DRUGS Flashcards
Pharmacology and action of adrenaline
- Naturally occurring sympathy mimetic agent
- Causes peripheral vasoconstriction
- Stimulation of cardiac conduction system causing increased contractions
- Causes bronchodilation and dilation of blood vessels to muscles
- IV/IO onset 30 sec, peak 3-5 min, duration 5-10 min
- IM onset 30-90 sec, peak 5-10 min, duration 5-10 min
Indications of adrenaline
- Cardiac arrest
- Anaphylaxis
- Severe asthma
- Severe croup with retroactive breathing
Contraindications of adrenaline
No absolute contraindications
Pharmacology and action of asprin
- Analgesic
- Antipyretic
- Anti inflammatory
- Anti platelet aggregation agent
- Reduces mortality significantly in AMI by minimising platelet aggregation and thrombus formation in order to retard the progression of coronary artery thrombosis
Indications of asprin
Chest pain/discomfort of presumed cardiac origin
Contraindications of asprin
- Known hypersensitivity to asprin / salicylates
- As magic patients with known hypersensitivity to salicylates
- Children < 12 yrs of age
Pharmacology and action of amiodarone
- 150mg/3ml ampoule
- Characteristics of all vaughan-Williams classifications
- Class 3 antidysrythmIc agent that prolongs action potential duration and hence refractory period of atrial, nodal and ventricular tissue
- Onset immediate, peak < 10 mins, duration 30-60 min
Indications of amiodarone
Cardiac arrest with persistent/shock resistant VF/VT ( post 3 consecutive shocks only)
Pharmacology and description of cophenylcaine
- Topical pump spray containing Lignocaine Hydrochloride 50mg/ml
- Phenylephrine 5mg/ml
- Topical anaesthetic and haemorrhage control agent for the relief of surface pain, nasal and oral bleeding
Contraindications of cophenylcaine
- Hypersensitivity to lignocaine or other anaesthetics
- Hypersensitivity to Phenylephrine
- Paediatrics less than 2 yrs
- Pregnancy
Indications of cophenylcaine
- Local pain: abrasions, small cuts and wounds
- Relief from mild to moderate epistaxis
- Post tonsillectomy haemorrhage
- Intra-oral haemorrhage
Description of fentanyl
A short acting synthetic narcotic analgesic
IN 600mcg/2ml
IV 100mcg/2ml
Indications of fentanyl
- Moderate to severe pain
2. Acute coronary system symptoms with a pain/discomfort score > 3/10 post 1 spray of GTN
Contraindications of fentanyl
- Hypersensitivity to fentanyl
- Less than 1 yr of age (IV/IO only)
- Occluded nasal passages or epistaxis (IN only)
Description of glucagon
- 1mg/1ml vial, accompanied by diligent for injection
- A hyperglycaemic agent that converts stored liver glycogen to glucose to increase blood glucose concentration
- Onset 4-7 mins, duration 10-30 min
Indications of glucagon
- Demonstrated hypoglycaemia where oral glucose cannot be administered and IV access cannot be obtained in a safe and timely manner
- Altered conscious state in a known diabetic
- Altered level of consciousness of unknown medical cause where BSL < 4mmol
Contraindications of glucagon
- Hypersensitivity
2. Known pheochromocytoma
Description of glucose oral gel
- 15g glucose gel in tube
- Rapidly absorbed from oral/buccal mucosa to increase blood glucose concentration
- Onset 2-5 min, duration 12-25 mins
Indications of glucose oral gel
- Demonstrated hypoglycaemia in altered conscious state in a known diabetic
- Altered conscious state of unknown medical cause where BSL < 4 mmol
Contraindications of glucose oral gel
Nil
Description of heparin sodium
- Naturally occurring anticoagulant which inhibits clotting of blood by enhancing rate at which anti thrombin III neutralises thrombin and activated factor X (Xa)
- Ampoules 5000 IU / 5 ml
- Onset of action is immediate following IV administration
Indications of heprin sodium
Patients with STEMI going directly to cardiac cath lab as per receiving hospital 12 lead ECG interpretation
Contraindications of heprin sodium
- Hypersensitivity to heparin
2. Presence of known haemorrhagic states
Description of atrovent
- Presents in 250mcg/1ml neb
- Anticholenergic bronchodilator. Inhibits the vagus reflexes that mediate bronchospasm
- Combined with nebuliser beta 2 agonist, atrioventricular produces significantly greater bronchodilation than beta 2 agonist alone
Indications of atrovent
- Severe bronchospasm and shortness of breath
- Severe life threatening asthma - paeds
- Severe life threatening asthma and COPD - adults
Contraindications of atrovent
Hypersensitivity
Description of IV saline
- Normal saline NaCl 0.9% in 1000ml soft plastic bag
- 10 ml plastic vial
- Sterile isotonic crystalloid solution
Indications of IV saline
Fluid replacement (volume expansion) for treatment of shock, fluid loss and cardiac arrest
Contraindications of IV saline
Circulatory overload
Description of GTN
- Spray bottle containing 200 X 0.4mg atomised spray
- Nitrates cause the relaxation of vascular smooth muscle resulting in
- vasodilation
- peripheral pooling and reduced venous return
- reduced left ventricular and diastolic pressure ( preload)
