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CSB331 OSCE > Drugs > Flashcards

Drugs Flashcards

1
Q

Indications of Paracetamol

A
  1. Minor Pain

2. Fever (causing distress)

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2
Q

Contraindications of Paracetamol

A
  1. KSAR

2. Patients < 1 month

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3
Q

Precautions of Paracetamol

A
  1. Hepatic or renal dysfunction

2. Pt taking anticoagulant medications

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4
Q

Side effects of Paracetamol

A

Nausea

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5
Q

Presentation of Paracetamol

A

Tablet, 500mg

Elixir 120mg/5ml

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6
Q

Adult dose of Paracetamol for minor pain and fever

A

PO 0.5g - 1g, repeat every 4 hours (must not admin within) total max dose 4g in 24hrs

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7
Q

Paediatric dose of Paracetamol for minor pain and fever ≥ 1 month

A

15mg/kg, single does only. Must not admin within 4 hrs of previous paracetamol admin.

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8
Q

Indications for Methoxyflurane

A

Pain

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9
Q

Contraindications for Methoxyflurane

A
  1. KSAR
  2. Pt < 1 year
  3. Hx or significant liver of renal disease
  4. Hx of malignant hyperthermia
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10
Q

Precautions for Methoxyflurane

A
  1. ALOC

2. Intoxicated or drug affected people

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11
Q

Presentation for Methoxyflurane

A

Bottle 3ml

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12
Q

Adult dose of Methoxyflurane for pain

A

INH 3ml, repeat once after 20min, max dose 6ml

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13
Q

Paediatric dosage for Methoxyflurane ≥1 yr

A

INH 3ml, single does only

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14
Q

True or false, you can leave a pt unattended who is self administering Methoxyflurane

A

False

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15
Q

What is the total weekly dose of Methoxyflurane that shouldn’t be exceed?

A

15ml, with admin on consecutive day not recommended

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16
Q

What dose should be administered per pt whilst in the ambulance

A

One dose of 3ml

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17
Q

How many doses can an ambulance officer administer in the ambulance per day?

A

2 doses

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18
Q

Indications for Salbutamol

A
  1. Bronchospasms

2. Suspected hyperkalaemia (with QRS widening AND/OR AV dissociation

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19
Q

Contraindications for Salbutamol

A
  1. KSAR

2. Pt < 2 years

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20
Q

Precautions for Salbutamol

A
  1. Acute Pulmonary Oedema

2. Ischaemic heart disease

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21
Q

Side effects of Salbutamol

A
  1. Anxiety
  2. Tachyarrhythmias
  3. Tremors
  4. hypokalaemia and metabolic acidosis
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22
Q

Presentation of Salbutamol

A

Nebule, 5mg/2.5ml

Ampoule 500microg/1ml

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23
Q

Adult dosage of Salbutamol for Bronchospasms

A

NEB 5mg, repeat PRN, no max dose.

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24
Q

Paediatric dose of salbutamol for Bronchospasm ≥ 2yrs

A

NEB 5mg, repeated PRN, no max dose.

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25
Q

Indications for GTN

A
  1. Suspected ACS with pain
  2. Acute cardiogenic pulmonary oedema
  3. Autonomic dysreflexia (with sysBP ≥160mmHg)
  4. Irukandji syndrome (with sysBP ≥160mmHg)
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26
Q

Contraindications for GTN

A
  1. KSAR
  2. HR< 50 OR > 150bpm
  3. SysBP <100mmHg
  4. Acute CVA
  5. Head Trauma
  6. Phosphodiasterase inhibitor medication admin (i.e. viagra, Levita) in previous 4 days
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27
Q

Side effects of GTN

A
  1. Dizziness
  2. Syncope
  3. Vascular headaches
  4. Hypotension
  5. Reflex Tachycardia
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28
Q

Presentation of GTN

A

Spray (SUBLING), 400microg/dose, 200 doses.

