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Placement revision > Main drug DTP's > Flashcards

Main drug DTP's Flashcards

1
Q

Administration routes: Adrenaline

A
  • Nebuliser (NEB) (ACP2; CCP)- CROUP
  • IM (ACP1; ACP2; CCP)
  • IV (ACP2; CCP)
  • IO (CCP)
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2
Q

Adrenaline: Adult dosages- Anaphylaxis or severe allergic reaction

A
  • IM (P) EpiPen 300 microg. Single-dose only.
  • IM (ACP1; ACP2; CCP) 500 microg (300 microg- if pregnant). Repeated at 5-minute intervals. No max dose
  • NEB (ACP2; CCP) 5 mg. Single-dose only.
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3
Q

Adrenaline: Adult dosages- Cardiac arrest

A
  • IV (ACP2; CCP) 1 mg repeated at 3-5 minute intervals). No max dose
  • IO (CCP) 1 mg repeated at 3-5 minute intervals. No max dose.
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4
Q

Adrenaline: Adult dosages- Severe life-threatening bronchospasm or silent chest

A
  • IM (ACP1; ACP2; CCP) 500 microg (300 microg- if pregnant) Repeated at 5 minute intervals.
    No max dose.
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5
Q

Adrenaline: Adult dosages- Shock

A
  • IV/ IO INF (CCP) 20-50 microg bolus (IV/IO)
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6
Q

Adult dosage Naloxone: Respiratory depression

A

1) IM (ACP1; ACP2; CCP) - 1.6 mg
Single-dose only.

2) IV (CCP)- 50 microg
Repeated PRN (facilitate airway management). No max dose
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7
Q

Adult dosages - GTN: Suspected ACS (with pain)

A

SUBLING- 400 microg.

Repeated at 5-minute intervals. No max dose

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8
Q

Adult dosages- GTN: Acute cardiogenic pulmonary odema

A

SUBLING- 400 microg.

Repeated at 5-minute intervals. No max dose

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9
Q

Adult dosages- GTN: Autonomic dysreflexia & Irukandji syndrome

A

SUBLING- 400 microg.

Repeated at 5-minute intervals. No max dose

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10
Q

Adult dosages- Significant nausea and/ or vomiting: Ondansetron

A

PO/ IM (ACP1; ACP2; CCP) 4-8 mg.
Total max dose 8 mg.

IV (ACP2; CCP) 4-8 mg.
Total max dose 8 mg.

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11
Q

Aspirin- Onset/ duration/ half-life

A

Onset- 10 minutes (variable)
Duration- 1 week (antiplatelet)
Half-life- 3.2 hours (300-650 mg)

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12
Q

Aspirin: Adult dosages ACS & Acute cardiogenic pulmonary oedema

A

PO (per oral) (ACP1; ACP2; CCP) >18 years- 300 mg

chewed and followed by a small sip of water

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13
Q

Aspirin: Contraindications

A

1) Allergy and/ or adverse drug reactions
2) Chest pain (psychostimulant overdose)
3) Bleeding or clotting disorders
4) Current GI bleeding or peptic ulcers
5) Patients <18 years

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14
Q

Aspirin: Precautions

A

1) Possible aortic aneurysm and any other condition that requires surgery
2) Pregnancy
3) History of GI bleeding and peptic ulcers
4) Concurrent anticoagulant therapy

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15
Q

Aspirin: Presentation

A

Tablet white - 300 mg

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16
Q

Aspirin: Side effects

A

1) Epigastric pain/ discomfort
2) Nausea and/or vomiting
3) Gastritis
4) GI bleeding
5) NSAID induced bronchospasm

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17
Q

Ceftriaxone: Adult dosages- Suspected meningococcal septicemia (w a non-blanching petechial and/ or purpuric rash)

A

IM (ACP1; ACP2; CCP) 2 g (2 x 1 g IM injections).
Single-dose only.

IV INF (ACP2; CCP) 2 g over 20 minutes. Single-dose only.

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18
Q

Ceftriaxone: Paediatric dosages- Suspected meningococcal septicemia (w a non-blanching petechial and/ or purpuric rash)

A

IM (ACP1; ACP2; CCP) 50 mg/ kg (rounded up to the nearest 5 kg). Total max dose 1 g. Single-dose only.

