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ALS Paramedic CPG cards > medications > Flashcards

medications Flashcards

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1
Q

Adrenaline

Presentation

A

1mg: 1ml
1mg: 10ml

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2
Q

Adrenaline

Pharmacology

A

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)

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3
Q

Adrenaline

Primary emergency indication

A

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

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4
Q

Adrenaline

Contraindications

A

Hypovolaemic shock without adequate fluid replacement

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5
Q

Adrenaline

Precautions

A

Consider reduced doses for

  • Pts with cardiovascular disease
  • Pts on monoamine oxidase inhibitors
  • Elderly/frail pts

Consider higher doses for
- Pts on beta blockers

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6
Q

Adrenaline

Side effects

A 
Sinus tachycardia 
Hypertension 
Ventricular arrhythmias
Feeling of anxiety/palpations 
May increase size of Myocardial infarctions 
Pupil dilation
Supraventricular arrhythmias
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7
Q

Adrenaline

Times

A

IV
Onset 30seconds
Peak 3-5minutes
duration 5-10minutes

IM
Onset 30-90seconds
Peak 4-10minutes
duration 5-10minutes

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8
Q

Adrenaline

Metabolism

A 
Metabolised by 
- monoamine oxidase and other enzymes in blood 
- liver 
- nerve endings 
excreted by kidneys
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9
Q

Aspirin

Presentation

A

300mg

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10
Q

Aspirin

Pharmacology

A

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

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11
Q

Aspirin

Metabolism

A

convert to salicylate in gut mucosa & liver

excreted by kidneys

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12
Q

Aspirin

Primary emergency indications

A

Acute coronary syndrome (ACS)

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13
Q

Aspirin

Contraindications

A 
Hypersensitivity
Actively bleeding peptic ulcer 
Bleeding disorders 
Chest pain associated with psychostimulant overdose with SBP >160mmHg 
Suspected dissecting aortic aneurysm
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14
Q

Aspirin

Precautions

A

Peptic ulcer
Asthma
Pts on other anti-coagulates

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15
Q

Aspirin

Side effects

A

Heartburn, nausea, gastrointestinal bleeding
Increased bleeding time
Hypersensitivity

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16
Q

Aspirin

Times

A

Onset n/a
Peak n/a
Duration 8-10days

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17
Q

Ceftriaxone

Presentation

A

1 g sterile powder in a glass vial

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18
Q

Ceftriaxone

Pharmacology

A

cephalosporin antibiotic

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19
Q

Ceftriaxone

Metabolism

A

excreted in urine & bile

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20
Q

Ceftriaxone

Primary emergency indications

A 
Meningococcal septicaemia 
Severe sepsis (consult only)
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21
Q

Ceftriaxone

Contraindications

A

Allergy to cephalosporin antibiotics

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22
Q

Ceftriaxone

Precautions

A

Allergy to Penicillin antibiotics

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23
Q

Ceftriaxone

Side effects

A

Nausea
Vomiting
Skin rash

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24
Q

Ceftriaxone

times

A

Onset n/a
peak n/a
duration n/a

25
Q

Dexamethasone

Presentation

A

8mg: 2ml

26
Q

Dexamethasone

Pharmacology

A

Corticosteroid secreted by the adrenal cortex

  • relieves inflammatory reactions
  • immunosuppression
27
Q

Dexamethasone

Metabolism

A

metabolism
- liver & other tissues
excreted by the kidneys

28
Q

Dexamethasone

Primary emergency indications

A

Moderate - severe croup
Adult stridor (non-foreign body)
exacerbation of COPD
Bronchospasm with acute respiratory distress not responding to nebulised salbutamol

29
Q

Dexamethasone

Contraindications

A

Known hypersensitivity

30
Q

dexamethasone

Precautions

A

Solutions that are

  • contaminated
  • discoloured
31
Q

dexamethasone

Side effects

A

nil of significance

32
Q

Dexamethasone

times

A

onset 30-60minutes
peak 2hrs
duration 36-72hrs

33
Q

Dextrose

Presentation

A

25g:250ml

34
Q

Dextrose

Pharmacology

A 
Slightly hypertonic crystalliod solution 
contains 
- Sugar 10% 
- water 
provides body with source of energy 
supplies body water
35
Q

Dextrose

Metabolism

A

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
36
Q

Dextrose

Primary emergency indications

A

Hypoglycaemia with BGL below 4mmol, altered conscious state and unable to self administer oral glucose.

37
Q

Dextrose

Contraindications

A

Nil of significance

38
Q

Dextrose

Precautions

A

Nil of significance

39
Q

Dextrose

Side effects

A

Nil of significance

40
Q

Dextrose

Times

A

IV
Onset 3minutes
Peak n/a
duration depends on severity

41
Q

Fentanyl

Presentation

A

100mcg: 2ml (IV)
250mcg: 1ml (IN)

42
Q

Fentanyl

Metabolism

A

metabolised by liver

excrete by kidneys

43
Q

Fentanyl

Pharmacology

A

Synthetic opioid analgesic

depression (analgesic)
respiratory depression (apnoea)
dependence (addiction)

slows conduction through AV node (beta 1)

44
Q

Fentanyl

Primary emergency indications

A 
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
45
Q

Fentanyl

Contraindications

A

Late second stage labour

Hypersensitivity

46
Q

Fentanyl

Precautions

A 
Elderly/ frail 
impaired hepatic function 
respiratory depression
current asthma 
Pts on monoamine oxidase inhibitors 
Known addiction 
Pt with rhinitis, rhinorrhoea, facial trauma
47
Q

Fentanyl

Side effects

A

Respiratory depression
Apnoea
rigidity of diaphragm/intercostal muscles
bradycardia

48
Q

Fentanyl

times

A

IV
Peak immediate
onset <5mins
duration 30-60mins

In
Peak 2 minutes

49
Q

Glucagon

Presentation

A

1mg:1ml

50
Q

Glucagon

Pharmacology

A

A naturally occurring hormone secreted by the pancreas

Works by converting stored glycogen in liver into glucose causing rise in BGL

51
Q

Glucagon

Metabolism

A

Metabolised by liver, kidneys, plasma

52
Q

Glucagon

Primary emergency indications

A

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

53
Q

Glucagon

Contraindications

A

Nil of significance

54
Q

Glucagon

Precautions

A

Nil of significance

55
Q

Glucagon

Side effects

A

Nausea

vomiting

56
Q

Glucagon

times

A

Peak 5 mins
onset n/a
duration 25mins

57
Q

GTN

Presentation

A

300mcg
600mch
Patch 50mg (0.4mg per hr)

58
Q

GTN

Pharmacology

A

A vascular smooth muscles relaxant

Venous dilation -

ALS Paramedic CPG cards (22 decks)

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