Jrcalc - Drug Know How Flashcards
What is the presentation of midazolam
Oral solution
2.5, 5, 7.5, 10mg
What is the max dose for ipratropium bromide
500mcg in 2ml
One max dose
What is the recommended oxygen need for effective nebulisation
6-8 litres
What is the dosage of ipratropium bromide
500mcg in 2ml
One dose = max dose
In COPD patients nebuliser should be limited to how much time
6 minutes before reassessment
Side effects of ipratropium bromide
Proxmal chest tightness
Allergic reaction
Tachycardia
Sickness
What is the action of ipratropium bromide
Bronchodilator - by working as a antimuscarinic
May have more benefit in paediatric asthma / adult COPD
What are the indicators for ipratropium bromide
Asthma - life threatening/ moderate
Asthma/ COPD - non responsive to salbutamol
Ibuprofen can be given with caution in which patient apart from asthma patients
Chron/ ulcerative colitis - may cause exacerbation
Patient with coagulation problems
Hypertension
what are the Contraindications for ibuprofen
Hypovolemic
Kidney problems
Gi problem - ulcers
Pregnancy - last 1/3
Chickenpox (children)
Allergic
If they had any other NSAID
Why should a clinician make sure a patient has eaten before giving ibuprofen.(NSAID)
As this drug disrupts the gastric lining causing ulcers - eat first = that creates a barrier
What drug can be given to asthma patient with caution
Asprin and ibuprofen (NSAIDS) due to chance of bronchoconstriction
- prostaglandin
What are the action of ibuprofen
Anti-pyrexia
Analgesia
Anti inflammatory*****
What is the indicator for ibuprofen
Pain
Pyrexia with discomfort
Soft tissue injury’s
What is the maximum dosage for ibuprofen
1.2g
3× 400mg dosage = 1.2g
3 dosage in a 24hour period
What is the dosage interval for ibuprofen
8 hours
What is the dosage of ibuprofen
400mg
Is there a repeat dosage after the initial 200mg of hydrocortisone in patient with anaphylaxis
No
One max dose
Is there a repeat dosage after the initial 100mg of hydrocortisone in patient with life threatening asthma
No
One max dose
What is the dosage of hydrocortisone for patients in anaphylaxis
200mg in 2ml
200mg in 4ml
What is the dosage of hydrocortisone of patients in life threatening asthma
100mg given over 2 minutes IV PREFERABLY
Or
IM
Is there a toxic dose for hydrocortisone
No
HOWEVER
Under PGD’s there is a max dosage
Which patient should be administered IM hydrocortisone
Those with suspected adrenal insufficient
Those who are at risk of adrenal insufficient such as patients who are unwell due to long term steroid use
When should hydrocortisone be administered in patient with confirmed adrenal crisis
As soon as - prior to conveyance
If the clinician is unsure if the patient is suffering from adrenal insufficient- should they administer hydrocortisone
Yes - preferably intra muscular
What route hydrocortisone be administered in patient with confirmed adrenal crisis
Intravenous
I’m
What are the indicators for hydrocortisone
Anaphylaxis
Adrenal crisis / addersonian crisis
Life threatening asthma
COPD
What is the dose interval of GTN for patient experience breathlessness due to heart failure (pulmonary odema )
5-10 minutes
How can you as the clinician increase the absorption rate of GTN
By ensuring oral mucosa is moiste
How is hydrocortisone prepared
100mg of hydrocortisone powder is mixed with 2ml of water
What must be considered and checked between dosages of GTN
Blood pressure - further dosage can only be given if blood pressure threshold are met
90mmgh for ACS
110mmcg for heart failure
What is the maximum dosage of GTN for patient experience breathlessness due to heart failure (pulmonary odema )
2.4mg which is equal to 6 sprays
400mcg ×6 = 2.4mg
What is the dosage of GTN for patient experience breathlessness due to heart failure (pulmonary odema )
400-800mcg = 1-2 sprays
What is the maximum dosage of GTN For patients experiencing ACS
No limit
What is the dosage interval for GTN in patient experience ACS
5-10 minutes
What is the dosage of GTN for patient experience ACS
