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Pharmacology > FOCUSED STUDY > Flashcards

FOCUSED STUDY Flashcards

1
Q

What are the contraindications of Adrenaline?

A

Nil for NSW Ambulance

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2
Q

What are the adverse reactions of adrenaline?

A
  • Tachycardia
  • Dysrhythmias, including VF
  • Hypertension
  • Pupillary dilation
  • Anxiety
  • Nausea and vomiting
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3
Q

What are the contraindications of aspirin?

A
  • Patients under 16yo
  • Allergy or hypersensitivity to aspirin
  • Patients meeting T1 trauma criteria
  • Active, suspected or known bleeding tendency
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4
Q

What are the adverse reactions of aspirin?

A
  • Gastric irritation (unlikely to be significant from 1 tablet)
  • Alergic reactions (e.g. asthma, rhinitis, urticaria, laryngeal oedema and shock)
  • Bleeding may take longer to stop
  • Aggravation of any bleeding tendency
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5
Q

What are the contraindications of benzyl penicillin?

A

Life threatening allergic reaction to penicillin

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6
Q

What are the adverse reactions of benzyl penicillin

A

Hypersensitivity reactions may occur (including urticaria, angio-edema, convulsions and anaphylaxis)

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7
Q

What are the contraindications of Compound Sodium Lactate?

A

Nil for NSW Ambulance

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8
Q

What are the adverse reactions of Compound Sodium Lactate?

A
  • Pulmonary Edema
  • Hypothermia
  • When given in excess can contribute to coagulopathies (hypothermic and dilutional) and exacerbate acidosis
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9
Q

What are the contraindications of droperidol?

A
  • Patients with known or suspectec hypersensitivity to droperidol
  • Patients less than 14yo
  • Patients with Parkinson’s disease
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10
Q

What are the adverse effects of droperidol?

A
  • Extrapyramidal reactions
  • Rarely, Neuroleptic malignant syndrome (characterised by muscular rigidity, fever, hyperthermia, altered LOC and autonomic instability)
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11
Q

What are the contraindications of fentanyl

A
  • Altered LOC (V, P or U)
  • Epistaxis or occluded nasal passages
  • Patients <1yo
  • Previous or known allergy or adverse reaction
  • Pregnant women >20 weeks gestation in labour
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12
Q

What are the adverse reactions of fentanyl?

A
  • Respiratory depression
  • Hypotension
  • Nausea and vomiting
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13
Q

What are the contraindications of fexofenadine?

A
  • Allergy or hypersensitivity to fexofenadine
  • patients <12yo
  • Previous administration of fexofenadine within 24hrs
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14
Q

What are the adverse reactions of fexofenadine?

A
  • Headache
  • Nausea
  • Dizziness
  • Dry mouth
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15
Q

What are the contraindications of glucagon?

A

Nil for NSW Ambulance

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16
Q

What are the adverse effects of glucagon?

A
  • Nausea and vomiting
  • Allergic reactions rarely occur
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17
Q

What are the contraindications for glucose 10%?

A

Nil for NSW Ambulance

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18
Q

What are the adverse effects of glucose 10%?

A
  • Tissue necrosis if extravasation from vein occurs.
  • May aggravate brain damage in head injuries and strokes.
  • May precipitate Wernicke’s Encephalopathy in alcoholics with thiamine deficiency.
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19
Q

What are the contraindications of glucose gel?

A

Decreased LOC or altered gag reflex

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20
Q

What are the adverse effects of glucose gel?

A

May precipitate Wernicke’s Encephalopathy in alcoholics with a thiamine deficiency

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21
Q

What are the adverse effects of glyceryl trinitrite?

A
  • Hypotension
  • Headache
  • Flushing
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22
Q

What are the contraindications of glyceryl trinitrite?