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19
Q

Contraindications:

A

Nil

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20
Q

Contraindications: Ceftriaxone

A
  • Allergy and/ or adverse drug reaction
  • Known anaphylaxis or severe allergic reaction to penicillin-based drugs- (isolated minor drug rash attributed to penicillin does not contraindicate the use of ceftriaxone)
  • Patients less than 1 month- consultation required
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21
Q

Contraindications: Fentanyl

A

1) Allergy and/or adverse drug reaction

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22
Q

Contraindications: GTN

A

1) Allergy and/ or adverse drug reaction
2) HR < 50 or > 150 BPM
3) SBP < 100 mmHg
4) Acute CVA
5) Head trauma
6) Phosphodiesterase inhibitor medication (e.g. Viagra or Levitra) in the previous 4 days

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23
Q

Contraindications: Ipratropium bromide

A

1) Allergy and/ or adverse drug reaction

2) Patients less than 1 year of age

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24
Q

Contraindications: Methoxyflurane

A

1) Allergy and/or adverse drug reaction
2) Patients <1 year
3) History of liver or renal disease
4) History of malignant hyperthermia

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25
Q

Contraindications: Midazolam

A
  • Allergy and/ or adverse drug reaction
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26
Q

Contraindications: Morphine

A
  • Allergy and/ or adverse drug reaction

- Kidney disease (renal failure)

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27
Q

Contraindications: Naloxone

A

1) Allergy and/ or adverse drug reaction

2) Newly born patient

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28
Q

Contraindications: Ondansetron

A
  • 1) Allergy and/ or adverse drug reaction
    2) Congenital long QT syndrome
    3) Current apomorphine therapy (dopamine agonist used in the treatment of Parkinsonism) therapy
    4) Patients less than 3 years of age
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29
Q

Contraindications: Paracetamol

A
  • Adverse and/ or adverse drug reactions

- Patients < 1 month old

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30
Q

Drug class: Adrenaline

A

Sympathomimetic

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31
Q

Drug class: Aspirin

A

Antiplatelet

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32
Q

Drug class: Ceftriaxone

A
  • Antibiotic
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33
Q

Drug class: Fentanyl

A
  • Narcotic analgesic-
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34
Q

Drug class: GTN

A

Vasodilator

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35
Q

Drug class: Ipratropium bromide

A

Anticholinergic agent

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36
Q

Drug class: Methoxyflurane

A
  • Analgesic (at low doses)
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37
Q

Drug class: Midazolam

A

Benzodiazepine (short acting)

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38
Q

Drug Class: Morphine

A

Narcotic analgesic

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39
Q

Drug Class: Naloxone

A

Opioid Antagonist

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40
Q

Drug class: Ondansetron

A

Anti-emetic

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41
Q

Drug class: Paracetamol

A
  • Analgesic

- Antipyretic

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42
Q

Duration and half-life: Naloxone

A
  • Duration: 60 minutes

- Half-life: 60 minutes

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43
Q

Fentanyl- Adult dosages: Significant pain

A
  • SUBCUT (ACP1; ACP2; CCP) - Approval required (QAS consult)
  • IM (ACP1) >70 years - 25- 50 microg (repeated at up to 50 microg every 10 minutes). Total max dose- 100 microg.
  • IM (ACP1) <70 years - 25- 100 microg. Repeated up to 50 microg (every 10 minutes). Total max dose - 200 microg.
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44
Q

GTN: Onset/ Duration/ Half-life

A

Onset- 2 minutes
Duration- 20-30 minutes
Half-life- 5.5 minutes

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45
Q

Indications of Naloxone

A

Respiratory depression (Secondary to Narcotic use)

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46
Q

Indications: Adrenaline

A

1) Anaphylaxis/ allergic reaction
2) Cardiac arrest
3) Croup
4) Bradycardia/ poor perfusion
5) Bronchospasm/ silent chest

