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Pharmacology > Indication/Diagnosis + Side Effects > Flashcards

Indication/Diagnosis + Side Effects Flashcards

1
Q

Adrenaline 1-1,1000

Indication/diagnosis

Side effects

A

Anaphylaxis

Life threatening Asthma with failing ventilations despite nebuliser therapy.

Side effects
None stated

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2
Q

Adrenaline 1-10,000

Indications/diagnosis
Side effects

A

Cardiac Arrest

Side effects
None stated

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3
Q

Amiodarone Hydrochloride

Indication/diagnosis

Side effects

A

Cardiac Arrest

Shockable Rhythms:
Pulseless VT
VF
If unresponsive to defibrillation administer after the 3rd shock!

Side effects 
Bradycardia 
Vasodilation causing hypotension, flushing
Bronchospasm
Arrhythmias -Torsades de pointes
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4
Q

Aspirin
Indications/ diagnosis

Side effects

A

Clinical or ECG evidence suggestive of myocardial infarction or ischemia.

Side effects
Increased risk of gastric bleeding
Wheezing in some asthmatics

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5
Q

Atropine Sulphate

Indications/ diagnosis

Side effects

A

Symptomatic Bradycardia in the presence of ANY of this adverse signs:

Absolute Bradycardia: pulse <40 bears per minute
Systolic BP below expected for age
Paroxysmal ventricular arrhythmias requiring suppression
Inadequate perfusion causing confusion
Bradycardia following ROSC

NB: Hypoxia is the most cause of bradycardia in children, therefore interventions to support ABC and oxygen therapy should be the 1st line therapy.

Side effects
Dry mouth, visual blurring, pupil dilation.
Confusion and occasional hallucinations
Tachycardia
Do not use <100mcg doses as they may cause paradoxical bradycardia

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6
Q

Benzylpenicillin Sodium

Indications/Diagnosis

Side effects

A

Suspected meningococcal disease in the presence of :

1) A non-blanching rash ( the classical, haemorrhagic non-blanching rash, may be petechial or purpuric)
2) Sign and symptoms suggestive of meningococcal septicaemia (stiff neck, photophobia etc.)

Side effects
None stated

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7
Q

Chlorphenamine

Indication/Diagnosis
Side effects
Actions

A

Severe anaphylactic reaction after initial resuscitation.

Symptomatic allergic reaction falling short of anaphylaxis but causing patient distress
example:Severe itching

Side effects
Sedation, Dry mouth, Headache, Blurred vision, Urinary Retention, Psychomotor impairment, Gastrointestinal disturbance, Convulsions (rare).
Children and older people are more likely to experience side effects.
Warn anyone receiving chlorphenamine against driving or undertaking other psychomotor task, due to sedative and psychomotor side effects.

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8
Q

Dexamethasone
Indication/ diagnosis
Action
Side effects

A

Mild, moderate, severe croup!
Refer to modified Taussig score and Respiratory illness in children.

Corticosteroid reduce subglottic inflammation

Side effects
Gastro intestinal upset
Hypersensitivity anaphylactic reaction

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9
Q

Diazepam
Indication/ diagnosis

Side effects

A

Patient who have prolonged (lasting 5 min or more ) or repeated (3 or more in an hour) convulsions who are CURRENTLY CONVULSING - not secondary to a hypoxic or hypoglycaemic episode.
Eclamptic convulsions-initiate treatment is lasting more 2-3 min or if it is recurrent.
Symptomatic cocaine toxicity (severe hypertension, chest pain or convulsing)

Side effects
Respiratory depression may occur, especially in the presence of alcohol.
Opioids drugs similarly enhance diazepams cardiac and respiratory depressive effects.
Hypotension may occur, this might be significant especially if the patient has to be moved from a horizontal position to allow extrication from an address. Caution should then be exercised and consideration given to either removing the patient flat or if the convulsion stopped and considered safe allow a 10 min recovery before removal.
Other side effects : light headiness, unsteadiness, drowsiness, confusion and amnesia.

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10
Q

Glucagon

Indication/diagnosis

Side effects

A

Hypoglycaemia,clinically suspected hypoglycaemia or unconscious patient wherein hypoglycaemia is considered a likely cause
Blood glucose <4.0 mmol/ litre
N.B. Glucagon should only be administered when oral glucose administration is not possible or ineffective and/or when IV access to administer 10% glucose is not possible.

Side effects
Nausea, vomiting, diarrhoea in children, hypokalaemia, hypotension in adults, Acute hypersensitive reaction (rare).

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11
Q

Glucose 10%

Indications/diagnosis

Side effects

A

Hypoglycaemia <4.0 mmol/ L or suspected hypoglycaemia when oral glucose not possible and a rapid improvement in clinical state and blood glucose level is required.
An unconscious patient where hypoglycaemia is considered likely the cause.
Management of hypoglycaemia in patient who haven’t responded to IM Glucagon after 10 minutes.

Side Effects
None listed

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12
Q

Glucose 40%

Indication/diagnosis

Side effects

A

Known or suspected hypoglycaemia in a conscious patient where there is no risk of choking or aspiration.

