HFB1213 Pharmacology - All drug sheets Flashcards
1
Q
Adrenaline - Presentation
A
1 mg in 1 mL glass ampoule (1:1000)
1 mg in 10 mL glass ampoule (1:10,000)
2
Q
Adrenaline - Pharmacology
A
A naturally occurring alpha and beta-adrenergic stimulant
Actions:
- Increases HR by increasing SA node firing rate (Beta1)
- Increases conduction velocity through AV node (Beta1)
- Increases myocardial contractility (Beta 1)
- Increases the irritability of the ventricles (Beta 1)
- Causes bronchodilatation (Beta 2)
- Causes Peripheral vasoconstriction (Alpha)
3
Q
Adrenaline - Metabolism
A
By monoamine oxidase and other enzymes in the blood, liver and around nerve endings; excreted by kidneys
4
Q
Adrenaline - Primary emergency indications
A
- Cardiac arrest - VF/VT, Asystole or PEA
- Inadequate perfusion (cardiogenic or non-cariogenic/non-hypovolaemic)
- Bradycardia with poor perfusion
- Anaphylaxis
- Severe asthma - imminent life threat not responding to nebuliser therapy, or unconscious with no BP
- Croup
5
Q
Adrenaline - Contraindications
A
- Hypovolaemic shock without adequate fluid replacement
6
Q
Adrenaline - Precautions
A
Consider reduced dose for:
- Elderly/frail Pt
- Pt with cardiovascular disease
- Pt on monoamine oxidase inhibitors
- Higher doses may be considered for Pts on beta blockers
7
Q
Adrenaline - Route of administration
A
IV
IM
Nebulised
IV infusion
IO
8
Q
Adrenaline - Side effects
A
Sinus tachycardia
Supraventricular arrhythmias
Ventricular arrhythmias
Hypertension
Pupillary dilatation
May increase size of MI
Feeling of anxiety/palpatations in the conscious Pt
9
Q
Adrenaline - Special Notes
A
IV Adrenaline should be reserved for life threatening situations.
IV effects:
Onset: 30sec
Peak: 3-5min
Duration: 5-10min
IM effects:
Onset: 30-90sec
Peak: 4-10min
Duration: 5-10min
10
Q
Aspirin- Presentation
A
300mg chewable tablet
300mg soluble/water dispensable tablet
11
Q
Aspirin - Pharmacology
A
An analgesic, antipyretic, anti-inflammatory and antiplatelet aggregation agent
Actions:
- To minimise platelet aggregation and thrombus formation in order to retard the progression of coronary artery thrombosis in ACS
- Inhibits synthesis of prostaglandins
- anti-inflammatory actions
12
Q
Aspirin - Metabolism
A
Converted to salicylate in the gut mucosa and liver; excreted mainly by the kidneys
13
Q
Aspirin - Primary emergency indications
A
- ACS
14
Q
Aspirin - Contraindications
A
- Hypersensitivity to aspirin/salicylates
- Actively bleeding peptic ulcers
- Bleeding disorders
- Suspected dissecting aortic aneurysm
- Chest pain associated with psychostimulant OD if systolic BP >160mmHg
15
Q
Aspirin - Precautions
A
- Peptic ulcers
- Asthma
- Pt on anticoagulants
16
Q
Aspirin - Route of administration
A
Oral
17
Q
Aspirin - Side effects
A
Heartburn, nausea, gastrointestinal bleeding Increased bleeding time Hypersensitivity reactions
18
Q
Aspirin - Special notes
A
Aspirin is C/I for use in acute febrile illness in children and adolescents
The anti-platelet effects of Aspirin persist for the natural life of platelets
Onset: n/a
Peak: n/a
Duration: 8-10days
19
Q
Dexamethasone - Presentation
A
8mg in 2mL glass vial
20
Q
Dexamethasone - Pharmacology
A
A corticosteroid secreted by the adrenal cortex
Actions:
- Relieves inflammatory reactions
- Provides immunosuppression
21
Q
Dexamethasone - Metabolism
A
By the liver and other tissues; excreted predominantly by the kidneys
22
Q
Dexamethasone - Primary emergency indications
A
- Bronchospasm associated with acute respiratory distress not responsive to nebulised Salbutamol
- Moderate - severe croup
- Acute exacerbation of COPD
23
Q
Dexamethasone - Contraindications
A
- Known hypersensitivity
24
Q
Dexamethasone - Precautions
A
- Solutions which are not clear or are contaminated should be discarded
25
Dexamethasone - Route of administration
IV (administered over 1-3min)
Oral
26
Dexamethasone - Side effects