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47
Q

Indications: Aspirin

A

1) Suspected ACS

2) Acute cardiogenic pulmonary oedema

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48
Q

Indications: Ceftriaxone

A
  • Suspected meningococcal septicemia (w a non-blanching petechial and/ or purpuric rash)
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49
Q

Indications: Fentanyl

A

1) Significant pain
2) Sedation
3) Autonomic dysreflexia (w SBP >160 mmHg)
4) Induction for rapid sequence intubation (RSI)

  • Morphine is the preferred narcotic- unless under specific circumstances*
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50
Q

Indications: GTN (Glyceryl trinitrate)

A

(AS A IRAKANDJI)

1) A- Acute cardiogenic pulmonary odema
2) S- Suspected ACS (with pain)

3) A- Autonomic dysreflexia (SBP >160 mmHg)
4) IRAKANDJI syndrome (SBP >160 mmHg)

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51
Q

Indications: Ipratropium bromide

A
  • Moderate bronchospasm (unresponsive to initial QAS salbutamol NEB)
  • Severe bronchospasm
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52
Q

Indications: Methoxyflurane

A

Pain

53
Q

Indications: Midazolam

A
  • Generalized seizures/ focal seizures (GCS <12)
  • Sedation:
  • for maintenance of an established LMA/ ETT
  • for procedures (e.g. TCP or cardioversion)
  • to facilitate safe assessment and treatment of an agitated head-injured patient
  • as an adjunct to opiate analgesia
  • for ketamine emergence
  • Acute behavioral disturbance (w an SAT score > 2) unresponsive to droperidol (max dose) administration
54
Q

Indications: Ondansetron

A

Significant nausea and/ or vomiting

55
Q

Indications: Paracetamol

A

1) Mild to moderate pain

2) Fever (causing distress)

56
Q

Ipratropium bromide: Adult dosages- Moderate bronchospasm (unresponsive to initial QAS salbutamol NEB) & severe bronchospasm

A

NEB (ACP1; ACP2; CCP) 500 microg. Repeated at 20-minute intervals. Total max dose- 1.5 mg.

57
Q

Ipratropium bromide: Paedatric dosages- Moderate bronchospasm (unresponsive to initial QAS salbutamol NEB) & severe bronchospasm

A

NEB (ACP1; ACP2;CCP)
> 6 years- 500 microg. Repeated at 20 minute intervals. Total max dose- 1.5 mg.

1-5 years- 250 microg. Repeated at 20-minute intervals. Total max dose- 750 microg.

58
Q

Metabolism: Adrenaline

A
  • Circulating adrenaline is metabolized by sympathetic nerve endings
  • Subject to the process of mitochondrial enzymatic breakdown by monoamine oxidase
59
Q

Metabolism: Aspirin

A
  • Aspirin is converted into salicylic acid in many tissues (primarily in GI mucosa and liver)
  • Excreted by the kidneys
60
Q

Metabolism: Ceftriaxone

A
  • Is excreted as a variety of active and inactive metabolites from the body through urine, bile and faeces
61
Q

Metabolism: Fentanyl

A
  • Hepatic and renal excretion
62
Q

Metabolism: Ipratropium bromide

A

Hepatic w excretion from the kidneys

63
Q

Metabolism: Methoxyflurane

A
  • By the liver and excreted mainly by the lungs.
64
Q

Metabolism: Midazolam

A

By the liver and excreted by the kidneys.

65
Q

Metabolism: Morphine

A
  • By the lungs, kidney and liver
66
Q

Metabolism: Paracetamol

A
  • By the liver, excreted by the kidneys
67
Q

Methoxyflurane: Adult dosages- Pain

A

INH (ACP1; ACP2; CCP) 3 ml (repeated once after 20 minutes). Total max dose of 6 ml.

68
Q

Methoxyflurane: Paedatric dosages- Pain

A

INH (ACP1; ACP2; CCP) >1 year- 3 ml. Single-dose only.