400-800mcg which is equal to 1-2 sprays
Every 5-10 minutes along as BP is above 90mmgh systolic
What are the contraindications of GTN
to much GTN can cause cardiac arrest
Stopping vein (in) unconscious heart patient
S - stenosis (mitral / aortic)
V - volume (hypovolemia)
In
U - unconscious patients
H - head trauma
P - pressure - hypotensive
When should GTN be given with caution
Patient with suspected posterior or inferior wall myocardial infarction (MI) DUE TO right MAIN OCCULSION- WHICH AFFECT RIGHT VENTRICLE causing hypotension
What are the consequences of the action of GTN
Reduced Blood pressure
Reduced cardiac spasm
Reduced preload
What are the action of GTN
Vasodilation of :
Coronary arteries : reducing cardiac spasm
Veins : reducing pre-load
What are the indicator for GTN
Cardiac chest pain - angina / MI where the systolic BP is above 90mmgh
Breathlessness due to pulmonary odema in heart failure whereby ot has uncontrolled hypertension
Patient with suspect cocaine toxicity
What is the presentation of GTN and for bonus points - what does each subunit dose contain
Spray
Bonus point - each spray contain 400mcg
What does GTN stand for
Glycern trinitrate
What is the site of absorbution for GTN
Sublingual - under the tongue
What classification of drug is morphine
Opioid
What is the maximum dosage for glucose 40%
20g
What are the contraindications for glucose 10%
IM OR SUBCUT administration
Why should you flush the IV line after administrating glucose 10%
As glucose causes irritation to the vein if stagnant next to it
What is the administration site for glucose 40% - and for double point how is it ABSORBED
Oral - absorbed by buccal routes
Buccal = gums
What is the presentation of glucose 40%
Plastic tube - containing 25g
What is the indication for glucose 40%
hypoglycaemia where there isn’t any risk of aspirations or choking
How many dosages of glucose 10% maybe given. And what is the maximum dosage
3 dosages maybe give of 10g glucose mixed in 100ml = 300ml max
What is the dose interval of glucose 10%
5 minutes
What is the initial dosage of glucose 10%
10g glucose mixed in 100ml
If a hypoglycemic patient with a reduced GCS starts improving with glucose 10% - should glucose be continued
Glucose 10% should be titrated to normal GCS
If a unconscious hypoglycaemic patient hasn’t shown any improvement to glucose 10% when can a second dose be given.
5 minutes
How does glucose 10% work
By giving sugar/glucuse straight into the blood stream
What is the difference between glucose 10% and glucose 40%
10% is a liquid form
40% is gel form
What drug can be given to unconscious patient who are hypoglycaemic and aren’t responding to glucagon
Glucose 10%
When is glucose 10% indicated
in hypoglycaemia ( sugar level below 4.0) where glucose gel isn’t possible - rapid improvement is required
Unconscious patient with suspected hypoglycaemic cause
In patient who haven’t responded to to glucagon after 10 minutes
When is atropine indicated
Symptomatic bradycardia such as
Absolute bradycardia (40BPM OR LESS)
Bradycardia post ROSC
Inadequate perfusion -which causes confusion
What is the presentation of glucagon
1mg POWDER to be mixed with water
What is the dosage for glucagon
1mg
How can you check the effectiveness of glucagon
By checking blood sugar level after 10-15 mins
How many time can glucagon be administered
Once
When administration furosemide how long should it be transfused into the system
2 minutes
What is the preference of first line benzodiazepine to patients that are convulsing
Midazolam - as this save time due to diazepam has to be given IV/IO or rectally.
Midazolam can be administered buccal
Should benzodiazepine be given as a preventive measure
NEVER. patient MUST be convulsing to receive benzodiazepine
Why is it best practice to have a BVM on hand for patients that have ingested benzodiazepine or opioids
Due to the risk of respiratory arrest
How long do eclamptic convulsions have to last before diazepam can be administered
Start treatment if seizure last over 2-3 minutes.
