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)
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)
3
Q
Adrenaline: Indications
A
Life-Threarening Allergic reaction, With breathing Difficulty or shock
Life-Threating Asthma with failing ventilation and ddeterioration dispite nebuliser
4
Q
Adrenaline: Route
A
Intramuscular
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
6
Q
Adrenaline: Side Effects
A
- Anxiety
- Tremor
- Fast Heart Rate
7
Q
Adrenaline: Contradictions
A
NONE
8
Q
Adrenaline: Cautions
A
NONE
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
10
Q
Aspirin: Indications
A
Suspected Myocardial Infarction (MI/Heart Attack)
11
Q
Aspin: Indications
A
Suspected MI/Heart Attack
12
Q
Aspirin: Route
A
Oral - chewed / soluble
13
Q
Aspirin: Adult Dose
A
300mg tablet
In suspected MI give regardless of any taken previously that day
14
Q
Aspirin: Side Effects
A
None
15
Q
Aspirin: Contradictions
A
Allergy to Aspirin or other anti-inflammatory medication (NSAID, E.g. ibuprofen)
Suspected Stroke
Know Active bleeding in guy
16
Q
Aspirin: cautions
A
MI: give to patients with history of ulcers or indigestion unless guy bleeding (e.g. vomiting blood)
17
Q
Aspirin: Child does
A
Do not use if under 16
18
Q
Co-amoxiclav: Indications
A
Open Fracture or heavily contaminated wound. Greater than 1h from hospital (at time of injury)
19
Q
Co-amoxiclav: Route
A
Oral - Do not crush
20
Q
Co-amoxiclav: Adult Dose
A
2x250/125 mg tablets
Once only
21
Q
Co-amoxiclav: Side Effects
A
Allergic reaction
Nausea/ vomiting
22
Q
Co-amoxiclav: contradictions
A
Allergy to Penicillin
History of jaundice
23
Q
Co-amoxiclav: Cautions
A
None
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
25
Diamorphine (Intranasal): Indications
Moderate to severe pain (6-10)
Suspected myocardial infarction (MI/Heart Attack) pian score 4 or above
26
Diamorphine (Intranasal): Route
Intranasal CIA atomiser
27
Diamorphine (Intranasal): Adult Dose
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
28
Diamorphine (Intranasal): Side Effects
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
29
Diamorphine (Intranasal): Cautious
Seek medical advice with;
Chest injury
Bleeding without shock
Head injury
Altered consciousness
Pregnant
Elderly
Taking other opioids
30
Diamorphine (Intranasal): use in children
Seek medical advice
Not if under 7
31
Diamorphine (Intranasal): additional equipment
BVM & Naloxone
32
Entonox: Indications
Pain above 4
Labour pains
33
Entonox: Route
Inhale with normal breathing
34
Entonox: Adult Dose
Controlled by patient
May take 5-10 minutes for maximum effect
35
Entonox: Side effects
Dizziness
Euphoria
Nausea
36
Entonox: Contradictions
Patient unable to self administrator
Head injury with reduced consciousness
Chest injury with possibility or pneumothorax
Diving in the past 24hours
37
Entonox: Cautions
Store cylinder horizontal and >10c for 24h+
Consider other analgesic in cold
Mix before administration
38
Entonox: use with children
Seek advice
Same dose as adults
39
Fentanyl (Lozenge): Indications
6-10 on pain score
Suspected MI/Heart attack with pain 4+
40
Fentanyl (Lozenge): Route
Oromucoeal Lozenge, patient to rub on inside of cheek for 15min
41
Fentanyl (Lozenge): Adult Dose
Refer to fentanyl protocol
800 micrograms
Maximum cumulative dose of 1600
42
Fentanyl (Lozenge): side effects
Respiratory depression
Nausea vomiting drowsiness hypotension
43
Fentanyl (Lozenge): contraindications
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
44
Fentanyl (Lozenge) : cautions
Seek medical advice with;
Chest injury
Bleeding without shock
Head injury
Altered consciousness
Pregnant
Elderly
Taking other opioids
45
Fentanyl (children)
Not for use if u18
46
When using fentanyl what must be to hand
BVM and Naloxone
47
Glucose Gel: Indications
Hypoglycemia (blood glocouse<4 mmol) in conscious patient
Exhaustion Hypothermia
48
Glucose Gel: Route
Oral
49
Glucose Gel: adult dose
10-20 grams - reassess after 5 min
Check after 5 min aim for >5 mmol/L
50
Glucose Gel: side effects
None
51
Glucose Gel: contraindications
None
52
Glucose Gel: Cautions
In unconscious rub onto gums
53
Glucose Gel: children
As per adult seek medical advice
54
Glyceryl Trinitrate: Indications
Cardiac chest pain in suspected angina or MI
55
Glyceryl Trinitrate: Route
Sub-lingual spray under tongue and close mouth
Sit patient down
56
Glyceryl Trinitrate: Adult Dose
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
Glyceryl Trinitrate: side effects
Headaches and facial flushing
Dizziness
Hypotension
58
Glyceryl Trinitrate: contradictions
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
Glyceryl Trinitrate: Cautions
Can be used with opioids however may exacerbate hypotension
60
Glyceryl Trinitrate: use in children
Not for under 18
61
Ibuprofen: indications
Pain 1-6
Soft tissue injury
Severe pain when used with other analgesic
62
Ibuprofen: route
Oral
63
Ibuprofen: adult dose
400mg (2 x 200mg)
Maximum 3 doses in 24h
64
Ibuprofen: side effects
Gastrointestinal bleeding
Can exacerbate asthma
65
Ibuprofen: contradictions
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