Ampoule, 50mg/10ml

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29
Q

Adult dose of GTN for Suspected ACS

A

SUBLING: 400microg, repeat 5 min, no max dose

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30
Q

Adult dose of GTN for acute cardiogenic pulmonary oedema

A

SUBLING: 400microg, repeat 5 min, no max dose

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31
Q

Adult dose of GTN for Autonomic dysreflexia and irukandji syndrome (with a sysBP ≥160mmHg

A

SUBLING: 400microg, repeat 5 min, no max dose

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32
Q

Paediatric dose of GTN for Autonomic dysreflexia and irukandji syndrome (with a sysBP ≥160mmHg

A

SUBLING: Consult

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33
Q

Indications for Aspirin

A
  1. Suspected ACS

2. Acute cardiogenic pulmonary oedema

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34
Q

Contraindications for Aspirin

A
  1. KSAR or hypersensitivity to NSAIDs
  2. Chest pain associated with psychostimulant overdose
  3. Bleeding OR clotting disorders (e.g. haemophilia)
  4. Current GI bleeding OR peptic ulcers
  5. Pts < 18yrs
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35
Q

Precautions for Aspirin

A
  1. Possible Aortic aneurysm or any other condition that may require surgery
  2. Pregnancy
  3. Hx of GI bleeding or peptic ulcers
  4. Concurrent anticoagulant therapy (e.g. Warfarin)
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36
Q

Side effects of Aspirin

A
  1. N/V
  2. NSAID induced bronchospasm
  3. Epigastric pain/discomfort
  4. GI bleeding
  5. Gastritis
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37
Q

Presentation of Aspirin

A

Tablet 300mg

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38
Q

Adult dose of Aspirin for suspected ACS and acute cardiogenic pulomary oedema ≥18yrs

A

PO: 300mg, chewed followed by a small sip of water.

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39
Q

For pts who have had < 300mg aspirin in last 24hrs and present with suspected ACS or APO, what total daily dose should be admin?

A

300-450mg

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40
Q

True or False, Aspirin is indicated for pt with suspect ACS or APO even if pain free.

A

True

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41
Q

True or false,in suspected ACS or APO, aspirin should be admin following the initial dose of GTN

A

True

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42
Q

Indications for Droperidol

A

Acute Behavioural Disturbances (with a SAT Score of >/= 2)

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43
Q

Contraindications for Droperidol

A
  1. KSAR or hypersensitivity to droperidol
  2. Parkinson’s disease
  3. Previous dystonic reaction to droperidol
  4. Patient’s < 16 years
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44
Q

Precautions for Droperidol

A

Concomitant use of CNS depressants

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45
Q

Side effects for Droperidol

A

Extrapyramidal effects e.g. dystonic reactions (rare)

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46
Q

Presentation of Droperidol

A

Vial, 10mg/2ml droperidol (DORM)

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47
Q

What is the dose for Droperidol for pts 16yo to <65yo

A

10mg repeated once at 15ins. Total max dose 20mg.

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48
Q

What is the dose for droperidol for >65 years.

A

Consult QCC

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49
Q

Indications for Adrenaline

A
  1. Anaphylaxis or Sever allergic reaction
  2. Severe life-threatening bronchospasms OR silent chest (speak in single words or haemodynamic compromise or ALOC)
  3. Bradycardia with poor perfusion (Unresponsive to atropine or TCP)
  4. Cardiac arrest
  5. Croup (stridor at rest)
  6. Shock unresponsive to adequate fluid resuscitation (excluding haemodynamic cause)
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50
Q

Contraindications for Adrenaline

A

Nil

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51
Q

Precautions for Adrenaline

A
  1. Hypertension
  2. Hypovolaemic shock
  3. Concurrent MOAI therapy
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52
Q

Side effects of Adrenaline

A
  1. Anxiety
  2. Hypertension
  3. Palpitations /Tachyarrhythmias
  4. Pupil dilation
  5. Tremor
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53
Q

What is the Presentation of Adrenaline

A

Ampoule, 1mg/1m; (1:1,000) adrenaline

Ampoule, 1mg/10ml (1:10,000) adrenaline

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54
Q

What is the adult dose of IM adrenaline for Anaphylaxis or severe allergic reaction?