What are the dosage of adminstration for chlorphenamine parentally
10mg in 1ml - only one max dose
What is the presentation of chlorphenamine
10mg in 1ml - ampoule
Presentation of adrenaline 1:1000
Ampoule - ready to draw up
Presentation of atropine
Ampoule - ready to draw up
What is a common side effect of benzodiazepine
Respiratory arrest - this is more common if the patient has had alcohol
Hypotension
What are the indicators for Chlorphenamine
Allergic reaction which fall short of anaphylaxis
Alleviate symptoms after initial treatment of anaphylaxis
Second plus dose for atropine
600mcg in 1ml
Initial dose of atropine
600mcg In 1ml
Route of administration of aspirin
Oral - dispersible or chewed
Route of administration of aspirin
Oral - dispersible or chewed
How should glucagon be administered
Intramuscular
When is glucagon indicated
Hypoglycaemia - known or suspected (in unconscious patients). Sugar level below 4.0
What is the dosage for furosemide
40mg in 4ml
What is the second dosage of diazepam for adults
10mg in 2ml
What classification of drug is available for paramedic to administer to patients that are convulsing (seizures)
Benzodiazepine
What are the indicators for Diazepam
Patient who have had convulsions which have lasted 5 minutes or more
Patient who have had 3 or more convulsions in an hour
Patient MUST be convulsing at time of administration
- cocaine toxicity
What is the preparation for benzylpenicillin parental (IV/ IO)
1.2 gram reconstituted with 20ml of water for injection
What are the contraindications for benzylpenicillin
Known severe allergic reaction -
simple rash doesn’t count as severe
Presentation of amiodarone
Prefilled syringe 💉
Actions of atropine
Blocks vagal activity
Improve A-V conduction
What are the different parental route for administration of chlorphenamine
IM, IV ,IO
What is the maximum dosage of diazepam for adults
20 milligrams
When is active charcoal indicated
When a toxin has been injected one hour prior to clinicians arrival or under direction of Toxbase
What is the first line treatment for hypoglycaemia
Glucose gel ( glucose 40%)
In which group of patients is glucagon sometimes ineffective
Young and elderly due to malnourished therefore lack of glycogen to turn to glucose
What is the pharmacological effect of glucagon
Converts glycogen to glucose
Which condition should be met to administer glucagon apart from hypoglycaemia
When glucose gel is ineffective or not possible to administer and IV isn’t possible (to administer glucose)
What are the contraindications for furosemide
Under 18yrs old
Cariogenic shock
What are the actions of furosemide
Diuretic
- act on kidneys = less reabsorption of water = blood less water = water in lungs/limbs enter blood via osmosis = symptoms relief
What are the indicators for furosemide
Pulmonary Oedema due to heart failure
What is the contraindications for diazepam
Hypersensitivity
What is the first dosage of diazepam for adults
10mg in 2ml
If the patient stop convulsing during the administration of benzodiazepine, should the clinician continue to finish giving the dosage
Yes
What is the duration that benzodiazepine must be given apart
10 minutes
What is a common side affect of opioids
Respiratory arrest
Hypotension
Why should a paramedic ask parents or carers if they have administered any medication to a patient suffering from convulsions
Parents or guardian may have administered
benzodiazepine, this will be classified as the first dose
What drug can be administered for symptomatic cocaine toxicity ( cheat pain, hypertension, convulsions)
Diazapam
GTN
Whats the names of Benzodiazepine that are available to UK paramedics
Diazapam & Midazolam
How should chlophenamine be given IV
Slowly over a duration of 1 minute
What are the contraindications of chlorphenamine
Allergy’s to this drug
Patient who are being treated with MAOIs
What is the dosage for benzylpenicillin intramuscular
1.2g reconstituted with water for injection to make 4ML
This dosage should be spread over 2 sites
Indication for benzylpenicillin
Suspect meningitis
Suspected due to sign and symptoms such as non - blanching Rash
What is the presentation of benzylpenicillin
600mg in 1.2g POWDER in a vial
Max dose for atropine
3mg = 5 dosage
600mcg ×5 = 3mg
Dose intervals for atropine
3-5 minutes
What is the Contraindications for atropine
Bradycardia due to hypothermia 🥶🥶🥶🥶🥶🥶🥶🥶🥶🥶🥶🥶🥶🥶🥶
Presentation of adrenaline 1:10,000
Prefilled syringe 💉
Presentation of aspirin
Tablet
When is aspirin contraindicated (Hauls)
HAULS
H emophiliacs
Allergy
Under 16 years old - causes Reyes disease
Liver failure with jaundice
Stomach- active GI bleed
When is aspirin indicated
Clinical or ECG evidence of ischemia or myocardial infarction (MI)
What is the dose of aspirin
300mg
What are the pharmological actions of amiodarone
Increase cardiac potential thus increases refractory period. Blocks sodium and potassium channels.
