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PPCS2 medications flash cards > Medications for PPCS2 - JRCALC > Flashcards

Medications for PPCS2 - JRCALC Flashcards

1
Q

What is the indications for activated charcoal?

A

Adults and children over 1 who have ingested toxins less than 1 hour before attendance by an ambulance clinician or toxbase has advised to take activated charcoal irrespective of time

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2
Q

What is activated charcoal used for?

A

The emergency treatment of acute oral poisoning and oral drug overdose

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3
Q

What are the contraindications for activated charcoal?

A

Under 1 year old
Pts presenting to the ambulance clinician more than 1 hour since ingestion of toxin
pts who are vomiting
Pts with reduced gastrointestinal motility with a risk of obstruction

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4
Q

How is activated charcoal administered?

A

Orally

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5
Q

What is the dosage for activated charcoal?

A

Adult - 50g
Child 25g
No repeat dose

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6
Q

What is the indications for adrenaline 1:1000?

A

Anaphylaxis and life threatening asthma

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7
Q

What is the action of adrenaline 1:1000?

A

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

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8
Q

How is adrenaline 1:1000 administered?

A

IM only

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9
Q

What is the initial dose of adrenaline 1:1000?

A

500mcg

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10
Q

What is the dose interval for adrenaline 1:1000

A

5 mins

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11
Q

What is the repeat dose for adrenaline 1:1000

A

500mcg

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12
Q

What is the max dose of adrenaline 1:1000?

A

No max dose

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13
Q

What is the indications for adrenaline 1:10000

A

Cardiac arrest
Post ROSC circulatory support

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14
Q

What is the action of adrenaline 1:10000?

A

It is a sympathomimetic that stimulates both alpha and beta adrenergic receptors, as a result myocardial and cerebral blood flow is enhanced during CPR and CPR becomes more effective due to increased peripheral resistance which improves perfusion pressures

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15
Q

What are the contra-indications of adrenaline 1:10000

A

Do not give if patients core temp is less than 30 degrees, if the temp is between 30-35 then double the time between doses

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16
Q

How is adrenaline 1:10000 administered?

A

IV or IO

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17
Q

What is the initial dosage for adrenaline 1:10000 in a cardiac arrest?

A

1mg

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18
Q

What is the repeat dose of adrenaline 1:10000 in a cardiac arrest?

A

1mg

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19
Q

What is the dose interval for adrenaline 1:10000 in a cardiac arrest?

A

3-5 mins

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20
Q

What is the max dose of adrenaline 1:10000 in a cardiac arrest?

A

No max dose

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21
Q

What is the initial dose of adrenaline 1:10000 in post ROSC?

A

50mcg

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22
Q

What is the dose interval for adrenaline 1:10000 post ROSC?

A

3-5 mins

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23
Q

What is the repeat dose for adrenaline 1:10000 post ROSC?

A

50-100mcg

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24
Q

What is the max dose for adrenaline 1:10000 post ROSC?

A

No max dose

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25
Q

What are the indications for amiodarone?

A

Cardiac arrest in shockable rhythms

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26
Q

What are the actions of amiodarone?

A

It is an antiarrhythmic - it lengthens cardiac action potential and therefore effective refractory period, prolongs QT interval on ECG.
Blocks sodium and potassium channels in the cardiac muscle.
Acts to stabilise and reduce electrical irritability of cardiac muscle

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27
Q

What are the contraindications of amiodarone?

A

If a patients core temp is less than 30 degrees

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28
Q

How is amiodaraone administered?

A

IV/IO

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29
Q

What is the initial dosage for amiodarone?

A

300mg after 3rd shock

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30
Q

What is the dose interval for amiodarone?

A

After 5th shock

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31
Q

What is the repeat dose of amiodarone?

A

150mg

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32
Q

What is the max dose of amiodarone?

A

450mg

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33
Q

What are the indications for aspirin?

A

Clinical or ECG evidence suggestive of an MI or ischaemia.
Suspected TIA and ALL of the following: symptoms have fully resolved, pt is not being conveyed to hospital, pt has been referred to local TIA pathway

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34
Q

What is the action of aspirin?

A

Has an anti platelet action which reduces clot formation

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35
Q

What are the contraindications for aspirin?