A

300mcg, repeated at 5 min intervals, no max dose

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55
Q

What is the adult dose of NEB adrenaline for Anaphylaxis or sever allergic reaction?

A

5mg, Single dose only.

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56
Q

What is the adult dose of IM Adrenaline for Severe Life-threatening bronchospasm or silent chest?

A

300mcg, repeated at 5 min intervals, no maximum dose.

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57
Q

What is the adult dose if IV Adrenaline for Cardiac arrest

A

1mg, repeated at 3-5min intervals, no max dose.

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58
Q

What is the > 6 yo Paed dose of IM Adrenaline for Anaphylaxis OR Severe allergic reaction

A

300mcg, at 5 min intervals, no max dose

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59
Q

What is the < 6 yo Paed dose of IM Adrenaline for Anaphylaxis OR Severe allergic reaction

A

150mcg, at 5 min intervals, no max dose

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60
Q

What is the Paed dose of NEB adrenaline for Anaphylaxis OR Severe allergic reaction.

A

5mg, Single dose only

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61
Q

What is the > 6 yo Paed dose of IM Adrenaline for Severe Life threatening bronchospasm OR Silent Chest

A

300 mcg, at 5 min intervals, no max dose

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62
Q

What is the >10kg ( > 1 yo) Paed dose of IV adrenaline for Cardiac Arrest

A

10mcg/kg, repeat at 3-5 min intervals, no max dose

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63
Q

What is the <10kg ( < 1 yo) Paed dose of IV adrenaline for Cardiac Arrest

A

100mcg, repeat at 3-5 min intervals, no max dose

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64
Q

What is the Paed dose of NEB adrenaline for Croup (with stridor at rest)

A

5mg, Single dose only

65
Q

Indications of Fentanyl

A
  1. Significant Pain
  2. Sedation (for the maintenance of an established ETT)
  3. Autonomic dysreflexia (with sysBP > 160mmHg)
66
Q

Contraindications of Fentanyl

A

KSAR or hypersensitivity to fenanyl

67
Q

Precautions of Fentanyl

A
  1. Elderly patients
  2. Hypotension
  3. Respiratory tract burns
  4. Respiratory depression and/or failure
  5. Known addiction to narcotics
  6. Current MAOI therapy
68
Q

Side affects of Fentanyl

A
  1. Bradycardia
  2. Drowsiness
  3. Hypotension
  4. Nausea and/ or vomiting
  5. Pin point pupils
  6. Respiratory depression
  7. Muscular rigidity (particularly muscles of Respiration)
69
Q

What is the presentation of Fentanyl

A

Ampoule, 100mcg/2ml Fentanyl

70
Q

What is the >70yo IM dose of Fentanyl for significant pain.

A

25 - 50mcg, repeated up to 50mcg every 10mins, total max dose 100mcg.

71
Q

What is the <70yo IM dose of Fentanyl for significant pain.

A

25 - 100mcg, repeated up to 50mcg every 10 mins, total max dose 200mcg.

72
Q

What is the >70yo IV dose of Fentanyl for significant pain

A

25 mcg, repeated at up to 25mcg every 5min, total max dose 100mcg

73
Q

What is the <70yo IV dose of Fentanyl for significant pain

A

25-50mcg repeated up to 50mcg every 5 mins total max dose 200mcg.

74
Q

What is the > 1 yo Paed dose of NAS Fentanyl for significant pain

A

1.5mcg/kg, repeat once at 1mcg/kg at 10 mins, total max dose 100mcg.

75
Q

What is the < 1 yo Paed dose of NAS Fentanyl for significant pain

A

Need to contact the QCC advise line in all situations

76
Q

What is the Paed dose of SUCUT Fentanyl for significant pain

A

Need to contact the QCC advise line in all situations

77
Q

What is the > 1 yo Paed dose of IM Fentanyl for significant pain

A

1-2 mcg/kg, single max dose 50mcg, total max dose 2mcg/kg

78
Q

What is the < 1 yo Paed dose of IM Fentanyl for significant pain

A

Need to contact the QCC advise line in all situations

79
Q

What is the > 1 yo Paed dose of IV Fentanyl for significant pain

A

1 mcg/kg, single Max dose 25mcg. Repeated at 0.5mcg/kg (max 25mcg) at 10 min intervals. Total max dose 2mcg/kg.

