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Drugs Flashcards

1
Q

Methoxyflurane

Contraindications

A
  1. Pre-existing kidney disease

2. Known to malignant hyperthermia

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2
Q

Methoxyflurane

Pharmacology

A

Inhalation of analgesic agent at low concentrations

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3
Q

Methoxyflurane
Presentation
Indications
Effects:

A

3 mL glass bottle
Pain Relief
25 minutes of pain relief
and comences after 8-10 breaths and lasts 3-5 minutes

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4
Q

Morphine

Contraindications

A
  1. Hypersensitivity
  2. 2nd Late stage labour
  3. Renal Impairment/ Failure
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5
Q

Morphine

Pharmacology

A

Opiod analgesic
CNS depression
Depression of cough reflex
Changes of mood

Vasodilation
Decrease conduction velocity through AV node

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6
Q

Morphine

Indications

A

Pain relief
Sedation to maintain intubation
Sedation to facilitate intubation (fentanyl not appropriate)

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7
Q

Morphine

Presentation

A

10mg in 1mL glass ampoule

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8
Q

Morphine

Effects

A

IV:
Onset: 2-5 minutes
Peak: 10 minutes:
Duration: 1-2 hours

IM:
Onset: 10-30 mins
Peak: 30-60 mins
Duration: 1-2 hours

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9
Q

Oxytocin

Presentation

A

10 units (IU) in 1 mL glass ampoule

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10
Q

Oxytocin

Pharmacology

A

Stimulates smooth muscle of the uterus producing contraction

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11
Q

Oxytocin

Indication

A
  1. Primary Postpartum Haemorrhage (PPH)
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12
Q

Oxytocin

Contraindications

A
  1. Previous Hypersensitivity
  2. Sever toxaemia (pre-eclampsia)
  3. Exclude multiple pregnancy before drug administration
  4. Cord prolapse
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13
Q

Oxytocin
Route
Effects

A

Route: IM
Effect:
Onset: 2-4 minutes
Duration: 30-60 minutes

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14
Q

Fentanyl

Presentation

A

100 mcg in 2 mL glass ampoule

250 mcg in 1 mL glass ampoule or cartridge (IN only)

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15
Q

Fentanyl

Pharmacology

A

Opiod analgesic
CNS depression:
Depression of cough reflex
depression leading to analgesia

Decrease conduction velocity through AV node

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16
Q

Fentanyl

Contraindications

A
  1. History of hypersensitivity

2. Late second stage of labour

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17
Q

Fentanyl

Route

A

IV
IN
IV INFUSION

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18
Q

Fentanyl

Indications:

A
  1. Sedation to maintain intubation
  2. Analgesia
  3. Severe headache
  4. Known Renal impairment
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19
Q

Fentanyl

Effects:

A

IV:
Onset: Immediate
Peak: <5 minutes
Duration: 30-60 minutes

IM:
Peak: 2 minutes

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20
Q

Fentanyl

Doses for pain relief

A

IV: 50 mcg at 5-minute intervals ALS consult after 200mcg
IN: 200 mcg repeat up to 50 mcg at 5 minute intervals (Max 400mcg IN
OR 100 mcg for frail <60 kg repeat 50 mcg at 5 minute intervals
IM: 100 mcg repeat 50 mcg after 15 minutes: OR 1mcg/kg for frail no repeat dose

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21
Q

Morphine

Doses for pain relief

A

IV: up to 5mg at 5 minute intervals (consult after 20mg intervals ALS)
IM: 10mg repeat 5 mg after 15 minutes
OR 0.1 mg/kg frail

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22
Q

Ketamine

Doses

A

IN: 75mg- repeat at 50 mg at 20 minute intervals - no max dose

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23
Q

Ketamine

Pharmacology

A

Anaesthetic agent

Works with the NMDA receptors. Produces a trance like dissociative state with amnesia.