Nil of significance in above indication
27
Dexamethasone - Special notes
Does not contain an antimicrobial agent, therefore use solution immediately and discard any residue
IV effects:
Onset: 30-60min
Peak: 2hours
Duration: 36-72hours
28
Dextrose 10 - Presentation
25g in 250mL infusion soft pack
29
Dextrose 10 - Pharmacology
A slightly hypertonic crystalloid solution
Composition:
- Sugar - 10% dextrose
- Water
Actions:
- Provides a source of energy
- Supplies body water
30
Dextrose 10 - Metabolism
Dextrose:
- Broken down in most tissues
- Stored in liver and muscle as glycogen
Water:
- Excreted by the kidneys
- Distributed throughout total body water, mainly in the extracellular fluid compartment
31
Dextrose 10 - Primary emergency indications
1. Diabetic hypoglycaemia (BGL analysis \< 4 mol/L) in Pt with altered conscious state who is unable to self-administer oral glucose
32
Dextrose 10 - Contraindications
1. Nil of significance in the above indication
33
Dextrose 10 - Precautions
1. Nil of significance in the above indication
34
Dextrose 10 - Route of administration
IV infusion
35
Dextrose 10 - Side effects
Nil of significance in the above indication
36
Dextrose 10 - Special notes
IV effects:
Onset: 3min
Peak: n/a
Duration: Depends on severity of hypoglycaemic episode
37
Fentanyl - Presentation
100mcg in 2mL glass ampoule
250mcg in 1 Ml glass ampoule or cartridge (IN use only)
38
Fentanyl - Pharmacology
A synthetic opioid analgesic
Actions:
CNS effects:
- Depression - leading to analgesia
- Respiratory depression - leading to apnoea
- Dependence (addiction)
Cardiovascular effects:
- Decreases conduction velocity through the AV node
39
Fentanyl - Metabolism
By the liver; excreted by the kidneys
40
Fentanyl - Primary emergency indications
1. Sedation to facilitate intubation
2. Sedation to maintain intubation
3. Sedation to facilitate transthoracic pacing
4. Sedation to facilitate synchronised cardioversion
5. CPR interfering Pt - ALS
6. Analgesia - IV/IN
- Hx of hypersensitivity or allergy to morphine
- Known renal impairment/failure
- Short duration of action desirable
- Hypotension
- Nausea and/or vomiting
- Severe headache
41
Fentanyl - Contraindications
1. Hx of hypersensitivity
2. Late second stage of labour
42
Fentanyl - Precautions
1. Elderly/frail Pt
2. Impaired hepatic function
3. Respiratory depression e.g. COPD
4. Current asthma
5. Pt on monoamine oxidase inhibitors
6. Known addiction to opioids
7. Rhinitis, rhinorrhea or facial trauma (IN route)
43
Fentanyl - Route of administration
IV
IN
IV infusion
44
Fentanyl - Side effects
Respiratory depression
Apnoea
Rigidity of the diaphragm and intercostal muscles
Bradycardia
45
Fentanyl - Special notes
Fentanyl is a schedule 8 drug under the Poisons Act and its use must be carefully controlled with accountability and responsibility
Respiratory depression can be reversed with Naloxone
100mcg Fentanyl is equivalent in analgesic activity to 10mg Morphine
IV effects:
Onset: Immediate
Peak: \< 5min Duration: 30-60min
IN effects:
Peak: 2min
46
Glucagon - Presentation
1mg (IU) in 1mL hypo kit
47
Glucagon - Pharmacology
A hormone normally secreted by the pancreas
Actions:
- Causes in blood glucose concentration by converting stored liver glycogen to glucose
48
Glucagon - Metabolism
Mainly by the liver, also by the kidneys and in the plasma
49
Glucagon - Primary emergency indications
1. Diabetic hypoglycaemia (BGL \<4mmol/L) in Pt with an altered conscious state who are unable to self-administer oral glucose
50
Glucagon - Contraindications
1. Nil of significance in the above indication
51
Glucagon - Precautions
1. Nil of significance in the above indication
52
Glucagon - Route of administration
IM
53
Glucagon - Side effects
Nausea and vomiting (rare)
54
Glucagon - Special notes
Not all patients will respond to glucagon, e.g. those with inadequate glycogen stores in the liver (alcoholics, malnourished).
