Drugs

Question 1

Ceftriaxone Indications

Answer 1

Suspected meningococcal septicaemia (with a non-blanching petechial AND/OR purpuric rash)

Question 2

Ceftriaxone contraindications

Answer 2

Allergy/adverse drug reaction

Known anaphylaxis or severe allergic reaction to penicillin based drugs

Patients less than 1 month (QAS consult)

Question 3

Ceftriaxone Adult dose IM

Answer 3

2g (2 x 1g IM injections)
Single dose only
Syringe prep: reconstitute two separate vials each containing 1 g of ceftriaxone with 2.6 mL of water for injection in a 3 ml syringe to achieve conc. of 1g/3mL

Question 4

Ceftriaxone Adult dose IV

Answer 4

2g over 20 minutes
Single dose only
Infusion prep: reconstitute 2 g of ceftriaxone with 19.2 mL of water for injection = concentration of 2g/20mL. Administer by SPRINGFUSER at a rate of 60mL/hr (over 20 mins)

Question 5

Ceftriaxone Paediatric dose IM

Answer 5

• all require QAS consult

50mg/kg (rounded to nearest5kg)
Total max dose 1g
Single dose only

Infusion prep: reconstitute 1 g of ceftriaxone with 2.6mL of water for injection. Withdraw the required dose into a 3mL syringe

ALL DOSES OVER 2mL are to be administered by two separate injections into alternate muscles

Question 6

Ceftriaxone Paediatric dose IV - greater than 20kg approx. older than 4 yrs)

Answer 6

50mg/kg (rounded up to the nearest 5kg)
Total max dose 2g
Single dose only
- Syringe prep: reconstitute 2g of ceftriaxone with 9.2ml of water for injection in a 30mL syringe. To achieve a conc. Of 200mg/mL (2g/10mL). Leave the excess in the vial.

Question 7

Droperidol indications

Answer 7

Acute behavioural disturbances (with a sat score > or equal to 2)

Question 8

Droperidol contraindications

Answer 8

Absolute 
allergy/adverse drug reaction 
Parkinson’s disease
Previous dystonic reaction to droperidol
Pateints <8yrs 

Relative
- Suspected sepsis

Question 9

Droperidol adult dose IM or IV

Consultation required for > 65 years OR 13-15 years

Answer 9

> 65 = 5mg. Repeated once at 15min prn, total max 10mg

16 to 65 years = 10mg. repeated once at 15min prn, total max 20mg

13 – 15years = 0.1 to 0.2mg/kg single max 10mg, repeated once at 15 min prn, total max 20mg

Question 10

Droperidol Paediatric dose IM or IV

Consult required

Answer 10

8 – 12 years
0.1 to 0.2mg/kg
single max 10mg
repeated once at 15 min prn. Total max 20mg

Question 11

Midazolam Indications

Answer 11

Generalised seizures/focal seizures (GCS < or equal to 12)

Question 12

Midazolam contraindications

Answer 12

Allergy or adverse drug reaction

Question 13

Midazolam Adult dose IV

Answer 13

70 yrs or older
2.5mg. Repeated 5 mins. Total max dose 10mg

< 70yrs
5mg. Repeated 5 mins. Total max dose 20mg

Question 14

Midazolam Adult dose IM or NAS

Answer 14

70 yrs or older
2.5mg. Repeated 10 mins. Total max dose 10mg

< 70yrs
5mg. Repeated 10 mins. Total max dose 20mg

Question 15

Midazolam Paediatric dose NAS or IM

Answer 15

200 microg/kg. single dose not to exceed 5mg
Repeated at half the initial dose (max 2.5mg) at 10 mins
Total max dose 10mg

Question 16

Glucose 10% Indications and contraindications

Answer 16

Indications = Symptomatic hypoglycaemia

Contraindications = NILL

Question 17

Glucose 10% Adult dose

Answer 17

IV
15g (150mL)
Repeated once at 100mL (10g) every 5 mins until BGL >4 mmol/L

Question 18

Glucose 10% Paediatric dose

Answer 18

IV
0.25 g/ kg (2.5mL/kg)
Repeated at 1mL/kg every 5 mins until BGL = >4.0 mmol/L

Question 19

Glucose gel indications

Answer 19

Symptomatic hypoglycaemia

Question 20

Glucose gel contraindications

Answer 20

Unconsciousness

Patients with difficulty swallowing

Patients <2yrs

Question 21

Glucose gel adult dose

Answer 21

15g
Repeated once if BGL <4.0 mmol/L
Total max dose 30g

Question 22

Glucose gel Paediatric dose

Answer 22

> or equal to 2 yrs = 15 g
Repeated once at 15 mins if BGL <4 mmol/L
Total max dose 30g

