DRUGS Flashcards
1
Q
What is adrenaline?
A
- Activates sympathetic nervous system
- α & β adrenergic agonist, stabilises mast cells, reduces subglottic oedema
2
Q
What is adrenaline used for?
A
- Severe croup
- Cardiac arrest
- Anaphylaxis
- Life threatening asthma
3
Q
Adrenaline routes
A
- IV
- IO
- IM
- Neb
4
Q
What is the dose of adrenaline for croup?
A
- Adults: 5mg nebuliser
- Paediatrics: <6 months 2.5 mg, >6 months 5mg
5
Q
What is the dose of adrenaline in cardiac arrest?
A
- IV 1mg every 4 minutes (every second cycle)
- IO 1 mg every 4 minutes (every second cycle)
6
Q
Special consideration for adrenaline in cardiac arrest
A
Hypothermia
- double drug intervals intervals in hypothermic patients (30 - 35degrees) (ie. every 8 minutes)
- withhold in <30
7
Q
What is the dose of adrenaline for anaphylaxis/ life threatening asthma?
A
- 10 microg/kg to max 500 microg
- repeat 5 mins PRN
8
Q
What is amioderone?
A
An antiarrhythmic
9
Q
Indications for amiodarone
A
Refractory VT/VF in cardiac arrest
10
Q
Routes of amiodarone
A
- IV
- IO
11
Q
Dose of amiodarone
A
300mg following 3rd shockable rhythm
- once only
12
Q
What is aspirin?
A
An anti platelet
13
Q
What is aspirin used for?
A
Cardiac chest pain
14
Q
Route of aspirin
A
Oral
15
Q
Dose of aspirin
A
300 mg tablet
16
Q
What is benzoyl penicillin?
A
Antimicrobial;
inhibits cell wall synthesis
17
Q
What is benzyl pencilian used for?
A
Suspected meningococcal septicaemia
18
Q
Routes of Ben pen
A
- IM
- IV (prefers in adults)
19
Q
Dose of Ben pen (both IM and IV):
A
Prepare as 1200 mg/4 mL (reconstituted in 3.2 mL water)
20
Q
What is fentanyl?
A
An opiate
21
Q
What is fentanyl used for?
A
Pain relief
22
Q
Routes of fentanyl
A
- IN
- IV (preferred in adults)
23
Q
What is the IV dose of fentanyl?
A
- 25 – 50 microg (slow push) every 5 min PRN;
Max total cumulative dose 300 microg - reconstitute with 8 mls of saline = 10microg/1ml
24
Q
What is the IN dose of fentanyl?
A
Up to 200 microg
repeat after 5 min if required
Max total cumulative dose 400 microg
25
What is fexofenadine?
Non sedating H1 antihistamine
26
What is fexofenadine used for?
Allergic reaction
27
Route of fexofenadine
Oral
28
Dose of fexofenadine
180 mg tablet, once daily
29
What is glucagon?
Glycogenolysis
30
Route of glucagon
IM
31
Dose of glucagon:
1 mg (in 1 mL water)
32
What is glucose 10%?
Hyperglycaemic
33
What is glucose 10% used for?
Hypoglycaemia
34
Dose of glucose 10%
- To effect glucose 25 g/250 mL
- Post ROSC: Aim BGL 4–10 mmol/L
35
What is GTN?
- A vasodilator
- decreases preload
36
What is GTN used for?
- cardiac chest pain
- ACPO
37
Route of GTN
Sub lingual
38
Dose of GTN
- 400 microg spray
- 300 micgrog tablet
- every 5 minutes while adequate BP
39
What is ipatropium?
Inhaled anticholinergic (M3)
40
What is ipatropium used for?
- Asthma
- COPD
41
Routes of ipatropium
- MDI
- NEB
42
Dose of ipatropium (MDI)
- 168 microg (8 puffs) * * 4 breaths per puff
- Once only
43
Dose of ipatropium (Neb)
500 microg (once only)**
** Except severe or life threatening asthma or severe exacerbations of COPD
repeat every 20 min to 3 doses
44
What is methoxyflurane?
Analgesic
45
What is methoxyflurane used for?
Pain relief
46
Route of methoxyflurane
Inhaled
47
Dose of methoxyflurane
3 mL
repeat once if required
(no more than 2 doses in 24 hours)
48
What is midazolam?
- A GABA stimulant
- CNS depressant
49
What is midazolam used for?
- seizures
- mental health transfers
- CPRIC
50
Route of midazolam (seizures)
- IM
51
Dose of midazolam (seizures)
0.1 mg/kg up to 10 mg repeat once to max 10 mg per dose;
(Only 5 ml per injection site)
52
What is naloxone?
Opioid antagonist
53
What is naloxone used for?