IM effects:
Onset: 5min
Peak: n/a
Duration: 25min
55
GTN - Presentation
0. 3mg tablet
0. 6mg tablets
Transdermal GTN Patch (50mg 0.4mg/hr release)
56
GTN - Pharmacology
Principally a vascular smooth muscle relaxant
Actions:
- Venous dilatation promotes venous pooling and reduces venous return to the heart (reduces preload)
- Arterial dilatation reduces systemic vascular resistance and arterial pressure (reduces preload)
The effects of the above are:
- Reduced myocardial O2 demand
- Reduced systolic, diastolic and mean arterial blood pressure, whilst usually maintaining coronary perfusion pressure
- Mild collateral coronial artery dilatation may improve blood supply to ischaemic areas of myocardium
- Mild tachycardia secondary to slight fall in blood pressure
- Preterm labour: Uterine quiescence in pregnancy
57
GTN - Metabolism
By the liver
58
GTN - Primary emergency indications
1. Chest pain with ACS
2. Acute LVF
3. Hypertension associated with ACS
4. Autonomic dysreflexia
5. Preterm labour (consult)
59
GTN - Contraindications
1. Known hypersensitivity
2. Systolic blood pressure \<110 mmHg tablet
3. Systolic blood pressure \<90 mmHg patch
4. Sildenafil Citrate (Viagra) or Vardenafil (Levitra) administration in the last 24hr or Tadalafil (Cialis) administration in the previous 4 days (PDE5 inhibitors)
5. Heart rate \> 150bpm
6. Bradycardia HR \<50bpm (excluding autonomic dysreflexia)
7. VT
8. Inferior STEMI with systolic BP \<160 mmHg
9. Right ventricular MI
60
GTN - Precautions
1. No previous administration
2. Elderly Pt
3. Recent MI
4. Concurrent use with other tocolytics
61
GTN - Route of administration
SL
Buccal
Transdermal
Infusion (interhospital transfer only)
62
GTN - Side effects
Tachycardia
Hypotension
Headache
Skin flushing (uncommon)
Bradycardia (occasionally)
63
GTN - Special notes (there are a shitload)
Storage:
- GTN is susceptible to heat and moisture. Make sure that tablets are stored in their original light resistant, tightly sealed bottles. The foil pack of the patches should be intact.
- Do not administer patient's own tablets, as its storage may not have been in optimum condidtions or it may have expired.
- Patches should be discarded prior to use-by date.
- Since both men and women can be prescribed PDE5 inhibitors all patients should be asked if and when they last had the medication to determine if GTN is C/I.
- Tadalafil (Cialis) may also be prescribed to men for treatment of benign prostatic hypertrophy. This is a new indication for this medication and may lead to an increased number of patients under this treatment regimen.
- GTN by IV infusion may be required for an inter hospital transfer as per the treating doctor's orders
Interhospital transfer:
The IV dose is to be prescribed and signed by the referring hospital medical officer. Infusions usually run in the range of 5 mcg/minute to 200 mcg/minute and increased 3-5 mcg/minute.
S/L effects:
Onset: 30sec - 2min
Peak: 5 - 10min
Duration: 15 - 30min
IV effects:
Onset: 30sec - 1min
Peak: 3 - 5min
Duration: 15 - 30min
Transdermal effect:
Onset: Up to 30mi
Peak: 2hrs
64
Ipratropium Bromide - Presentation
250 mcg in 1 mL nebule or polyamp
65
Ipratropium Bromide - Pharmacology
Anticholinergic bronchodilator
Actions:
- Allows bronco dilatation by inhibiting cholinergic bronchomotor tone (i.e. blocks vagal reflexes which mediate bronchoconstriction)
66
Ipratropium Bromide - Metabolism
Excreted by the kidneys
67
Ipratropium Bromide - Primary emergency indications
1. Severe respiratory distress associated with bronchospasm
2. Exacerbation of COPD irrespective of severity
68
Ipratropium Bromide - Contraindications
1. Known hypersensitivity to Atropine or its derivatives
69
Ipratropium Bromide - Precautions
1. Glaucoma
2. Avoid contact with eyes
70
Ipratropium Bromide - Route of administration
Nebulised (in combination with salbutamol)
71
Ipratropium Bromide - Side effects
Headache
Nausea
Dry mouth
Skin rash
Tachycardia (rare)
Palpitations (rare)
Acute angle closure glaucoma secondary to direct eye contact (rare)
72
Ipratropium Bromide - Special notes
There have been isolated reports of ocular complications (dilated pupils, increased intraocular pressure, acute angle glaucoma, eye pain) as a result of direct eye contact with Ipratropium Bromide formulations.
