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Guidelines > Medicines > Flashcards

Medicines Flashcards

1
Q

Adenosine dose

A

6mg IV followed by second dose 12mg IV if SVT does not revert

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2
Q

Adenosine indication

A

Patients older than 12 with SVT and ventricular rate greater than 150,
and known responsiveness to adenosine
and causing moderate cardiovascular compromise

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3
Q

Adenosine contraindications

A

Known severe allergy
Known sick sinus syndrome
History of second or third degree heart block without pacemaker
Heart transplant without pacemaker

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4
Q

Adenosine caution

A

Asthma or COPD acute exacerbation and/or history of life threatening bronchospasm
Wolf Parkinson White if any chance of rapid atrial fibrillation

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5
Q

Adenosine administration

A

6mg in 2ml, given neat into ACF followed by rapid flush.

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6
Q

Adenosine adverse effects

A

Bradycardia and/or sinus pause up to 30 seconds
Shortness of breath or urge to breathe deeply
Lightheadedness
Nausea, flushing
Chest pressure or severe apprehension

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7
Q

Adenosine pharmokinetics

A

Rapidly taken up and metabolised within seconds by red blood cells and vascular endothelial cells

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8
Q

Adenosine onset of effect

A

5 to 10 seconds

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9
Q

Adenosine duration of effect

A

10-20 seconds.

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10
Q

Adrenaline mechanism of action

A

Stimulates alpha and beta receptors, primarily alpha 1, beta 1, and beta 2 receptors.
alpha 1 stimulation causes smooth muscle contraction, vasoconstriction, stimulation of glycogenolysis and gluconeogenesis
beta 1 causes increase in inotropy, chronotropy, and dromotropy
beta 2 causes smooth muscle relaxation, skeletal muscle vasodilation, bronchodilation, and stabilisation of mast cell membranes to reduce histamine release

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11
Q

Adrenaline indication

A 
Cardiac arrest
Anaphylaxis 
Severe asthma 
Imminent respiratory arrest in COPD
Severe bradycardia
Moderate to severe stridor 
IN for epistaxis 
topical for wounds 
shock where unresponsive to metaraminol
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12
Q

Adrenaline contraindications

A

None

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13
Q

Adrenaline cautions

A

Myocardial ischaemia

Tachydysrhythmia

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14
Q

Adrenaline dose

A

Topical 1:10000 diluted to total of 10ml.
Intranasal 1:10000 diluted to a total of 10ml, with 0.2mg or 2ml through a MAD
Nebuliser, 5mg undiluted
IM neat (0.5mg for asthma repeated q10 minutes, q10 for not improving anaphylaxis, q5 minutes for deteriorating anaphylaxis)
IV undiluted for cardiac arrest

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15
Q

Adrenaline adverse effects

A 
Tachycardia
Tachydysrhythmia 
Myocardial Ischaemia
Ventricular ectopy 
Hypertension 
Nausea and vomiting 
Tremor, anxiety, sweating 
Hyperglycaemia
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16
Q

Adrenaline onset IV

A

5-10 seconds

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17
Q

Adrenaline onset IM

A

2-5 minutes

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18
Q

Adrenaline onset topical and intranasal

A

on contact

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19
Q

Adrenaline pharmacokinetics

A

Adrenaline is metabolised by the liver and taken up by sympathetic nerve endings. There are no significant effects from liver impairment on acute administration.

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20
Q

Amiodarone mechanism

A

An antidysrthymic with broad spectrum of activity.
Predominately class three activity (it prolongs the action potential duration, reduces automaticity and prolongs refractory period of atrial, nodal and ventricular tissues)
… resulting in reduction of abnormal electrical activity, a reduction in electrical conduction, reduction in heart rate, and stabilisation of SA and AV nodes.
Small increase in coronary blood flow & reduction in myocardial oxygen consumption by reducing inotropy.

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21
Q

Amiodarone indications

A

Cardiac arrest in VT or VF after first dose of adrenaline
adults in sustained VT
Adults with moderate cardiovascular compromise as result of fast AFib or fast AFlutter

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22
Q

Amiodarone contraindications

A

Known severe allergy
Known severe allergy to iodine
VT secondary to TCA poisoning (can cause worsening shock).

