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CP1 Pharmacology > EMT Drugs > Flashcards

EMT Drugs Flashcards

1
Q

Paracetamol MOA

A

Inhibits production of prostaglandins resulting in reduction in pain and fever

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2
Q

Paracetamol Onset and Duration

A

30-60 mins to kick in
Lasts 4-6 hours

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3
Q

Paracetamol Usual Preparation

A

500mg tablets
50mg/ml syrup

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4
Q

Paracetamol Indications

A

-Mild or moderate pain
-Moderate to severe pain, in addition to other medicines

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5
Q

Paracetamol Contraindications

A

Known severe allergy

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6
Q

Paracetamol Cautions

A

-Taken in the last 4 hours
-Abdominal pain, particularly if unwell or vomiting
-Known severe liver disease

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7
Q

Paracetamol Dosage

A

1.5g for adult greater than 80kg
1g for adult less than or equal to 80kg

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8
Q

Paracetamol Common Adverse Effects

A

None

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9
Q

Paracetamol Administration

A

PO (with water)
Syrup

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10
Q

Ibuprofen MOA

A

-NSAID predominantly used for treating pain
-Inhibits activity of enzyme prostaglandin synthetase, reducing prostaglandin production and causing a reduction in pain, inflammation and fever.

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11
Q

Ibuprofen Onset and Duration

A

30-60mins to kick in
Lasts 4-6 hours

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12
Q

Ibuprofen Usual Preparation

A

200mg tablets
20mg/ml syrup

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13
Q

Ibuprofen Indications

A

-Mild to moderate pain, usually in combination with paracetamol
-Moderate to severe pain, usually in combination with other medicines

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14
Q

Ibuprofen Contraindications

A

-Known severe allergy
-Pregnancy
-Presence of sepsis, dehydration, shock or clinically significant bleeding
-Known worsening of bronchospasm with NSAIDs

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15
Q

Ibuprofen Cautions:

A

-Taken in the last 4 hours
-Abdominal pain, particularly if unwell or vomiting
-Age greater than/equal to 75, particularly if frail

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16
Q

Ibuprofen Dosage

A

600mg for adult greater than 80kg
400mg for adult less than/equal to 80kg

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17
Q

Ibuprofen Common Adverse Effects

A

-Increased bleeding
-Renal impairment
-Indigestion, GI ulceration and GI bleeding associated with long-term administration

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18
Q

Ibuprofen Administration

A

PO (with water)
Syrup

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19
Q

Methoxyflurane MOA

A

Inhalational analgesic. The MOA is not clear.

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20
Q

Methoxyflurane Onset and Duration

A

1-2 mins to kick in
Lasts 2-5 mins after stopping administration

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21
Q

Methoxyflurane Indications

A

-Moderate to severe pain, particularly when there will be a significant delay in an opiate being administered

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22
Q

Methoxyflurane Contraindications

A

-Known severe allergy
-Personal or family history of malignant hyperthermia
-Known renal impairment
-Had in the last week

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23
Q

Methoxyflurane Cautions

A

-Age greater than or equal to 75, particularly if frail
-Pre-eclampsia
-Administration in a confined space
-Acute exacerbation of chronic pain