Side effects none listed

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13
Q

Glyceryl Trinitrate GTN

Indication/diagnosis

Side effects

A

Cardiac chest pain due to angina or myocardial infarction, when Systolic BP is more then 90 mmHg
Breathlessness due to pulmonary oedema in acute heart failure when Systolic BP is greater the 110 mmHg

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14
Q

Hydrocortisone

Indications/diagnosis

Side effects

A

Severe or life-threatening asthma
Provided cannulation is easy and administration does not delay transport to hospital
Anaphylaxis
Only after Adrenaline (if indicated) and chlorophenamine administration
Adrenal Crisis including Addisonian Crisis.
Esthablished adrenal crisis (IV route) ensure hydrocortisone is administrated as soon as possible
Suspected adrenal insufficiency or unexplained collapse in steroid dependent patients (can be given IM should not delay transport).
N.B. Not indicated in exacerbation of COPD

Side effects
Both sodium phosphate and sodium succinate solutions contain significant amount of phosphate preservatives and might cause stinging or burning sensations.
See JRCALC

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15
Q

Ibuprofen

Indication/diagnosis

Side effects

A

Relief of mild to moderate pain
Pyrexia with discomfort ( may help to relieve the misery and often unpleasant symptoms associated with febrile illnesses e.g. aches and pains
Soft tissue injuries
Best when used as part of balanced analgesic regim.

Side effects

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16
Q

Ipatropium Bromide

Indications/diagnosis
Side effects

A

Acute, severe or life threatening asthma
Acute asthma unresponsive to Salbutamol
Exacerbation of COPD, unresponsive to Salbutamol

17
Q

Morphine Sulphate

Indications/diagnosis

Side effects

A

Pain associated with myocardial infarction (analgesic of first choice).
Severe pain as a component of a balanced analgesic regime

18
Q

Morphine Sulphate in End of Life Care

Indications/diagnosis

A

Pain management for adults in end of life care, refer to end of life care guidelines.
Wherever possible liaison should occur with palliative nursing team.

Same side effects

19
Q

Naloxone

Indications/diagnosis

Side effects

A

The reversal of acute opioid or opioid toxicity
for respiratory arrest or respiratory depression.
Unconsciousness associated with respiratory depression of unknown cause, where opioid overdose could be a possibility.
In cardiac arrest where opioid toxicity is likely the cause.
Patients exposed to high potency veterinary or anaesthetic preparations should be given naloxone immediately if :
-consciousness is impaired
- exposure occurred within the last 10 min, even if asymptomatic.

Side effects
In patients who are physically dependent on opioids
Naloxone may precipitate violent withdrawal symptoms, including cardiac arrhythmias.
In these cases it is better for the naloxone to be titrated to effectively reverse the cardiac or respiratory depression, leave patients in groggy state with continuous reassessment of ventilation and circulation.

20
Q

Nitrous oxide

Indications
Side effects

A

Moderate to severe pain .
Labour pain.

Side effects
Minimal side effects

21
Q

Ondasetron

Indications/ diagnosis

Side effects

A

Prevention and or treatment of opioids induced nausea and vomiting (e.g. morphine)
Treatment of nausea and vomiting
In children’s travel associated of nausea and vomiting.
Side effects
Hiccups, constipation, flushing, hypotension, chest pains, Arrhythmia, Bradycardia, Headaches, Seizures, Movement disorders, injection site reaction.

22
Q

Oxygen

Indication/diagnosis

Side effects

A

Children
Significant illness or/and injuries.
Adults
Critical illness requiring high level of supplemental of oxygen .
Serious illnesses requiring moderate levels of oxygen if the patient is hypoxaemic.
COPD and other conditions requiring controlled or low dosages of oxygen.
Condition where the patient should be monitored closely but oxygen is not required unless patient hypoxaemic.

Side effects
Drying and irritating the mucous membrane over a period of time.
In patient with COPD there is a risk that even moderate levels of oxygen can lead built up of carbon dioxide levels which may cause respiratory depression and lead to respiratory arrest.

23
Q

Paracetamol

Indications
Side effects

A

Relief of mild to moderate pain, or high temperature with discomfort (not for high temperature alone).
Intravenous:
As part of balanced analgesic regime, paracetamol is effective in reducing opioid requirements while improving analgesic efficacy, alternative analgesic when morphine is contraindicated.
Side effects are extremely rare, occasionally Paracetamol can cause hypotension if given too quickly intravenously.

24
Q

Salbutamol

Indications/diagnosis

Side effects

A

Acute asthma attack where normal inhaler has failed to relieve symptoms.
Expiratory wheezing associated with, allergy, anaphylaxis, smoke inhalation or other lower airway cause.
Exacerbation of COPD.

Side effects
Tremor, tachycardia, palpitations, headache, feeling of tension, peripheral vasodilation, muscle cramps, rash.

25
Q

Sodium Chloride 0.9%

Indications/diagnosis

Side effects

A 
Adult fluid therapy 
-medical condition without haemorrhage 
-medical condition with haemorrhage 
-trauma related haemorrhage 
-Burns 
-Limb crush injury 
Child fluid therapy
-medical conditions 
-trauma related haemorrhage 
-Burns 
Flush 
-as a flush to confirm patency of intravenous or intraosseous cannula.
-as a flush after drug administration

Side effects
Over infusion may precipitate pulmonary oedema and breathlessness

26
Q

Syntometrine

Indications/diagnosis

Side effects

A

Post-partum haemorrhage within 24 hours of delivery of the infant where bleeding from the uterus is uncontrollable with uterine massage.
Miscarriage with life threatening bleeding with confirmed diagnosis ( where the patient has gone home with treatment and started to bleed ).

Side effects 
Nausea and vomiting 
Abdominal pain 
Headache, hypertension and bradycardia 
Chest pain, and rarely anaphylactic reaction.

Pharmacology (3 decks)

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