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23
Q

Amiodarone cautions

A

None in cardiac arrest

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24
Q

Amiodarone dosage

A

300mg for adult… (2x 150mg in 2ml vial)

If VT or VF persists, a second dose of 150mg May be administered.

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25
Q

Amiodarone administration

A

Neat IV bolus of 300mg in 4ml, two vials

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26
Q

Amiodarone adverse effects

A

Hypotension
Lightheadedness
Bradydysrhysmia

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27
Q

Amiodarone onset

A

5-10 minutes

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28
Q

Amiodarone duration

A

1-4 hours after single dose.

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29
Q

Amiodarone pharmacokinetics

A

Metabolised by liver.

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30
Q

Amoxiclav mechanism

A

Is a beta-lactate antibiotic with broad activity against gram negative and gram positive bacteria. Also has some activity against anaerobic bacteria, particularly those from the mouth.
Inhibits production of the bacterial cell wall causing bacteria to die.

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31
Q

Amoxiclav indications

A

Sepsis and:
Patient is aged greater than 12
One or more High Risk factors are present
Time to hospital greater than 30 minutes
Cellulitis where single IV dose may be given if referred to primary care but delay may be present.

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32
Q

Amoxiclav contradindications

A

Known severe allergy

Known severe allergy penicillins or cephalosporins

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33
Q

Amoxiclav cautions

A

None! Free square.

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34
Q

Amoxiclav dose

A

1.2g

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35
Q

Amoxiclav administration

A

Dissolve 1.2g in nacl and dilute to 10ml. administer IV over 1-2 minutes preferably into running IV line
Do not administer IM if IV access cannot be obtained.

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36
Q

Amoxiclav onset

A

30-60 minutes

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37
Q

Amoxiclav duration

A

6-8 hours

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38
Q

Amoxiclav Pharmacokinetics

A

Excreted in urine - clearance prolonged in renal impairment, does not alter dose.

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39
Q

Aspirin mechanism

A

Has antiplatelet, antipyretic, anti-inflammatory and analgesic effects but only given for antiplatelet effect
Inhibits cyclooxygenase which results in reduction of formation of thromboxane and prostaglandins

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40
Q

Aspirin indications

A

Myocardial ischaemia

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41
Q

Aspirin contraindications

A

Known severe allergy

Third trimester of pregnancy

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42
Q

Aspirin caution

A

Known bleeding disorder (usually in favour of administration)
Clinically significant bleeding
Known worsening bronchospasm with NSAIDs

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43
Q

Aspirin dose

A

300mg in 1 tablet

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44
Q

Aspirin admin

A

One 300mg tablet sublingual or dispersed in water.

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45
Q

Aspirin common adverse effects

A

Increased bleeding

Indigestion and gastric bleeding only risk with prolonged use

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46
Q

Aspirin onset

A

30-60 minutes

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47
Q

Aspirin duration

A

3-5 days for antiplatelet activity

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48
Q

Aspirin pharmacokinetics

A

Absorbed in stomach, metabolised in liver

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49
Q

Aspirin interactions

A

Warfarin

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50
Q

Ceftriaxone mechanism

A

Cephalosporin antibiotic with broad activity against gram negative and positive bacteria. inhibits production of the bacterial cell wall.

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51
Q

Ceftriaxone indications

A

Suspected meningococcal septicaemia

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52
Q

Ceftriaxone contraindications

A

Anaphylaxis to cephalosporins

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53
Q

Ceftriaxone cautions

A

None. Free square.

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54
Q

Ceftriaxone dose

A

2g IV

2g IM if IV access cannot be obtained

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55
Q

Ceftriaxone administration

A

Reconstitute 2g and dilute to 10ml, administer IV over 1-2 minutes preferably into a running line.
Reconstitute 2g with 4ml nacl and split into roughly equal doses for IM administration

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56
Q

Ceftriaxone adverse effects

A

None

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57
Q

Ceftriaxone onset

A

30-60 minutes

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58
Q

Ceftriaxone duration

A

24 hours

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59
Q

Ceftriaxone pharmacokinetics

A

Excreted in urine and bile

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60
Q

Clopidogrel mechanism

A

Powerful antiplatelet agent, blocks ADP.

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61
Q

Clopidogrel indications

A

STEMI thrombolysis.

