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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
Contraindications: Midazolam
- Allergy and/ or adverse drug reaction
26
Contraindications: Morphine
- Allergy and/ or adverse drug reaction | - Kidney disease (renal failure)
27
Contraindications: Naloxone
1) Allergy and/ or adverse drug reaction | 2) Newly born patient
28
Contraindications: Ondansetron
- 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
29
Contraindications: Paracetamol
- Adverse and/ or adverse drug reactions | - Patients < 1 month old
30
Drug class: Adrenaline
Sympathomimetic
31
Drug class: Aspirin
Antiplatelet
32
Drug class: Ceftriaxone
- Antibiotic
33
Drug class: Fentanyl
- Narcotic analgesic-
34
Drug class: GTN
Vasodilator
35
Drug class: Ipratropium bromide
Anticholinergic agent
36
Drug class: Methoxyflurane
- Analgesic (at low doses)
37
Drug class: Midazolam
Benzodiazepine (short acting)
38
Drug Class: Morphine
Narcotic analgesic
39
Drug Class: Naloxone
Opioid Antagonist
40
Drug class: Ondansetron
Anti-emetic
41
Drug class: Paracetamol
- Analgesic | - Antipyretic
42
Duration and half-life: Naloxone
- Duration: 60 minutes | - Half-life: 60 minutes
43
Fentanyl- Adult dosages: Significant pain
- 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.
44
GTN: Onset/ Duration/ Half-life
Onset- 2 minutes Duration- 20-30 minutes Half-life- 5.5 minutes
45
Indications of Naloxone
Respiratory depression (Secondary to Narcotic use)
46
Indications: Adrenaline
1) Anaphylaxis/ allergic reaction 2) Cardiac arrest 3) Croup 4) Bradycardia/ poor perfusion 5) Bronchospasm/ silent chest
47
Indications: Aspirin
1) Suspected ACS | 2) Acute cardiogenic pulmonary oedema
48
Indications: Ceftriaxone
- Suspected meningococcal septicemia (w a non-blanching petechial and/ or purpuric rash)
49
Indications: Fentanyl
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*
50
Indications: GTN (Glyceryl trinitrate)
(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)
51
Indications: Ipratropium bromide
- Moderate bronchospasm (unresponsive to initial QAS salbutamol NEB) - Severe bronchospasm
52
Indications: Methoxyflurane
Pain
53
Indications: Midazolam
- 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
Indications: Ondansetron
Significant nausea and/ or vomiting
55
Indications: Paracetamol
1) Mild to moderate pain | 2) Fever (causing distress)
56
Ipratropium bromide: Adult dosages- Moderate bronchospasm (unresponsive to initial QAS salbutamol NEB) & severe bronchospasm
NEB (ACP1; ACP2; CCP) 500 microg. Repeated at 20-minute intervals. Total max dose- 1.5 mg.
57
Ipratropium bromide: Paedatric dosages- Moderate bronchospasm (unresponsive to initial QAS salbutamol NEB) & severe bronchospasm
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
Metabolism: Adrenaline
- Circulating adrenaline is metabolized by sympathetic nerve endings - Subject to the process of mitochondrial enzymatic breakdown by monoamine oxidase
59
Metabolism: Aspirin
- Aspirin is converted into salicylic acid in many tissues (primarily in GI mucosa and liver) - Excreted by the kidneys
60
Metabolism: Ceftriaxone
- Is excreted as a variety of active and inactive metabolites from the body through urine, bile and faeces
61
Metabolism: Fentanyl
- Hepatic and renal excretion
62
Metabolism: Ipratropium bromide
Hepatic w excretion from the kidneys
63
Metabolism: Methoxyflurane
- By the liver and excreted mainly by the lungs.
64
Metabolism: Midazolam
By the liver and excreted by the kidneys.
65
Metabolism: Morphine
- By the lungs, kidney and liver
66
Metabolism: Paracetamol
- By the liver, excreted by the kidneys
67
Methoxyflurane: Adult dosages- Pain
INH (ACP1; ACP2; CCP) 3 ml (repeated once after 20 minutes). Total max dose of 6 ml.
68
Methoxyflurane: Paedatric dosages- Pain
INH (ACP1; ACP2; CCP) >1 year- 3 ml. Single-dose only.