When can adrenaline 1:10,000 not be administered during a cardiac arrest
When patient core temperature is less than 30° degrees 🥶
What is the duration of activation for paracetamol
4-6 hours
What is the max dose for adrenaline 1:10,000
No max dose
What is the pharmological action of adrenaline
Stimulates alpha receptors (vasoconstriction and increased contractility of the myocardium) and beta receptor (bronchodilator)
When is adrenaline 1:10,000 indicated during a cardiac arrest
Non shockable - straight away or after the third shock in consecutive shocks
What is the time duration of adrenaline 1:10,000 for patient who are hypothermic (30-34.9° degrees)
6-10 minutes ( duration is doubled )
What is the dose for amiodarone at the 5th shock mark
150mg in 10ml
What is the route of administration for adrenaline 1:10,000
Parental - IV or IO
What is the route of adrenaline 1:1000
IM - intramuscular
What are the different presentations of paracetamol available to UK paramedics
Iv (mixture of 1g in 250ml saline) or oral (2×500mg tablets)
What is the dosage of paracetamol
1g
How is salbutamol administrated
Nebuliser
What is the dosage for adrenaline 1:1000 and following dosages if its recommended
500mcg with following dosage at same dosage
What is the duration for nebulator treatment in COPD patients
6 minutes - then reassess
What is the duration interval for adrenaline 1:10,000
3-5 minutes
What’s is the dose of active charcoal
50g in 250ml - only one administration allowed
What is classified as a acute paracetamol overdose and how can a paramedic treat it
4mg+ in one hour /
or your full daily dosages 24 hour in one hour = treatment active charcoal
In which situation is salbutamol indicated
Expiratory wheeze, exacerbation of COPD / Asthma
In which situations is hydrocortisone indicated
Anaphylaxis or adrenal crisis or life threatening asthma
In what situation is adrenaline 1:10,000 indicated
Cardiac arrest
In which situation is adrenaline 1:1000 indicated
Life threatening asthma or anaphylaxis
what is the max dose for adrenaline 1:1000
no max dose
What is the dose of amiodarone after the 3rd shock
300mg in 10ml
What is the dose for amiodarone after the first shock
0
What are the indicators for midazolam
Patient who are ACTIVELY convulsing
Who also meet the following criteria:
Convulsion lasting 5 mins +
3+ convulsion in one hour
Under what laws and conditions apart from clinical presentation can a paramedic administer midazolam
Under PGD or if a patient has there own prescription under then it must be administered according to the prescribed instructions or care plan
What are the action of midazolam
Bonus point : what is the onset of action for those actions
Anti- convulsion -5 minutes
Sedative - after 15 minutes
Are there any contraindications for midazolam
None EXPECT indicators must be met
What are the side affects of midazolam
Hypotension
Respiratory arrest
Amnesia
Reduced gcs - can cause airway probs
What are drugs that can reach peak effect for stopping seizures
Midazolam and diazepam
What is the only route of adminstration for miazolam to UK paramedics
Buccal
What is the initial dosage of miazolam for adults
10mg in a pre filled 2ml syringe
What is the dose interval between adminstration of midazolam
10 minutes
What is the second dosage of midazolam in adults
10 mg in a pre filled 2ml syringe 💉
How many times can a paramedic administer midazolam to adults in the UK -
Bonus points : what is the max dose
2 times
Max dose 20mg
So 2× 10mg dosages in pre filled 2ml syringe 💉
What is the maximum dosage for adminstration of midazolam in adults
20mg
What is the indicator for misoprostol
Post partum haemorrhage - WITHIN 24HOUR OF BIRTH, and can’t be control by utrine massage
Life threatening bleed(500ML +) (obstetric) - less than 24 week and miscarriage MUST be confirmed (SEEN)
What is misopeostol used for
Bleed post and pre birth but must follow strict indication