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62
Q

Clopidogrel contraindications

A

Known severe allergy

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63
Q

Clopidogrel cautions

A

Clinically significant bleeding
At risk of bleeding
Pregnancy

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64
Q

Clopidogrel dose

A

300mg if less than 75 years
75mg if greater than 75 years
Tablet

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65
Q

Clopidogrel adverse effects

A

Increased bleeding

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66
Q

Clopidogrel onset

A

30-60 minutes

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67
Q

Clopidogrel pharmacokinetics

A

prodrug, must be metabolised in the liver into active form.

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68
Q

Droperidol mechanism of action

A

Blocks dopamine and alpha receptors centrally, resulting in sedation, reduced agitation, and mental detachment.

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69
Q

Droperidol indications

A

Patients aged greater than or equal to 12 years with agitated delirium causing a mild to moderate risk to safety when olanzapone has not been administered or is ineffective.

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70
Q

Droperidol contraindications

A

Known severe allergy

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71
Q

Droperidol cautions

A

Parkinson’s disease - risk of worsening movement disorder.
Concurrent administration of other sedatives - this will increase and prolong effects.
Intoxication - potentiates
Elderly or frail - increase/prolong effects

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72
Q

Droperidol dosage

A

10mg IM or IV, reduce to 5 if patient is frail, repeat once after 20 minutes.

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73
Q

Droperidol administration

A

IM neat, lateral thigh

Dilute 10mg to 10ml and administer IV over 1-2 minutes.

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74
Q

Enoxaparin mechanism

A

Low molecular weight heparin anticoagulant, potentiating activity of antithrombin III causing inhibition of multiple coagulation factors

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75
Q

Enoxaparin indication

A

STEMI thrombolysis

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76
Q

Enoxaparin contraindications

A

Known severe allergy

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77
Q

Enoxaparin cautions

A

Clinically significant bleeding
Risk of bleeding
Pregnancy

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78
Q

Enoxaparin dose

A

Weight and age based. 60-100mg for those under 75 and 44-75 for those over 75.

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79
Q

Enoxaparin administration

A

subcut into abdominal wall

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80
Q

Enoxaparin onset

A

10-30 minutes

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81
Q

Enoxaparin duration

A

12-24 hours

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82
Q

Enoxaparin pharmacokinetics

A

Excreted in urine.

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83
Q

Fentanyl mechanism of action

A

Opiate analgesic.

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84
Q

Fentanyl indications

A 
Moderate to severe pain
Cardiogenic pulmonary oedema with severe anxiety 
RSI
Sedation post intubation 
Symptom control at end of life care
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85
Q

Fentanyl contraindications

A

Known severe allergy
Unable to obey commands (other than rsi, end of life care, post intubation)
Respiratory depression

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86
Q

Fentanyl cautions

A

Aged less than one year
High risk of respiratory depression (severe copd, home bipap)
Labour
Concurrent administration of other opiates or cns depressants
Elderly or frail
Signs of shock.

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87
Q

Fentanyl dose

A

IV analgesia - 10-50mcg every five minutes for an adult.
IN analgesia 100mcg for adult, further doses 50mcg every ten minutes without maximum dose. 200 + 100 adult over 80kg.
IM 50-100mcg for an adult.

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88
Q

Fentanyl adverse effects

A 
Respiratory depression 
Bradycardia 
Hypotension 
Sedation 
Nausea and vomiting 
Itch 
Euphoria
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89
Q

Fentanyl onset

A

IV 2-5 minutes, maximum in 10-15.
IN 5-10 minutes.
IM 5-10 minutes

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90
Q

Fentanyl duration

A

30-60 minutes although respiratory depression may last hours.

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91
Q

Fentanyl pharmacokinetics

A

Fat soluble, well absorbed through nasal mucosa.
Causes histamine release. Small fall in blood pressure.
Metabolised in liver.

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92
Q

Gentamicin mechanism of action

A

Aminoglycoside antibiotic with broad activity against gram-negative bacteria. inhibits cell protein synthesis.