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24
Q

Methoxyflurane Dose

A

Maximum 6ml (two doses) for pt aged greater than or equal to 12

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25
Methoxyflurane Usual Preparation
3ml ampoules with whistle
26
Methoxyflurane Common Adverse Effects
-Sedation -Light headed -Taste*
27
Methoxyflurane Administration
-Pour into top and swirl around -If runs out and needs more, can top up with second dose -Deep breaths in and out of opening as much as needed -Can cover hole for better effect
28
GTN MOA
-Vasodilator, acts on vascular smooth muscle, causing venous and arterial vasodilation, with the predominant effect being on veins. -MOA not clear but results in formation of nitric oxide (vasodilator). GTN causes: -Decrease in venous return (preload) to heart causes decreased ventricular filling and cardiac output causing decreased myocardial oxygen demand -Arterial dilation decreases peripheral resistance (afterload) causing decreased force L ventricle must overcome to eject blood into arteries, decreasing myocardial oxygen demand -Dilation of coronary arteries which may increase coronary blood supply
29
GTN Onset and Duration
1-2mins to kick in Lasts 15-30 mins
30
GTN Usual Preparation
Metered Dose bottle delivering 0.4mg doses
31
GTN Indications
-Myocardial Ischaemia -Cardiogenic Pulmonary Oedema -Control of hypertension associated with autonomic dysreflexia -Control of hypertension (usually in conjunction with labetalol) prior to fibrinolytic treatment for STEMI -Control of hypertension (usually in conjunction with labetalol) during inter-hospital transfer for STEMI -STEMI
32
GTN Contraindications
-Known severe allergy -Systolic BP less than 110mmHg -HR less than 40/min -Heart rate greater than 150/min -Ventricular Tachycardia
33
GTN Cautions
-STEMI, particularly if involving R ventricle -The pt is frail -Signs of shock -Dysrhythmia -Has taken a phosphodiesterase inhibitor in the last 24 hours -Known aortic or mitral stenosis
34
GTN Dosage
-Myocardial ischaemia - 0.4mg ever 5 mins, consider increasing dosing interval to 10 mins if caution present -STEMI - 0.4mg with caution. Withhold if signs of poor perfusion present -CPO - 0.8mg every 5 mins, consider increasing dosing interval to 10 mins if caution present. Increase dose and frequency if pt not improving. -Control of HTN - 0.4mg every 5 mins
35
GTN Common Adverse Effects
-Hypotension -Flushing -Headache -Tachycardia -Feeling light headed
36
GTN Administration
Spray under tongue, if not possible, into mouth. Pt should be lying flat if caution present
37
Aspirin MOA
-Antiplatelet, antipyretic, anti-inflammatory and analgesic effects -Administered for anti-platelet activity -Inhibits enzyme cyclooxygenase which reduces formation of prostaglandins and thromboxane
38
Aspirin Onset and Duration
30-60 mins to kick in Lasts 3-5 days (anti-platelet activity)
39
Aspirin Usual Preparation
300mg tablets
40
Aspirin Dosage
300mg (one tablet)
41
Aspirin Common Adverse Effects
-Increased bleeding -Although indigestion, GI ulceration/bleeding are commonly listed here, only associated with long-term administration
42
Aspirin Indications
-Myocardial ischaemia -STEMI
43
Aspirin Contraindications
-Known severe allergy -Third trimester pregnancy
44
Aspirin Cautions
-Known bleeding disorder -Clinically significant bleeding -Known worsening of bronchospasm with NSAIDs
45
Aspirin Administration
PO - get pt to chew tablet/dissolve it in water
46
Adrenaline MOA
-Alpha 1 stimulation: smooth muscle contraction, vasoconstriction of blood vessels and stimulation of glycogenolysis and gluconeogenesis -Beta 1 stimulation: increase in cardiac contractility, increase in HR, increase in the speed of electrical conduction within the heart -Beta 2 stimulation: smooth muscle relaxation, skeletal muscle vasodilation, bronchodilation, stabilisation of mast cell membranes which reduces histamine release
47
Adrenaline Onset and Duration
