Drugs Flashcards
What are the indications for ADX?
Cardiac arrest, post ROSC circulatory support
What is the action of ADX?
Sympathomimetic that stimulates alpha and beta adrengenic receptors, enhances myocardial and cerebral blood flow during CPR, CPR therefore improved due to increased peripheral resistance which increases perfusion.
What are the cautions and contra-indications of ADX?
Severe hypertension with pts on beta blockers
DNA when temp < 30°C, double period between doses when 30°C<temp<35°C
What are the indications and contra-indications for atropine?
Bradycardia with ANY of:
Absolute bradycardia (<40BPM)
Hypotension
Paroxysmal ventricular arrythmias requring supression
Inadequate perfusion causing confusion etc.
Bradycardia following ROSC
DNA for hypothermic bradycardia or pts with heart transplants
What is the action of atropine?
Atropine is a muscarinic antagonist that blocks the affects of acetylcholine and other choline esters, decreasing vagal activity and enhancing A-V conduction.
What are the main side effects of atropine?
Dry mouth, blurred vision, pupil dilation, confusion, occasional hallucinations. Small doses (<100mg) can cause paradoxical bradycardia.
What are the indications and contra-indications of amiodarone?
Shockable cardiac arrest arrhythmias after 3rd shock
Contra-indicated in core temp <30ºC
When should you administer amiodarone during cpr?
After the 3rd shock and an additional bolus depending on age to unresponsive VF or pulseless VT following the 5th shock.
What is the action of amiodarone?
Blocks sodium and potassium channels, lengthening cardiac potential and therefore effective refractory period.
Acts to stabilise and reduce electrical irritability of cardiac muscles.
What are the usual side effects of amiodarone?
Bradycardia
Vasodilation/hypotension
Bronchospasm
Arrhythmias
What are the indications and contra-indications for benzylpenicillin?
Suspected meningococcal disease in the presence of:
Petechial/purpuric rash
and/or
signs/symptoms suggestive of meningococcal septicaemia
Contr-indications:
Known severe penicillin allergy (more than a simple rash alone)
What is benzylpenicillin?
A narrow-spectrum antibiotic
When should you use more than one injection site for IM benzylpenicillin?
When injecting more than 2ml of volume
What are the indications for chlorphenamine?
Relief of anaphylactic symptoms, should be given if symptoms fall short of anaphylaxis or after adrenaline if oral antihistamines are not suitable
What is the action of chlorphenamine?
Binds to the H1 histamine receptors blocking the action of endogenous histamine.
What are the contra-indications for chlorphenamine?
Known hypersensitivity
MAOI treatment within the last 14 days
What are the possible side effects of chlorphenamine?
Sedation and pyschomotor impairment (warn patients not to drive or do other complex tasks)
Dry mouth
Headache
Blurred vision
Urinary retention
GI disturbance
Convulsions (rare)
What patient demographics are more likely to experience the side effects of chlorphenamine?
Children and the elderly
What is the adult dose for IV Glucose?
10 gram (100ml)
What is the dose interval for IV Glucose?
5 minutes
How should IV glucose by flushed after administration?
Thoroughly (at least 20ml)
What are the indications and contra-indications for dexamethasone?
Indications:
Croup
Contra-indications:
Impending respiratory failure
What is the mechanism of dexamethasone?
Dexamethasone is a potent glucocorticoid with an anti-inflammatory action that decreases laryngeal mucosal oedema
Why should you be cautious when administering dexamethasone to children with possible or confirmed upper airway compromise?
Distressing the child may exacerbate airway compromise