Medications Flashcards
Adrenaline 1 in 1,000 (IM)
✅ Anaphylaxis
✅ Life threatening Asthma
Antero-lateral thigh 💉
Adrenaline 1 in 1,000 (Neb)
✅ Severe/ Life-threatening Croup
Adrenaline 1 in 10,000 (IV/IO)
✅ Cardiac arrest
Amiodarone (IV/IO)
✅ Only after 3rd shock in
SHOCKABLE RHYTHM ONLY
✅ After 5th shock
Aspirin 300mg (Oral)
✅ Adults with suspected NSTEMI or STEMI
❌ Multiple contraindications
Atropine for Bradycardia (IV/IO)
✅ Symptomatic Bradycardia for all ages
❌ Hypothermic pt’s
❌ Cardiac transplant
Atropine for OP poisoning (IV/IO/IM)
✅ Suspected OP poisoning in Children under 8
✅ In the absence of Duodote for pt’s 8+
❌ None in presence of life threatening OPP
Benzylpenicillin (🐌IV/IO/IM)
✅ Suspected Meningococcal Disease from birth
❌ Known SEVERE allergy ONLY
Carbetocin (🐌IV/IM)
✅ Primary Post-partum haemorrhage within 24 hours after birth.
ONLY AFTER DELIVERY, uterine massage is ineffective and after 20 weeks gestation
❌ Received Syntometrine
❌ Before all foetuses delivered
Chlorphenamine (IM/IV)
✅ Symptomatic Allergic reaction in pt’s 1 month +
❌ MAOI’s within last 14 days
Co-amoxiclav (🐌IV/IO)
✅ Obvious or suspected open fracture in pt’s 1yr +
❌ Multiple
Dexamethasone (Oral)
✅ Mild to Life-threatening Croup in pt’s 1mth- 10 yrs
❌ Hypertension
❌ Infection or Sepsis
Diazepam (🐌IV/IO/Rectal)
✅ Convulsion of 5 mins+ OR 3rd convulsion in an hour AND currently convulsing from birth
✅ Eclamptic Convulsion
✅ Symptomatic Cocaine Toxicity
❌ Not for seizure secondary to hypoglycaemia
Duodote (IM, mid-lateral thigh)
✅ Over 8 years with suspected OPP/ nerve agent
❌ None in life threatening
Furosemide (🐌 IV)
✅ Respiratory distress in pt’s with pulmonary oedema or acute HF
❌ Under 18
❌ Cardiogenic Shock
❌ Reduced GCS with liver cirrhosis
❌ Severe Renal Failure
Glucagon (IM ONLY)
✅ Hypoglycaemia where oral and IV glucose are not possible in pt’s from birth to adults
❌ Pheochromocytoma (Adrenal medulla tumour)
Glucose 10% (IV/IO)
✅ Hypoglycaemia in pt’s unable to receive oral 40%
❌ None if Oral route is inappropriate and hypo is confirmed
Glucose 40% (Buccal)
✅ Known or suspected hypoglycaemia
❌ None
GTN (sublingual)
✅ In Acute HF if Systolic is OVER 110
✅ Cardiac CP from suspected ACS if Systolic over 90
✅ Suspected cocaine toxicity with CP
❌ Several
🟠 CAUTION in pt’s with suspected posterior or R-Ventricle MI
Hydrocortisone (🐌IV/IO/IM)
✅ Severe/ Life-threatening Asthma
✅ Acute Exacerbation of COPD
✅ Adrenal Crisis (Such as Addisons)
❌ Known allergy only
Ibuprofen (Oral)
✅ Mild to moderate pain in pt’s 3 months+
✅ Pyrexia with discomfort
❌ Several see JRCALC
Fluids (IV/IO)
✅ Trauma, isolated head injury to maintain BP of 110
✅ Trauma, penetrating to trunk to maintain a good central pulse OR maintain BP 60
✅ Trauma, penetrating limb to maintain peripheral pulse or BP 90
✅ Trauma, blunt trunk or limb to maintain peripheral pulse or BP 90
✅ Crush syndrome should receive 2L regardless of BP
✅ Burns, see JRCALC for percentages
✅ Dehydration from any medical cause
✅ Sepsis
✅ DKA
✅ Anaphylaxis
Ipratropium Bromide (Neb)
✅ Acute severe/ life-threatening Asthma
✅ Acute asthma unresponsive to salbutamol alone
✅ Exacerbation of COPD, unresponsive to salbutamol
❌ None
Lidocaine (IO)
✅ Life threatening presentation and IV cannot be established in conscious pt
❌ Several see JRCALC
Penthrox (Inhaled)
✅ 18+ with moderate/severe pain from trauma
❌ Multiple see JRCALC
Midazolam (Buccal)
✅ Convulsion of 5 mins+ OR 3rd convulsion in an hour AND currently convulsing from birth WHERE IV ACCESS CANNOT BE ESTABLISHED
