medical emergency drug kit Flashcards
What is GTN used for?
angina
What dosage of GTN spray is kept in the medical emergency kit?
400 micrograms
What route is GTN spray administered?
Sublingually (under the tongue)
What type of inhaler is kept in the medical emergency drugs kit?
Salbutamol
What dosage per usage is administered with a salbutamol inhaler?
100 micrograms
What medical emergency drug is administered for myocardial infarction?
Dispensable aspirin.
What dosage of dispensable aspirin is administered in the event of an MI?
300 mg
What is administered in the event of a hypoglycaemic attack?
1mg Glucagon
How is glucagon administered during a hypoglycaemic attack?
Intramuscularly
Which drug is administered in the event of status epilepticus?
Midazolam
How much midazolam is administered in the event of status epilepticus?
5 mg/ml or 10 mg/ml
How is midazolam administered?
Buccally
How much adrenaline is administered to adults and children over 12?
500 micrograms
How much adrenaline is administered to children from 6-12?
300 micrograms
How much adrenaline is administered to children under 6?
150 micrograms
When would oxygen be administered?
For anaphylaxis, asthma attack, angina and myocardial infarction.
In the event of anaphylaxis, how much oxygen would be administered?
15 litres/min through a non-rebreathe mask.
8 drugs found in the ME kit:
- Adrenaline (1:1000)
- Dispensable Aspirin 300mg
- Glucagon injection (1 unit vial)
- Glucose (oral administration)
- GTN spray
- Midazolam oral mucosal solution
- Oxygen
- Salbutamol aerosol inhaler (100 micrograms)
What is the mode of action for adrenaline?
ALPHA AGONIST:
reverses peripheral vasodilation and reduces oedema.
BETA AGONIST
- dilates the bronchial airways.
- inhibit mast cell activation so early administration helps anaphylaxis.
Presentation of Adrenaline
- Ampoules (administered either 23-21 needle).
- Pre-filled syringes.
- Auto-injector devices.
autoinjectors not used due to expense
What are the side effects of adrenaline administration?
- palpitations
- dry mouth
- only adverse effect was an MI in a patient with severe ischemic heart disease *
What is the mechanism of action for adrenaline?
COX-1 and COX-2 inhibitors.
Inhibits thrombus formation to create an antiplatelet effect.
Presentation of soluble aspirin.
Soluble aspirin 300mg either in a child proof container or blister pack.
Dose and route of administration of Aspirin.
300mg crushed or chewed
(reduces the incidence of re-occlusion following thrombolytic therapy)
Contraindications of Aspirin
A known allergy
When should glucagon be administered?
When the patient is in an unconscious state of hypoglycaemia (blood sugar levels of less than 3)
What is the mode of action for glucagon?
Increases the patient’s blood sugar levels by metabolising glycogen in the liver.
Presentation of glucagon in the medical emergency drugs kit?
Glucagon injection As GlucaGen Hypokit.
stored in the fridge or out below 25C for up to 18 months
Glucagon dose and route of administration.
Adults and children greater than 8 or 25 kg, inject all of the medicine.
Children under 8, inject half the medicine (0.5 ml).
Side effects of Glucagon.
Nausea, vomiting and temporary tachycardia.
Contraindications for use of Glucagon
- Allergy to glucagon or lactose.
- Tumour of the adrenal gland.
- Tumour of the pancreas.
When would glucose be administered?
Hypoglycaemia
when conscious, co-operative and IN-TACT GAG REFLEX
Dose of Glucose
10-20g of 40% fast acting glucose gently rubbed to aid absorption.
When does GTN reach its peak concentration?
4 minutes
How does GTN work?
Increases the production of Nitric Oxide which initiates the relaxation of smooth muscle to produce arterial and venous vasodilation.
What does GTN present as in the drugs kit?
Pressured container (red) which delivers 400 micrograms.
Dose and route of administration of GTN.
1 or 2 metered doses (400-800 micrograms) given under the tongue whilst the patient holds their breath.
no more than 3 doses at one time
Mode of action of midazolam?
Binds to the GABA receptor but doesn’t displace GABA, it increases the affinity for its receptor site on the same receptor complex.
Reduces seizure activity.
Midazolam dose.
Child 1-5: 5 mg
Child 5-10: 7.5 mg
Child above 10: 10mg