- reduced systemic vascular resistance ( after load)
- reduced myocardial energy and oxygen requirement
- relaxes spasm of coronary arteries
Indications for GTN
- Chest pain/discomfort of presumed cardiac origin that is not relieved by rest and reassurance with a systolic BP > 90mmHg
- Acute cardiac pulmonary oedema with systolic BP > 90mmHg
Contraindications of GTN
- Hypersensitivity
- Hypotension < 90mmHg systolic
- Medications used for erectile dysfunction within 24hrs
Description of ketamine
- 200mg/2ml ampoule
- Rapid onset dissociative anaesthetic
- IV onset: 1min
Indications of ketamine
- Second line agent for severe pain of traumatic origin
2. Actively disturbed patients requiring sedation where midazolam has already been utilised
Contraindications of ketamine
- Hypersensitivity
- Age < 12 months
- Non traumatic pain
- Active cardiovascular disease including cardiac chest pain, heart failure, severe/ poorly controlled hypotension
- Active psychiatric condition ( unless pre treatment with Midazolam
Description of salbutamol
- 5mg/2.5 ml plastic nebule
- 100mcg dose per puff from MDI
- Sympathomimetic - short acting synthetic beta 2 adrenoreceptor stimulant that causes relaxation of bronchial smooth muscle (bronchodilation)
4 initial effect 2-5 mins max by 10 min
Indications of salbutamol
Bronchospasm and respiratory distress associated with weeze
- acute bronchiol asthma
- bronchitis
- smoke inhalation
- severe allergic/anaphyactic reaction
- acute pulmonary oedema of non cardiac origin
- salt water aspiration syndrome
- chronic airway limitations (CAL)
Contraindications of salbutamol
- Hypersensitivity
2. Cardiogenic pulmonary oedema
Description of panadol
- 500 mg tablets
2. Simple oral analgesic for relief of mild to moderate pain and fever
Indications of panadol
- Headache
- Minor-moderate pain
- Fever
Contraindications of panadol
- Known hypersensitivity
2. Paracetamol within the last 4hrs
Description of ondansetron
- 4 mg in 2 ml ampoule
- 4 mg oral wafers
- Anti nauseant and anti emetic
- Selective 5-HT3 receptor antagonist blocking serotonin centrally in the chemoreceptor trigger zone and peripherally on the vagus nerve terminals
- Onset up to 30 mins
Indications of ondansetron
- Moderate to severe nausea
- Active vomiting
- Prophylaxis for eye and spinal injuries
Contraindications of ondansetron
- IM - paeds < 2 yrs old
2. Hypersensitivity
Description of naloxone
1- 0.4 mg/1ml vial
2- naloxone is a pure narotic antagonist that exerts its effects by competitive inhibition at opioid receptor site. It prevents or reverses effects of opioids including respiratory depression, sedation and hypotension. In absence of opiods it exhibits no pharmacological activity
Indications of naloxone
Reverse respiratory depression in a suspected narcotic OD
Contraindications of naloxone
Responsive patient with adequate respirations and who are protecting their own airway
Description of midazolam
- 15mg/3ml (5mg/ml) ampoule
- Water soluble benzodiazepine that has anxiolytic, sedative and anticonvulsive characteristics. These are based on its bond with receptors in the CNS. Its action to increase the inhibitory effect of the g-aminobuyric acid ( GABA) neurotransmitters on GABA receptors and subsequent membrane threshold.
- Midazolam is lipid soluble in physiological pH and it reaches the CNS quickly
Indications of midazolam
- Seizures
- Disturbed/combative behaviour
- Combative TBI patients
- Back pain due to muscle spasm in adults
Containdications of midazolam
Hypersensitivity
Description of methoxyflurane
- 3ml ampoule
- A halogenated ether that produces powerful modification of awareness of pain with assosiated light headed sensation
- 6-8 breaths / 1-2 min onset with max level after 2-4 min
Indications of methoxyflurane
- Pain
Contraindications of methoxyflurane
- Pts unable to understand/cooperate
- Pts with severe renal impairment
- Pts with head injury and altered conscious state that prevents cooperation
- Hypersensitivity eg malignant hyperthermia
Description of lignocaine
- 20mg/2ml (1%) in plastic ampoule
- Sodium channel blocker
- Onset 1-2 min
Indications of lignocaine
Local anaesthetic for :
- IV cannualtion
- suturing
- IO infusion
Contraindications of lignocaine
- Hypersensitivity
Description of IV glucose 10%
- 500ml bag 10% glucose (10g per 100ml)
- A hypertonic crystalloid solution that provides a readily available source of energy (glucose)
- Onset within 1 min
Indications of IV glucose 10%
Demonstrated hypoglycaemia where oral glucose administration is inappropriate in :
Altered conscious state in a known diabetic
Altered couscous state of unknown medical cause with a BSL < 4mmol
Cardiac arrest
Contraindications of IV glucose 10%
- Diabetic coma where BSL is excessively high
- Glucose/Galactose malabsorption
- Anuria
- Intraspinal/intercranial injury
- Corn (Maize) allergy
- Pts at risk of ischemic stroke
- Use after an ischaemic stroke
What TV cartoon show does the phrase”purple monkey dishwasher” originate from????
The Simpsons