A

Known allergy/sensitivity
Children under 16
Active gastrointestinal bleeding
Haemophilia or other known clotting disorders
Severe hepatic failure with jaundice

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36
Q

How is aspirin administered?

A

Orally

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37
Q

What is the initial dose of aspirin?

A

300mg - NO REPEAT DOSE

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38
Q

What is the max dose of aspirin?

A

300mg

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39
Q

What are the indications for atropine ?

A

Symptomatic bradycardia in the presence of ANY of these adverse signs:
Absolute bradycardia (pulse less than 40 per min)
Systolic BP below expected for age
Paroxysmal ventricular arrythmias requiring suppression
inadequate perfusion causing confusion
Bradycardia following ROSC

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40
Q

What are the contra-indications for atropine?

A

Should not be given to treat bradycardia in suspected hypothermia.
Do not give to patients with cardiac transplants - their hearts will not respond to vagal blocking by atropine and paradoxical high degree AV block or sinus arrest may result

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41
Q

What are the actions of atropine?

A

Reverses effects of vagal overdrive.
Increases HR by blocking vagal activity in sinus bradycardia, second or third degree heart block. Enhances A-V conduction

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42
Q

How is atropine administered?

A

IV/IO

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43
Q

What is the initial dose for atropine?

A

600mcg

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44
Q

What is the dose interval for atropine?

A

3-5 mins

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45
Q

What is the repeat dose for atropine?

A

600mcg

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46
Q

What is the max dose for atropine?

A

3mg

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47
Q

What are the indications for benzylpenicillin?

A

Suspected meningococcal disease in the presence of:
A non-blanching rash and/or signs and symptoms suggestive of meningococcal septicaemia

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48
Q

What is the action of benzylpenicillin?

A

Antibiotic: narrow-spectrum

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49
Q

What are the contra-indications for benzylpenicillin?

A

Known severe penicillin allergy

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50
Q

How is benzylpenicillin administered?

A

IV/IO or IM

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51
Q

What is the initial dose for benzylpenicillin?

A

1.2g - NO REPEAT DOSE

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52
Q

What is the max dose for benzylpenicillin?

A

1.2g

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53
Q

What are the indications for chlorphenamine?

A

Symptomatic allergic reactions failing short of anaphylaxis but causing pt distress.
Alleviating distressing cutaneous symptoms in anaphylaxis only after emergency treatment with adrenaline and the pt is stable and oral antihistamine administration is not possible

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54
Q

What are the contraindications of chlorphenamine?

A

Known hypersensitivity.
Pts who have been treated with monoamine oxidase inhibitors within the last 14 days

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55
Q

What is the action of chlorphenamine?

A

Blocks the effect of histamine released during an allergic reaction

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56
Q

How is chlorphenamine administered?

A

IM, IV and oral

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57
Q

What is the initial dose for IM/IV chlorphenamine?

A

10mg - NO REPEAT DOSE

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58
Q

What is the initial dose of oral chlorphenamine?

A

4mg - NO REPEAT DOSE

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59
Q

What is the indication for dexamethasone?

A

Croup in children

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60
Q

What is the contra-indication for dexamethasone?

A

Impending respiratory failure

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61
Q

What is the action of dexamethasone?

A

Corticosteroid - reduces subglottic inflammation

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62
Q

How is dexamethasone administered?

A

Orally

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63
Q

What is the initial dose for dexamethasone?

A

5.2mg or 6mg - NO REPEAT DOSE

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64
Q

What are the indications for diazepam?

A

Pts with prolonged convulsions (lasting 5 mins or more) or repeated convulsions (3 or more in an hour) and are currently convulsing.
Eclamptic convulsions if it lasts over 2-3 mins or if it is recurrent
Symptomatic cocaine toxicity (severe hypertension, chest pain or convulsions)

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65
Q

What are the actions of diazepam?

A

Central nervous system depressant, acts as an anticonvulsant and sedative

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66
Q

What is the contra-indication for diazepam?

A

Patients with known hypersensitivity

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67
Q

How is diazepam administered?

A

IV, IO or rectal

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68
Q

What is the initial dose of diazepam?

A

10mg

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69
Q

What is the dose interval for diazepam?

A

10 mins

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70
Q

What is the repeat dose for diazepam?

A

10mg

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71
Q

What is the max dose for diazepam?

A

20mg

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72
Q

What are the indications for furosemide?