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93
Q

Gentamicin indications

A

Sepsis, in addition to amoxicillin/clavulanic acid) where site of infection is urinary tract, abdomen, or unknown and:
Patient aged 12+
One or more high risk factors
Time to hospital is greater than 30 minutes

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94
Q

Gentamicin contraindications

A

Known severe allergy

Pregnancy

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95
Q

Gentamicin cautions

A

Empty square player choice

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96
Q

Gentamicin dosage

A

400mg if greater than 80kg
320 if 60-80kg
240 if less than 60kg

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97
Q

Gentamicin administration

A

Dilute dose up to 10-20ml of saline and give IV over 1-2 minutes preferably into a running IV line

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98
Q

Gentamicin adverse effects

A

Damage to inner ear with prolonged use

Rental impairment with prolonged use

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99
Q

Gentamicin onset of effect

A

30-60 minutes

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100
Q

Gentamicin duration

A

24 hours

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101
Q

Gentamicin pharmacokinetics

A

Excreted in urine.

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102
Q

Gentamicin interactions

A

May potentiate effects of neuromuscular blockers, resulting in longer duration of action for these drugs

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103
Q

Glucagon mechanism

A

Increases blood glucose level by stimulating glucogenolysis, predominately within the liver.

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104
Q

Glucagon indication

A

Hypoglycaemia when patient cannot safely swallow and IV access cannot be obtained

105
Q

Glucagon contraindications

A

Known severe allergy

106
Q

Glucagon cautions

A

Blank square player choice.

107
Q

Glucagon dosage

A

1mg IM for adult or child 5+

0.5mg IM for child <5

108
Q

Glucagon onset

A

5-10 minutes

109
Q

Glucagon duration

A

15-60 minutes

110
Q

Glucagon pharmacokinetics

A

Excreted unchanged into bile and urine.

111
Q

GTN mechanism

A

Vasodilator. causes venous and arterial dilation.
Reduction in venous return (preload). reduces myocardial oxygen demand.
Arterial dilation reduces afterload by dilating arteries, reduces work of left ventricle and drops oxygen demand.
May dilute coronary arteries and improve blood supply.

112
Q

GTN indications

A

Myocardial ischaemia
Cardiogenic pulmonary oedema
Control of hypertension associated with autonomic dysreflexia
Control of hypertension prior to fibrinolytic treatment for STEMI.

113
Q

GTN contraindications

A 
Known severe allergy 
Systolic BP less than 100mmHg
Heart rate less than 40/min 
Heart rate greater than 150/minute 
VT
114
Q

GTN cautions

A 
STEMI especially right sided. 
Small, frail or unstable patient 
Poor perfusion 
Dysthymia 
Medicine for erectile dysfunction in last 24 
Known aortic or mitral stenosis
115
Q

GTN dosage

A

Myocardial ischaemia: 0.4mg every 3-5 minutes, increase dosing interval to every ten if required.
CPO 0.8mg every 3-5 minutes. increase dose and frequency if patient not improving, provided systolic BP stable over 100mmHg.

116
Q

GTN adverse effects

A 
Hypotension 
Flushing 
Headache 
Tachycardia 
Feeling light-headed
117
Q

GTN onset

A

1-2 minutes

118
Q

GTN duration

A

15-30 minutes

119
Q

GTN pharmacokinetics

A

Absorbed through oral mucosa, reaches vascular system without passing through liver.
Metabolised in liver.

120
Q

GTN interactions

A

Increased effect if patient taking antihypotensive medication

Severe and prolonged hypotension may occur if medicine for ED has been taken in last 24.

121
Q

Heparin mechanism

A

Anticoagulant, potentiates activity of antithrombin III causing inhibition of multiple coagulation factors.

122
Q

Heparin indication

A

STEMI fibrinolytic pathway

123
Q

Heparin contraindications

A

Known severe allergy

Age 75 or older.

124
Q

Heparin cautions

A

Clinically significant bleeding
At risk of bleeding.
Pregnancy

125
Q

Heparin dosage

A

5000 units.

126
Q

Heparin administration

A

Dilute to total volume of 10ml using saline, administer over 1-2 minutes.

127
Q

Heparin adverse effects

A

Increased bleeding.

128
Q

Heparin onset

A

5-15 minutes

129
Q

Heparin duration

A

24 hours

130
Q

Heparin pharmacokinetics

A

Unclear.

131
Q

Ibuprofen mechanism

A

NSAID

inhibits activity of prostaglandins, reducing pain inflammation and fever.

132
Q

Ibuprofen indications

A

Mild pain, particularly soft tissue and musculoskeletal pain.