24 week or less - with confined miscarriages + life threatening bleed
Major bleed - post birth within 24 hours
When should misoprostol be used as a first line treatment
POST partum hemorrhage in pt with pre-eclampsia or hypertension (140/90+)
What is the action of misoprostol
Stimulates utrine contractions
How long does misoprostol take to work ( onset of action)
7-10 minutes
What are the contraindications for misoprostol
- Bleeding with fetus in womb
- In labour prior to birth
-Allergy’s
Bleeding post 24 hours of birth
How is misoprostol delivered ( route of administration)
Sublingually (preferred)
Rectal
What is the initial dose of misoprostol
800mcg
What is the maximum dosage for misoprostol
800mcg - max dose
What is the presentation of misoprostol
Tablet
What is the presentation of morphine sulfate available to paramedic on UK ambulances
** BONUS POINT FOR DOSAGES**
Morphine ampoule ( 10mg/1ml)
Oromorph - 10mg/5ml)
What are the indicators for morphine sulfate
severe pain( such as trauma or MI) or movements up following the analgesia ladder
Can ambulance morphine be given for end of life
Yes
But you should try to give patients own prescription first
In which situation can ambulance morphine be given in end of life
- When patient own pain or breathlessness medication hasn’t been prescribed yet.
-Their supply of morphine has ran out - medication is present but without a patient specific document which is to be signed by a independent prescriber
- if you havent tested all causes for the breathlessness
What should a paramedic do before giving morphine to end of life patients ( when they are actively dieing)
Consult with palliative care or nursing teams to discuss if anticipatory medication are in place
What do guidelines state about. Breathlessness and morphine in end of life patients
Patient must be breathlessness which causes distress.
The clinician MUST address and investigate any potential causes first
And then morphine can be administered
What are the action of morphine
Strong opioid analgesia
Sedative, analgesia, euphoria (feel high)
Why can morphine or other opioids causes hypotension
This drug triggers the body to produce histamine - which causes vasodilation.
Thus hypotension
What are the contraindications for morphine sulfate
Respiratory arrest - under 10RR or 20 in kids
Under 1 years old
Hypotension - under 90 systolic
Head injury with reduced GCS (9 or less)
Allergy
What is the special guidelines for morphine administration in end of life patients
If the clinician confirm patient is in their final moment - General contraindications DO NOT apply - as we are their to remove symptoms to aid pain free death and the benefits outways the risk
What is the best route to administer mophine in end of life patients
Subcutaneous - as it reduces the risk of side effects ( even tho these don’t apply as the need for mophine outways the risk )
When should a paramedic administer morphine with caution - and in small subunit dosages
-Known severe liver or kidney impairment
-Pregnancy - NOT TO BE GIVEN IN LABOUR
-chest injury - with breathing issues ( but can also improve breathing issue if it’s pain based 😂😂)
- head injury ( if it’s a ICP (then can increase aterial poca2 thus increasing ICP)
-Alcohol as it’s a nerve suppressant paired with morphine a suppressant
Chest injury, alcohol, head injury, pregnancy, kidney/ liver problems
Morphine can be given to 4 types of patients but with care. Bonus point why
Head injury - icp
Chest injury - respiratory arrest
Kidney / liver failure - clearing
Drunk patient - nerve supress
Pregnant PT - crossed placetal barrier
What are the side effects of morphine sulfate
Respiratory depression/ arrest
Cardiovascular depression
Drowsiness
Pupil constriction
Nausea and vomiting 🤮
What must be an end of life patients blood pressure when administering morphine
In the final days to hours the blood pressure maybe below 90mmgh - it doesn’t matter as we are there to control symptoms.
