Drug Quiz 2024 Flashcards
Quiz Questions & Scenarios Based on Drug List
What disease would your pt have a history of that would prevent the use of Olanzapine?
Parkinson’s Disease
What must you do prior to administering Fentanyl IN?
Prime the atomiser first with 0.1mL.
When administering Glucose Gel should the pt be advised to swallow the substance?
No - Administer small amounts of oral glucose gel into lower cheek pouch over gums/cheek and externally massage cheek. Do not allow the pt to just swallow it.
The presentation of Naloxone is 400mcg/1ml. How would you dilute this for IV?
Draw up entire ampoule in 400mcg/1ml in a 10ml syringe. Add 9mls NaCl to make 0.4mg in 10mls, titrated administration
Your pt is willing to self administer Olanzapine. How will they do this and what will be their dose?
PO 10mg (2x 5mg wafers)
You are called to a suburban home where a 50-year-old male has been found unconscious by his wife. The wife reports that he has been on prescription opioids for years now for a chronic back pain. The patient has pinpoint pupils, is breathing at 6 breaths per minute, and his SpO2 is 82% on room air. His pulse is slow and thready.
What medication(s) would you administer to this patient, and what are the appropriate doses?
Naloxone - 400mcg IM or IV. If IV access is available, dilute 400mcg/1ml with 9ml of NaCl (making 0.4mg in 10ml) and titrate to effect, administering small doses every 2 minutes until the pt’s respiratory rate improves.
Your preparing Fentanyl Citrate for your patient who is 56 years old, they report they weigh 70kg. What does will they recieve and how are you calculating in?
1mcg/kg
1mcg x 70kgs = 70mcg/7mls
What is the maximum total dose of Droperidol allowed within 24 hours?
20mg
What is the maximum number of doses of Ondansetron that can be given in a prehospital setting?
Ondansetron can be repeated once after 30 minutes if required, making the maximum number of doses two.
You are called to a residential home where a 72-year-old female has been found unresponsive by her spouse. The spouse reports that she recently had surgery for a hip replacement and has been taking prescribed pain medication. Today, she noticed her wife was difficult to wake and confused. When you arrive the pt is unresponsive, however breathing spontaneously with an SpO2 of 88% on room air.
What further investigations and drugs might you consider?
Your findings:
RR: 8 breaths per minute
HR: 48 bpm
BP: 102/60 mmhG
Temp: 36.5
Pupils: Pinpoint & reactive
Drug intervention:
Naloxone IM 400mcg/1ml or IV 400mcg/10ml, repeated every 2 mins as required.
What drug can be administered prophylactically for eye and spinal injuries?
Ondansetron
You respond to a 25-year-old female patient who is complaining of intense nausea and vomiting following an injury with suspected spinal injury. She is unable to tolerate oral medication.
What pharmaceutical intervention would you consider for this pt?
4mg IM Ondansetron
What is the dose of a single GTN spray and how often can it be repeated?
400mcg, repeated every 5 mins as required with no max.
You are called to a pt who has been seizing for 7 minutes, what drug intervention would you use?
IM Midazolam 5mg/ml, possible to repeat once after 10 mins if IV is unable to be establish and seizures continue or reoccur.
IV Midazolam 2.5mg/2.5ml (max dose 15mg) - can be repeated at 5 minute intervals as needed.
What are the indication for administering Sodium Chloride 0.9% and the initial dose for each indiciation.
Fluid replacement for shock and fluid loss - 250ml bolus.
Hypovolaemic cardiac arrest - 20ml/kg
Post ROSC - 250ml
You are called to a public park by the mother of a 28-year-old male with a history of bipolar disorder is experiencing an acute manic episode. On arrival, the pt is extremely aggressive, attempting to punch bystanders and throw objects. He is shouting threats and refuses to respond to verbal de-escalation attempts. The pt is actively trying to charge at anyone who comes near.
What is this pt’s RASS score and what pharmaceutical intervention would you consider?
RASS 4 (Combative)
Rationale: The patient is exhibiting overtly combative behaviour, attempting to harm bystanders and anyone approaching. This level of aggression and violence indicates the highest RASS score.
Ketamine IM 4mg/kg (max 400mg)
What are the indications for Olanzapine?
