Medications Flashcards

Question

Atropine Precautions

Answer 1

- May not be effective with 3rd degree heart block - Isolated Bradycardia or link to traumatic cause is not an indication for atropine. All reversible causes should be addressed prior to consideration of Atropine. - 12 lead ECG prior to rule out STEMI and 3rd degree - Bradycardia in children is usually a result of hypoxia or vagal stimulation. Look at reversible causes - May affect glaucoma - Max effective dose is 3mg for bradycardia. For organophosphate repeat doses may be required and is achieved when with an increased HR, dilated pupils and decreased secretion, do not delay transport as atropinisation might not be achievable in the pre-hospital setting.

Answer 2

Tachycardia and/or palpitations Dilated pupils and/or blurred vision Dry mouth and/or urinary retention Confusion, restlessness (large doses) Hot, dry skin (large doses)

Answer 3

Topical pump spray containing: Lignocaine hydrochloride 50mg/ml Phenylephrine 5mg/ml A topical local anaesthetic and haemorrhage control agent for the relief of surface pain, nasal and oral bleeding

Answer 4

Local pain: abrasions, small cuts and wounds Relief of mild and moderate epistaxis Post tonsillectomy haemorrhage Intra-oral haemorrhage

Answer 5

Hypersensitivity to phenylephrine, lignocaine or other anaesthetics Children <2yrs Pregnancy

Answer 6

Caution with cardiovascular, hepatic and/or renal disease. For oral use, nozzle inserted within the anterior 1/3 of mouth to avoid gag stimulation. Each spray delivers 100 microlitres of fluid. The dose of lignocaine in each squirt is 5 mg and the dose of phenylephrine in each squirt is 0.5mg

Answer 7

Oral administration may cause a transient bitter taste. Pause between subsequent doses.

Answer 8

10mg in 2ml

Answer 9

A neuroleptic, antipsychotic agent that acts on Alpha and Dopamine receptors, resulting in sedation Use of a sedative agent should never be considered routine. Have a high threshold to offer or administer

Answer 10

3-5 min IV and IM

Answer 11

- Disturbed and Abnormal Behaviour (RASS 1 ~ 3) if considered appropriate where risk to safety is evident and de-escalation has not been effective. - Dementia and frail patients where Olanzapine cannot be administered or is ineffective.

Answer 12

- Known allergy - Known Parkinson’s Disease - Where Ketamine has been administered to sedate this episode - Age < 6 years old - Post-ictal Disturbed & Abnormal Behaviour

Answer 13

- Address organic causes for behavioural presentations at all times- eg. CVA, TBI, Hypoxia, Hypoglycaemia, etc - Post-ROSC agitation - consult ASMA / SOC CSP - Dementia patients – apply caution. Use lower doses ‘Agitated or Excited Delirium’, ‘Acute Behavioural Disturbance’ and ‘Drug Induced Psychosis’ are some alternative terms

Answer 14

- Extrapyramidal effects / Dyskinesia - Increased falls risk - Hypotension - Apply monitoring as soon as practicable

Answer 15

- Sedation is HIGH RISK – only after careful deliberation between officers and must not be based primarily at the request or influence of other agencies on scene (e.g. Police etc.) - Positive RASS score does not automatically = need to sedate - Age <16 years old – prior ASMA consult wherever practicable - ETOH / Intoxication – apply caution - Repeat & Maintenance doses – have low threshold to consult ASMA for repeat or maintenance doses - SpO2 and EtCO2 monitoring whenever level of consciousness drops (~RASS -2 or below) - DO NOT transport in supine position (increases risk of laryngospasm from secretions) – transport in lateral position - Monitor airway and breathing effort closely for signs of impairment - Restraint – Prone and/or handcuffed to rear carries excessive risk and MUST NOT occur. Physical restraint in any position that amplifies the risk of positional asphyxia, must be closely observed for signs of air hunger and hypoxia - RASS scores must be agreed and documented - Estimated weight must be agreed before administration and documented

Answer 16

IN: 450mcg in 1.5ml IV/IO: 100mcg in 2ml

Answer 17

A short acting synthetic narcotic analgesic

Answer 18

Moderate to severe pain. Acute Coronary Syndromes where GTN has been ineffective

Answer 19

Hypersensitivity Child <1 year of age (IV / IO only) Occluded nasal passages or epistaxis (IN only)