A
  • BP <90mmHg systolic
  • Pulse rate <50/min or >150/min
  • Patients <16yo
  • Use of drugs to treat erectile dysfunction:
    • Sildenafil (viagra) or Vardenafil (Levitra) within 24hrs.
    • Tadalafil (Cialis) within 96hrs.
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23
Q

What are the contraindications of hydrocortisone?

A
  • Known or suspected allergy to corticosteroids, sodium succinate or sodium phosphate.
  • Uncontrolled infection except patients with adrenal insufficiency.
  • Active peptic ulcer disease.
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24
Q

What are the adverse effects of hydrocortisone?

A

Nil for NSW Ambulance

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25
Q

What are the contraindications of ibuprofen?

A
  • Patients <7yo
  • Renal impairment
  • Dehydration
  • History of allergic reactions to ibuprofen
  • Known hypersensitivity to NSAIDs
  • Active peptic ulcer disease or GI bleeding
  • Self administration within 4-6hrs and/or:
    • 6 tablets (1.2g) within 24hrs (12+yo); or
    • 4 tablets (800mg) within 24hrs (>7 - <12yo).
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26
Q

What are the adverse effects of ibuprofen?

A
  • GI irritation
  • Hypersensitivity reaction (including urticaria and itchiness)
  • Nausea and vomiting
  • Diarrhoea
  • Renal impairment
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27
Q

What are the contraindications for ipratropium bromide?

A
  • Allergy or hypersensitivity to ipratropium bromide
  • Glaucoma
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28
Q

What are the adverse effects for ipratropium bromide?

A

Mild anticholinergic effects (e.g. urinary retention)

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29
Q

What are the contraindications for methoxyflurane?

A
  • Malignant hyperthermia
  • Untreated renal failure
  • Decreased LOC (V, P or U)
  • Concurrent tetracycline use (e.g. doxycycline)
  • Acute behavioural disturbance
  • Patients <1yo
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30
Q

What are the adverse reactions of methoxyflurane?

A
  • Decreased LOC
  • Renal damage in high doses
31
Q

What are the contraindications of metoclopramide?

A
  • Suspected bowel obstruction
  • Suspected or known haematemesis or melaena
  • Previous history of extrapyramidal/distonic reaction
  • Allergy or hypersensitivity to metoclopramide
  • Patients <16yo
  • Patients with Parkinson’s disease
32
Q

What are the adverse effects of metoclopramide?

A
  • Restlessness, drowsiness and fatigue
  • Extrapyramidal/acute dystonic reactions including spasms of the facial muscles, trismus, rhythmic protrusion of the tongue, abnormal speech, spasm of the extra occular muscles and unnatural positioning
33
Q

What are the contraindications of midazolam?

A

Nil for NSW Ambulance

34
Q

What are the adverse effects of midazolam?

A
  • Respiratory and cardiovascular depression which may be exacerbated in patients with limited physiological reserves and/or under the influence of alcohol or drugs.
  • Decreased LOC resulting in upper airway obstruction
35
Q

What are the contraindications of morphine?

A
  • Decreased LOC (V, P or U with the exception of patients requiring post intubation sedation)
  • Pregnant women < 40 weeks gestation (corrected)
  • Pregnant women 20+ weeks gestation in labour
  • Allergy or hypersensitivity to morphine
36
Q

What are the adverse effects of morphine?

A
  • Nausea and vomiting
  • Hypotension
  • Decreased LOC
  • Respiratory depression
37
Q

What are the contraindications of naloxone?

A

Neonates born to opioid addicted mothers due to risk of inducing opioid withdrawl

38
Q

What are the adverse effects of naloxone?

A
  • Opioid withdrawl (nausea, vomiting, sweating, tachycardia, hypertension and combative behaviour)
  • Pulmonary oedema in patients with pre-existing cardiac conditions
  • Dysrhythmias (VT, VF)
39
Q

What are the contraindications of ondansetron?

A
  • Patients <2yo
  • Allergy or hypersensitivity to ondansetron
  • Concurrent apomorpine administration
40
Q

What are the adverse effects of ondansetron?