A

pulmonary oedema and/or respiratory distress due to acute failure

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73
Q

What are the contra-indications for furosemide?

A

Reduced GCS with liver cirrhosis
Cardiogenic shock
Severe renal failure with anuria
Children under 18

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74
Q

What is the action of furosemide?

A

A potent diuretic with a rapid onset (within 30 mins) and short duration

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75
Q

How is furosemide administered?

A

IV

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76
Q

What is the initial dose for furosemide?

A

40mg - NO REPEAT DOSE

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77
Q

What are the indications for glucagon?

A

Hypoglycaemia or unconscious patients why hypoglycaemia is considered a likely cause
Should only be administered when oral glucose is not possible or is ineffective and/or IV access to administer 10% glucose is not possible

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78
Q

What are the contra-indications for glucagon?

A

Pheochromocytoma
Do not give through IV injection because of increased vomiting associated with IV use

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79
Q

What is the action of glucagon?

A

A hormone that induces the conversion of glycogen to glucose in the liver, thereby raising blood glucose levels

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80
Q

How is glucagon administered?

A

IM

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81
Q

What is the initial dose for glucagon?

A

1mg - NO REPEAT DOSE

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82
Q

What are the indications for glucose 10%?

A

Hypoglycaemia or suspected hypoglycaemia when oral administration is not possible and rapid improvement in clinical state and blood glucose level is required.
An unconscious patient where hypoglycaemia is considered a likely cause.
Management of hypoglycaemia in patients who have no responded to the administration of IM glucagon after 10 mins

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83
Q

What is the action of glucose 10%?

A

Reversal of hypoglycaemia by direct delivery of glucose to the systemic circulation

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84
Q

What are the contra-indications for glucose 10%?

A

IM or subcutaneous injection

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85
Q

How is glucose 10% administered?

A

IV OR IO infusion

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86
Q

What is the initial dose for glucose 10%?

A

10g

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87
Q

What is the dose interval for glucose 10%?

A

5 mins

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88
Q

What is the repeat dose for glucose 10%?

A

10g

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89
Q

What is the max dose for glucose 10%?

A

30g

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90
Q

What is the indication for glucose 40% gel?

A

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

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91
Q

What are the contra-indications for glucose 40% gel?

A

None

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92
Q

What is the action of glucose 40% gel?

A

Rapid increase in blood glucose levels via buccal absorption

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93
Q

How is glucose 40% gel administered?

A

Buccal

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94
Q

What is the initial dose for glucose 40% gel?

A

10-20g

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95
Q

What is the dose interval for glucose 40% gel?

A

15 mins

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96
Q

What is the repeat dose for glucose 40% gel?

A

10g

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97
Q

What is the max dose for glucose 40% gel?

A

None

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98
Q

What are the indications for GTN?

A

Cardiac chest pain due to angina or MI when systolic BP is greater than 90mmHg.
Acute heart failure with ischaemia or uncontrolled hypertension.
Patients with suspected cocaine toxicity presenting with chest pain

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99
Q

What are the contra-indications for GTN?

A

Hypotension in angina or MI or less than 110mmHg in acute heart failure.
Hypovolaemia.
Head trauma.
Cerebral haemorrhage.
Unconscious patients
Known severe aortic or mitral stenosis
Viagra in last 24 hours

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100
Q

What are the actions of GTN?

A

A potent vasodilator drug resulting in:
1. Dilation of coronary arteries/relief of coronary spasm
2. Dilation of systemic veins resulting in lower pre-load
3. Reduced blood pressure

101
Q

How is GTN administered?

102
Q

What is the initial dose for GTN in patients with angina, MI or suspected cocaine toxicity?

A

400-800mcg/ 1-2 sprays

103
Q

What is the repeat dose for GTN in patients with angina, MI or suspected cocaine toxicity?

A

400-800mcg/ 1/2 sprays

104
Q

What is the dose interval for GTN in patients with angina, MI or suspected cocaine toxicity?

A

5-10 minutes

105
Q

What is the max dose for GTN in patients with angina, MI or suspected cocaine toxicity?

A

No max dose

106
Q

What is the initial dose for GTN in patients with heart failure?

A

400-800mcg/ 1-2 sprays

107
Q

What is the repeat dose for GTN in patients with heart failure?