Answer 20

- Elderly patients - Respiratory depression: especially those at risk e.g. patients with severe COPD - Patients currently on MAO inhibitors or MAO inhibitor use within previous 14 days - Caution in larger doses of women in active labour - Use of IV Ketamine as analgesic prior to minimum dose of IV Fentanyl requires ASMA authorisation: Paediatric: 100 microg Adult < 70 years old: 200 microg Adult > 70 (or frail): 100 microg - Administer slowly - Cease administration prior to calculated dose if desired effect is obtained. - Patients under extended care (e.g. 'ramped' patients) who have already been administered pain relief should have careful consideration with regards to the dosages of fentanyl administered, titrating only to effect.

Answer 21

- Adopt a low threshold to engage with the ED team if pain remains difficult to control - Drowsiness - Nausea/vomiting - Respiratory depression; (monitor pulse oximetry) - Cardiovascular effects: Bradycardia Hypotension (rare)

Answer 22

1mg in 1ml

Answer 23

A hyperglycaemic agent that converts stored liver glycogen to glucose to increase blood glucose concentration.

Answer 24

4-7 minutes, duration 10-30 minutes.

Answer 25

For demonstrated hypoglycaemia where oral glucose cannot be administered and IV access cannot be obtained in a safe and timely manner. - Altered conscious state in a known diabetic or of otherwise unknown cause where blood glucose level is below 4mmol/L.

Answer 26

Hypersensitivity Known pheochromocytoma, insulinoma & glucagonma

Answer 27

- Only effective if sufficient liver glycogen is present (eg: it does not work on alcohol or anorexia induced hypoglycaemia). - Even if fully recovered, encourage transport for follow up and review. - Give complex carbohydrates orally when patient has responded to prevent recurrence

Answer 28

Nausea/vomiting Gastric pain Transient rise of blood pressure for patients taking beta blockers

Answer 29

500ml bag 10% glucose 10g per 100ml

Answer 30

- A hypertonic crystalloid solution that provides a readily available source of energy (glucose) - Contains 100 mg glucose anhydrous/ml

Answer 31

Demonstrated hypoglycaemia where oral glucose administration is inappropriate in: - Altered conscious state in known diabetic or of otherwise unknown cause where blood glucose level is below 4 mmol/L. - Cardiac arrest, only if hypoglycaemia is suspected as a contributory cause of the arrest, not an early indication.

Answer 32

No IV access

Answer 33

- Large gauge cannula into a large vein, with patency with free flowing bolus (>20 mL) of 0.9% normal saline, before administering glucose 10% using a 20 mL syringe via the injection port, titrated to effect. - Administration via an IO should utilise a 20 mL syringe and a three way tap. - High concentration of IV glucose may aggravate dehydration due to its hypertonicity whereby it draws water from the cells. - IV glucose is corrosive and IV patency must be ensured before administration. - Careful titration of glucose in head injured patients is vital as glucose leaking into CNS tissue will aggravate the injury, resulting in cerebral oedema. - Monitor blood glucose level carefully; beware of drop in level again after the patient has recovered. - Even if fully recovered, encourage transport - IO administration is only as a last resort after all other avenues have been exhausted and the patient needs lifesaving glucose. - Do not wait on scene for glucose to take effect. - Note that repeat doses of Glucose 10% (Intravenous) may be needed achieve normoglycaemia

Answer 34

Hyperglycaemia Diuresis Tissue necrosis Thrombophlebitis

Answer 35

Rapidly absorbed from oral/buccal mucosa to increase blood glucose concentration Contains 15g glucose

Answer 36

2-5 minutes; duration 12-25 minutes

Answer 37

Demonstrated hypoglycaemia in: - Altered conscious state in a known diabetic. - Altered conscious state of unknown medical cause, where blood glucose level is below 4 mmol/L.

Answer 38

- Airway patent and in lateral position if unconscious. - Always consider airway when administering gel. - Even if fully recovered, encourage to be transported to a medical facility to ensure effective follow up and review. - Will liquefy over 30°C, however it is still useable.

