Medications

Question 1

Aspirin

Answer 1

Presentation
300 miligram tablet that is chewed

Indications
Clinical or ECG evidence suggestive of myocardial infarction or ischaemia

What it does
Has antiplatelet action which reduces clot formation

Contra-Indication
Known aspirin allergy or sensitivity
Children under the age of 16
Active gastrointestinal bleeding
Haemophilia or other known clotting disorders
Severe hepatic failure with jaundice

Cautions
Asthma
Pregnancy
Renal failure
Moderate hepatic disease without jaundice
Gastric or duodenal ulcer
Current treatment with anticoagulants

Side Effects
increased risk of gastric bleeding
wheezing in some asthmatics

Question 2

Adrenaline 1 miligram in 1 ml

Answer 2

Presentation
1 miligram of adrenaline in 1 ml
IM injection

Indications
Anaphylaxis
Life-threatening asthma with failing ventilation and continued deterioration despite nebuliser therapy

Actions
Reverses allergic manifestations of acute anaphylaxis
Relieves bronchospasm in acute severe asthma

Cautions
Severe hypertension (high blood pressure) may occur in patients on non-cardioselective beta-blockers (propanolol)

Question 3

Chlorphenamine

Answer 3

Presentation
IM, tablet or oral solution

Indications
Severe anaphylactic reactions after initial resuscitation.
Symptomatic allergic reactions falling short of anaphylaxis but causing patient distress (e.g. severe itching)

Actions
An antihistamine that blocks the effect of histamine released during a hypersensitivity (allergic) reaction

Contra-Indications
Known hypersensitivity
The anticholinergic properties of chlorphenamine are intensified by monoamine oxidase inhibitors (MAOIs).
Chlorphenamine injection is therefore contraindicated inpatients who have been treated with MAOIs within the last 14 days.

Cautions
Pregnancy and breastfeeding
Hypotension
Epilepsy
Glaucoma
Severe liver disease

Question 4

Clopidogrel

Answer 4

Presentation
Tablet

Indications
Acute ST-elevation myocardial infarction (STEMI)
• In patients not already taking clopidogrel
• In patients receiving thrombolytic treatment
• Anticipated thrombolytic treatment
• Anticipated thrombolytic Anticipated primary percutaneous coronary intervention (PPCI)

Actions
Inhibits platelet aggregation

Contra-indications
Known allergy or hypersensitivity to clopidogrel
Known severe liver impairment
Active pathological bleeding such as peptic ulcer or intracranial haemorrhage

Cautions
As the likely benefits of a single dose of clopidogrel outweigh the potential risk, clopidogrel may be administered in:
Pregnancy
Patients taking non-steroid anti-inflammatory drugs (NSAIDs)
Patients with renal failure

Side effects
Dyspepsia (extreme indigestion)
Abdominal pain
Diarrhoea
Bleeding (gastrointestinal and intracranial)
The occurance of severe bleeding is similar to that observed with the administration of aspirin

Question 5

Dexamethason (DEX)

Answer 5

Presentation
Nebulizer

Indications
Mild/ Moderate/ Severe Croup
Scored using the modified Taussig Score

Actions
Corticosteroid - reduces subglottic inflammation

Contra-Indications
Impending respiratory failure

Cautions
Upper airway compromise can be worsened by any procedure that distresses the child
This might include the administration

Side Effects
Gastro-Intestinal upset
Hypersensitivity/ anaphylactic reaction

Question 6

Glucagon

Answer 6

Hypoglycaemia, clinically suspected hypoglyceamia or unconcious patients where hypoglycaemia is considered a likely cause
Blood Glucose < 4.0 mmol/ L

Question 7

Glucose 40%

Answer 7

known or suspected hypoglycaemia in a conscious patient where there is no risk of choking or aspiration

Question 8

Glyceryl Trinitrate

Answer 8

Cardiac chest pain due to angina or myocardial infarction, when systolic blood pressure is greater than 90mmHg

Question 9

Ibuprofen

Answer 9

Relief of mild to moderate pain

Pyrexia with discomfort
(may help to relieve the misery and often unpleasant symptoms that often accompany febrile illness e.g. aches and pains)

soft tissue injuries

best when used as part of a balanced analgesic regime.

Question 10

Ipratropium Bromide

IPB

Answer 10

Acute, severe or life-threatening asthma.

Acute asthma unresponsive to salbutamol

exacerbation of chronic obstructive pulmonary disease (COPD), unresponsive to salbutamol

Question 11

Naloxone Hydrochloride

NLX

Answer 11

The reversal of acute opioid or opiate toxicity for respiratory arrest or respiratory depression

Unconscious, associated with respiratory depression of unknown cause, where opioid overdose is a possibility

Question 12

Nitrous Oxide

Entonox

Answer 12

Moderate to sever pains

Labour pains

Question 13

Oxygen

Answer 13

Children
Significant illness or injury

Adults
Critical illness requiring high levels of supplemental oxygen

Serious illness requiring moderate levels of supplemental oxygen if the patient is hypoxaemic

COPD and other conditions requiring controlled or low-dose oxygen therapy

Conditions for which patients should be monitored closely but oxygen therapy is not requred unless the patient is hypoxaemic

Question 14

Paracetamol

Answer 14

Oral
relief of mild to moderate pain or high temperature with discomfort
(not just for high temperature)

Intravenous
as part of a balanced analgesic regimen for severe pain paracetamol is effective in reducing opioid requirements while improving analgesic efficecy and is an alternative analgesic when morphine is contraindicated.

Question 15

Salbutamol

Answer 15

Acute asthma attack where normal inhaler therapy has failed to relieve syptoms.

expiratory wheezing associated with allergy, anaphylaxis, beta-blocker overdose, smoke inhalation or other lower airway cause.

exacerbation of chronic obstructive pulmonary disease (COPD)