The nebuliser mask must therefore be fitted properly during inhalation and care taken to avoid Ipratropium Bromide solution entering the eyes.
Ipratropium Bromide must be nebuliser in conjunction with Salbutamol and is to be administered as a single dose only.
Onset: 3 - 5min
Peak: 1.5 - 2hrs
Duration: 6hrs
73
Methoxyflurane - Presentation
3 mL glass bottle
74
Methoxyflurane - Pharmacology
Inhalation analgesic agent at low concentrations
75
Methoxyflurane - Metabolism
Excreted mainly by the lungs
By the liver
76
Methoxyflurane - Primary emergency indications
1. Pain relief
77
Methoxyflurane - Contraindications
1. Pre-existing renal disease / renal impairment
2. Concurrent use of tetracycline antibiotics
3. Exceeding total dose of 6 mL in 24hr period
4. Personal or family history of malignant hypothermia
5. Muscular dystrophy
78
Methoxyflurane - Precautions
1. The Penthrox inhaler must be hand-held by the Pt so that if unconsciousness occurs it will fall from the patient's face. Occasionally the operator may need to assist but must continuously assess the level of consciousness
2. Pre-eclampsia
3. Concurrent use with oxytocin may cause hypotension
79
Methoxyflurane - Route of administration
Self-administered under supervision using the hand held Penthrox inhaler
80
Methoxyflurane - Side effects
Drowsiness
Decrease in blood pressure and bradycardia (rare)
Exceeding the maximum total dose of 6 mL in a 24hr period may lead to renal toxicity
81
Methoxyflurane - Special notes
The maximum initial priming dose for Methoxyflurane is 3 mL. This will provide approximately 25 minutes of analgesia and may be followed by one further 3 mL dose once the initial dose is exhausted if required. Analgesia commences after 8 - 10 breaths and lasts approximately 3 - 5 minutes once discontinued.
Do not administer in a confined space. Ensure adequate ventilation in ambulance.
Malignant hyperthermia is a very rare condition that can be induced by volatile anaesthetics such as methoxyflurane. Ask Pt about any past history or family history of adverse reactions to inhaled anaesthetics.
In patients with muscular dystrophy, volatile agents may precipitate life-threatening rhabdomyolysis.
82
Morphine - Presentation
10 mg in 1 mL glass ampoule
83
Morphine - Pharmacology
An opioid analgesic
Actions:
CNS effects
- Depression (leading to analgesia)
- Respiratory depression
- Depression of cough reflex
- Stimulation (changes of mood, euphoria or dysphoria, vomiting, pin-point pupils
- Dependence (addiction)
Cardiovascular effects:
- Vasodilatation
- Decreases conduction through the AV node
84
Morphine - Metabolism
By the liver; excreted by the kidneys
85
Morphine - Primary emergency indications
1. Pain relief
2. Sedation to maintain intubation
3. Sedation to enable intubation
4. RSI
86
Morphine - Contraindications
1. History of hypersensitivity
2. Renal impairment / failure
3. Late second stage of labour
87
Morphine - Precautions
1. Elderly / frail Pt
2. Hypotension
3. Respiratory depression
4. Current asthma
5. Respiratory tract burns
6. Known addiction to opioids
7. Acute alcoholism
8. Pt on monoamine oxidase inhibitors
88
Morphine - Route of administration
IV
IM
Subcutaneous
89
Morphine - Side effects
CNS effects:
- Drowsiness
- Respiratory depression
- Euphoria
- Nausea, vomiting
- Addiction
- Pin-point pupils
Cardiovascular effects:
- Hypotension
- Bradycardia
90
Morphine - Special notes
Morphine is a Schedule 8 drug under the Poisons Act and its use must be carefully controlled with accountability and responsibility.
Side effects of Morphine can be reversed with Naloxone
Occasional wheals are seen in the line of the vein being used for IV injection. This is not an allergy, only a histamine release.
