DTPs Flashcards
Oxygen Drug Class, Pharmacology, and Metabolism
Drug Class: Gas
Pharmacology: A colourless, odourless gas essential for the production of cellular energy
Metabolism: N/A
Oxygen Indications, Contraindications, and Precautions
Indications:
- A wide range of conditions resulting in, or potentially resulting in systemic and/or localised hypoxia
Contraindication:
- Known paraquat poisoning with SpO2 equal to or greater than 88%
- History of bleomycin therapy with SpO2 equal to or greater than 88%
Complications:
- Patients with paraquat poisoning or bleomycin lung injury may be harmed by supplemental oxygen. Avoid unless the patient is hypoxaemic.
- Prolonged administration to premature neonates
- Newly born neonates will have low SpO2 for the first 10 mins after birth
- Patients with cyanotic heart disease may have saturation targets between 75% to 85%
- A BVM will not supply adequate oxygen unless IPPV is provided
- The use of high flow oxygen in an attempt to protect against subsequent hypoxaemia in the event of determination has the potential to delay the recognition of such determination (may provide false reassurance that patient is stable)
Oxygen Side Effects
- Hypoventilation in some COPD patients with hypoxic drive
- Drying of airway mucous membranes
Oxygen Presentation and Schedule
Oxygen Onset, Duration, and Half-life
Oxygen Routes of Administration
Oxygen Special Notes
Oxygen Dosages
Methoxyflurane Drug Class, Pharmacology, and Metabolism
Drug class: Analgesic (at low dosages)
Pharmacology: Methoxyflurane is volatile, self-administered inhalation analgesic indicated for short term pain relief. Methoxyflurane is more susceptible to metabolism and has a greater propensity to diffuse into fatty tissue
Metabolism: By the liver and excreted mainly by the lungs
Methoxyflurane Indications, Contraindications, and Precautions
Indications:
- Pain
Contraindications:
- Allergy and/or adverse drug reaction
- Patients <1 year
- History of significant liver or renal disease
- History of malignant hyperthermia
Precautions:
- ALOC
- Intoxicated or drug affected patients
Methoxyflurane Presentation and Schedule
Presentation: Bottle, 3mL methoxyflurane
Schedule: S4 (Restricted Drugs)
Methoxyflurane Onset, Duration, and Half-life
Onset: 1-3 mins
Duration: 5-10 mins
Half-life: Not available
Methoxyflurane Side Effects
ALOC, cough, renal/hepatic failure (following repeated high dose exposure)
Methoxyflurane Routes of Administration
Inhalation (INH)
Methoxyflurane Dosages
Adults: 3mL, repeated once after 20 mins, (total max dose is 6mL0
Paediatric (1yo or older): 3mL, single dose only
Ibuprofen Drug Class, Pharmacology, and Metabolism
Drug Class: Non-steroidal anti-inflammatory drug (NSAID)
Pharmacology: Ibuprofen is a non-selective NSAID that inhibits the synthesis of prostaglandins resulting in analgesic, antipyretic, and anti-inflammatory actions
Metabolism: metabolised by the liver and excreted mainly by the kidneys
Ibuprofen Indications, Contraindications, and Precautions
Indications:
- Moderate pain due to acute inflammation / tissue injury
Contraindications:
- Allergy and/or adverse drug reaction to any NSAID or aspirin
- Concomitant NSAID therapy
- Current GI bleeding or peptic ulcers
- Dehydration and/or hypovolemia
- Renal impairment
- NSAID induced asthma
- Heart failure
- Pregnancy
- Angiotensin-converting enzyme (ACE) inhibitor OR Angiotensin II receptor blocker (ARB) therapy
- Paediatric patients <13yo
- Geriatric patients >64yo
- Patients taking anticoagulant medications
- Diuretic Treatment
Precautions:
- Asthma
- Hepatic dysfunction
- History of GI bleeding or peptic ulcers
Ibuprofen Side Effects
Nausea, dyspepsia, GI bleeding, dizziness
Ibuprofen Presentation and Schedule
Presentation: tablet, 200mg ibuprofen
Schedule: S2 (therapeutic poisons)
Ibuprofen Onset, Duration, and Half-life
Onset: About 15mins
Duration: 4-6 hours
Half-life: 2 hours
Ibuprofen Onset, Duration, and Half-life
Onset: About 15mins
Duration: 4-6 hours
Half-life: 2 hours
Ibuprofen Routes of Administration
Per Oral (PO)
Ibuprofen Adult Dosages
200-400mg, must not be administered within 6 hours of previous ibuprofen administration
Ibuprofen Adult Dosages
Adult: 200-400mg, must not be administered within 6 hours of previous ibuprofen administration
Paediatric: QAS officers are not authorised to administer ibuprofen to paediatric patients
Paracetamol Drug Class, Pharmacology, and Metabolism
Drug Class: Analgesic, Antipyretic
Pharmacology: Paracetamol is a p-aminophenol derivative that exhibits analgesic and antipyretic activity. It does not possess significant anti-inflammatory activity.