69
Q

Midazolam- Adult dosages: Acute behavioral disturbance ( w SAT >2) unresponsive to droperidol administration (max dose)

A
  • IM (ACP2) - Approval required (QAS consult line)

- IV (ACP2) - Approval required (QAS consult line)

70
Q

Midazolam- Adult dosages: Generalized seizure/ focal seizure (GCS <12)

A

NAS (ACP1; ACP2; CCP)
>70 years- 2.5 mg.
Repeated every 10 minutes. Total max-dose 10 mg.
<70 years- 5.0 mg.
Repeated every 10 minutes. Total max dose of 20 mg.

IM (ACP1; ACP2; CCP) 
>70 years- 2.5 mg.
Repeated every 10 minutes. Total max dose 10 mg.
<70 years- 5.0 mg. 
Repeated every 10 minutes.
Total max dose 20 mg.

IV administration same as IM- ACP2 CCP

71
Q

Morphine is preferred over fentanyl- except under specific circumstances:

A

1) Allergy and/ or adverse drug reaction
2) Haemodynamic instability
3) Known/ suspected kidney disease
3) When NAS narcotic administration is the preferred treatment and/ or
4) Suspected ACS

72
Q

Morphine is the preferred narcotic agent except if:

A

1) Suspected ACS
2) Allergy or adverse drug reaction
3) Haemodynamic instability
4) Known suspected kidney disease
5) NAS narcotic admin is the preferred treatment

73
Q

Morphine: Adult dosages- Significant pain

A
  • Subcut (ACP1; ACP2; CCP)- Approval required
  • IM (ACP1)
    >70 years 2.5-5 mg (repeated up to 5 mg every 10 minutes). Max dose 10 mg.
    <70 years 2.5-10 mg (repeated up to 5 mg every 10 minutes). Max dose 20 mg.
74
Q

Morphine: Adult dosages- Significant pain & Autonomic dysreflexia (SBP >160 mmHg)

A
  • IM (ACP2)
    >70 years 2.5-5 mg (repeated up to 5 mg every 10 minutes). Max dose 10 mg.
    <70 years 2.5-10 mg (repeated up to 5 mg every 10 minutes). Max dose 20 mg.
75
Q

Morphine: Indications

A

1) Significant pain
2) Sedation
3) Autonomic dysreflexia (SBP > 160 mmHg)

76
Q

Onset (IM): Naloxone

A

3-5 minutes

77
Q

Onset (IV): Naloxone

A

1-3 minutes

78
Q

Onset/ durantion: Methoxyflurane

A
  • Onset: 1-3 minutes
  • Duration: 5-10 minutes
  • half-life- not available*
79
Q

Onset/ Duration/ Half-life: Adrenaline

A

Onset:

  • IV 30 seconds
  • IM 60 seconds

Duration:
- 5-10 minutes

Half-life:
- 2 minutes

80
Q

Onset/ duration/ half-life: Ceftriaxone

A

Onset: dose/ route variable

Duration: approx. 1 day

Half-life: 6 - 9 hours

81
Q

Onset/ duration/ half-life: Fentanyl

A
  • Onset: < 3 minutes
  • Duration: 30- 60 minutes
  • Half-life: 2- 3 hours
82
Q

Onset/ duration/ half-life: Ipratropium bromide

A

Onset: 1.5- 3 minutes (peak 1.5- 2 hours)
Duration: 4-6 hours
Half-life: 3 hours

83
Q

Onset/ duration/ half-life: Midazolam

A

Onset:

  • IM 5-15 minutes
  • IV 1-3 minutes

Duration:
- Variable

Half-life:
- 2.5 hours

84
Q

Onset/ Duration/ Half-life: Morphine

A

Onset:

  • IM 5-10 minutes (peak- 20-30 minutes)
  • IV 2-5 minutes (peak- 20 minutes)

Duration- 1-2 hours

Half-life- 2 hours

85
Q

Paediatric dosages- Significant nausea and/ or vomiting: Ondansetron

A

PO (ACP1; ACP2; CCP) > 5 years- 4 mg.
Single-dose only.

IM (ACP1) > 5 years- 2 mg.
Single-dose only.

IM (ACP2; CCP) > 3 years- 100 microg/kg.
Single-dose only, not to exceed 4 mg.

IV (ACP2; CCP) > 3 years- 100 microg/kg.
Slow push over 2-3 minutes.
Single-dose only, not exceed 4 mg.