A

400-800mcg/ 1-2 sprays

108
Q

What is the dose interval for GTN in patients with heart failure?

109
Q

What is the max dose for GTN in patients with heart failure?

A

2.4mg/6 sprays

110
Q

What are the indications for heparin?

A

ST elevation MI where heparin is required as adjunctive therapy with tenecteplase to reduce the risk of re-infaction.

111
Q

What is the action of heparin?

A

Anticoagulant

112
Q

What are the contra-indications for heparin?

A

Haemophilia and other haemorrhagic disorders.
Thrombocytopenia
Recent cerebral haemorrhage
Severe hypertension
Severe liver disease
Oesophageal varices
Peptic ulcer
Major trauma
Recent surgery to eye or nervous system
Acute bacterial endocarditis
Spinal or epidural anaesthesia

113
Q

How is heparin administered?

A

IV single bolus

114
Q

What is the initial dose for heparin for someone less than 67kg?

A

4000 units

115
Q

What is the repeat dose of heparin?

A

1000 units

116
Q

When would you give a repeat dose of heparin?

A

If heparin infusion has not commenced within 45 mins of the original bolus of thrombolytic agent

117
Q

What is the max dose of heparin for someone less than 67kg

A

4000 units

118
Q

What is the initial dose for someone 67kg+?

A

5000 units

119
Q

What is the max dose of heparin for someone 67kg+

A

5000 units

120
Q

What are the indications for hydrocortisone?

A

Severe or life-threatening asthma
Acute exacerbation of COPD
Adrenal crisis which is time critical
Prevention of adrenal crisis in pts who suffer
Pregnant women with known Addison’s disease who are in established labour

121
Q

What is the action of hydrocortisone?

A

Glucocorticoid steroid drug that restores blood pressure, blood sugar, cardiac synchronicity and volume. Therapeutic actions include suppression of inflammation and immune response

122
Q

How is Hydrocortisone administered?

A

IV/IO post ROSC
IM

123
Q

What is the initial dose of hydrocortisone?

A

100mg - NO REPEAT DOSE

124
Q

What is the max dose of hydrocortisone?

125
Q

What are the indications for ibuprofen?

A

Relief of mild to moderate pain
Pyrexia with discomfort
Soft tissue injuries

126
Q

What are the actions of ibuprofen?

A

Analgesic
Antipyretic
Anti-inflammatory

127
Q

What are the contra-indications for ibuprofen?

A

Dehydration
Hypovolaemic
Known to have renal insufficiency
Patients with active upper gastrointestinal disturbance
Women in the last trimester of pregnancy
Child with chickenpox
Patients who have previously shown hypersensitivity reactions
Pts with active peptic ulcer
Patients with severe heart failure, renal failure or hepatic failure
Patients on anticoagulant drugs e.g warfarin

128
Q

How is ibuprofen administered?

129
Q

What is the initial dose for ibuprofen?

130
Q

What is the dose interval for ibuprofen?

131
Q

What is the max dose of ibuprofen?

A

1.2g per 24 hours

132
Q

What are the indications for ipratropium bromide?

A

Acute, severe or life-threatening asthma
Acute asthma unresponsive to salbutamol
Exacerbation of COPD, unresponsive to salbutamol
Expiratory wheezing

133
Q

What is the action of ipratropium bromide?

A

It is an antimuscarinic bronchodilator, it may provide short term relief in acute asthma

134
Q

What are the contra-indications for ipratropium bromide?

A

None in the emergency situation

135
Q

How is ipratropium administered?

A

Nebulised with 6-8L of oxygen - limit to 6 mins in COPD patients

136
Q

What is the initial dose of ipratropium bromide?

A

500mcg - NO REPEAT DOSE

137
Q

What is the max dose of ipratropium bromide?

138
Q

What are the indications for magnesium sulfate in adults over 12 years?

A

Severe exacerbations of asthma, not responding to continuous salbutamol
Eclampsia
Severe pre-eclampsia - BP 160/110 or more
Torsades de Pointes

139
Q

What are the indications for magnesium sulfate in children 2-11 years?

A

Severe acute asthma or continuing respiratory deterioration in anaphylaxis, not responding to continuous salbutamol nebulisation

140
Q

What are the contra-indications for magnesium sulfate?

A

Known hypermagnesaemia

141
Q

What are the actions of magnesium sulfate?