80
Q

What is the < 1 yo Paed dose of IV Fentanyl for significant pain

A

Need to contact the QCC advise line in all situations

81
Q

Indications of Glucagon

A
  1. Symptomatic hypoglycaemia (with the inability to self-administer oral glucose)
82
Q

Contraindications of Glucagon

A
  1. KSAR or hypersensitivity to glucagon.
83
Q

Precautions of Glucagon

A
  1. Nil
84
Q

Side effects of Glucagon

A
  1. Nil
85
Q

What is the presentation of Glucagon

A

Vials (powder and solvent), 1 mg glucagon

86
Q

What is the adult dose of IM Glucagon for Symptomatic hypoglycaemia

A

1mg, single dose, Reconstitue 1mg of glucagon with 1 ml of water for injection in a 3ml syringe. (1mg/1ml)

87
Q

What is the > 25kg Paed dose of IM Glucagon for Symptomatic Hypoglycaemia

A

1 mg single dose only

88
Q

What is the < 25kg Paed dose of IM Glucagon for Symptomatic Hypoglycaemia

A

0.5mg single dose only

89
Q

Indications of Glucose gel

A
  1. Symptomatic hypoglycaemia (with the ability to self-administer oral glucose)
90
Q

Contraindications of glucose gel

A
  1. Unconscious
  2. pts with difficulty swallowing.
  3. Pts < 2 years
91
Q

Precautions of glucose gel

A

Nil

92
Q

Side effects of glucose Gel

A
  1. Nausea and/ or vomiting

2. Diarrhoea

93
Q

Presentation of glucose gel

A

Tube, 15g glucose

94
Q

What is the adult and Paediatric dose of PO oral glucose

A

15g, repeated once at 15mins if BGL <4.0 mmol/L. total max dose 30g.

95
Q

Indications for Glucose 10%

A

Symptomatic hypoglycaemia (with inability to self-administer oral glucose)

96
Q

Contraindications for glucose 10%

A

Nil

97
Q

Precautions for glucose 10%

A
  1. Hyperglycaemia
98
Q

Side effects for glucose 10%

A

Nil

99
Q

What is the presentation of 10% Glucose

A

Viaflex Plastic container, 250ml glucose 10% (25g)

100
Q

What is the adult dose of IV INF 10% Glucose for symptomatic hypoglycaemia

A

15g (150ml) repeated at 100ml (10g) boluses ever 5 mins until BGL > 4.0mmol/L.

101
Q

What is the Paed dose of IV INF 10% Glucose for Symptomatic Hypoglycaemia

A

0.25g/kg (2.5ml/kg), repeated at 1ml/kg (0.1g/kg) boluses every 5 minutes until BGL > 4.0mmol/L

102
Q

Indications of Midazolam

A
  1. Generalised Seizure / focal seizure (GSC = 12)

2. Sedation

103
Q

Contraindications of Midazolam

A
  1. KSAR or hypersensitivity to Midazolam
104
Q

Precautions of Midazolam

A
  1. Reduced dosages should be used in elderly pts, pts with chronic renal failure, congestive cardiac failure, or shock.
  2. Can cause sever respiratory depression
  3. Myasthenia gravis
  4. Multiple sclerosis
105
Q

Side effects of Midazolam

A
  1. Hypotension

2. Respiratory depression particularly when associated with other CNS depressants including alcohol and narcotics.

106
Q

What is presentation for Midazolam

A

Ampoule 5mg/1ml, Midazolam

107
Q

What is >70yo adult dose of IM/NAS Midazolam for generalised/focal seizures

A

2.5mg repeated every 10mins, total max dose 10mg.

