MEDICAL CPG (ADULT) Flashcards
(26 cards)
LIST CLINICAL SIGNS OF SIGNIFICANT DEHYDRATION
- Fatigue
- Altered conscious state
- Poor skin turgor
- Dry mucosa
- Decreased sweating and urination
- Postural changes including tachycardia, hypotension or dizziness
- Evidence of poor fluid intake compared to fluid loss
LIST 4 CAUSES OF UNDIFFERENTIATED NAUSEA AND VOMITING
Secondary to:
- Cardiac chest pain
- Opioid analgesia
- Cytotoxic drugs/radiotherapy
- Severe gastroenteritis
WHAT IS THE PREFERRED TREATMENT FOR N&V IN PREGNANT WOMEN WITH SIGNS OF DEHYDRATION?
Normal Saline
WHY IS ONDANESTRON NOT THE ANTI-EMETIC OF CHOICE FOR PATIENTS ONTRAMADOL?
Ondansetron is an antagonist at the same receptor sites where Tramadol is active as an analgesic. Use of Ondansetron for N&V following Tramadol will reduce the effectiveness of the analgesia.
HOW MUCH FLUID CAN BE ADMINISTERED UNDER THE DEHYDRATION GUIDELINE FOR PATIENTS WITH LESS THAN ADEQUATE PERFUSION?
Normal Saline IV (Max. 40mL/kg) titrated to response
If further fluid is required, call Clinician – If Clinician unavailable, q Normal Saline 20mL/kg IV (Max. 60mL/kg)
HOW MUCH FLUID CAN BE ADMINISTERED FOR PATIENTS WHO ARE ADEQUATELY PERFUSED BUT SIGNIFICANTLY DEHYDRATED?
Normal Saline 20mL/kg IV over 30/60
PROCHLORPERAZINE CAN BE ADMINISTERED INTRAVENOUSLY - TRUE OR FALSE?
False - IM only
LIST 6 NEUROLOGICAL CAUSES OF NAUSEA AND VOMITING
- Head injury
- Stroke
- Meningitis
- Migraines
- Meniere disease
- Motion sickness
WHAT IS THE PHARMACOLOGICAL ACTION OF ONDANSETRON?
5HT3 antagonist which blocks receptors both centrally and peripherally
LIST 3 INDICATIONS OF ONDANESTRON
- Undifferentiated nausea and vomiting
- Prophylaxis for spinally immobilised or eye injured patients
- Vestibular nausea in patients < 21 years of age
LIST 4 CONTRAINDICATIONS OF ONDANSETRON
- Hypersensitivity
- Apomorphine use
- Known long QT syndrome
- Hypokalaemia or hypomagnesaemia
WHAT IS THE MAXIMUM DOSE OF ONDANSETRON THAT CAN BE ADMINISTED TO PATIENTS WITH LIVER DISEASE?
8mg per day
PATIENTS WITH PHENYLKETONURIA (PKU) SHOULD BE ADMINISTERED ONDANSETRON - TRUE OR FALSE?
False - As Ondansetron contains aspartame
PATIENTS WITH PHENYLKETONURIA (PKU) SHOULD BE ADMINISTERED ONDANSETRON - TRUE OR FALSE?
False - As Ondansetron contains aspartame
LIST 5 COMMON SIDE EFFECTS OF ONDANSETRON
- Headache
- Fever
- Dizziness
- Constipation
- Rise in liver enzymes
LIST 7 RARE SIDE EFFECTS OF ONDANSETRON
- Hypersensitivity
- Visual disturbances
- Seizures
- Extrapyramidal reaction
- Widened QRS complex
- Prolonged QT
- Tachyarrhythmias (E.g. AF, SVT)
WHAT IS THE PHARMACOLOGICAL ACTION OF PROCHLORPERAZINE?
Acts on several central neurotransmitter systems
LIST 5 INDICATIONS OF PROCHLORPERAZINE
Treatment or prophylaxis of nausea/vomiting for:
- Motion sickness
- Planned aeromedical evacuation
- Allergy or C/I to Ondansetron
- Headache irrespective of N&V
- Vertigo
WHAT ARE 5 CONTRAINDICATIONS OF PROCHLORPERAZINE
- Circulatory collapse
- CNS depression
- Hypersensitivity
- Patients < 21 years of age
- Pregnant patients
WHAT ARE 3 PRECAUTIONS OF PROCHLORPERAZINE
- Hypotension
- Epilepsy
- Patients affected by alcohol or on anti-depressants
LIST 6 SIDE EFFECTS OF PROCHLORPERAZINE
- Drowsiness
- Blurred vision
- Hypotension
- Sinus tachycardia
- Skin rash
- Extrapyramidal reactions
WHY IS EPILEPSY A PRECAUTION OF PROCHLORPERAZINE ADMINISTRATION
May lower seizure threshold, but does not directly induce seizures
WHY IS EPILEPSY A PRECAUTION OF PROCHLORPERAZINE ADMINISTRATION
May lower seizure threshold, but does not directly induce seizures
WHY IS EPILEPSY A PRECAUTION OF PROCHLORPERAZINE ADMINISTRATION
May lower seizure threshold, but does not directly induce seizures