Question 23

Glucagon indications

Answer 23

Symptomatic hypoglycaemia

Refractory anaphylaxis (unresponsive to 3 x IM adrenaline and fluid resus)

Question 24

Glucagon contraindications

Answer 24

allergy/adverse drug reaction

Question 25

Glucagon syringe preparations

Answer 25

>25kg and adults = reconstitute 1mg of glucagon with 1mL of water for injection in a 3mL syringe Less than or equal to 25kg = reconstitute 1mg of glucagon with 2mL of water for injection in a 3mL syringe to achieve a final conc. Of 1mg/2mL. Decant 1mL for 0.5mg/1mL

Question 26

Glucagon adult dose for symptomatic hypoglycaemia

Answer 26

IM | 1mg single dose only

Question 27

Glucagon paediatric dose for symptomatic hypoglycaemia

Answer 27

IM >25kg = 1mg single dose only < or equal 25kg = 0.5mg single dose only

Question 28

Glucagon adult dose for refractory anaphylaxis

Answer 28

IV (or IM if paramedics unable to achieve IV access) | 1mg single dose only

Question 29

Glucagon paediatric dose for refractory anaphylaxis

Answer 29

IV (or IM if paramedics unable to achieve IV access) >25kg = 1mg single dose only < or equal 25kg = 0.5mg single dose only

Question 30

Adrenaline Indications

Answer 30

Cardiac arrest Anaphylaxis OR severe allergic reaction Severe life-threatening bronchospasm OR silent chest

Question 31

Adrenaline contraindications

Answer 31

NONE

Question 32

Adrenaline adult dose cardiac arrest

Answer 32

Adult dose = IV 1mg repeated 3-5 min intervals No max dose

Question 33

Adrenaline adult dose anaphylaxis

Answer 33

IM = 500microg (300 if known pregnancy) repeated 5 mins. No max dose NEB = 5mg Single dose only (only to be administered after IM)

Question 34

Adrenaline paediatric dose anaphylaxis

Answer 34

``` IM 6 yrs or older = 300 microg 6-1yr = 150 microg 6 months – 1yr =100 microg < 6 moths = 50 microg ALL repeated at 5 mins. No max dose NEB = 5mg Single dose only (only to be administered after IM) ```

Question 35

Adrenaline adult dose bronchospasm or silent chest

Answer 35

IM = 500microg (300 if known pregnancy) repeated 5 mins. No max dose

Question 36

Adrenaline paediatric dose bronchospasm or silent chest

Answer 36

``` IM 6 yrs or older = 300 microg 6-1yr = 150 microg 6 months – 1yr =100 microg < 6 moths = 50 microg ALL repeated at 5 mins. No max dose ```

Question 37

Salbutamol indications

Answer 37

Bronchospasm Suspected hyperkalaemia (with QRS widening AND/OR AV dissociation) – CCP NEEDED

Question 38

Salbutamol contraindications

Answer 38

Allergy and/or adverse drug reaction | Patients <1yr

Question 39

Salbutamol adult dose

Answer 39

MDI 12 (1.2) MDI inhalations Repeat at 10 mins No max dose NEB 5mg repeat PRN No max dose

Question 40

Salbutamol paediatric dose MDI

Answer 40

1-5 yrs = 6 (600) microg MDI inhalations. Repeated 10 mins. No max dose > or equal to 6 years = 12 (1.2mg) MDI inhalations. Repeated at 10 mins. No max dose

Question 41

Salbutamol paediatric dose NEB

Answer 41

1-5yrs = 2.5 mg. repeated PRN. No max dose > or equal to 6 yrs = 5mg. Repeated PRN. No max dose

Question 42

Ipratropium bromide Indications

Answer 42

``` Moderate bronchospasm (unresponsive to QAS salbutamol NEB) Severe bronchospasm ```

Question 43

Ipratropium bromide contraindications

Answer 43

Allergy or adverse drug reaction | Patients < 1yr

Question 44

Ipratropium bromide adult dose

Answer 44

NEB 500 microg. Repeated 20 mins Total max dose = 1.5 mg

Question 45

Ipratropium bromide Paediatric dose

Answer 45

NEB 6 yrs or older = 500 microg. Repeated 20 mins. Total max dose = 1.5 mg 1-5yrs = 250 microg. Repeated 20 min intervals. Total max dose = 750 microg