Answer 39

Airway Obstruction

Answer 40

400mcg per spray

Answer 41

Nitrates cause the relaxation of vascular smooth muscle resulting in: - Vasodilation - Peripheral pooling and reduced venous return - Reduced left ventricular end diastolic pressure (preload) - Reduced systemic vascular resistance (afterload) - Reduced myocardial energy and oxygen requirements - Relaxes spasm of coronary arteries

Answer 42

- Chest pain/discomfort of presumed cardiac origin not relieved by rest and reassurance with systolic BP > 90 mmHg. - Acute Cardiac Pulmonary Oedema with systolic BP >90 mmHg. - Autonomic Dysreflexia with systolic BP > 160 mmHg.

Answer 43

- Hypersensitivity - Hypotension < 90 mmHg - Recent use of medications used for erectile dysfunction: Sildenafil (Viagra®) or Vardenafil (Levitra®) or Avanafil (Spedra®) use in the previous 24 hours Tadalafil (Cialis®) use in the previous 3 days

Answer 44

- Nitrates = early intervention, do not delay - Administer in seated or semi-recumbent position - Do not shake GTN bottle prior to administration - Assess BP before every dose - Severe hypotension is an uncommon side effect - Intoxication (effect are enhanced) - Phosphodiesterase 5 inhibitor medication administration in previous 4 days

Answer 45

Hypotension (rare) Tachycardia Flushing Headache Dizziness - when GTN infusion used for ACPO, hypotension side effects amplified

Answer 46

5000IU in 5mL

Answer 47

A naturally occurring anticoagulant which inhibits the clotting of blood by increasing the rate at which antithrombin III neutralises thrombin and activated factor X (Xa)

Answer 48

IV: Immediate

Answer 49

Patients with STEMI going directly to Cardiac Catheterisation Laboratory as per receiving hospital 12-lead ECG interpretation

Answer 50

- Hypersensitivity to Heparin - Active bleeding (excluding menses) or disease states with an increased risk of bleeding (e.g. haemophilia)

Answer 51

Haemorrhagic risks in case of possible trauma

Answer 52

Haemorrhage Hyperkalaemia Thrombocytopenia

Answer 53

0.9% in 250ml or 1000ml 10ml flush

Answer 54

A sterile isotonic crystalloid solution

Answer 55

Fluid replacement (volume expansion) for the treatment of shock, fluid loss, and cardiac arrest.

Answer 56

Severe pulmonary oedema

Answer 57

Adult patients with penetrating trauma, ectopic pregnancy or aortic aneurysm with hypotension and signs of impaired organ perfusion may benefit from permissive hypotension (systolic blood pressure of 70mmHg)

Answer 58

Hypervolemia

Answer 59

250mcg in 1ml 20mcg per puff MDI

Answer 60

- An anticholinergic bronchodilator. It inhibits the vagal reflexes that mediate bronchospasm - Combined with a nebulised short-acting beta-2 agonist (e.g. salbutamol), ipratropium bromide produces significantly greater bronchodilation than a short-acting beta-2 agonist alone

Answer 61

Severe bronchospasm: - Adult: Severe to life-threatening asthma or COPD - Paediatric: Severe to life-threatening asthma

Answer 62

Hypersensitivity

Answer 63

- Glaucoma - Avoid contact with eyes

Answer 64

Headache Nausea, dizziness Dry mouth, throat irritation Taste disturbance Skin rash

Answer 65

200mg in 2ml

Answer 66

Rapid acting dissociative anaesthetic Use of a sedative agent should never be considered routine. Have a high threshold to offer or administer

Answer 67

IM: 5-10 minutes IV: 1 minute

Answer 68

- IV: Second line agent for severe pain of traumatic origin post IV Fentanyl administration. ASMA consult needed if IV Fentanyl minimum dose (age dependent as per CPG) has not been given prior to IV Ketamine administration - IM: First line agent for severe pain of traumatic origin should other means of administering pain medication not be available - Combative Traumatic Brain Injury - (RASS 4) First line agent for severely disturbed or abnormal behaviour where there is an immediate risk to safety and rapid tranquilisation is required and no other sedative medications have already been administered to this patient

Answer 69

- Hypersensitivity - Active cardiovascular disease including cardiac chest pain, heart failure, severe or poorly controlled hypertension - Patients with delayed transfer of care (i.e. 'ramped') - Disturbed and abnormal behaviour that are clearly not RASS 4 or where other sedative agents have already been administered (ASMA authority required) - Rapid Tranquilsation ONLY: Age < 16 years old - Age < 1 years old

