medications Flashcards
Adrenaline
Presentation
1mg: 1ml
1mg: 10ml
Adrenaline
Pharmacology
Naturally occurring alpha & beta adrengic stimulant
Increasing HR increasing firing through SA node (beta 1)
Increasing conduction velocity through the AV node (beta 1)
Increased Myocardial contractility (beta 1)
Increased Ventricular irritability (beta 1)
Vasoconstriction (alpha)
bronchodilation (beta 2)
Adrenaline
Primary emergency indication
Cardiac arrest (PEA, asystole, Pulseless VT or VF)
Inadequate perfusion (cardiogenic/non-cardiogenic)
Bradycardia with poor perfusion
Anaphylaxis
Croup - severe
Asthma- Unconscious with no BP, imminent life threat, not responding to nebulised treatment
Adrenaline
Contraindications
Hypovolaemic shock without adequate fluid replacement
Adrenaline
Precautions
Consider reduced doses for
- Pts with cardiovascular disease
- Pts on monoamine oxidase inhibitors
- Elderly/frail pts
Consider higher doses for
- Pts on beta blockers
Adrenaline
Side effects
Sinus tachycardia Hypertension Ventricular arrhythmias Feeling of anxiety/palpations May increase size of Myocardial infarctions Pupil dilation Supraventricular arrhythmias
Adrenaline
Times
IV
Onset 30seconds
Peak 3-5minutes
duration 5-10minutes
IM
Onset 30-90seconds
Peak 4-10minutes
duration 5-10minutes
Adrenaline
Metabolism
Metabolised by - monoamine oxidase and other enzymes in blood - liver - nerve endings excreted by kidneys
Aspirin
Presentation
300mg
Aspirin
Pharmacology
an analgesic, antiplatelet, anti-inflammatory, anti-pyretic
Works to minimise platelet aggregation & thrombus formation to retard the progression of coronary artery thrombus in ACS
Inhibit prostaglandin synthesis - anti-inflammatory actions
Aspirin
Metabolism
convert to salicylate in gut mucosa & liver
excreted by kidneys
Aspirin
Primary emergency indications
Acute coronary syndrome (ACS)
Aspirin
Contraindications
Hypersensitivity Actively bleeding peptic ulcer Bleeding disorders Chest pain associated with psychostimulant overdose with SBP >160mmHg Suspected dissecting aortic aneurysm
Aspirin
Precautions
Peptic ulcer
Asthma
Pts on other anti-coagulates
Aspirin
Side effects
Heartburn, nausea, gastrointestinal bleeding
Increased bleeding time
Hypersensitivity
Aspirin
Times
Onset n/a
Peak n/a
Duration 8-10days
Ceftriaxone
Presentation
1 g sterile powder in a glass vial
Ceftriaxone
Pharmacology
cephalosporin antibiotic
Ceftriaxone
Metabolism
excreted in urine & bile
Ceftriaxone
Primary emergency indications
Meningococcal septicaemia Severe sepsis (consult only)
Ceftriaxone
Contraindications
Allergy to cephalosporin antibiotics
Ceftriaxone
Precautions
Allergy to Penicillin antibiotics
Ceftriaxone
Side effects
Nausea
Vomiting
Skin rash
Ceftriaxone
times
Onset n/a
peak n/a
duration n/a
Dexamethasone
Presentation
8mg: 2ml
Dexamethasone
Pharmacology
Corticosteroid secreted by the adrenal cortex
- relieves inflammatory reactions
- immunosuppression
Dexamethasone
Metabolism
metabolism
- liver & other tissues
excreted by the kidneys
Dexamethasone
Primary emergency indications
Moderate - severe croup
Adult stridor (non-foreign body)
exacerbation of COPD
Bronchospasm with acute respiratory distress not responding to nebulised salbutamol
Dexamethasone
Contraindications
Known hypersensitivity
dexamethasone
Precautions
Solutions that are
- contaminated
- discoloured
dexamethasone
Side effects
nil of significance
Dexamethasone
times
onset 30-60minutes
peak 2hrs
duration 36-72hrs
Dextrose
Presentation
25g:250ml
Dextrose
Pharmacology
Slightly hypertonic crystalliod solution contains - Sugar 10% - water provides body with source of energy supplies body water
Dextrose
Metabolism
Dextrose
- broken down in most tissues
- stored in liver & muscle as glycogen
water
- excreted by kidneys
- distributed throughout total body water, mainly in extracellular compartment
Dextrose
Primary emergency indications
Hypoglycaemia with BGL below 4mmol, altered conscious state and unable to self administer oral glucose.
Dextrose
Contraindications
Nil of significance
Dextrose
Precautions
Nil of significance
Dextrose
Side effects
Nil of significance
Dextrose
Times
IV
Onset 3minutes
Peak n/a
duration depends on severity
Fentanyl
Presentation
100mcg: 2ml (IV)
250mcg: 1ml (IN)
Fentanyl
Metabolism
metabolised by liver
excrete by kidneys
Fentanyl
Pharmacology
Synthetic opioid analgesic
depression (analgesic)
respiratory depression (apnoea)
dependence (addiction)
slows conduction through AV node (beta 1)
Fentanyl
Primary emergency indications
Enable intubation (RSI) maintain intubation transcutaneous pacing synchronised cardioversion CPR interfering Pt
Analgesic
- Contraindication for morphine
- Hypersensitivity to morphine
- Headache
- Hypotension
- Nausea & vomiting
- Renal impairment/disease
- short duration of action desirable
Fentanyl
Contraindications
Late second stage labour
Hypersensitivity
Fentanyl
Precautions
Elderly/ frail impaired hepatic function respiratory depression current asthma Pts on monoamine oxidase inhibitors Known addiction Pt with rhinitis, rhinorrhoea, facial trauma
Fentanyl
Side effects
Respiratory depression
Apnoea
rigidity of diaphragm/intercostal muscles
bradycardia
Fentanyl
times
IV
Peak immediate
onset <5mins
duration 30-60mins
In
Peak 2 minutes
Glucagon
Presentation
1mg:1ml
Glucagon
Pharmacology
A naturally occurring hormone secreted by the pancreas
Works by converting stored glycogen in liver into glucose causing rise in BGL
Glucagon
Metabolism
Metabolised by liver, kidneys, plasma
Glucagon
Primary emergency indications
Hypoglycaemia with BGL below 4mmol, altered conscious state, unable to self administer oral glucose
adult anaphylaxis in which pt remains hypotensive following adrenaline administration, with past history of heart failure or taking beta blocker medication
Glucagon
Contraindications
Nil of significance
Glucagon
Precautions
Nil of significance
Glucagon
Side effects
Nausea
vomiting
Glucagon
times
Peak 5 mins
onset n/a
duration 25mins
GTN
Presentation
300mcg
600mch
Patch 50mg (0.4mg per hr)
GTN
Pharmacology
A vascular smooth muscles relaxant
Venous dilation -