✅ Eclamptic Convulsion WHERE IV ACCESS CANNOT BE ESTABLISHED
✅ Symptomatic Cocaine Toxicity
❌ Psychogenic non-epileptic seizure
❌ Two doses of BZ’s already given
Misoprostol (Oral/Rectal)
✅ Primary PPH where IV uterotonic contraindicated or unavailable
✅ Primary PPH not responding to oxytocin, syntometrine or Carbetocin
✅ Confirmed miscarriage with life-threatening haemorrhage under 20 weeks gestation WITH NO FETUS IN UTERO
❌ IV uterotonic available
❌ Fetus in utero
❌ Undiagnosed miscarriage
Morphine (IV/IO/IM/SC/Oral)
✅ Pain associated with suspected myocardial Infarction
✅ Severe Pain and BP above 90 (in adults)
✅ Breathlessness and pain in End of Life pt’s
❌ Under 1
❌ Respiratory Depression
❌ Hypotension
❌ Head Injury with below AV(P)U or GCS below 9
❌ Known Hypersensitivity
🟠 Extreme Caution in Pregnancy
🟠 Chest Injury
🟠 Hepatic or Renal Failure (consider small doses)
🟠 Head Injury
🟠 Low weight/frail/elderly
🟠 Alcohol Intoxication
🟠 On antidepressants, sedatives or tranquillisers
Naloxone (IV/IO/IM)
[IN in pt’s 12 years +)
✅ Reversal of respiratory depression due to acute opioid toxicity
✅ Unconsciousness associated with respiratory depression where opioid overdose is a possibility
❌ Neonates should be treated with BVM and O2
Entonox (Inhaled)
✅ Moderate to severe pain
✅ Labour pain
❌ Head injury with impaired consciousness
❌ Decompression sickness ‘The Bends’
❌ Violent psychiatric pt’s
❌ Abdo pain with suspected obstruction
❌ Intraocular injection within 8 weeks
🟠 Suspected or confirmed pneumothorax, polytrauma or penetrating torso injury
Ondansetron (🐌IV/IM)
✅ Treatment of nausea or vomiting
✅ Prevention and treatment of opiate-induced nausea & vomiting
✅ For travel associated nausea or vomiting in children
❌ Under 1 month old
❌ Known hypersensitivity
❌ Congenital long QT syndrome
🟠 Prolonged QT interval
🟠 Hepatic impairment
🟠 Pregnancy
🟠 Breastfeeding
Oxygen (Inhaled)
✅ Illness requiring oxygen
✅ Significant illness or injury in children
❌ Explosive environment 💥
Paracetamol (Oral/🐌IV)
✅ Mild to moderate pain
✅ High temperature with discomfort
❌ Severe Liver disease
❌ Max cumulative dose already reached
🟠 Renal impairment
🟠 Pregnancy
🟠 Adults under 50kg will need a reduced dose
Prednisolone (Oral)
✅ For supply to pt’s following an episode of acute asthma that is suitable for home management
❌ No pre-existing asthma diagnosis
❌ Initial presentation of near life-threatening asthma
❌ Any Asthma red flags
❌ Suspected or confirmed infection
❌ Myocardial Infarction in past 4 weeks
❌ Recent live viral vaccine
❌ Currently taking oral steroids
❌ Already received 2x doses in past month
🟠 Breastfeeding
🟠 Pregnancy
🟠 Diabetics
Salbutamol (Nebulised)
✅ Acute asthma where inhaler therapy not effective
✅ Expiratory wheeze due to anaphylaxis, beta-blocker overdose, smoke inhalation or other lower airway cause
✅ Exacerbation of COPD
❌ None
🟠 Hypertension
🟠 Angina
🟠 Hyperthyroidism
🟠 Late pregnancy
🟠 Abnormal softening of airway
Tranexamic Acid (🐌IV/IO)
✅ Known or suspected severe internal or external haemorrhage within 3 hours of bleed starting
✅ Any pt receiving a tourniquet/ haemostatic gauze/ pressure dressing/ chest dressing
✅ Pt in traumatic cardiac arrest
✅ Traumatic brain injury in pt’s 18+ with GCS 12 or less within 3 hours of injury
✅ Post-partum haemorrhage AFTER administration of a uterotonic
❌ Known anaphylaxis to TXA
❌ Obvious resolution of haemorrhage
❌ Haemorrhage started over 3 hours ago
🟠 Pregnancy
🟠 History of convulsions or new convulsions
🟠 Known history of acute venous/arterial thrombosis
🟠 Several Renal impairment