Try using there anticipatory pack first
Check prior dosage - to not overdose
What does the law state about morphine
It’s a class A CONTROLLED drug, it MUST be securely stored and it’s movement TRACKED.
What does the law say about the disposal of Morphine
It must be disposed off (duped) in the presence of a witness
What is the indication for dexamethasone
Croup
What are the actions of dexamethasone
Steroid - reduces inflammation of subglottis
If the procedure of administration of dexamethasone irrates the child what should the clinician do
STOP - as this may increase airway compromise
When is the criteria for TXA administration
What is the time frame for administration
Patient triggering local major trauma criteria
Head injury with GCS of less than 12
Patient with suspected or known internal hermitage
Post partum hemmorage
Bleeding due to obstetrics
External hemmorage
ALL WITHIN 3 HOURS
If severe bleeding is suspect or known when should TXA be given by
Within 3 hours
What is the difference between classification and schedule for drug
Classification is based upon how dangerous the drug is to society
Schedule is based on its medicinal benefits
How should morphine be prepared for IV
Diluted by sodium chloride 0.9% to make 10mg in 10ml
What are the indications for morphine
Severe pain
First choice for an mi
What are the indications for morphine
Severe pain
First choice for an mi
Can morphine be given for pregnancy
Yes but in short dosages as it can cross the placental barrier
Not for labour pains
Can morphine be given for pregnancy
Yes but in short dosages
Not for labour pains
What is the main side effect of morphine - what can you give to reduce the effects of this
Nausea and vomiting consider on downsetron
In end of life care, were morphine has been administered when should a paramedic administer counter medication
Where toxicity is believed such as respiratory depression below 8 breath for a minute
How should morphine iv be reconstituted
With sodium chlooride 0.9% to make 10 milligrams in 10 mil
How should morphine be administers concentration dosage
10 mg into 10mil
10 minutes adminster IV
If pain persists further 2ml every 5 mins till 20mg limit met
How is the narcan hydrochloride found in the ampu le ( first dosage)
400mcg in 1ml
What are the indications for narcan
And it’s pharmacological action
Reversal of opiods
Unconsciousness caused by respiratory depression
Cardiac arrest due to opioids
Somebody who has been involved with anaesthetics
What are the indications for narcan
And it’s pharmacological action
Reversal of opiods
Unconsciousness caused by respiratory depression
Cardiac arrest due to opioids
Somebody who has been involved with anaesthetics
What are the contraindications for narcan
Neonates born to opiate addicted moms
What are the contraindications for narcan
Neonates born to opiate addicted moms
In what different routes can narcan be administered
IM SUBCUT IV IO
In what different routes can narcan be administered
IM SUBCUT IV IO
In what different routes can narcan be administered
IM SUBCUT IV IO
Should patients who have been administered narcan the transported to hospital and why
Yes
Narcan has a short half life of 30 mins
So further doseage maybe required
Should patients who have overdosed on methadone be transported to hospital even though narcan has been the administered
-1/2 life of natcan
How long does methadone last in the body
Yes as it takes methodone 8 hours to leave the system + they are high risk of death due to respiratory arrest
- narcans half life of 30 minutes
For patients who have taken methadone and refuse hospital conveyance with capacity - what should the clinician do
Leave them with a responsible adult
A loafing dose maybe administered 800mcg of narcan
What is methadone what is the hard life line
A synthetic opioid that is used to help wean people of opioids
Duration is 15 minutes of 60 minutes
How should narcan be prepared for IV ( adult ) opioid dependant
Gain 800 micrograms of narcan (two bottles) with 8ml of sodium chlorides = total volume 10ml
1ml given titrated to effect- kindly some patients in a groggy state ( violent or dependant )
What is the dosages for narcan
Duration apart
Max dosage
