Drugs Flashcards
Morphine Contraindications
Known hypersensitivity, Late second stage labor and renal impairment/failure.
Morphine Pre cautions
Elderly and frail patients, hypotension, respiratory depression, current asthma, respiratory tract burns, known opioid addiction, acute alcoholism, Pts. on MAO’s.
Morphine dosage
Pain: up to 5mg IV repeat @ 5/60 max. 20 mg
Adrenaline Contraindications
Hypovolaemic shock without adequate fluid replacement.
Adrenaline Precautions
Elderly/frail pts., pts with cardiovascular disease, pts on MAO inhibitors,
Adrenaline Side effects
Sinus tachycardia, supra-ventricular arrhythmia, ventricular arrhythmia’s, hypertension, pupillary dilation, may increase size of MI, feeling of anxiety/palpitations in the conscious patient.
Adrenaline pharmacology
Beta 1 effects:
Increases HR by increasing SA node firing rate, increased conduction velocity through AV node, Increased myocardial contractility, increases irritability of ventricles.
Beta 2: bronchodilation
Alpha: peripheral vasoconstriction
Aspirin contraindications
Hypersensitivity, actively bleeding peptic ulcers, bleeding disorders, suspected dissection aortic aneurism, chest pain associated with psychostimulant OD if BP >160
Aspirin Precaution
Peptic ulcer, asthma, pts on anticoagulants.
Aspirin side effects
Heartburn, nausea, GI bleeding, increased bleeding time, hypersensitivity reactions.
Ceftriaxone Indication
Suspected meningococcal septicaemia: Adult dose - 1 g IV diluted to 10 mL with water for injection. 1g IM to 4mL with 1% Lignocaine.
Ceftriaxone Contraindications
Allergy to cephalosporin antibiotics
Ceftriaxone Precaution
Allergy to penicillin antibiotics
Ceftriaxone Side effects
Nausea and vomiting, skin rash.
Dexamethasone Indication
Bronchospasm w/ actute resp. distress unresponsive to neb. salbutamol, moderate to severe croup and acute exacerbation of COPD
Dexamethsone Contra’s and Precautions
Contra: known hypersensitivity.
Precaution: solutions which are not clear or are contaminated should be discarded.
Fentanyl Indication
Analgesia: IN 200 mcg repeat 50 mcg IN @ 5/60 (max. 400)
frail half initial dose.
IV: 50 mcg IV repeat 50 mcg @ 5/60 max. 200
CPR interfering pt.
25 mcg IV repeat 3-5 minutes
Fentanyl contra’s
hypersensitivity, late second stage labour.
Fentanyl precautions
elderly/frail pts., impaired hepatic function, respiratory depression, current asthma, pt. on MAO inhibitors, known addiction to opioids, facial trauma IN route.
Fentanyl side effects
respiratory depression, apnoea, rigidity of diaphragm/intercostals, bradycardia.
Glucagon
Indication: Diabetic hypoglycaemia adult dose 1 IU IM.
Contra’s: nil of significance
Precaution: nil of significance
side effects: nausea and vomiting rare
Glyceryl Trinitrate indication
Chest pain with ACS (300 mcg S/L), acute LVF, hypertension with ACS, autonomic dysreflexia, and preterm labour (consult).
Glyceryl Trinitrate contra’s
hypersensitivity, SBP<110 (tablet), SBP<90 (patch), Sildenafil/vardenfil in last 24hours or Tadalafil in last 4 days, HR >150, HR <50, VT, inferior STEMI with SBP <160 mmHg and right ventricular infarction.
Glyceryl Trinitrate Precautions
No previous administration, elderly Pts, recent MI and concurrent use with other tocolytics.
Glyceryl Trinitrate side effects
tachycardia, hypotension, headache, skin flushing (uncommon) and bradycardia (occasionally)
Ketamine Indications
RSI adult doses 1.5 mg/kg IV (max 200mg)
Extreme traumatic pain refractory to opioid analgesia, extreme agitation, CPR interfering patient.
Ketamine Contra
Known hypersensitivity, severe hypertension (SBP>180)
Ketamine precautions
any condition where significant elevation of BP would be hazardous e.g. hypertension, CVA, recent AMI and CCF.
Admin. for analgesia to be injected slowly over 1 minute.
Methoxyflurane indication
pain relief 3 mL via penthrox inhaler.
Methoxyflurane contra’s
pre-existing renal disease, tetracycline antibiotics, >6mL in 24 hours, personal or family Hx of malignant hyperthermia, muscular dystrophy.
Methoxyflurane precautions
must self-administered, pre-eclampsia and use with oxytocin may cause hypotension.
Methoxyflurane side effects
drowsiness, decrease in BP and HR (rare), renal toxicity.
Midazolam Indications
Generalised convulsive status epilepticus, 10 mg IM repeat 10 mg IM @ 10 minutes.
Also used for RSI
Midazolam contra’s
known hypersensitivity
Midazolam precautions
reduced doses may be required for elderly, chronic renal failure, CCF or shock., the CNS depressant effects of benzo’s are enhanced in the presence of narcotics and other tranquilisers including alcohol, can cause severe resp. depression in pts with COPD, pts. with myasthenia.
Midazolam side effects
Loss of airway control, resp. depression, hypotension, depressed level of consciousness
Naloxone indication
Opioid drug overdose: 1.6-2 mg IM heroin, 100 mcg IV other opioid.
Naloxone contra’s and precautions
Contra’s: nil of significance.
Precautions: prepare for combative pt., should not be administered to newborns.
Ondansetron indication
Nausea and vomiting, vestibular nausea, prophylaxis.
Ondansetron contra’s
hypersensitivity, concurrent apomorphine use, long QT syndrome, hypokalaemia or hypomagnesamia
Ondansetron precautions
pts with liver disease whould not receive >8mg/day, care should be taken with pts. on diuretics, PKU, concurrent use of tramadol, pregnancy.
Paracetamol indication
mild pain, headache.
1000 mg oral
Paracetamol contraindications
hypersensitivity, children < 1 month, paracetamol administerd in the past 4 hours, total paracetamol intake within last 24 hours excessing 4 g (adults) or 60mg/kg, suspected ischaemia chest pain.
Paracetamol precautions
impaired, hepatic function, elderly/frail, malnourished
Salbutamol indication
Resp distress with suspected bronchospasm:
asthma, severe allergic reactions, COPD, smoke inhalation, oleoresin capsicum spray.
Salbutamol contra’s
nil of significance
Salbutamol precautions
large doses of salbutamol have been reported to cause intracellular metabolic acidosis
Salbutamol effects
sinus tachycardia, muscle tremor (common)