IV effects:
Onset: 2 - 5min
Peak: 10min
Duration: 1 - 2hrs
IM effects:
Onset: 10 - 30min
Peak: 30 - 60min
Duration: 1 - 2hrs
91
Naloxone - Presentation
0.4 mg in 1 mL glass ampoule
92
Naloxone - Pharmacology
An opioid antagonist
Action:
- Prevents or reverses the effects of opioids
93
Naloxone - Metabolism
By the liver
94
Naloxone - Primary emergency indications
1. Altered conscious state and respiratory depression secondary to administration of opioids or related drugs
95
Naloxone - Contraindications
1. Nil of significance in the above indication
96
Naloxone - Precautions
1. If Pt is known to be physically dependent on opioids, be prepared for a combative Pt after administration
2. Neonates
97
Naloxone - Route of administration
IM
IV
98
Naloxone - Side effects
Symptoms of opioid withdrawal:
- Sweating, goose flesh, tremor
- Nausea and vomiting
- Agitation
- Dilatation of pupils, excessive lacrimation
- Convulsions
99
Naloxone - Special notes
The duration of action of naloxone is often less than that of the opioid used, therefore repeated doses may be required.
Naloxone reverses the effects of opioids with none of the actions produced by other opioid antagonists when no opioid is present in the body. (For example, it does not depress respiration or or cause pupillary constriction). In the absence of opioids, Naloxone has no perceivable effects.
Following an opioid associated cardiac arrest Naloxone should not be administered. maintain assisted ventilation.
Following head injury Naloxone should not be administered. Maintain assisted ventilation if required.
IV effects:
Onset: 1 - 3min
Peak: n/a
Duration: 30 - 45min
IM effects:
Onset: 1 - 3min
Peak: n/a
Duration: 30 - 45min
100
Normal Saline - Presentation
10 mL polyamp
500 mL and 1000 mL infusion soft pack
101
Normal Saline - Pharmacology
An isotonic crystalloid solution
Composition:
Electrolytes (sodium and chloride in a similar concentration to that of extracellular fluid)
Action:
- Increases the volume of the intravascular compartment
102
Normal Sline - Metabolism
Electrolytes:
- Excreted by the kidneys
Water:
- Excreted by the kidneys
- Distributed throughout total body water, mainly in the extracellular fluid compartment
103
Normal Saline - Primary emergency indication
1. As a fluid replacement in volume depleted patients
2. Cardiac arrest secondary to hypovolaemia or where the Pt might be fluid responsive
3. To expand intravascular volume in the non-cardiac, non-hypovolaemic hypotensive Pt e.g. anaphylaxis, burns. sepsis
4. As a fluid challenge in unresponsive, non-hypovolaemic, hypotensive patients (other than LVF). e.g. asthma
5. Fluid for diluting and administering IV drugs
6. Fluid TKVO for IV administration of emergency drugs
104
Normal Saline - Contraindications
1. Nil of Significance in the above indication
105
Normal Saline - Precautions
1. Consider modifying factors when administering for hypovolaemia
106
Normal Saline - Route of administration
IV
IO
107
Normal Saline - Side effects
Nil of significance in the above indication
108
Normal Saline - Special notes
IV half life:
Approximately 30 - 60min
109
Ondansetron - Presentation
4 mg orally disolved tablet
8 mg in 4 mL glass bottle
110
Ondansetron - Pharmacology
Anti-emetic
Action:
5HT3 antagonist which blocks receptors both centrally and peripherally
111
Ondansetron - Metabolism
By the liver
112
Ondansetron - Primary emergency indications
1. Undifferentiated nausea and vomiting
2. Prophylaxis for spinally immobilised or eye injured Pt
3. Vestibular nausea in Pt \<21 years of age
113
Ondansetron - Contraindications
1. Known hypersensitivity
2. Concurrent Anpomorphine use
3. Known long Q-T syndrome
4. Hypokalaemia or hypomagnesaemia
114
Ondansetron - Precautions
1. Pt with liver disease should not receive more than 8 mg of Ondansetron per day
2. Care should be taken with patients on diuretics who may have an underlying electrolyte imbalance
3. Ondansetron contains aspartame and should not be given to patients with phenylketonuria
4. Concurrent use of Tramadol
5. Pregnancy
115
Ondansetron - Route of administration
Oral (ODT)
IV
IM
116
Ondansetron - Side effects
Rare (\<0.1%)
Hypersensitivity reactions (including anaphylaxis)
Q-T prolongation
Widened QRS complex
Tachyarrythmias (including AF and SVT)
Seizures
Extrapyramidal reaction
Visual disturbances (including transient loss of vision)
Common (\>1%)
Constipation
Headache
Fever
Dizziness
Rise in liver enzymes
117
Ondansetron - Special notes
ODT
Onset: 2min
Peak: 20min
Duration: 120min
IV
Onset: 5min
Peak: 10min
Duration: between 2.5 and 6.1hrs
IV doses should be delivered as a slow push push (minimum 30sec)
118
Paracetamol - Presentation
500 mg tablets
120 mg in 5 mL oral liquid (24 mg/mL)
119
Paracetamol - Pharmacology
An analgesic and antipyretic agent
Actions:
- Exact mechanism of action unclear; thought to inhibit prostaglandin synthesis in the CNS
120
Paracetamol - Metabolism
By the liver; excreted by the kidneys
121
Paracetamol - Primary emergency indications
1. Mild pain
2. Headache
122
Paracetamol - Contraindications
1. Hypersensitivity to paracetamol
2. Children \< 1 month of age
3. Paracetamol already administered within past 4hrs
4. Total paracetamol intake within past 24hrs exceeding 4 g (adults) or 60 mg/kg (children)
5. Chest pain in suspected acute coronary syndrome
123
Paracetamol - Precautions
1. Impaired hepatic function or liver disease
2. Elderly/frail
3. Malnourished
124
Paracetamol - Route of administration
Oral
125
Paracetamol - Side effects
1. Hypersensitivity reactions including severe skin rashes (rare)
2. Haematological reactions (rare)
126
Paracetamol - Side notes
There are several brands of paracetamol available in Australia. Paracetamol is also found in many combination medicines, both prescription and over the counter. Carefully determine previous Paracetamol intake before dose administration.