133
Q

Ibuprofen contraindications

A

Known severe allergy

Third trimester pregnancy

134
Q

Ibuprofen cautions

A 
Taken ibuprofen within last 4 hours. 
Abdominal pain with vomiting 
Age greater than or equal to 75 years
Dehydration or shock 
Known renal impairment 
Known bleeding disorder 
Clinically significant bleeding 
Known worsening bronchospasm with NSAIDs
Warfarin 
Pregnancy
135
Q

Ibuprofen dose

A

600mg for adult 80kg+
400 for patient under 80kg
Paediatric doses

136
Q

Ibuprofen adverse effect

A

Rental impairment

Increased bleeding

137
Q

Ibuprofen onset

A

30-60 minutes

138
Q

Ibuprofen duration

A

4-6 hours

139
Q

Ibuprofen pharmacokinetics

A

Absorbed in stomach and small intestine

Metabolised by liver

140
Q

Ibuprofen interactions

A

Warfarin

141
Q

Ipratropium mechanism

A

Bronchodilator
Anticholinergic agent with predominantly antimuscarinic activity. blocks acetylcholine receptors to cause vagal inhibition resulting in bronchodilation

142
Q

Ipratropium indication

A

Bronchospasm secondary to asthma or COPD

Prominent bronchospasm secondary to airway burns, smoke inhalation or chest infection

143
Q

Ipratropium contraindications

A

Known severe drug allergy

144
Q

Ipratropium cautions

A

None, free square, player choice.

145
Q

Ipratropium dosage

A

0.5mg for adults and children once only

146
Q

Ipratropium common adverse effects

A

Tachycardia
Dry mouth
Blurred vision (repeat doses)

147
Q

Ipratropium onset

A

2-5 minutes

148
Q

Ipratropium duration

A

6 hours.

149
Q

Ipratropium pharmacokinetics

A

Small amount of nebulised dose absorbed, mostly in lungs or swallowed.
Excreted through urine

150
Q

Ketamine mechanism

A

Ketamine is an analgesic, complex actions but primarily an NMDA receptor antagonists - inhibits excitatory neurotransmitters in the brain.
Low doses for analgesia, large doses for amnesia and dissociation, larger for anaesthesia

151
Q

Ketamine indications

A

Severe pain
Dissociation for cardioversion, joint relocation, limb alignment.
Agitated delirium causing severe or life threatening risk to safety
RSI
Movement during CPR interfering with resuscitation
Asthma with severe agitation that is impairing ability to provide safe treatment/transport

152
Q

Ketamine contraindications

A

Known severe allergy

Aged less than 1 year

153
Q

Ketamine cautions

A

Unable to obey commands
Active psychosis
Hypertension
Clinical conditions that may be worsened by hypertension such as stroke
Current myocardial ischaemia
Concurrent administration of sedatives or midazolam
Elderly and/or frail

154
Q

Ketamine dosage

A

Analgesia:
30mg IV over 15 minutes for patient over 80kg repeated as required.
20mg IV over approximately 15 minutes if patient weighs 50-80kg repeated as required
See paediatric drug dose table, give over 15 minutes.
0.5mg/kg IM or PO up to maximum of 50mg if IV access cannot be obtained. this may be repeated once after 20 minutes.

155
Q

Ketamine administration

A

IV if possible
Over fifteen minutes if possible
Dilute 100mg (1ml) into. 100ml bag of 5% glucose. shake well and label.
draw up dose and admitted 2mg/2ml every 1-2 minutes
Or run at 2-3 drops a second.

156
Q

Ketamine common adverse effects

A 
Transient hypertension 
Tachycardia 
Apnoea 
Nausea and vomiting 
Sedation 
Hallucinations
157
Q

Ketamine onset

A

IV 1-2 minutes
IM 5-10 minutes
PO 10-20 minutes

158
Q

Ketamine duration

A

10-60 minutes

159
Q

Ketamine pharmacokinetics

A

Metabolised in liver.

160
Q

1% lignocaine mechanism

A

Local anaesthetic, blocks the initiation and transmission of nerve impulses by blocking the moment of sodium ions across the nerve cell membrane.