108
Q

What is <70yo adult dose of IM/NAS Midazolam for generalised/focal seizures

A

5.0 mg repeated every 10mins, total max dose 20mg.

109
Q

What is the Paed dose of IM/NAS Midazolam for Generalise/focal seizures

A

200mcg/kg, single dose not to exceed 5mg. repeat at half initial does (max 2.5mg) at 10min intervals. Total max dose 10mg.

110
Q

Indications of morphine

A
  1. Significant pain
  2. Autonomic dysreflexia (with sys BP >160mmHg)
  3. Sedation for the maintenance of an established LMA/ETT
111
Q

Contraindications of Morphine

A
  1. KSAR or hypersensitivity to morphine

2. Renal failure

112
Q

Precautions of Morphine

A
  1. Elderly pts
  2. Hypotension
  3. Respiratory tract burns
  4. Respiratory depression and/or failure
  5. Known addition to narcotics
  6. Concurrent MOAI therapy
  7. Cardiac chest pain
113
Q

Side effects of Morphine

A
  1. Bradycardia
  2. Drowsiness
  3. Hypotension
  4. Nausea and/or vomiting
  5. Pin point pupils
  6. Respiratory depression
114
Q

What is the presentation of Morphine

A

Ampoule, 10mg/1mL Morphine

115
Q

What is the >70yo Adult dose of IM morphine for Significant pain

A

2.5-5mg repeated at up to 5 mg every 10mins, total max dose 10mg.

116
Q

What is the <70yo Adult dose of IM morphine for Significant pain

A

2.5-10mg, repeated at up to 5mg every 10mins. Total max dose 20mg.

117
Q

What is the >70yo Adult dose of IV morphine for Significant pain

A

2.5mg, repeated at up to 2.5mg every 5 mins, total max dose 10mg

118
Q

What is the <70yo Adult dose of IV morphine for Significant pain

A

2.5 - 5mg, repeated at up to 2.5mg every 5 mins, total max dose 20mg

119
Q

What is the >1 yo Paed dose of IM Morphine for Significant Pain or Autonomic Dysreflexia (with a significant BP >160mmHg)

A

100-200mcg/kg, single max dose 5mg. Total max dose 200mcg/kg.

120
Q

What is the < 1 yo Paed dose of IM Morphine for Significant Pain or Autonomic Dysreflexia (with a significant BP >160mmHg)

A

Need to contact the QCC advise line in all situations

121
Q

What is the >1 yo Paed dose of IV Morphine for Significant Pain or Autonomic Dysreflexia (with a significant BP >160mmHg)

A

100mcg/kg, single max dose 2.5mg, repeat at 50mcg/kg (max 2.5mg) at 5 min intervals. Total max dose 200mcg/kg.

122
Q

What is the < 1 yo Paed dose of IV Morphine for Significant Pain or Autonomic Dysreflexia (with a significant BP >160mmHg)

A

Need to contact the QCC advise line in all situations

123
Q

Indications for Naloxone

A
  1. Respiratory Depression (Secondary to the administration of narcotic drugs)
124
Q

Contraindications for Naloxone

A
  1. KSAR or hypersensitivity to naloxone
125
Q

Precautions for Naloxone

A
  1. Use with caution on pts with pre-existing cardiac disease
126
Q

Side effects for Naloxone

A
  1. Narcotic reversal can cause combativeness, vomiting, sweating, tachycardia and hypertension
  2. May produce acute withdrawal convulsions in the chronic narcotic user
  3. Pulmonary oedema
127
Q

What is the presentation of Naloxone

A

400mcg/1ml, Naloxone

128
Q

What is the adult dose of IM Naloxone for respiratory depression

A

1.6mg single dose only

129
Q

What is the Paed dose of IM Naloxone for respiratory depression

A

20mcg/kg, single dose only, not to exceed 800mcg

130
Q

Indications for Ondansetron

A
  1. Nausea and/OR vomiting

2. Prophylactic administration for pt presenting with ACS

131
Q

Contraindications for Ondansetron

A
  1. KSAR to ondansetron or other 5-HT3 receptor Antagonists
  2. Congenital long QT syndrome.
  3. Concurrent apomorphine (apamine agonist use in the treatment of parkinsonism) therpay.
  4. Pts < 3 years.
132
Q