A

Relaxes bronchial muscles
Competitively blocks entry of calcium into synaptic endings reducing neuromuscular transmission

142
Q

How is magnesium sulfate administered?

143
Q

What is the initial dose of magnesium sulfate in asthma?

A

2g - NO REPEAT DOSE

144
Q

What is the initial dose of magnesium sulfate in eclampsia and severe pre-eclampsia?

A

4g - NO REPEAT DOSE

145
Q

What is the initial dose of magnesium sulfate in Torsades de Pointes?

A

2g - NO REPEAT DOSE

146
Q

What is the indication for penthrox?

A

The emergency relief of moderate to severe pain in conscious adult patients with trauma and associated pain

147
Q

What are the contra-indications for penthrox?

A

Under 18s
Recent use of penthrox, more than 15ml in the previous week
Patients with known allergy or hypersensitivity to penthrox or anaesthetic gases
Patients with liver damage or impairment
CKD stage 4/5
Altered level of consciousness due to any cause
Clinically evident cardiovascular instability e.g hypotensive, heart failure
Respiratory depression
Personal or family history of malignant hyperthermia born severe adverse reaction to inhaled anaesthetic gases

148
Q

What is the action of penthrox?

A

Inhaled analgesic designed for self administration using a handheld device under supervision, can be used as a non opioid alternative to morphine or in conjunction with morphine four very severe pain. It is believed to reduce conduction of pain signals across gap junctions

149
Q

How is penthrox administered?

150
Q

What is the initial dose for penthrox?

A

3ml (1 bottle)

151
Q

What is the repeat dose for penthrox?

A

3ml (1bottle)

152
Q

What is the dose interval for penthrox?

153
Q

What is the max dose for penthrox?

A

6ml (2 bottles)

154
Q

What are the indications for metoclopramide hydrochloride?

A

Nausea and vomiting in adults aged 18 or over
Prevention and treatment of nausea and vomiting following administration of morphine

155
Q

What are the contra-indications for metoclopramide hydrochloride?

A

Under 18s
Renal failure
Phaeochromocytoma
Gastrointestinal obstruction
Perforation/haemorrhage/ 3-4 days after GI surgery
Cases of drug overdose

156
Q

What is the action of metoclopramide hydrochloride?

A

Anti-emetic which acts centrally as well as on the GI tract

157
Q

How is metoclopramide hydrochloride administered?

158
Q

What is the initial dose for metoclopramide hydrochloride?

A

10mg - NO REPEAT DOSE

159
Q

What is the max dose for metoclopramide hydrochloride?

160
Q

What are the indications for midazolam?

A

Pts who have prolonged convulsion lasting 5 mins or more or repeated convulsions (3 or more in an hour) and are currently convulsing.
Convulsion continuing 10 mins after first dose of medication

161
Q

What are the contra-indications for midazolam?

162
Q

What is the action of midazolam?

A

Short acting benzodiazepine with anxiolytic, sedative and anticonvulsant properties. the buccal route onset of action is usually within 5 mins. The sedative effect decreases from 15 mins onwards

163
Q

How is midazolam administered?

164
Q

What is the initial dose of midazolam?

165
Q

What is the repeat dose of midazolam?

166
Q

What is the dose interval for midazolam?

167
Q

What is the max dose for midazolam?

168
Q

What are the indications for misoprostal?

A

Primary or secondary PPH where there is excessive bleeding from the birth canal which is uncontrolled by the use of syntometrine where available or where syntometrine is contraindicated or unavailable.
Confirmed miscarriage with excessive bleeding from the birth canalwhich is uncontrolled by the use of syntometrine where available or where syntometrine is contraindicated or unavailable.

169
Q

What are the contraindications for misoprostal?

A

If there is any specific reason to suspect another foetus is in the uterus.
Known anaphylaxis to misoprostal or any other component of the product or to other prostaglandins

170
Q

What are the actions of misoprostal?

A

It is a uterotonic medicine which stimulates contraction of the uterus for the control of bleeding after birth.

171
Q

How is misoprostal administered?

A

Sublingual or rectal

172
Q

What is the initial dose for misoprostal?

A

800mcg - NO REPEAT DOSE

173
Q

What is the max dose for misoprostal?

174
Q

What are the indications for morphine?