86
Q

Paracetamol- Adult dosages- Mild to moderate pain/ fever

A

PO (presentation- tablet) (ACP1; ACP2; CCP) - 0.5 g- 1 g.
Must not be administered within 4 hours or previous paracetamol administration.
Repeated every 4 hours. Total max dose 4 g in 24 hours.

87
Q

Pediatric dosages- Aspirin

A

Not authorized to administer to patients under 18 years

88
Q

Pediatric dosages- GTN: Autonomic dysreflexia & Irukandji syndrome

A

SUBLING (ACP2; CCP)- Approval required (consultation line)

89
Q

Pharmacology: Adrenaline

A
  • Naturally occurring catecholamine
  • Primarily acts on the alpha and beta-adrenergic receptors
  • Actions of these receptors cause an increase in:
    1) bronchodilators (B1)
    2) heart rate (B1)
    3) force of myocardial contraction (B1)
    4) increase in irritability of ventricles (B1)
    5) Vasoconstriction
90
Q

Pharmacology: Aspirin

A
  • Inhibits platelet aggregation by irreversibly inhibiting cyclo-oxygenase
  • Reducing synthesis of thromboxane A2 (inducer of platelet aggregation)
91
Q

Pharmacology: Ceftriaxone

A
  • Is a third-generation cephalosporin antibiotic with a bactericidal action
92
Q

Pharmacology: Fentanyl

A
  • Synthetic narcotic analgesic

- Acts on CNS by binding with opioid receptors

93
Q

Pharmacology: GTN

A
  • Potent vasodilator
  • Decreases preload by increasing venous capacity
  • Reducing ventricular filling pressure
  • Decreasing arterial BP (afterload)
94
Q

Pharmacology: Ipratropium bromide

A
  • Is an antimuscarinic agent that promotes bronchodilation by inhibiting cholinergic bronchomotor tone.
95
Q

Pharmacology: Midazolam

A
  • Midazolam is a short-acting CNS depressant that induces amnesia, anaesthesia, hypnosis and sedation.
  • Achieves this by enhancing the action of inhibitory neurotransmitter gamma-amino butyric acid
  • Depressant effects occur at all levels of CNS
96
Q

Pharmacology: Naloxone

A
  • Opioid Antagonist
  • Prevents or reverses the effects of opioids including: 1) Respiratory depression
    2) Sedation
    3) Hypotension
97
Q

Pharmacology: Ondansetron

A
  • Ondansetron is a serotonin 5-HT3 receptor antagonist used primarily as an antiemetic (following surgery or chemotherapy)
  • Reduces the activity of the vagus nerve, which activates the vomiting center in the medulla and also blocks serotonin receptors
98
Q

Pharmacology: Paracetamol

A
  • Exhibits analgesic and antipyretic activity

- Does not possess anti-inflammatory activity

99
Q

Precautions: Adrenaline

A

1) Hypertension
2) Hypovolemic shock
3) Concurrent MAOI therapy

100
Q

Precautions: Ceftriaxone

A
  • Nil
101
Q

Precautions: Fenatnyl

A

1) Older people
2) Hypotension
3) Respiratory tract burns
4) Respiratory depression and/ or failure
5) Known addiction to narcotics
6) Current MAOI therapy

102
Q

Precautions: GTN

A

1) Suspected inferior AMI
2) Cerebral vascular disease
3) Risk of hypotension and/ or syncope
4) Intoxication (GTN effects are enhanced)
5) Phosphodiesterase inhibitor medication (e.g. Viagra or Levitra) in the previous 4 days

103
Q

Precautions: Ipratropium bromide

A

Glaucoma

104
Q

Precautions: Methoxyflurane

A

1) ALOC

2) Intoxicated or drug-affected patients

105
Q

Precautions: Midazolam

A
  • Can cause respiratory depression with patients with COPD
  • Multiple sclerosis
  • Myasthenia gravis
  • Reduced dosage should be used in older people, patients with chronic renal failure, congestive cardiac failure or shock
106
Q