A
  • Headache and/or flushing
  • Seizures and movement disorders
  • Visual disturbance
  • Hypersensitivity reactions (including anaphylaxis)
41
Q

What are the contraindications of Oxygen?

A
  • Paraquat poisoning if SpO2% > 90% on room air.
  • Concurrent use with methoxyflurane
42
Q

What are the adverse effects of oxygen?

A

Increased fire and explosion risk.

43
Q

What are the contraindications of oxytocin?

A

Allergy or hypersensitivity to oxytocin.

44
Q

What are the adverse effects of oxytocin?

A
  • Common - headache, tachycardia, bradycardia, nausea, vomiting.
  • Rare - anaphylactoid reaction with dyspnoea, hypotension, shock, rash and arrhythmias.
45
Q

What are the contraindications of paracetamol?

A
  • Allergy or hypersensitivity to paracetamol.
  • Liver failure
  • Patients <7yo
  • Multiple previous doses:
    • Self administration within 4hrs; and/or
    • 4g (8 tablets) within 24hrs for 12+yo; or
    • 2g (4 tablets) within 24hrs for 7 - <12yo
46
Q

What are the adverse effects of paracetamol?

A
  • Nausea
  • Liver failure in overdose situations
47
Q

What are the contraindications of salbutamol?

A

Nil for NSW Ambulance

48
Q

What are the adverse effects of Salbutamol?

A
  • Dysrhythmias in large doses
  • Shakes and tremors
49
Q

What is the mechanism of action of Adrenaline?

A
  • Stimulates the Alpha and Beta receptors of the sympathetic nervous system to produce the fight or flight reaction.
  • Alpha stimulation causes peripheral vasoconstriction. It raises the perfusion pressure of internal organs during cardiac arrest, and it decreases capillary permeability and increases blood pressure in anaphylaxis.
  • Beta 1 stimulation causes increased myocardial excitability and contractility, and tachycardia.
  • Beta 2 stimulation causes bronchodilation.
50
Q

What is the mechanism of action of aspirin?

A
  • Inhibits platelet aggregtion thereby limiting thrombus enlargement in acute coronary syndrome.
  • Reduces production of prostaglandins thereby relieving pain and fever.
51
Q

What is the mechanism of action of Benzyl Penicillin?

A

Bactericidal; Inhibits bacterial cell wall synthesis and causes cytolysis when the bacterium tries to divide.

52
Q

What is the mechanism of action of Compound Sodium Lactate?

A

Following intravenous infusion it is distributed throughout the extracellular fluid space. Approximately 25% of the volume infused stays in the intravascular space for a variable period of time.

53
Q

What is the mechanism of action of droperidol?

A
  • Droperidol produces marked tranquilisation and sedation.
  • May decrease BP due to direct vasodilatory effect and alpha block.
  • Droperidol potentiates other CNS depressants, e.g. narcotic analgesics such as fentanyl and benzodiazepines such as midazolam.
54
Q

What is the mechanism of action of Fentanyl?

A
  • Potent opioid analgesic
  • Effective drug for intranasal use because it is rapidly absorbed across mucous membranes.
55
Q

What is the mechanism of action of fexofenadine?

A
  • Non-sedating anti-histamine.

Fexofenadine is a H1 histamine receptor antagonist. It binds to inactive H1 receptors, preventing them from activating. This prevents histamine

56
Q

What is the mechanism of action of glucagon?

A

Glucagon converts liver glycogen to glucose. Glucagon may not be effective if glycogen stores are depleated due to starvation or chronic liver disease.

57
Q

What is the mechanism of action of Glucose 10%?

A

Principle energy source for body cells, especially the brain.

58
Q

What is the mechanism of action of Glucose Gel?

A

Principle energy source for body cells, especially the brain.

59
Q

What is the mechanism of action of Glyceryl Trinitrate?