-IM: 2-5 mins to kick in -Nebulised, topical and IN: on contact -Cardiovascular effects last 5-15 mins. Mast cell membrane effects may last for several hours.
48
Adrenaline Usual Preparation
Ampoule with 1mg/ml
49
Adrenaline Indications
-Anaphylaxis -Severe asthma -Stridor causing moderate or severe respiratory distress -IN for clinically significant epistaxis -Topical for clinically significant bleeding from a wound
50
Adrenaline Contraindications
Nil
51
Adrenaline Cautions
-Myocardial ischaemia -Tachdysrhythmias
52
Adrenaline Dosage
-Anaphylaxis systemic signs: 0.5mg IM - repeat every 10 mins if pt not improving or 5 mins if pt deteriorating -Asthma if not improving with nebs - 0.5mg IM Stridor with moderate/severe respiratory distress - 5mg nebuliser - repeat as required every 10 mins (8L/min) IN: 0.2mg (2ml of 1:10,000) per bleeding nostril Topical: depends on wound size but dilute as above
53
Adrenaline Common Adverse Effects
-Tachycardia -Tachdysrhythmia -Myocardial ischaemia -Ventricular ectopy -Hypertension -Nausea and vomiting -Tremor, anxiety and sweating -Hyperglycaemia
54
Adrenaline Administration
-IM: undiluted -Nebulised: undiluted -IN: dilute each mg to a total of 10ml. Use mucosal atomising device and direct pressure -Topical: dilute as above. Apply topically with direct pressure
55
Salbutamol MOA
Bronchodilator that stimulates beta-2 receptors
56
Salbutamol Onset and Duration
2-5 mins to kick in Lasts 1-2 hours
57
Salbutamol Usual Preparation
Ampoules either 5mg in 2.5ml or 2.5mg in 2.5ml
58
Salbutamol Indications
-Bronchospasm secondary to asthma or COPD -Prominent bronchospasm secondary to airway burns, smoke inhalation or chest infection -Release syndrome following crush injury -Known or suspected hyperkalaemia with ECG changes
59
Salbutamol Contraindications
Known severe allergy
60
Salbutamol Cautions
Nil
61
Salbutamol Dosage
-MDI: one puff into MDI and spacer, followed by six breaths. Repeat 6x -Nebulised for bronchospasm: 5mg, repeated as required (initial dose with 0.5mg ipratropium) -Nebulised for release syndrome following crush injury or known/suspected hyperkalaemia: 5mg, repeat as required
62
Salbutamol Common Adverse Effects
-Tremor -Tachycardia
63
Salbutamol Administration
-MDI: 1 puff, six breaths (x6) -Nebulised: administer undiluted using air as driving gas for COPD and O2 as driving gas for all other indications (8L/min)
64
Ipratropium MOA
-Bronchodilator. Anticholinergic agent with predominantly antimuscarinic activity -Blocks acetylcholine receptors, causing vagal inhibition which causes bronchodilation
65
Ipratropium Onset and Duration
2-5 mins to kick in Lasts 6 hours
66
Ipratropium Usual Preparation
0.5mg in 2ml ampoule
67
Ipratropium Indications
-Bronchospasm secondary to asthma or COPD -Bronchospasm secondary to airway burns, smoke inhalation or chest infection
68
Ipratropium Contraindications
Known severe allergy
69
Ipratropium Cautions
Nil
70
Ipratropium Dosage
0.5mg once only
71
Ipratropium Common Adverse Effects
-Tachycardia -Dry mouth -Blurred vision (usually only with repeated doses)
72
Ipratropium Administration
Administer nebuliser undiluted (in combination with salbutamol) using air as driving gas for COPD and oxygen as driving gas for asthma (8L/min)
73
Glucose Gel MOA
Provides a source of glucose that can be easily swallowed and rapidly absorbed
74
Glucose Gel Onset and Duration
5-10 mins to kick in Lasts 30-60 mins
75
Glucose Gel Usual Preparation
Sachet containing 10-20g glucose
76
Glucose Gel Dosage
10-20g. Administer 1 sachet and repeat every 10 mins if hypoglycaemia persists or recurs
77
Glucose Gel Common Adverse Effects
None
78
Glucose Gel Indications
-Hypoglycaemia in adults and children provided the pt is conscious enough to be able to swallow safely -Hypoglycaemia in neonates
79
Glucose Gel Contraindications
Nil
80
Glucose Gel Cautions
Nil
81
Glucose Gel Administration
PO
82
Prednisone MOA
-Prodrug that is metabolised to prednisolone in the liver. -Corticosteroid with anti-inflammatory and immunosuppressant actions -Inhibits production of inflammatory mediators, causing a decrease in inflammatory and immune response