400 micrograms followed by an addition 400 micrograms three minutes apart
Max dosage 4000mcg
What is the dosage for narcan in opioid-based cardiac arrest
Duration apart
Max dose
400 micrograms
800 micrograms 1 minute apart
Max dose 10,000 micrograms
What is the composition of nitrous oxide / entenox
50% oxygen 50% nitrous oxide
What are the contraindications for nitrous oxide or antiox (HOPS)
H ( head injury - reduced GCS)
O ( obstruction bowel )
P( physictric PT - disturbed
S( decompression sickness - diving )
What are the indications for nitrous oxide and Knox
Labour pains or moderate severe pains
What are the indications for nitrous oxide and Knox
Labour pains or moderate severe pains
How long does it take before entenox reaches a analgesic effect
5 to 10 minutes
What are the indications for ondansetron
Nausa or vomiting
Pt who maybe given opioids
What are the indications for ondansetron
Nausa or vomiting
What are the contraindications for ondansetron
Known allergies
Under 1-month-old
Prolong qtc interval 500 milliseconds
If a patient has been administered on dance Tron should they be left at home
It is possible but further investigations must be sought clinicion must seek further assistance before leaving at home with ondanzitron
What is the dosage for ondanzatron
4 mg no repeat dosages
What is the dosage for ondanzatron
4 mg no repeat dosages
What are contraindications for oxygen
Explosive environments
What are the indications for paracetamol
Pain relief
High temperature that is causing discomfort
What are the indications for salbutamol
Exacerbation of COPD or asthma
Expiratory wheeze
What are the indications for salbutamol
Exacerbation of COPD or asthma
Expiratory wheeze
What are the pharmacological actions of salbutamol
Agonistic
Beta 2 adrenal receptor releases bronco construction
- however it can affect beta 1 once beta 2 saturated = tachycardia
What are the contraindications for salbutamol.
Non in emergency
What is the duration that nebulisation maybe given to COPD PT
6 mins
When should salbutamol be stopped
Once a therapeutic affect has been achieved
Side effects become excessive such as tremors or tachycardia above 140 bpm
What is the adult dosage for salbutamol
5 mg with 6 to 8 litres of oxygen
What are the indications for sodium chloride 0.9%- fluids
Crush injury
Dehydration
Major trauma - maintain permissive hypotension
Burns
Maintaing - 100mmgh systolic BP
What are the indications for sodium chloride 0.9%- fluids
Crush injury
Dehydration
Major trauma - maintain permissive hypotension
Burns
Maintaing - 100mmgh systolic BP
What are the indications for syntomatrine
Postpartum henridge within 24 hours of birth with no relief from utrine massage
Life threatening bleeding with confirmed miscarriage
What are the pharmacological actions of
syntomatrine
How long does it take to work
Stimulates utrine contractions
Take 7 minutes to work
What are the contraindications for syntomatrine
Bleeding during labour
IF THE BABY IS IN SITO !!! CAN CAUSE MISCARRIAGE!!!!
Severe eclampsia
If a condition arrives to a lady who has postpartum hemorrhage within last 24 hours what drugs can be administered and if so can they be administered together
Misoprostol and syntomatrine they must be administered 15 minutes apart if required
Consider TXA + Fluids + 02
What is the dosage for syntomatrine + what’s it pair
- route of administration
500mcg with 5 units of oxytocin
IM
What is the dosage for amidodrone and adrenaline in cardiac arrest for a child
5mcg per kg - amidodrone ( same dosage for 3+5th shock
10mcg per kg - adrenaline
Why is adrenaline 1:10,000 usage in cardiac arrest
Stimulates Beta adreno-recoptors
B1 = increased vasoconstriction of vessel + contractility of heart = increased force of contraction
B2 = reduceds bronchospasm = helpful in asthmatic or anaphylaxis based arrests
Why is amiodroane used during cardiac arrest ( basic)
Anti arithmic drug, that reduced hearts excitability ( VF/PVT)
Why is the usage for glucose during cardiac arrest
It directly increased blood sugar levels
Why is sodium chloride (fluids) used during cardiac arrest
- increase volume = increased output
- dilutes toxins ( lactive acid / keystones glucose ect)
Treat hypovolemia