Precautions: Morphine

A

1) Older people
2) Hypotension
3) Respiratory tract burns
4) Respiratory depression and/ or failure
5) Known addiction to narcotics
6) Concurrent MAOI therapy
7) Cardiac chest pain

107
Q

Precautions: Naloxone

A

1) Use with caution on patients with pre-existing cardiac disease

108
Q

Precautions: Ondansetron

A

1) Hepatic impairment
2) Intestinal obstruction
3) Patients with risk factors for QT interval prolongation or cardiac arrhythmias
4) First-trimester pregnancy (may only be administered for extreme and uncontrolled hyperemesis)

109
Q

Precautions: Paracetamol

A
  • Hepatic dysfunction
  • Soluble tablets:
    Patients with sodium restriction (heart failure chronic kidney disease)
    Phenylketonuria
110
Q

Presentation: Ceftriaxone

A
  • Vial (powder)- 1 g of ceftriaxone
111
Q

Presentation: Paracetamol

A

1) Tablet, 500 mg paracetamol
2) Elixer, 120 mg/ 5 ml paracetamol
3) Soluble tablet, 250 mg paracetamol

112
Q

Route of administration: Midazolam

A
  • Intranasal (NAS) (ACP1; ACP2; CCP)
  • Intramuscular injection (IM) (ACP1; ACP2; CCP)
  • Intravenous injection (IV) (ACP2; CCP)
  • Intraosseous injection (IO) (CCP)
113
Q

Routes of administration for Naloxone

A

1) IM

2) IV

114
Q

Routes of administration: Ceftriaxone

A
  • IM (ACP1; ACP2; CCP)
  • IV INF (ACP2; CCP)
  • IO INF (CCP)
115
Q

Routes of administration: GTN

A

1) Sublingual (ACP1; ACP2; CCP)

2) Intravenous infusion (CCP)

116
Q

Routes of administration: Ipratropium bromide

A

Nebuliser (NEB) (ACP1; ACP2; CCP)

117
Q

Routes of administration: Methoxyflurane

A

Inhalation (INH)

ensure vehicles are adequately ventilated- to reduce occupational exposure

118
Q

Routes of administration: Morphine

A
  • SUBCUT (ACP1; ACP2; CCP)
  • IM (ACP1; ACP2; CCP)
  • IV (ACP2; CCP)
  • IO (CCP)
119
Q

Side effects: Adrenaline

A

1) Anxiety
2) Hypertension
3) Palpitations/ tachyarrhythmia
4) Pupil dilation
5) Tremor

120
Q

Side effects: Ceftriaxone

A
  • Nausea and/ or vomiting

- Severe pain at the IM administration site

121
Q

Side effects: Fentanyl

A

1) Bradycardia
2) Drowsiness
3) Hypotension
4) Nausea and/ or vomiting
5 Pinpoint pupils
6) Respiratory depression
7) Muscular rigidity (particularly muscles of respiration)

122
Q

Side effects: GTN

A

1) Dizziness
2) Hypotension
3) Syncope
4) Reflex tachycardia
5) Vascular headaches

123
Q

Side effects: Ipratropium bromide

A

1) Dilated pupils
2) Dry mouth
3) Palpitations

124
Q

Side effects: Methoyflurane

A

1) ALOC
2) Cough
3) Renal or hepatic failure

125
Q

Side effects: Midazolam

A
  • Hypotension

- Respiratory depression particularly associated with other CNS depressants including alcohol and narcotics

126
Q

Side effects: Morphine

A

1) Bradycardia
2) Drowsiness
3) Hypotension
4) Nausea and/ or vomiting
5) Pinpoint pupils
6) Respiratory depression

127
Q

Side effects: Naloxone

A 
- Narcotic reversal can cause: (SEXY TALK CAN HELP VOMITING)
S- Sweating
T- Tachycardia
C-  Combativeness
H- Hypertension
V- Vomiting
  • Pulmonary Oedema
  • Acute withdrawal convulsions (in chronic narcotic user)
128
Q

Side effects: Ondansetron

A

1) Headache
2) Constipation
3) Sensation of warmth and flushing
4) Dysrhythmias

129
Q

Side effects: Paracetamol

A
  • Nausea

Placement revision (5 decks)

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