Answer 70

- Stable psychiatric disorders such as Schizophrenia - Hyperthyroidism or receiving thyroid replacement due to increased risk of hypertension and tachycardia - Analgesia – IV Fentanyl minimum dose (age dependant as per CPG) should be given prior to IV Ketamine administration - Analgesia for Non traumatic pain (IM / IV / IO) in opioid-dependent patients – consider SOC CSP consult - Sedation warnings

Answer 71

Blood pressure and pulse frequently elevated Random purposeless movements, muscle twitching and rash are common Hypersalivation Emergence reactions (10%) Transient laryngospasm Transient apnoea or respiratory depression

Answer 72

20mg in 2ml OR 50mg in 5ml

Answer 73

1-2 minutes

Answer 74

Reversibly interrupt impulse conduction in peripheral nerves and stabilise excitable cell membranes by blocking Sodium Channels

Answer 75

Local anaesthesia for: - IV cannulation - IO infusion - Suturing - Finger thoracostomy in the conscious patient

Answer 76

Hypersensitivity

Answer 77

Adverse drug reactions are rare when lignocaine is used as a local anaesthetic and is administered correctly.

Answer 78

- Tinnitus, dizziness, anxiety, confusion, perioral numbness - Cardiovascular effects: Bradycardia, hypotension, dysrhythmias - CNS effects - Respiratory depression

Answer 79

3mL ampoule

Answer 80

A halogenated ether that produces powerful modification of the awareness of pain with an associated light headed sensation.

Answer 81

6-8 breaths, 1-2 minutes, peak 2-4 minutes

Answer 82

Patients who are unable to understand or co-operate. Patients with severe renal impairment. Patients with head injury and altered consciousness that prevents co-operation with its use. Hypersensitivity e.g. malignant hyperthermia

Answer 83

- Use charcoal filter - Use extractor fan during transit - Instruct the patient to breathe in through their mouth and out through their mouth via the inhaler. For maximum effect cover the air dilutor hole. - Initial breath is strong and may cause the patient to cough, so advise to take gently - Watch for drowsiness - If oxygen is required deliver separately - Place in a sealed plastic bag when not in use

Answer 84

Lightheaded Dizziness Drowsy Nausea Malignant hyperthermia

Answer 85

15mg in 3ml

Answer 86

A water-soluble benzodiazepine that has anxiolytic, sedative and anticonvulsive characteristics. This is due to its bonding with receptors in the CNS; its action to increase the inhibitory effect of the g-aminobutyric acid (GABA) neurotransmitter on the GABA receptors and subsequent membrane threshold. - Midazolam is lipid-soluble in physiological pH and it reaches the CNS quickly. - Use of a sedative agent should never be considered routine. Have a high threshold to offer or administer.

Answer 87

- Prolonged seizure activity - generalised seizure lasting ≥ 5 minutes OR recurrent / status seizure activity as per CPG - Focal seizure activity which is prolonged (≥ 5 minutes) and is associated with a GCS ≤ 12 as per CPG - Second-line IV agent for maintenance of sedation after Droperidol administration for Disturbed and/or Abnormal Behaviour

Answer 88

Hypersensitivity Use of Midazolam for sedation after Ketamine requires ASMA authority

Answer 89

- Early monitoring as soon as practicable is required when administering midazolam; including SpO2, respiratory rate, pulse and blood pressure - SpO2 and EtCO2 monitoring must be applied whenever level of consciousness drops consistent with the Sedative Warnings section. - Psychostimulants, in toxic levels can produce severe agitation and psychotic behaviour - Paediatric patients: Intramuscular administrations should always be prepared in a 1mL IM syringe Have a low threshold to consult with ASMA when repeat or maintenance doses are required for sedation

Answer 90

Respiratory depression Hypotension Anterograde and retrograde amnesia Myasthenia Gravis

Answer 91

0.4mg in 1ml

Answer 92

A pure opioid antagonist; exerts effect by competitive inhibition at the opioid receptor sites. Prevents or reverses the effects of opioids, including: respiratory depression sedation and hypotension. In the absence of opioids, it exhibits essentially no pharmacological activity.

Answer 93

Reversal of respiratory depression in a suspected narcotic overdose

Answer 94

Hypersensitivity

Answer 95

- Polypharmacy overdose. - Half-life of naloxone is < 1 hour; repeat doses may be required to maintain effect with longer acting opioids and those with active metabolites (e.g. methadone, diphenoxylate, codeine). Observe patients who respond to naloxone for 2-3 hours after administration for signs of re-narcotisation. - Response to Naloxone is rapid; reconsider diagnosis if there is a failure to respond to 2 mg Naloxone. - Patients may be aggressive post Naloxone and administration due to hypoxia. Scene safety and personal safety are paramount.