Ibuprofen: cautions
Asthma (most will know if they can take nsaids)
Over 65 and not used to taking
67
Ibuprofen: children
Seek medical advice
12< as adult
7-11 200mg max 3 in 24h
68
Ipratropium Bromide: indications
Acute severe asthma attack (second line)
69
Ipratropium Bromide: route
Nebulised
70
Ipratropium Bromide: adult dose
500 micrograms (2x 250mg /1ml nebules
Add to salbutamol in nebuliser for first dose in life threatening
71
Ipratropium Bromide: side effects
Headaches
Nausea
Dry mouth
Fast heart rate
72
Ipratropium Bromide: contradictions
None in emergency
73
Ipratropium Bromide: cautions
None in emergency
74
Ipratropium Bromide: use on children
Seek advice
6-17 250 micrograms (1x nebul)
75
Midazolam: Indications
Any seizure+5 min and still fitting
3 or more in 1h and currently convulsing
Any after head injury
76
Midazolam: route
Intranasal via atomiser
Buccal via syringe
77
Midazolam: adult dose
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
Midazolam: side effects
Respiratory depression
Droziness dizzyness
79
Midazolam: Contradictions
Known allergy
80
Midazolam: Cautions
New onset must be referred to hospital
Known advised to seek follow up
81
Midazolam: children
Refer to protocol get advice
Not for under 5
82
Naloxone: Indications
Known or suspected opioid overdose, causing respiratory or cardiovascular depression or reduced GCS
Administer is resps <10pm or GCS <10
83
Naloxone: Route
Atomiser
Ensure adequate oxygenation ventilation via BVM
84
Naloxone: adult dose
Refer to protocol
400mg/1ml 200mg per nostril
Is no response repeat every 3 min up to 4 times and seek advice
85
Naloxone: side effects
Return of pain
Nausea, vomiting, tachycardia
Acute withdrawal in addicts
86
Naloxone: contradictions
None
87
Naloxone: cautions
Duration is short lived resp and cardio depression may recur and be fatal
Dose may need repeating until breathing normal and conscious
88
Naloxone: children
Refer to protocol
Get advice
Dose same as adult
89
Ondanseton: indications
Nausea and vomiting
90
Ondanseton: route
Oral tablet or film "melt"
91
Ondanseton: adult dose
4mg can repeat after 30min
Maximum dose 8mg
92
Ondanseton: side effects
Rare after 1 dose
93
Ondanseton: contradictions
Known sensitivity
94
Ondanseton: cautions
None in acute situation
95
Ondanseton: children
Seek advice
12-17 as adult
<12 do not give
96
Oxygen: indications
All seriously ill or injured
Oxygen sats <94%
97
Oxygen: route
Inhaled
98
Oxygen: adult dose
10-15lpm via non rebreather mask
6-8lpm via nebuliser for asthma
99
Oxygen: side effects/cautions
Risk of fire
Patients with COPD chronic obstructive pulmonary disease require observation (aim for SpO2 88%-92%
100
Oxygen: contradictions
Patients with; heart attack, chest pain , stroke , heat exhaustion UNLESS OXYGEN SATURATION <94%
101
Oxygen: children
As adult get advice
102
Paracetamol: indications
1-6 on pain scale
Use alongside other analgesic using analgesic ladder
103
Paracetamol: route
Oral
104
Paracetamol: adult dose
1 gram (2 x 500mg tablets)
Can repeat after 4 h
16 + AND >50kg maximum dose 4 grams on 24h
105
Paracetamol: side effects
None in acute situation
106
Paracetamol: contradictions
Known allergy
Taken in the last 4 hours
Maximum dose taken
107
Paracetamol: cautions
Adults <50kg half dose
108
Paracetamol: children
Seek advice
Check dosage
109
Prochlorperazine: Indications
Nausea or vomiting
110
Prochlorperazine: route
Buccal (place high between upper lip and gum)
111
Prochlorperazine: adult dose
6mg (2 X3 mg tablets every 2 hours)
Maximum 18mg (6x tablets)
112
Side effects: dystonia, abnormal muscle spasms
Rarely respiratory depression
113
Prochlorperazine: contradictions
Reduced consciousness
114
Prochlorperazine: cautions
History of dystonia
Epilepsy
Elderly
115
Prochlorperazine: children
12-18 start with 3mg give further 3mg if persists
Not for under 12
116
Salbutamol (via inhaler): Indications
Asthma where patient has forgotten medication
117
Salbutamol (via inhaler): route
Inhaled, preferably with spacer
118
Salbutamol (via inhaler): adult dose
2-10 puffs - each puff inhaled separately
Give nebulised if severe
119
Salbutamol (via inhaler): side effects
Tremor, fast pulse, headache
120
Salbutamol (via inhaler): contradictions
Non in acute asthma
121
Salbutamol (via inhaler): cautions
None in acute asthma
122
Salbutamol (via inhaler): children
Seek advice
As per adult
123
Salbutamol (nebuliser): Indications
Asthma with no response to inhaler
Wheeze associated with ; allergy , anaphylaxis, smoke inhalation
124
Salbutamol (nebuliser): route
Nebulised with O2 at 6-8l per min
125
Salbutamol (nebuliser): adult dose
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
Salbutamol (nebuliser): side effects
Tremor, fast pulse, headache
127
Salbutamol (nebuliser): contradictions
None in acute
128
Salbutamol (nebuliser): cautions
Seek advice if repeat dose needed
129
Salbutamol (nebuliser): children
Seek advice
>5 adult dose
<5 2.5mg
If indicated give 3 doses with 5 min interval
130
Diamorphine: Exclusions
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