A

Pain associated with suspected MI.
Severe pain as a component of a balanced analgesia regimen.

175
Q

What are the contra-indications for morphine?

A

Children under 1
Respiratory depression - less than 10
Hypotension - below 90mmHg
Head injury with significantly impaired level of consciousness
Known hypersensitivity

176
Q

What are the actions of morphine?

A

Strong opioid analgesic, it produces sedation, euphoria and analgesia, it may both depress respiration and induce hypotension. Histamine is released following morphine administration and this may contribute to vasodilatory effects, this may also account for the urticaria and bronchoconstriction that are sometimes seen.

177
Q

How is morphine administered?

A

Ideally IV but can be given orally or IM

178
Q

What is the initial dose for morphine?

A

10mg - but give slowly and 2mg at a time

179
Q

What is the repeat dose for morphine?

180
Q

What is the dose interval for morphine?

181
Q

What is the max dose of morphine?

182
Q

What are the indications for naloxone?

A

The reversal of acute opioid or opiate toxicity for respiratory arrest or respiratory depression.
Unconsciousness associated with respiratory depression of unknown cause where opioid overdose is a possibility.
In cardiac arrest where opioid toxicity is considered to be the likely cause

183
Q

What are the contra-indications for naloxone?

A

Neonates born to opioid addicted mothers

184
Q

What are the actions of naloxone?

A

Complete or partial reversal of the respiratory depression effects of opioid drugs.

185
Q

How is naloxone administered?

A

IV/IO/IM/ intranasal

186
Q

What is the initial dose of naloxone?

187
Q

What is the repeat dose of naloxone?

A

400mcg or 800mcg in cardiac arrest

188
Q

What is the dose interval for naloxone?

A

3 mins or 1 min in cardiac arrest

189
Q

What is the max dose of naloxone?

A

4000 mcg or 10000mcg in cardiac arrest

190
Q

What are the indications for entonox?

A

Moderate to severe pain
Labour pains

191
Q

What are the contra-indications for entonox?

A

Chest injury or clinically suspected pneumothorax.
Severe head injuries with impaired consciousness due to possible presence of intracranial air
Violently disturbed psychiatric patients
Decompression sickness
An intraocular injection of gas within the last 8 weeks
abdominal pain where intestinal obstruction is suspected

192
Q

What is the action of entonox?

A

Inhaled analgesic agent

193
Q

How is entonox administered?

A

Mouthpiece

194
Q

What are the indications for ondansetron?

A

Prevention and treatment of opiate induced nausea and vomiting

195
Q

What are the contra-indications for ondansetron?

A

Known sensitivity of ondansetron.
Infants less than 1 month old
congenital long QT syndrome

196
Q

What is the action of ondansetron?

A

An anti-emetic that blocks 5HT receptors both centrally and in the gastrointestinal tract

197
Q

How is ondansetron administered?

198
Q

What is the initial dose for ondansetron?

199
Q

What is the repeat dose for ondansetron?

200
Q

What is the dose interval for ondansetron?

201
Q

What is the max dose for ondansetron?

202
Q

What are the indications of oxygen?

A

Critical illnesses 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

203
Q

What is the contra-indication for oxygen?

A

Explosive environments

204
Q

What are the actions of oxygen?

A

Essential for cell metabolism, adequate tissue function is essential for normal physiological function.
Oxygen assists in reversing hypoxia by raising the concentration of inspired oxygen

205
Q

What are the indications for paracetamol?

A

Mild/moderate pain for oral
moderate/severe pain for IV

206
Q

What are the contra-indications for paracetamol?

A

Known paracetamol allergy
Already taken within last 4 hours

207
Q

What are the actions of paracetamol?

A

Analgesis and antipyretic

208
Q

What is the initial dose for oral paracetamol?

209
Q

What is the repeat dose for oral paracetamol?

210
Q

What is the dose interval for oral paracetamol?

211
Q

What is there max dose of oral paracetamol?

212
Q

What is the initial dose for IV paracetamol

213
Q

What is the repeat dose for IV paracetamol?

214
Q

What is the dose interval for IV paracetamol?

215
Q

What is the max dose for IV paracetamol?

216
Q

What are the indications for prednisolone?

A

Treatment of moderate to severe exacerbations of asthma.
Treatment of exacerbation of COPD

217
Q

What are the contra-indications for prednisolone?