Precautions of Ondansetron

A
  1. Hepatic impairment
  2. Intestinal obstruction
    Pts with risk factors for QT interval prolongation or cardiac arrhythmias.
133
Q

Side effects of Ondansetron

A
  1. Headache
  2. Constipation
  3. Sensation of warmth or flushing
  4. Dysrhythmias
134
Q

What is the presentation of Ondansetron

A

Ampoule, 4mg/2ml Ondansetron

135
Q

What is the adult dose of IM/IV Ondansetron for Nausea or Vomiting

A

4-8mg, total max dose 8mg

136
Q

What is the > 3 years Paed dose of IM/IV Ondansetron for Nausea and/or vomiting

A

100mcg/kg Single dose only, not to exceed 4mg (slow push over 2-3 mins for IV)

137
Q

Indications for Ipratropium bromide

A
  1. Moderate or Severe Bronchospasm
138
Q

Contraindications for Ipratropium bromide

A
  1. KSAR or hypersensitivity to Anticholinergics

2. Pts < 2 years

139
Q

Precautions for Ipratropium bromide

A
  1. Glaucoma
140
Q

Side effects for Ipratropium bromide

A
  1. Dilated pupils
  2. Dry mouth
  3. Palpitations
141
Q

What is the presentation of Ipratropium brominde?

A

Nebule, 250mcg/1mL

142
Q

What is the adult dose of NEB Ipratropium bromide for Moderate or Severe bronchospams

A

500mcg, single dose only

143
Q

What is the > 2 yo dose of NEB Ipratropium bromide

A

250mcg, single dose only.

144
Q

Indications for Ceftriaxone

A
  1. Suspected meningococcal septicaemia (with a non-blanching petechial and/or purpuric rash)
145
Q

Contraindications for Ceftriaxone

A
  1. KSAR or hypersensitivity to cephalosporin drugs
  2. Known Anaphylaxix or sever allergic reaction to penicillin based drugs (isolated minor drug rash attributed to penicillin dose not contraindicate the use of ceftriaxone)
146
Q

Precautions for Ceftriaxone

A
  1. Nil.
147
Q

Side effects for Ceftriaxone

A
  1. Nausea and/or vomiting

2. pain at the IM administration site.

148
Q

What is the presentation of Ceftriaxone?

A

Vile 1g ceftriaxone

149
Q

What is the adult dose of IM/IV Ceftriaxone for Suspected meningococcal septicaemia

A

1g, single dose only

150
Q

What is the IM preparation of Ceftriaxone?

A

Reconstitute 1g of Ceftriaxone with 3.6ml of water for injectino in a 10ml syringe. (250mg/1ml)

151
Q

What is the IV preparation of Ceftriaxone?

A

Reconstitute 1g or ceftriaxone with 9.6ml of water for injection in a 10ml syringe (100mg/1ml)

152
Q

What is the Paed dose of IM/IV Ceftriaxone?

A

50mg/kg rounded up to the nearest 5kg)

153
Q

Indications for Oxytocin

A
  1. Active management fo the thirds stage of labour (following confirmed deliver of all foetuses)
  2. Prevention and/or treatment of primary postpartum haemorrhage
154
Q

Contraindications for Oxytocin

A
  1. KSAR
  2. Pre-eclampsia
  3. Cord Prolapse
  4. Undelivered foetuses
155
Q

Precautions for Oxytoncin

A
  1. Myocardial ischemia

2. May potentiate hypotension when administered with analgesia

156
Q

Side effects for Oxytoncin

A
  1. Nausea and/or vomiting
  2. Headache
  3. Bradycardia
  4. Tachycardia
157
Q

Presentation of Oxytocin

A

Ampoule, 10 international units (IU)/1ml

158
Q

What is the adult dose of IM Oxytocin

A

10 IU, single dose only.

CSB331 OSCE (3 decks)

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