Medications Flashcards
Glyceryl Trinitrate Indications
- Chest pain/discomfort of presumed cardiac origin not relieved by rest and reassurance with systolic BP > 90mmHg
- Acute Cardiac Pulmonary Oedema with systolic BP > 90mmHg
Ondansetron Contrainidications
- IM - Paediatrics less than 2 years old.
- Hypersensitivity.
Amiodarone Precautions / Complications
- Heart failure;
- Thyroid dysfunction;
- Amiodarone is only indicated for shock resistant VF/VT, and should be administered post 3 consecutive shocks;
- In the hypothermic patient, withhold until body temperature is above 30C.
- Between 30-35C double the interval between doses.
Methoxyflurane Contraindications
- 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
Cophenylcaine Description
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
Aspirin Description
Aspirin has the following pharmacological actions:
- Analgesic
- Antipyretic
- Anti-inflammatory
- Anti-platelet aggregation agent
Reduces mortality significantly in Acute Myocardial Infarction by minimising platelet aggregation and thrombus formation in order to
retard the progression of coronary artery thrombosis.
Midazolam Indications
- Seizures (CPG 2.3).
- Disturbed/ abnormal behaviour (CPG 2.5).
- Back pain due to muscular spasm in adults.
Naloxone Indications
- Reverse of respiratory depression in a suspected narcotic overdose.
Paracetamol Precautions / Complications
- Advise not to take more Paracetamol during the next 4 hours.
- Overdose may cause serious, potentially fatal liver damage.
Lignocaine Indications
Local anaesthesia for:
- IV cannulation
- IO infusion
- Suturing
Glyceryl Trinitrate Description
Glyceryl Trinitrate (GTN): Spray bottle containing 200 x 0.4mg atomised sprays. Nitrates cause the relaxation of vascular smooth muscle resulting in:
- Vasodilation.
- Peripheral pooling and reduced venous return.
- Reduced left ventricular and diastolic pressure (preload).
- Reduced systemic vascular resistance (afterload).
- Reduced myocardial energy and oxygen requirements.
- Relaxes spasm of coronary arteries
Methoxyflurane Description
3ml Ampoule.
- A halogenated ether that produces powerful modification of the awareness of pain with an associated light headed sensation.
- 6-8 breaths/ 1-2 min onset with maximum level after 2-4 minutes.
Methoxyflurane Indications
- Pain
IV Crystalloid Solutions Contraindications
- Circulatory overload
Glucose Oral Gel Description
15g glucose gel in tube.
- Rapidly absorbed from oral/buccal mucosa to increase blood glucose concentration.
- Onset 2-5 minutes, duration 12-25 minutes
Copheylcaine Indications
- Local pain: abrasions, small cuts and wounds
- Relief of mild and moderate epistaxis
- Post tonsillectomy haemorrhage
- Intra-oral haemorrhage
Midazolam Precautions / Complications
- If small, frail or over 65 years old, try half adult dose first.
- Myasthenia gravis.
- Further doses above maximum require authorisation by phone consult to Ambulance Medical Advisor.
- Respiratory depression.
- Hypotension.
- Anterograde and retrograde amnesia.
Intravenous Glucose Contraindications
- Diabetic coma where blood glucose levels are excessively high.
- Glucose / galactose malabsorption syndrome.
- Anuria.
- Intraspinal or intracranial haemorrhage.
- Corn (maize) allergy.
- Patients at risk of ischaemic stroke.
- Use after an ischaemic stroke.
Ondansetron Precautions / Complications
- Administer IV Ondansetron slowly over 2 minutes (neat or diluted) to prevent blurred vision and dizziness.
- Preferred method for paediatric patients is oral wafer.
- Headache. Malaise / fatigue. Drowsiness. Dizziness. Rash/ allergic reaction.
Fentanyl Indications
- Moderate to severe pain.
- Acute Coronary Syndromes with a pain/discomfort score > 3/10 post 1 spray of GTN.
Heparin Sodium Indications
Patients with STEMI going directly to Cardiac Catheterisation Laboratory as per receiving hospital 12-lead ECG interpretation.
Glucagon Contraindications
- Hypersensitivity.
- Known pheochromocytoma
Ketamine Indications
- A second line agent for severe pain of traumatic origin.
- Actively disturbed patients requiring sedation where midazolam has already been utilised.
- Combative Traumatic Brain Injury.
Amiodarone Description
- 150mg in a 3ml ampoule;
- Class III antidysrhythmic agent that prolongs the action potential duration and hence the refractory period of atrial, nodal and ventricular tissue.
- It has characteristics of all Vaughan-Williams classes of antidysrhythmics;
- Immediate onset, peak
Naloxone Precautions / Complications
- Polypharmacy overdose.
- Naloxone half life may be less than that of the Narcotic
- Withdrawal symptoms eg: aggression, agitation, nausea, vomiting, dilated pupils, lacrimation
Glucagon Precautions / Complications
- Glucagon is effective in treating hypoglycaemia only if sufficient liver glycogen is present (eg: it does not work on alcohol or anorexia induced hypoglycaemia).
- Even if fully recovered patients should be encouraged to be transported to a medical facility to ensure effective follow up and review.
- Nausea/vomiting, Gastric pain
- Transient rise of blood pressure for patients taking beta blockers
Adrenaline Precautions / Complications
- Ischaemic Heart Disease;
- In the hypothermic patient, withhold until body temperature is above 30C.
- Between 30-35C double the interval between doses
- Dysrhythmias;
- Hypertension;
- Pupil dilation;
- Tremor;
- Anxiety;
- Palpitations
Heparin Sodium Contraindications
- Hypersensitivity to Heparin
- Presence of known haemorrhagic states
Glyceryl Trinitrate Precautions / Complications
- Nitrates are an early intervention and should not be delayed until on the stretcher or inside the ambulance.
- Administer to the patient in a 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.
- Tachycardia, Flushing, Headache
Ketamine Precautions / Complications
- Used with caution in patients with stable psychiatric disorders such as Schizophrenia (unless pre-treatment with midazolam).
- Use with caution in patients with hyperthyroidism or receiving thyroid replacement due to increased risk of hypertension and tachycardia.
- Use cautiously with IV Fentanyl due to potentiation of anaesthesia effects, waiting 5 minutes between doses.
- 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
Lignocaine Description
20mg/2ml - (1%) in a plastic ampoule
- Sodium Channel blocker
- Onset 1-2 minutes