69
Midazolam- Adult dosages: Acute behavioral disturbance ( w SAT >2) unresponsive to droperidol administration (max dose)
- IM (ACP2) - Approval required (QAS consult line) | - IV (ACP2) - Approval required (QAS consult line)
70
Midazolam- Adult dosages: Generalized seizure/ focal seizure (GCS <12)
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
Morphine is preferred over fentanyl- except under specific circumstances:
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
Morphine is the preferred narcotic agent except if:
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
Morphine: Adult dosages- Significant pain
- 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
Morphine: Adult dosages- Significant pain & Autonomic dysreflexia (SBP >160 mmHg)
- 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
Morphine: Indications
1) Significant pain 2) Sedation 3) Autonomic dysreflexia (SBP > 160 mmHg)
76
Onset (IM): Naloxone
3-5 minutes
77
Onset (IV): Naloxone
1-3 minutes
78
Onset/ durantion: Methoxyflurane
- Onset: 1-3 minutes - Duration: 5-10 minutes * half-life- not available*
79
Onset/ Duration/ Half-life: Adrenaline
Onset: - IV 30 seconds - IM 60 seconds Duration: - 5-10 minutes Half-life: - 2 minutes
80
Onset/ duration/ half-life: Ceftriaxone
Onset: dose/ route variable Duration: approx. 1 day Half-life: 6 - 9 hours
81
Onset/ duration/ half-life: Fentanyl
- Onset: < 3 minutes - Duration: 30- 60 minutes - Half-life: 2- 3 hours
82
Onset/ duration/ half-life: Ipratropium bromide
Onset: 1.5- 3 minutes (peak 1.5- 2 hours) Duration: 4-6 hours Half-life: 3 hours
83
Onset/ duration/ half-life: Midazolam
Onset: - IM 5-15 minutes - IV 1-3 minutes Duration: - Variable Half-life: - 2.5 hours
84
Onset/ Duration/ Half-life: Morphine
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
Paediatric dosages- Significant nausea and/ or vomiting: Ondansetron
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
Paracetamol- Adult dosages- Mild to moderate pain/ fever
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
Pediatric dosages- Aspirin
Not authorized to administer to patients under 18 years
88
Pediatric dosages- GTN: Autonomic dysreflexia & Irukandji syndrome
SUBLING (ACP2; CCP)- Approval required (consultation line)
89
Pharmacology: Adrenaline
- 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
Pharmacology: Aspirin
- Inhibits platelet aggregation by irreversibly inhibiting cyclo-oxygenase - Reducing synthesis of thromboxane A2 (inducer of platelet aggregation)
91
Pharmacology: Ceftriaxone
- Is a third-generation cephalosporin antibiotic with a bactericidal action
92
Pharmacology: Fentanyl
- Synthetic narcotic analgesic | - Acts on CNS by binding with opioid receptors
93
Pharmacology: GTN
- Potent vasodilator - Decreases preload by increasing venous capacity - Reducing ventricular filling pressure - Decreasing arterial BP (afterload)
94
Pharmacology: Ipratropium bromide
- Is an antimuscarinic agent that promotes bronchodilation by inhibiting cholinergic bronchomotor tone.
95
Pharmacology: Midazolam
- 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
Pharmacology: Naloxone
- Opioid Antagonist - Prevents or reverses the effects of opioids including: 1) Respiratory depression 2) Sedation 3) Hypotension
97
Pharmacology: Ondansetron
- 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
Pharmacology: Paracetamol
- Exhibits analgesic and antipyretic activity | - Does not possess anti-inflammatory activity
99
Precautions: Adrenaline
1) Hypertension 2) Hypovolemic shock 3) Concurrent MAOI therapy
100
Precautions: Ceftriaxone
- Nil
101
Precautions: Fenatnyl
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
Precautions: GTN
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
Precautions: Ipratropium bromide
Glaucoma
104
Precautions: Methoxyflurane
1) ALOC | 2) Intoxicated or drug-affected patients
105
Precautions: Midazolam
- 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
Precautions: Morphine
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
Precautions: Naloxone
1) Use with caution on patients with pre-existing cardiac disease
108
Precautions: Ondansetron
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
Precautions: Paracetamol
- Hepatic dysfunction - Soluble tablets: Patients with sodium restriction (heart failure chronic kidney disease) Phenylketonuria
110
Presentation: Ceftriaxone
- Vial (powder)- 1 g of ceftriaxone
111
Presentation: Paracetamol
1) Tablet, 500 mg paracetamol 2) Elixer, 120 mg/ 5 ml paracetamol 3) Soluble tablet, 250 mg paracetamol
112
Route of administration: Midazolam
- Intranasal (NAS) (ACP1; ACP2; CCP) - Intramuscular injection (IM) (ACP1; ACP2; CCP) - Intravenous injection (IV) (ACP2; CCP) - Intraosseous injection (IO) (CCP)
113
Routes of administration for Naloxone
1) IM | 2) IV
114
Routes of administration: Ceftriaxone
- IM (ACP1; ACP2; CCP) - IV INF (ACP2; CCP) - IO INF (CCP)
115
Routes of administration: GTN
1) Sublingual (ACP1; ACP2; CCP) | 2) Intravenous infusion (CCP)
116
Routes of administration: Ipratropium bromide
Nebuliser (NEB) (ACP1; ACP2; CCP)
117
Routes of administration: Methoxyflurane
Inhalation (INH) *ensure vehicles are adequately ventilated- to reduce occupational exposure*
118
Routes of administration: Morphine
- SUBCUT (ACP1; ACP2; CCP) - IM (ACP1; ACP2; CCP) - IV (ACP2; CCP) - IO (CCP)
119
Side effects: Adrenaline
1) Anxiety 2) Hypertension 3) Palpitations/ tachyarrhythmia 4) Pupil dilation 5) Tremor
120
Side effects: Ceftriaxone
- Nausea and/ or vomiting | - Severe pain at the IM administration site
121
Side effects: Fentanyl
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
Side effects: GTN
1) Dizziness 2) Hypotension 3) Syncope 4) Reflex tachycardia 5) Vascular headaches
123
Side effects: Ipratropium bromide
1) Dilated pupils 2) Dry mouth 3) Palpitations
124
Side effects: Methoyflurane
1) ALOC 2) Cough 3) Renal or hepatic failure
125
Side effects: Midazolam
- Hypotension | - Respiratory depression particularly associated with other CNS depressants including alcohol and narcotics
126
Side effects: Morphine
1) Bradycardia 2) Drowsiness 3) Hypotension 4) Nausea and/ or vomiting 5) Pinpoint pupils 6) Respiratory depression
127
Side effects: Naloxone
``` - 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
Side effects: Ondansetron
1) Headache 2) Constipation 3) Sensation of warmth and flushing 4) Dysrhythmias
129
Side effects: Paracetamol
- Nausea

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