A
  • Dilates coronary arteries
  • Dilates systemic veins and arteries
  • Decreases cardiac preload/afterload, and blood pressure.

Glyceryl trinitrate is converted to nitros oxide, which causes a cascade leading to the dephosphorylation of the myosin light chain of smooth muscles. This causes relaxation (dilation) and increased blood flow in veins, arteries and cardiac tissue

60
Q

What is the mechanism of action of Hydrocortisone?

A

glucocorticoid drug that reduces inflammation and suppresses immune response.

61
Q

What is the mechanism of action of Ibuprofen?

A
  • Inhibition of prostaglandin synthesis which is important in the mediation of pain, fever and inflammation.
  • Provides anti-inflammatory and analgesic effects well suited to musculoskeletal injuries.
62
Q

What is the mechanism of action of Ipratropium Bromide?

A
  • Bronchodilation.
  • Blocks vagal reflexes which mediate bronchoconstriction.
  • Synergistic when used in combination with salbutamol.
63
Q

What is the mechanism of action of methoxyflurane?

A

Methoxyflurane is a central nervous system depressant.

64
Q

What is the mechanism of action of metoclopramide?

A

Metoclopramide blocks central dopamine receptors.

Metoclopramide antagonises D2 and 5-HT3 receptors in the CTZ. This inhibits the medulla vomiting centre, which stops the vomiting reflex.

It also agonises 5-HT4 receptors in the stomach. This increases upper GI peristalsis/motility, and increases the emptying of the stomach into the duodenum/jejunum. This prevents the stomach contents from being vomited.

65
Q

What is the mechanism of action of midazolam?

A

An anticonvulsant with anxiolytic and amnesic effects.

Midazolam is a short-acting benzodiazepine.

It increases the actions of the inhibitory neurotransmitter GABA, by binding to the benzodiazepine site on GABA-A receptors, which potentiates the effects of GABA through increasing the frequency of chloride channel opening.

66
Q
A
67
Q

What is the mechanism of action of Morphine?

A
  • Decreases pain perception and anxiety.
  • Causes peripheral vasodilation.

Morphine binds to mu, delta and kappa opioid receptors in the CNS and PNS. This results in the activation of descending inhibitory pathways of the CNS as well as inhibition of the nociceptive afferent neurons of the PNS, which leads to an overall reduction of the nociceptive transmission.

68
Q

What is the mechanism of action of naloxone?

A
  • Reverses symptoms caused by opioid analgesics:
    • Respiratory depression
    • Sedation
    • Hypotension

Naloxone antagonizes opioid effects by competing for the same receptor sites, especially the mu-opioid receptor.

69
Q

What is the mechanism of action of ondansetron?

A

Blocks central and peripheral 5-HT3 receptors.

Ondansetron is a seratonin antagonist. it blocks 5-HT3 serotonin receptors centrally in the CTZ, and peripherally on the vagus nerve terminals.

70
Q

What is the mechanism of action of oxygen?

A

Essential element for aerobic metabolic needs and sustaining life.

71
Q

What is the mechanism of action of ondansetron?

A
  • Oxytocin stimulates receptors in the uterus to cause the muscle fibres to contract.
  • When given after birth, the stimulation causes contractions that aid in shortening the time of the third stage of labour and also decreases the risk of a postpartum haemmorhage. It does this by using the contractions to detach the placenta from the uterine wall and the continued contractions of the uterine fibres help to expel any blood or clots in the uterine cavity.
  • When given to treat a postpartum haemmorhage it’s main aim is to increase the amount of contractions to help with minimising blood loss.
72
Q

What is the mechanism of action of paracetamol?

A

Temporary relief of pain and discomfort in arthritis, headache, muscular and neuralgic conditions; also reduces fever.

73
Q

What is the mechanism of action of Salbutamol?

A

Stimulates Beta 2 receptors in bronchial smooth muscle resulting in bronchodilation.

Pharmacology (23 decks)

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