Disturbed and Abnormal Behaviour (RASS 1-3) where risk to safety is evident and the pt can tolerate or self-administer oral wafer. Preferred first line sedation in frail pts and those with dementia.
In a post-ROSC scenario, how much Sodium Chloride 0.9% can be administered before considering Adrenaline?
A maximum of 500ml should be administered to maintain systolic BP >100mmHg before administering Adrenaline.
What is the maximum dose of Atropine for symptomatic bradycardia?
3mg
What routes can Cophenylcaine be administered through?
Intranasal (IN), oral (PO), and topical.
Besides managing prolonged seizure activity, when else can Midazolam be used?
Sedation maintenance post IV Droperidol
What is the contraindication for using Aspirin?
Hypersensitivity to aspirin or salicylates.
How is Salbutamol administered through a nebuliser, and what is the dosage?
Salbutamol is administered by emptying 1-2 nebules (5-10mg) into the nebuliser compartment and attaching oxygen at 6-8 L/min.
True or False: All initial doses of Ketamine are given IM?
False - When used as a 2nd line agent for traumatic pain the initial dose is administered IV.
When is Glucagon indicated?
For hypoglycaemia as a third line agent when IV access is not possible.
What is the initial and repeat dose for Heparin?
Initial: 5000IU/5ml
Repeats: NIL
What are the contraindications for using Cophenylcaine?
Hypersensitivity and pregnancy.
What drug is used to treat both symptomatic bradycardia and organophosphate poisoning.
Atropine
When establishing IV access with the intention of administering TXA what consideration needs to be made?
A second large bore IV line should be established as no other medication can be given through the same port as the TXA which takes 10 mins to administer and therefore can inhibit treatment if a second line is not available.
When administering IV Ondansetron what considerations need to be made?
Draw up entire ampoule in 10ml syringe, add 8ml NaCl to make 4mg/10ml, slow push over 1 min.
Ketamine presents as 200mg/2ml. To draw up for IV administration foor analgesic effect, how would you prepare the drug?
Draw up entire ampoule (200mg/2ml) in a 20ml syringe. Add 18ml NaCl to make 10mg/ml. Attach 3 way tap to 1 or 3ml syringe and draw up 0.5ml - 2ml as a single dose.
What are the contraindications for Salbutamol?
Cardiogenic acute pulmonary oedema (APO) and hypersensitivity.
What are the available routes of administration for Salbutamol and the initial dose for each?
NEB: 5- 10mg (1 - 2 nebules)
MDI: 400-1200mcg (4-12 puffs)
What is the repeat for Adrenaline, Post-ROSC
IV 50mcg/0.5ml every 3-5 mins as required.
What are the routes of administration for Sodium Chloride 0.9%?
IV and IO
Midazolam presents as 15mg/3ml. How would you dilute this for easiest IV administration?
Draw up entire ampoule (15mg/3ml). Add 12ml NaCl to make 15mg/15ml. Administer in 2.5mg/2.5ml increments in 5 minute intervals as required.
How often is Adrenaline administered in a cardiac arrest scenario?
Every 3-5 minutes (administered every second loop)
You are called to a workplace where a 45-year-old male has collapsed. His colleagues mention that he is diabetic. The patient is conscious but confused and diaphoretic. His blood glucose level is 2.8 mmol/L. He is unable to swallow safely.
What medication(s) would you administer, and what are the appropriate doses?
Glucose 10%. - 15g/50ml IV bolus, administered over several minutes. If IV access is not yet established, use Glucagon 1mg IM.
Rationale: Glucose 10% is the first-line treatment for hypoglycaemia when the patient is unable to take oral glucose. It quickly raises blood glucose levels, reversing the symptoms of hypoglycaemia. If IV access is delayed, Glucagon serves as an alternative to stimulate glucose release.
Droperidol can be given via IM or IV, what are the initial doses for each route?
IM: 5-0mg/1-2ml
IV: 2.5-10mg/0.5-1mg (age & intoxication dependant)
What is the Post-ROSC Adrenaline dose and how is it drawn up?
Dose: IV 50mcg/0.5ml.
Prep: Draw up 1mg/1ml of adrenaline in 10ml syringe. Add 9mls NaCl to create 1mg/10mls. Attach 3 way tap to 1ml syringe and draw up 50mcg/0.5ml as a single dose.