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24
Q

Ketamine

Indication

A 
Intubation
Analgesia
Sedation 
-agitation
-patient movement during CPR
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25
Ketamine | Contraindications
Suspected non-traumatic brain injury with severe hypertension >180
26
Ketamine | Effects
``` Onset: IM -3-4 minutes IN: 5 minutes Peak: IN: 20 minutes Duration: IM: 12-25 minutes IN: 45 minutes ```
27
Adrenaline | Presentation
1 mg in 1mL glass ampoule | 1mg in 10mL glass ampoule
28
Adrenaline | Pharmacology
A naturally occurring alpha and beta-adrengic stimulant Increases HR by increasing SA node firing rate Increases conduction velocity through the AV node Increases myocardial contractility Increases the irritability of the ventricles Causes BRONCHODILATION Causes peripheral vasconstriction
29
Adrenaline | Indications
1. Cardiac arrest VF/VT Aystole or PEA 2. Inadequate perfusion 3. Bradycardia with poor perfusion 4. Anaphlauxis 5. Severe asthma -not responding to nebulised therapy or unconscious with no BP 6. Croup
30
Adrenaline | Contraindications
1.Hypovolaemic shock without adequate fluid replacement
31
Adrenaline | Routes
``` IV IM Nebulised IV Infusion IO ```
32
Adrenaline | Effects:
``` IV: Onset: 30 seconds Peak: 3-5 minutes Duration: 5-10 minutes IM: Onset: 30-90 secounds Peak: 4-10 minutes Duration: 5-10 Minutes ```
33
Adrenaline Doses
1. 500 mcg IM repeat at 5/60 max 1.5
34
Ondansetron | Presentation
4mg Orally tablet | 8mg in 4ml glass ampoule
35
Ondansetron | Pharmacology
Actions: 5HT3 antagonist which blocks receptors both centrally and peripherally
36
Ondansetron | Contraindications
1. Patients currently recieving apomorphine
37
Ondansetron | Effects:
``` Oral: Onset: 2 minutes Peak: 20 minutes Duration: 120 minutes IV: Onset: 5 minutes Peak: 10 minutes Duration: between 2.5 and 6.1 hours ```
38
Dexamethasone | Presentation
8mg in 2mL glass vial
39
Dexamethasone | Presentation
8mg in 2mL glass vial
40
Dexamethasone | Pharmacology
A corticosteroid secreted by the adrenal cortex Actions: Relieves inflammatory reactions Provides immunosuprresion
41
Dexamethasone | Pharmacology
A corticosteroid secreted by the adrenal cortex Actions: Relieves inflammatory reactions Provides immunosuprresion
42
Dexamethasone | Contraindication
1.Known Hypersensitivity
43
Dexamethasone Route Effects
``` IV EFFECTS: Onset: 30-60 minutes Peak: 2 hours Duration: 36-72 ```
44
Glyceryl Trinitrate | Presentation
0.3 mg tablet 0.6 Tablets Transdermal GTN patch (50mg)
45
Glyceryl Trinitrate | Pharmacology
Vascular smooth muscle relaxant Venous dilation promotes venous pooling and reduces venous return Arterial DILATION reduces vascular resistance Reduces myocardial 02 demand Reduced systolic, diastolic, and mean arterial blood pressure
46
Glyceryl Trinitrate | Indications
1. Chest pain with ACS 2. Acute LVF 3. Hypertension associated with ACS 4. Autonomic dysreflexia 5. Preterm labour
47
Glyceryl Trinitrate | Contraindications
(2 Blood pressure. 5 Heart. Hypersensitivity and Viagra ) 1. Hypersensitivity 2. Systolic blood pressure <110 mmHg tablet 3. Systolic blood pressure <90mmHg patch 4. Heart Rate >150bpm 5. Bradycardia HR <50bpm (excluding autonomic dysreflexia) 6. VT 7. Inferior STEMI with systolic BP <160 mmHg 8. Right ventricular MI 9. Sildenafil Citrate (Viagra) or Vardenafil (Levitra) administration in the previous 24 hour or tadalafil administration in the previous 4 days