The usual dose of Paracetamolfor children is 15 mg/kg per dose. the maximum total dose of 60 mg/kg therefore equates to 4 doses within a 24hr period.
Hepatic damage is very rare when Paracetamol is taken at recommended dosages.
Paracetamol is not indicated for the treatment of fever in the emergency setting.
Onset: 30min
Peak:
Duration: 4hrs
127
Prochlorperazine (Stemetil) - Presentation
12.5 mg in 1 mL glass ampoule
128
Prochlorperazine (Stemetil) - Pharmacology
An anti-emetic
Action:
- Acts on several central euro-transmitter systems
129
Prochlorperazine (Stemetil) - Metabolism
Metabolised by the liver; excreted by the kidneys
130
Prochlorperazine (Stemetil) - Primary emergency indications
1. Treatment or prophylaxis of nausea / vomiting for
- Motion sickness
- Planned aeromedical evacuation
- Known allergy or C/I to Ondansetron administration
- Headache irrespective of nausea / vomiting
- Vertigo
131
Prochlorperazine (Stemetil) - Contraindications
1. Circulatory collapse (cool, pale, clammy skin, tachycardia, hypotension)
2. CNS depression
3. Previous hypersensitivity
4. Pt \< 21 years of age
5. Pregnancy
132
Prochlorperazine (Stemetil) - Precautions
1. Hypotension
2. Epilepsy
3. Pt affected by alcohol or on anti-depressants
133
Prochlorperazine (Stemetil) - Route of administration
IM
134
Prochlorperazine (Stemetil) - Side effects
Drowsiness
Blurred vision
Hypotension
Sinus tachycardia
Skin rash
Extrapyramidal reactions (usually the dystonic type)
135
Prochlorperazine (Stemetil) - Special notes
IM effects:
Onset: 20min
Peak: 40min
Duration: 6hrs
136
Salbutamol - Presentation
5 mg in 2.5 mL polyp
pMDI (100 mcg per actuation)
137
Salbutamol - Pharmacology
A synthetic beta adrenergic stimulant with primary beta 2 effects
Action:
- Causes bronchodilatation
138
Salbutamol - Metabolism
By the liver; excreted by the kidneys
139
Salbutamol - Primary emergency indications
1. Respiratory distress with suspected bronchospasm:
- asthma
- severe allergic reactions
- COPD
- smoke inhalation
- oleoresin capsicum spray exposure
140
Salbutamol - Contraindications
1. None of significance in the above indications
141
Salbutamol - Precautions
1. Large doses of Salbutamol have been reported to intracellular metabolic acidosis
142
Salbutamol - Route of administration
Nebulised
pMDI
143
Salbutamol - Side effects
Sinus tachycardia
Muscle tremor (common)
144
Salbutamol - Special notes
Salbutamol nebulas / polyps have a shelf life of one month after the wrapping is opened. The date of the opening of the packaging should be recorded and the drug and the drug should be stored in an environment of \< 30°C
Although infrequently used, Salbutamol by IV infusion may be required during inter hospital transfers of some women in premature labour
The dose is to be prescribed and signed by the referring hospital medical officer
Nebulised effects:
Onset: 5 - 15min
Peak: n/a
Duration: 15 - 50min
145
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