83
Prednisone Onset and Duration
30-60 mins to kick in Lasts 24 hours
84
Prednisone Usual Preparation
5mg or 20mg tablets Syrup 5mg/ml
85
Prednisone Dosage
-40mg (two tablets) -If taking prednisone already: if less than 40mg, give full dose and have treatment revised by GP within 2 days. If more than or equal to 40mg, do not administer, advise to take usual amount and have treatment revised by GP within 2 days
86
Prednisone Common Adverse Effects
-Fatigue -Sodium and water retention (may worsen HTN and HF with prolonged dosing) -Gastrointestinal reflux
87
Prednisone Indications
-Bronchospasm associated with asthma or COPD -Croup -Prominent rash associated with anaphylaxis, provided all systemic signs of anaphylaxis have resolved -Minor allergy associated with rash
88
Prednisone Contraindications
Known severe allergy
89
Prednisone Cautions
Age less than five years with asthma
90
Prednisone Administration
PO (with water) Syrup
91
Glucagon MOA
Increases BGL by stimulating glycogenolysis (breakdown of glycogen into glucose), predominantly within the liver
92
Glucagon Onset and Duration
5-10 mins to kick in Lasts 15-60 minutes
93
Glucagon Usual Preparation
1mg powder
94
Glucagon Dosage
1mg IM once
95
Glucagon Common Adverse Effects
None
96
Glucagon Indications
Hypoglycaemia when the pt cannot safely swallow glucose/food and IV access cannot be obtained
97
Glucagon Contraindications
Known severe allergy
98
Glucagon Cautions
Nil
99
Glucagon Administration
Dissolve powder using syringe and administer IM
100
Ondansetron MOA
Antiemetic. Blocks serotonin receptors centrally in the brain and peripherally in the GI tract, resulting in a reduction of nausea and vomiting
101
Ondansetron Onset and Duration
5-10 mins to kick in Lasts 4-8 hours
102
Ondansetron Usual Preparation
Ampoule of 4mg/2ml or 8mg/4ml
103
Ondansetron Dosage
4mg IM, may be repeated once after 20 mins if required
104
Ondansetron Common Adverse Effects
-Headache -Flushing
105
Ondansetron Indications
Clinically significant nausea and/or vomiting
106
Ondansetron Contraindications
-Known severe allergy -Age less than one year -Suspected serotonin syndrome
107
Ondansetron Cautions
Nil
108
Ondansetron Administration
IM undiluted
109
Loratadine MOA
-Non-sedating antihistamine -Antagonises (blocks) peripheral histamine receptors, blocking the action of histamine and reducing itching and redness
110
Loratadine Onset and Duration
-30-60 mins to kick in Lasts 12-24 hours
111
Loratadine Usual Preparation
10mg tablets
112
Loratadine Dosage
10mg
113
Loratadine Common Adverse Effects
None
114
Loratadine Indications
-Minor allergic reactions confined to skin involvement -Prominent itch associated with anaphylaxis, provided all systemic signs of anaphylaxis have resolved
115
Loratadine Contraindications
-Known severe allergy -Age less than one year
116
Loratadine Cautions
Pregnancy
117
Loratadine administration
PO (with water)
118
Oxygen MOA
-Treatment for hypoxia -High concentrations of oxygen can cause oxygen free-radicals. This causes vasoconstriction of small arteries, potentially lowering blood flow to tissues and organs -High concentrations of oxygen may worsen inflammatory states
119
Oxygen Dosage/Administration
Nasal prongs 1-4L/min Simple mask 6L/min Nebuliser mask 8L/min Reservoir mask 10L/min BVM 10L/min Delivery device should be appropriate to the setting
120
Oxygen Indications
-SPO2 less than 92% on air (exception - high risk pts or neonatal resuscitation) -Airway obstruction -Severe respiratory distress (exception - high risk pts) -Severe shock -Severe TBI -Suspected carbon monoxide poisoning -Smoke inhalation -Decompression illness -Conditio requiring sedation to be administered -Cluster headache
121
Oxygen Contraindications
Only use when indicated
122
Oxygen Cautions
-COPD -Morbid Obesity -Neonatal patients -Patients on home CPAP/BiPAP -Use in a confined space or around fuel sources that may result in a fire
123

CP1 Pharmacology (1 decks)

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