Answer 96

Withdrawal symptoms such as: Aggression Agitation Nausea/vomiting Dilated pupils and lacrimation THN - max dose is 3.6mg, attempt to convince to transport to hospital, if not leave them with THN, document if given, only give to SJA patients

Answer 97

5mg tablet

Answer 98

A second generation antipsychotic agent that acts on multiple receptors (incl. serotonin and dopamine receptors), resulting in sedation Use of a sedative agent should never be considered routine. Have a high threshold to offer or administer.

Answer 99

~10 minutes

Answer 100

- Disturbed and Abnormal Behaviour (RASS 1 ~ 3) if considered appropriate where risk to safety is evident and de-escalation has not been effective - Patient is able to tolerate or self-administer an oral wafer - Preferred first line sedation agent in frail patients and those with Dementia

Answer 101

Known Allergy Known Parkinsons Disease Age < 6 years old

Answer 102

- Address organic causes for behavioural presentations at all times- eg. CVA, TBI, Hypoxia, Hypoglycaemia, etc - Dementia patients – apply caution. Use lower doses - Oral dispersible tablet may be dissolved in water (may slightly delay onset of action but still preferable in non-emergent cases) - ‘Agitated or Excited Delirium’, ‘Acute Behavioural Disturbance’ and ‘Drug Induced Psychosis’ are some alternative terms that may be used by other agencies

Answer 103

Extrapyramidal effects / Dyskinesia Increased falls risk Hypotension – Apply monitoring as soon as practicable

Answer 104

4mg in 2ml 4mg wafer

Answer 105

- Anti-nauseant and anti-emetic - Selective 5-HT3 receptor antagonist blocking serotonin centrally in the chemoreceptor trigger zone and peripherally on Vagus nerve terminals.

Answer 106

Up to 30 minutes

Answer 107

Moderate to severe nausea Active vomiting Prophylaxis for eye and spinal injuries

Answer 108

Paediatrics <2 years old Hypersensitivity

Answer 109

- Oral wafer is the preferred method of administration for ALL patients unless actively vomiting. - Administer IV Ondansetron slowly over 2 minutes (neat or diluted) to prevent blurred vision and dizziness.

Answer 110

Headache Malaise/fatigue Drowsiness Dizziness Rash/allergic reaction

Answer 111

Oxygen is a treatment for hypoxaemia and has not been shown to have any effect on breathlessness in non-hypoxaemic patients.

Answer 112

Adult: - Oxygen should be titrated to achieve oxygen saturations of between 94 – 98%, (or 88 – 92% for COPD patients). These are achieved through the use of different flow rates and oxygen masks. Paediatric: - All paediatric patients with significant illness or injury should receive oxygen. Newborn resuscitation should ideally be commenced with room air for the first couple of breaths.

Answer 113

Explosive or flammable environments Normoxia

Answer 114

- If the target saturations cannot be maintained with the nasal cannula or medium concentration mask then change to a non-rebreather oxygen mask. - Oxygen increases the toxicity in paraquat poisoning, target saturations of 88–92%. - Remember that some conditions can affect SpO2 readings e.g. carbon monoxide poisoning and cold digits

Answer 115

- Patients with acute episodes of COPD are at risk of developing carbon dioxide retention if they are given excessive supplemental oxygen. This can cause acidosis and subsequent organ dysfunction. - High oxygen concentrations can lead to increased production of reactive free radicals resulting in cellular damage. This may be responsible for the detrimental effects observed with the use of high flow oxygen in myocardial infarction and stroke.

Answer 116

500mg tablet

Answer 117

A p-aminophenol derivative that exhibits analgesic and antipyretic activity.

Answer 118

≥ 30 minutes

Answer 119

Mild to moderate pain - For example, headache, sprain/strain, toothache, etc. - As a component of a multimodal analgesic regime.

Answer 120

- Known hypersensitivity to Paracetamol. - Do not give if patient has had Paracetamol in the preceding 4 hours. - Cannot exceed the maximum allowed single dose or exceed the maximum allowed paracetamol daily dose (24hrs).