A

Had prednisolone within last 2 hours.
Pts not included in the inclusion criteria
Vomiting or unable to swallow
Known hypersensitivity to steroid or excipients.
Suspects or known systemic infection
Active peptic ulcer disease

218
Q

What is the action of prednisolone?

A

It is a glucocorticoid steroid that suppresses part of the immune system and reduces inflammation and swelling

219
Q

What is the initial dose of prednisolone?

A

40mg - NO REPEAT DOSE

220
Q

What are the indications for salbutamol?

A

Acute asthma attack where normal inhaler therapy has failed to relieve symptoms.
Expiratory wheezing associated with allergy, anaphylaxis, beta blocker overdose, smock inhalation or other lower airway cause.
Exacerbation of COPD

221
Q

What are the contra-indications for salbutamol?

A

none in emergency situation

222
Q

What is the action of salbutamol?

A

It is a selective beta 2 adrenoreceptor stimulant drug that has a relaxant effect on the smooth muscle in airways

223
Q

What is the initial dose for salbutamol?

224
Q

What I the repeat dose for salbutamol?

225
Q

What is the dose interval for salbutamol?

226
Q

What is the max dose for salbutamol?

227
Q

What are the indications for sodium chloride 0.9%?

A

Medical conditions with or without haemorrhage
Burns
Limb crush injury
Trauma related haemorrhage
As a flush

228
Q

What are the contra-indications for sodium chloride 0.9%

A

Do not give solely to keep a vein open

229
Q

What is the action of sodium chloride 0.9%?

A

Increases vascular volume which consequently raises cardiac output and improves perfusion

230
Q

How is sodium chloride 0.9% administered?

231
Q

What are the doses for sodium chloride 0.9%

A

See JRCALC

232
Q

What are the indications for sodium lactate compound?

A

Blood and fluid loss to correct hypovolaemia and improve tissue perfusion when sodium chloride 0.9% isnt available.
Dehydration

233
Q

What are the contra-indications for sodium lactate compound?

A

Neonates
Diabetic hyperglycaemic ketoacidotic coma and pre coma

234
Q

What is the action of sodium lactate compound?

A

Increases vascular volume which consequently raises cardiac output and improves perfusion

235
Q

What is the dosage of sodium lactate compound?

A

see JRCALC

236
Q

What are the indications of syntometrine?

A

Primary or secondary PPH where there is excessive bleeding from the birth canal.
Confirmed miscarriage or termination of pregnancy with excessive bleeding where a patient has gone home

237
Q

What are the contra-indications of syntometrine?

A

Known or suspected foetus in utero.
Current severe hypertension over 140mmHg
Known anaphylaxis tenth active substances
Severe cardiac, liver or kidney disease

238
Q

What are the actions of syntometrine?

A

The oxytocin in syntometrine is a synthetic form which stimulates contraction of the uterus. Ergometrine also produces a sustained uterine contraction for the control of bleeding after birth

239
Q

How is syntometrine administered?

240
Q

What is the initial dose of syntometrine?

A

500mcg of ergometrine and 5 units of oxytocin -0 NO REPEAT DOSE

241
Q

What are the indications of Tenecteplase?

A

Acute ST segment elevation MI with 6 hours of symptom onset where PPCI is not readily available

242
Q

What are the contra-indications for tenecteplase?

A

See JRCALC for checklist

243
Q

How is tenecteplase administered?

244
Q

What is the initial dose for tenecteplase?

A

Weight dependent - see JRCALC
Only 1 dose - no repeats
Max dose varies form 6000 units to 10,000 units

245
Q

What are the indications for tranexamic acid?

A

Actual or suspected severe haemorrhage
Head injury
Traumatic cardiac arrest
PPH
pregnancy

246
Q

What are the contra-indications for tranexamic acid?

A

Bleeding started more than 3 hours ago
Previous anaphylaxis to this drug
Obvious resolution of haemorrhage]

247
Q

How is tranexamic acid administered?

A

IV/IO or IM

248
Q

What is the initial dose of tranexamic acid?

A

1g - NO REPEAT DOSE unless in PPH then can give a further 1g after 30 mins

249
Q

What is the action of tranexamic acid?

A

It is an anti-fibrinolytic which reduces the breakdown of blood clot

PPCS2 medications flash cards (1 decks)

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