48
Glyceryl Trinitrate | Route
SL Buccal Transddermal
49
Glyceryl Trinitrate | Effects:
S/L effects: Onset: 30sec-2 minutes Peak: 5-10 minutes Duration 15-30 minutes Transdermal effect Onset: up to 30 minutes Peak: 2 hours
50
Glycerl Trinitate | Doses
``` 600mcg S/L if SBP >110 OR 300mcg S/L Repeat at 5 minute interbals GTN PATCH: 50mg (0.4 mg/hr) remove if falls under <90 systolic ```
51
Paracetamol | Pharmacology
Analgesic | Exact mechanism of action unclear, thought to inhibit prostaglandin synthesis in the CNS
52
Paracetamol | Presentation
500mg tablets 120 mg in 5mL oral 1000mg in 100 mL soft pack
53
Paracetamol | Contraindications
2. Children <1 month of age 3. Paracetamol already administered in the past 4 hours. 4. Total paracetamol intake within past 24 hours exceeding 4g (adults) or 60mg/kg (children) 5. CHEST PAIN suspected in ACS
54
Paracetamol | Route
IV | ORAL
55
Paracetamol | Effects
Oral Onset: 30 minutes Peak: N/A Duration: 4 hours
56
Paracetamol | Doses
Paracetamol Orally 1000mg
57
What is more preferred morphine or fentanyl
Fentanyl has an immediate onset time whereas morphine takes 2-5 minutes. Fentanyl peak is a lot shorter than morphine and doesn't last as long which can decrease further complications down the road as they are both respiratory depressants (causing apnoea) and decrease the conduction velocity through the av node.
58
Paracetamol | Doses
1000 mg orally
59
Salbutamol | Presentation
5 mg in 2.5 mL polyamp | pMDI (100mcg per actuation)
60
Salbutamol | Pharmacology
Synthetic beta-adrenergic stimulant with primary beta 2 effects Actions causes bronchodilation (keeps the lungs open)
61
Salbutamol | Indications
``` Asthma Severe allergic reactions COPD smoke inhalation Oleoresin capsicum exposure ```
62
Salbutamol | Contraindications
NONE
63
Salbutamol Route Effects
``` Pmdi Nebulised Nebulized effects: Onset 5-15 minutes Peak: N/a Duration 15-50 minutes ```
64
Ipratropium Bromide | Presentation
250 mcg in 1 mL nebule or polyamp
65
Ipratropium Bromide | Pharmacology
Anticholinergic bronchodilator Allows for bronchodilation by inhibiting cholinergic bronchomotor tone blocks vagal reflexes which mediate bronchoconstriction OPENS UP THE LUNGS
66
Ipratropium Bromide | Contraindications
1. Hypersensitivity to atropine or its derivatives
67
Ipratropium Bromide | Effects
Onset: 3-5 minutes Peak: 1.5-2 hours Duration: 6 hours
68
Aspirin | Presentation
300mg chewable tablets | 300mg soluble or water
69
Aspirin | Pharmacology
Analegesic, antipyretic Actions: To minimize platelet aggregation and thrombus formation in order to retard the progression of artery thrombosis in ACS Inhibits synthesis of anti-inflammatory actions Decrease chance of clotting decreasing turbulant blood flow and increasing laminar flow
70
Aspirin | Contraindications
(SCHAB) 1. Suspected dissecting aortic aneurysm 2. Chest pain associated with pyschostimulant OD if SBP >160 mmHg 3. Hypersensitivity 4. Actively bleeding peptic ulcers 5. Bleeding disorders.
71
Aspirin Indications Route Effects
``` ACS Oral Onset: n/a Peak: n/a Duration: 8-10 days ```
72
Aspirin | Dose
300mg tablet

Paramedicine (3 decks)

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