Opioid overdose
54
Route of naloxone
- IN
- IM
- IV
55
Dose of naloxone (IN)
120 microg
every 30-60 sec PRN
56
Dose of naloxone (IM)
400 microg every 1-2 min PRN
57
Dose of naloxone (IV)
100 microg every 30-60 sec PRN
58
What is ondansetron?
5HT3 antagonist
59
What is ondansetron used for?
Nausea and vomiting
60
Routes of ondansetron
- oral
- IV
- IM
61
Dose of ondansetron
- IV 4mg, slow push, repeat once
- IM - 4mg, repeat once
- oral - 4 mg, repeat once
62
What is paracetamol?
Analgesic
63
What is paracetamol used for?
Pain
64
Routes of paracetamol
- IV
- Oral
65
Dose of paracetamol
- 1000mg
- if not given in past 4 hours
66
What is prednisone?
Corticosteroid
67
What is prednisone used for?
- croup
- asthma
- COPD
68
Route of prednisone
- oral (tablet or liquid)
69
Dose of prednisone
50 mg (if no oral steroids in past 24 hrs)
Asthma- moderate - severe COPD (as per management plan if possible)
70
Dose of prednisone for croup/ asthma in paediatrics
Croup: 1 mg/kg (max 50 mg) mild - moderate (if tolerated) severe or life threat (post adrenaline neb if tolerated)
Asthma: 1 mg/kg (max 50 mg)
moderate - severe (if tolerated & no oral steroids in past 24 hrs)
71
What is salbutamol?
- smooth muscle relaxant
- bronchodilator
- B2 antagonist
72
What is salbutamol used for?
- asthma
- COPD
- anaphylaxis with bronchospasm
73
Route of salbutamol
- MDI
- NEB
74
Dose of salbutamol (MDI)
Mild - moderate asthma: 1200 microg (12 puffs)* * 4 breaths per puff
MDI preferred in COPD - change to neb if ineffective or patient unable to use MDI
75
Dose of salbutamol (NEB)
- Moderate asthma: 5 mg - every 20 min up to 3 doses
- Severe asthma: 15 mg & repeat if required
- Life threatening asthma: 15 mg continuous
- COPD: 5 mg; (repeat every 20 min up to 3 doses for severe exacerbations)
76
What is sodium chloride 9%
Isotonic crystalloid solution
77
What is sodium chloride used for?
- fluids
- Hypovolaemia haemorrhagic or obstructive shock states
- Sepsis with hypotension or dehydration (symptomatic)
- Neurogenic shock
- Haemorrhage (3rd trimester pregnancy)
- Postpartum haemorrhage
- burns
- Cardiac arrest if hypovolaemic or obstructive shock states (address 4 Hs/4 Ts)
- Post ROSC hypotension and altered GCS
78
Dose of sodium chloride for Hypovolaemia haemorrhagic or obstructive shock states
-20 mls/kg
- To radial pulse & stable GCS
79
Dose of sodium chloride for Sepsis with hypotension or dehydration (symptomatic)
Consult
80
Dose of sodium chloride for Neurogenic shock
Up to 1000 mL, until permissive hypotension
81
Dose of sodium chloride for Haemorrhage (3rd trimester pregnancy)
250 mL aliquots up to 1000 mL; Consult if more required
82
Dose of sodium chloride for Postpartum haemorrhage
250 mL aliquots, repeat as necessary to achieve radial pulse & adequate cerebral perfusion
83
Dose of sodium chloride for burns
Re-establish & maintain normal volume
84
Dose of sodium chloride for Cardiac arrest if hypovolaemic or obstructive shock states (address 4 Hs/4 Ts)
Up to 20 mL/kg (in 500 mL aliquots)
In trauma additional up to 10 mL/kg if required
Consult if more required
85
Dose of sodium chloride for Post ROSC hypotension and altered GCS
Up to 10 mL/kg (in 250 mL aliquots) until radial pulse or SBP 100 mmHg; max 1000 mL Consult if hypotension persists
86
Pain management options
Consider clinical support in cases where pain is significant or likely to be difficult to control Administer paracetamol (providing it has not been given in the past 4 hours):
- Oral paracetamol 1000mg (if tolerated),
OR
- IV paracetamol 1000 mg/100 mL over 10 min; followed by 100 mL sodium chloride 0.9% flush at the same infusion rate,
- Consider inhaled methoxyflurane 3 mL; may be repeated once if required to a total of no more than 2 doses over the previous 24 hours
If severe pain, stable GCS of 15 (or patient’s normal GCS) with a systolic BP ≥ 100 mmHg, select from:
- IV fentanyl 25 - 50 microg slow push (over no less than 1 min); may be repeated at 5 min intervals as required (The total cumulative dose of IV fentanyl must not exceed 300 microg;) (OR IN)
If pain is uncontrolled consider ICP for ketamine