Answer 121

- There is no evidence that fever itself worsens the course of an illness. The primary goal should be to improve overall comfort - SJA do not support the use of paracetamol in infants < 6 months. - 100mg/mL suspension bottle (20 mL) Paracetamol suspension bottle is single patient use only. Only used enteral syringe/dropper with suspension

Answer 122

Nil known at therapeutic doses

Answer 123

25mg in 5ml

Answer 124

Redipred Oral 30ml elixir for oral administration A steroid that prevents the release of inflammatory mediators

Answer 125

Peak effect 1 hour

Answer 126

- Mild / Moderate croup - Severe croup after nebulised Adrenaline administration

Answer 127

Known hypersensitivity to corticosteroids Live virus immunisation within last 48 hours (e.g. MMR, Chicken Pox, Yellow Fever)

Answer 128

- 30ml Bottle is single patient use only - Children who are on immunosuppressant drugs are more susceptible to infections than healthy children, e.g.: Chicken pox and measles - Impaired immune responsiveness

Answer 129

- Side effects occur following prolonged use and are of little consequence in an emergency setting - Vomiting

Answer 130

5mg in 2.5ml 100mcg per puff

Answer 131

Short acting Beta 2 agonist that causes relaxation of bronchial smooth muscle (bronchodilation).

Answer 132

2-5 minutes, maximum by 10 minutes.

Answer 133

Bronchospasm and respiratory distress associated with wheeze: - Acute Bronchial Asthma - Bronchitis - Smoke inhalation - Severe allergic / anaphylactic reactions - Acute Pulmonary Oedema of non-cardiac origin - Salt Water Aspiration Syndrome (SCUBA divers) - Chronic Obstructive Pulmonary Disease (COPD)

Answer 134

Known hypersensitivity to salbutamol Cardiogenic pulmonary oedema Age <12 months

Answer 135

- A spacer / MDI is the preferred route for influenza like illness. - MDI and spacer is equally as effective as nebulisation, in all asthma situations, where patient is still able to adequately inhale. - Use of a nebuliser is recommended where the patient loses this ability. - If hypoxic, nebulise salbutamol in preference to MDI, to address both hypoxia and bronchospasm. The nebulised route also makes it possible to administer Ipratropium Bromide simultaneously.

Answer 136

Muscle tremor Tachycardia, palpitations Headache

Answer 137

1mg in 10ml

Answer 138

- Antifibrinolytic - A synthetic derivative of the amino acid lysine that inhibits fibrinolysis (clot breakdown) by blocking the lysine binding site on plasminogen, competitively inhibiting the activation of plasminogen to plasmin. - Hepatic metabolism with renal excretion.

Answer 139

Within minutes Duration 17 hours, half-life 3 hours

Answer 140

- Significant trauma (< 3 hours) with signs of hypovolaemia or - Significant active haemorrhage that requires the use of : - Tourniquet/s - Haemostatic/pressure dressing/s - Suspected head injury (< 3hours) with GCS motor score of 4 (withdrawing from pain) or below - Severe Primary or Secondary Post-Partum Haemorrhage (> 1000 mL) or PPH with signs of hypovolaemia (birth/bleed occurred < 3hrs) - Significant post-tonsillectomy haemorrhage

Answer 141

- Known hypersensitivity to Tranexamic Acid. - Injury time more than 3 hours (associated with increase in mortality).

Answer 142

- TXA administration in the traumatic patient in the metropolitan area should ordinarily prompt transport to a major trauma centre - Rapid administration may lead to hypotension and dizziness. - No medications or blood products (except 0.9% Sodium Chloride Solution) should be added or co-administered through the same giving set. - Give as early as possible post event. Survival benefit is reduced by 10% for every fifteen minute delay with no benefit seen after 3 hours - Address critical interventions (airway management, control of major haemorrhage etc.) before administration of tranexamic acid. - Tranexamic acid administration should not delay transfer, noting it may be administered en route. - Slow IV push is the first line management option. TXA can be given via an infusion, however, familiarity in using infusions and availability of an appropriate label to identify the infusion should dictate if this option is utilised. - Safety during pregnancy has not been demonstrated, but the balance of risk is such that it should be administered if the indications are met in life threatening circumstances

Answer 143

Hypotension (fast infusion rate) Headache Dizziness Convulsions (lowers seizure threshold) Nausea and/or vomiting Diarrhoea