Mechanism of Action/Route/Presentation

Question 1

Adrenaline

Answer 1

1mg in 1mL Ampoule - IM/IV/IO
Naturally occurring Alpha & Beta-Adrenergic agonist.
Causes peripheral vasoconstriction (Alpha)
Increases firing rate through SA node to increase HR (Beta 1)
Increases conduction velocity through AV (Beta-1)
Irritates ventricles to increase myocardial contractility (Beta-1)
Causes bronchodilatation (Beta-2)
increases intracellular cyclic adenosine monophosphate (c-AMP) production in mast cells and basophils, reducing release of inflammatory mediators (Beta-2)

Cardiac Arrest 1mg IV Repeated @ 4min Intervals
Asthma 300mcg IM repeated @ 20min Intervals
Anaphylaxis 500mcg IV/IM repeated @ 5min Intervals

Question 2

Aspirin

Answer 2

300mg Chewable tablet
Cyclooxygenase-1 (COX1) Inhibitor - inhibits platelet aggregation by irreversibly inhibiting cyclooxygenase enzyme, reducing synthesis of thromboxane A2 (induces platelet aggregation) for the life of the platelet
inhibiting synthesis of prostaglandins to prevent the further build-up of atherosclerotic plaque thrombi

Question 3

Ceftriaxone

Answer 3

1g in sterile powder in vial
Cephalosporin antibiotic
Ceftriaxone selectively and irreversibly inhibits mucopeptide synthesis in bacterial cell wall.

Question 4

Diazepam

Answer 4

5mg tablet

Benzodiazepine - exhibits anxiolytic and sedative effects

Question 5

Droperidol

Answer 5

10mg in 2mL vial
Antipsychotic - Inhibits dopamine mediated neurotransmission in the cerebrum and basal ganglia, also inhibits the CTZ in medulla
Droperidol causes a CNS depression at subcortical levels of the brain, midbrain, and brainstem reticular formation.

Question 6

Fentanyl

Answer 6

100mcg in 2mL
Synthetic narcotic analgesic
Acts on CNS causing depression leading to analgesia
Respiratory depression leading to apnoea
Dependence (addiction)
CVS effects: decreases conduction velocity through AV node.

Question 7

Glucagon

Answer 7

1mg in 1mL Hypokit
Raises concentration of glucose in blood by causing glyconeolysis - converting stored glycogen in liver to be released as glucose for rapid uptake to increase BGL.
Stimulating gluconeogenesis, which is the production of glucose from amino acids and glycerol in the liver.

Question 8

Glucose 5%

Answer 8

100mL infusion soft pack
Isotonic crystalloid solution (5% sugar)
Provides small source of energy.
Supplies body water
Vehicle for dilution & administration of IV drugs

Question 9

Glucose 10%

Answer 9

25g in 250mL infusion soft pack

Slightly hypertonic crystalloid solution

Question 10

Glucose Paste

Answer 10

15g glucose paste

Hypertonic sugar solution for oral use

Question 11

Glyceryl Trinitrate (GTN)

Answer 11

400mcg sublingual spray
Potent Vasodilator - principally a vascular smooth muscle relaxant
Preload: venous dilatation promotes venous pooling and reduces blood flow back to heart
Afterload: arterial dilatation reduces systemic vascular and arterial pressure
acts to reduce the workload of the heart to reduce preload and afterload and subsequently lower the myocardial oxygen demands of the heart, lower systolic & diastolic & MAP, whilst usually maintaining coronary perfusion pressure

Question 12

Ipratropium Bromide (Atrovent)

Answer 12

500mcg in 1mL polyamp - 8 puffs pMDI
Anticholinergic bronchodilator - antimuscarinic allows bronchodilatation by inhibiting cholinergic bronchomotor tone (i.e blocks vagal reflexes which mediate bronchoconstriction)

Question 13

Lignocaine Hydrochloride

Answer 13

100mg in 5mL ampoule
A local anaesthetic agent
Prevents initiation and transmission of nerve impulses causing local anaesthesia

Question 14

Methoxyflurane

Answer 14

3ml glass bottle
Inhalation analgesic at low concentrations
CNS depressant

Question 15

Metoclopramide (Maxalon)

Answer 15

10mg in 2mL
Dopamine Receptor Antagonist (D2 antagonist works in chemoreceptor trigger zone (CTZ) to prevent nausea and vomiting
Increases tone of lower oesophageal sphincter leading to peristalsis and gastric emptying
Antiemetic which accelerates gastric emptying and peristalsis

Question 16

Midazolam

Answer 16

5mg in 1ml
Short acting CNS depressant
Anxiolytic - reduces anxiety
Sedative
Anti-convulsant
GABA-1 receptor agonist
enhance the inhibitory action of the amino acid neurotransmitter gamma-aminobutyric acid (GABA) to GABA receptors causing increased inhibition neurons by opening chloride channels and causing hyperpolarisation

Question 17

Morphine

Answer 17

1mg in mL ampoule

Narcotic analgesic
CNS depressant leading to analgesia
Respiratory depressant
Depression of cough reflex

CVS effects 1. vasodilatation 2. decreased conduction velocity through A.V node

Question 18

Naloxone

Answer 18

0.4mg in 1ml amp
A narcotic antagonist - competitive binding opioid receptor antagonist
Prevents or reverses the effects of narcotics
In overdose IM 800mcg
Repeat @ 5 mins 400mcg IM/IV
Max dose 2mg

IV 100mcg titrated to response every 60s max 2mg -if no response after 1mg strongly consider other causes transport without delay

Question 19

Normal Saline

Question 20

Ondansetron

Answer 20

4mg in 2mL
Antiemetic
Serotonin 5HT3 receptor antagonist.
Effects both central and peripheral nerves
reduces activity of and vagus nerve, inhibiting the vomiting centre in medulla oblongata
blocks serotonin receptors in CTZ

Question 21

Oxygen

Question 22

Paracetamol

Answer 22

Paracetamol 500mg

Analgesic and antipyretic agent
Thought to inhibit prostaglandin synthesis in the CNS

Question 23

Prochlorperazine

Answer 23

12.5mg in 1mL ampoule
An antiemetic - acts on several central neurotransmitter systems
Antipsychotic drug 1st gen D2 receptors in CTZ
Prochlorperazine blocks the D2 dopamine receptors in the brain resulting in the blockade of postsynaptic dopamine receptors in the mesolimbic system and subsequent inhibition of nausea & vomiting

Question 24

Salbutamol

Answer 24

5mg in 2.5ml nebule (10mg in 5ml dose neb)
500mcg 1mL ampoule
100mcg in 5mL pMDI (8 puffs)
synthetic Beta-adrenergic agonist primarily
Causes bronchodilation by acting on Beta-2 receptors in lungs