Medical Toxicology Drugs Flashcards
What are the indication for adrenaline?
Cardiac arrest
Anaphylaxis OR severe allergic reaction
Severe life-threatening bronchospasm OR silent chest
Shock unresponsive to adequate fluid resuscitation
Bradycardia with poor perfusion
Croup (moderate to severe)
What are the contraindications for adrenaline?
Nil
What are the precautions for adrenaline?
Hypertension
Hypovolaemic shock
Concurrent MAOI therapy
Quetiapine toxicity
What are the side effects of adrenaline?
Anxiety
Hypertension
Palpations/tachyarrhythmias
Pupil dilation
Termor
What is the onset, duration, and half-life for adrenaline?
30 sec (IV) OR 60 sec (IM)
5-10 mins
2 mins
What is the adult dose of adrenaline in a cardiac arrest?
IV: 1mg - repeated at 3-5 min intervals (no max dose)
What is the adult dose of adrenaline for anaphylaxis OR severe allergic reaction?
IM: 500 mcg - repeated at 5 min intervals
NEB: 5mg - single dose
What is the paediatric dose of adrenaline for anaphylaxis OR severe allergic reaction?
IM: 6yrs or older - 300mcg
1 yr to <6 yrs - 150mcg
6 mths to <1 yr - 100mcg
<6 mths - 50mcg
NEB: 5mg single dose
What is the indication(s) for loratadine?
Symptomatic urticaria (without evidence of anaphylaxis)
What are the contraindications for loratadine?
Allergy AND/OR ADR
Anaphylaxis
Patients <8 years
What are the precautions for loratadine?
Severe hepatic impairment
Increased risk of sedation and anticholinergic effects in older people
What are the side effects of loratadine?
Drowsiness
Fatigue
Headache
Nausea
Dry mouth
What are the adult and paediatric doses for loratadine?
Adult: PO 10mg single dose
Paed >8yrs: PO 10mg single dose
What are the indications for ceftriaxone?
Suspected meningococcal septicaemia (with a non-blanching petechial AND/OR purpuric rash)
What are the contraindications for ceftriaxone?
Absolute:
Allergy AND/OR ADR
Known immediate OR severe hypersensitivity to penicillin OR carbapenem based drugs
Relative:
Patients <1 month
What are the precautions for ceftriaxone?
Any allergy of hypersensitivity to penicillin or carbapenem
What are the side effects of ceftriaxone?
Pain and/or inflammation at the injection site
What is the adult dose for ceftriaxone?
IM: 2g (2x 1g IM injections) single dose only - reconstitute with 2.4mL of water for injection in a 3mL syringe (1g/3mL)
IV: 2g slow push over 5 minutes
Reconstitute 2g with 18.8mL of water for injection (2g/20mL)
What is the paediatric dose for ceftriaxone?
IM: 50mg/kg (rounded to the nearest 5kg) - reconstitute 1g with 2.4mL water for injection.
<5kg = 250mg or 0.75mL
>5-10kg = 500mg or 1.5mL
>10-15kg = 750mg or 2.25mL
>15kg = 1g or 3mL
What is the indication for glucose gel?
Symptomatic hypoglycaemia (with the ability to self-administer oral glucose)
What are the contraindications for glucose gel?
Unconsciousness
Patients with difficulty swallowing
Patients less than 2 years of age
What are the precautions of glucose gel?
Nil
What are the side effects of glucose gel?
Nausea and/or vomiting
Diarrhoea
What are the adult and paediatric doses for glucose gel?
15g
Repeated once at 15 minutes if BGL is < 4.0mmol/L
Total max dose 30g
What are the indications for glucagon?
Symptomatic hypoglycaemia (with the inability to self-administer oral glucose)
Refractory anaphylaxis with persistent hypotension/shock (unresponsive to 3xIM adrenaline injections and adequate fluid challenges)