Metabolism: By the liver, excreted by the kidneys
Paracetamol Indications, Contraindications, and Precautions
Indications:
- Mild to moderate pain
- Fever (causing distress)
Contraindications:
- Allergy and/or adverse rug reaction
- Patients less than one month old
Precautions:
- Hepatic dysfunction
- Soluble tablets
Paracetamol Side Effects
Nausea
Paracetamol Presentation and Schedule
Presentation:
- Tablet, 500mg paracetamol
- Elixir, 120mg/5mL paracetamol
- Soluble tablet, 250mg paracetamol
Schedule: S2 (therapeutic poisons)
Paracetamol Onset, Duration, and Half-life
Onset: 10-60mins
Duration: 4 hours
Half-life: Approximately 2 hours
Paracetamol Routes of Administration
Per oral (PO)
Paracetamol Dosages
Adult (tablet): 0.5g-1g, must not be administered within 4 hours of previous paracetamol administration, repeated every four hours, max dose in 24h is 4g
Paediatrics (elixir): children greater than or equal to one month old, 15mg/kg, single dose only, not within 4 hours of previous administrations
Paediatrics (soluble tablets): greater than or equal to 7 years, 15mg/kg, single dose only, not within 4 hours of previous administrations
Ondansetron Drug Class, Pharmacology, Metabolism
Drug Class: anti-ematic - 5-HT3 antagonist
Pharmacology: Ondansetron is a serotonin 5-HT3 antagonist. It works by blocking the action of seratonin, a natural substance that may cause nausea and vomiting
Metabolism: the majority of the circulation ondansetron is metabolised by the liver and excreted through the kidneys
Ondansetron Indications, Contraindications and Precautions
Indications:
- Significant nausea and/or vomiting
Contraindications:
- Allergy and/or adverse drug reaction
- Congenital long QT syndrome
- Current apomorphine therapy (used in severe Parkinson’s disease)
- Patients less than 2 years old
Precautions:
- Hepatic Impairment
- Elderly Patients
- Intestinal obstruction
- Patients with risk factors for QT interval prolongation or cardiac arrhythmias
- First trimester pregnancy (may only be administered for extreme and uncontrolled hyperemesis)
Ondansetron Adverse events
Common (>1%):
- Headache
- Constipation
Rare (<0.1%):
- Hypersensitivity reactions (including anaphylaxis)
- ECG Changes
Ondansetron Presentation and Schedule
Presentation:
- Ampoule: 4mg/2mL ondansetron
- Orally disintegrating tablet (ODT): 4mg ondansetron
Schedule:
- S4 (Restricted drugs)
Ondansetron Onset, Duration, and Half-life
Onset: 5 mins
Duration: several hours
Half-life: 3-4 hours
Ondansetron Routes of Administration
Per oral, IM, IV
Ondansetron Dosages
Adults: (PO/IM) 4-8mg, total max dose is 8mg
Paediatrics:
- PO: 2-4 years: 2mg, >5 years: 4mg
- IM: >2 years: 100microg/kg (rounded up to nearest 5kg)
Hydrocortisone Indications, Contraindications, and Precautions
Indications:
- Asthma (excluding mild)
- Acute exacerbation of COPD (with evidence of respiratory distress)
- Refractory anaphylaxis with persistent wheeze (and unresponsive to 3x IM adrenaline (epinephrine)
- Symptomatic adrenal insufficiency (with known history of Addison’s disease, congenital adrenal hyperplasia, pan-hypopituitarism or long term steroidadministration)
Contraindications:
- Allergy and/or adverse drug reaction
Precautions
- Hypertensive
Hydrocortisone Drug Class, Pharmacology, and Metabolism
Drug class: Corticosteroid
Pharmacology: Hydrocortisone is an adrenocorticoid steroid with multiple mechanisms of action including anti-inflammatory activity, immunosuppressive properties and anti-proliferative actions
Metabolism: Hepatic metabolism, renal excretion
Hydrocortisone Side Effects
nil