuliser): route

A

Nebulised with O2 at 6-8l per min

125
Q

Salbutamol (nebuliser): adult dose

A

5mg (2x 2.5 mg in 2.5 ml nebules)
If indicated give 3 doses with 5min intervals
Seek advice if repeat dose needed
No maximum
Add ipratropium Bromide to first dose if Life threatening

126
Q

Salbutamol (nebuliser): side effects

A

Tremor, fast pulse, headache

127
Q

Salbutamol (nebuliser): contradictions

A

None in acute

128
Q

Salbutamol (nebuliser): cautions

A

Seek advice if repeat dose needed

129
Q

Salbutamol (nebuliser): children

A

Seek advice
>5 adult dose
<5 2.5mg
If indicated give 3 doses with 5 min interval

130
Q

Diamorphine: Exclusions

A

Known allergy/hypersensitivity to opioids
Head injury or reduced consciousness (P/U)
Injury or active bleeding to nose
Chest injury with oxy sat <94% despite oxygen therapy
Respiratory depression
Signs of shocks

hudfgbhsdjhadoj; (6 decks)

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