161
Q

Lignocaine indications

A

Subcut for IV cannulation pain
Subcut for digital ring blocks
Intraosseous for bone pain associated with fluid infusion via IO needle

162
Q

1% lignocaine contraindications

A

Known severe allergy

Local infection in area of injection

163
Q

1% lignocaine cautions

A

Anticoagulant when using for ring block

164
Q

1% lignocaine dose

A 
Subcut max dose for adult 200mg (20ml of 1%) - may be repeated once after thirty minutes. 
Intraosseous 50mg (5ml) for an adult. May be repeated once after fifteen minutes
165
Q

1% lignocaine adverse effects

A

Sting at site of injection

166
Q

1% lignocaine onset

A

1-2 minutes for IV cannulation

5-10 for digital ring block

167
Q

1% lignocaine duration

A

30-60 minutes

168
Q

1% lignocaine pharmacokinetics

A

Liver

169
Q

Loratadine mechanism

A

non-sedating antihistamine; blocks peripheral histamine receptors.

170
Q

Loratadine indications

A

Minor allergic reactions confined to skin involvement.

Prominent itch associated with anaphylaxis, if all systemic signs have resolved

171
Q

Loratadine contraindications

A

Known severe allergy

Age under 1 year

172
Q

Loratadine cautions

A

Pregnancy

173
Q

Loratadine dose

A

10mg oral for adult or 5mg for child 1-11.

174
Q

Loratadine onset

A

30-60 minutes

175
Q

Loratadine duration

A

12-24 hours

176
Q

Midazolam mechanism

A

Benzodiazepine, enhances activity of GABA to cause anticonvulsant, sedative, amnesiac, and anxiolytics function.

177
Q

Midazolam indications

A

Prolonged seizures

Agitated delirium causing a mild to moderate safety risk and droperidol is unavailable or ineffective

178
Q

Midazolam contraindications

A

Free square player choice.

179
Q

Midazolam cautions

A

Concurrent administration with other sedatives
Intoxication
Elderly or frail

180
Q

Midazolam dose

A

IV - dilute 2 ml from a 15mg/3nl ampule to a total of 10ml and administer as IV bolus. 5mg, repeated once after five minutes.
IM - draw up a dose from 3ml ampule, neat. 10mg, repeat once after ten minutes.

181
Q

Midazolam adverse effects

A

sedation
Respiratory depression
Hypotension
Amnesia

182
Q

Midazolam onset

A

IV 2-3minutes

IM 3-5 minutes

183
Q

Midazolam duration

A

30-60 minutes; sedative effect may last longer.

184
Q

Midazolam pharmacokinetics

A

Liver

185
Q

Naloxone mechanism

A

Opiate receptor antagonist, competes with opiates and reverses their effects.

186
Q

Naloxone indication

A

Opiate poisoning suspected, significantly impaired level of consciousness or impaired breathing
Excess adverse effects from administration of opiates

187
Q

Naloxone contraindications

A

Known severe allergy

188
Q

Naloxone cautions

A

Chronic opiate use - risk of adverse physiological effect with rapid opiate withdrawal.

189
Q

Naloxone dose

A
  1. 1 - 0.4 IV every five minutes as required for an adult

0. 8 IM as required, repeated every 20 minutes.

190
Q

Naloxone common adverse effects

A

Sweating
Tachycardia
Hypertension

191
Q

Naloxone onset

A

IV 1-2 minutes

IM 5-10 minutes

192
Q

Naloxone duration

A

30-60 minutes

193
Q

Olanzapine mechanism

A

Atypical antipsychotic; reduces agitation, causes sedation and anxiolytics and stabilisation of mood.

194
Q

Olanzapine indications

A

Patients aged 12 or greater with agitated delirium causing mild to moderate risk to safety, when the patient will take an oral medication.

195
Q

Olanzapine contraindications

A

Known severe allergy

Poisoning with an antipsychotic such as quetiapine or risperidone.

196
Q

Olanzapine cautions

A

Pregnancy
Intoxication
Elderly or frail

197
Q

Olanzapine dose

A

10mg PO repeated once. 5mg PO if patient is frail.

198
Q

Olanzapine adverse effects

A

Sedation

199
Q

Olanzapine onset

A

10-20 minutes

200
Q

Olanzapine duration

A

12-24 hours

201
Q

Ondansetron mechanism

A

Antiemetic, blocks serotonin receptors in brain and GI tract, reducing nausea and vomiting

202
Q

Ondansetron indication

A

Clinically significant nausea and/or vomiting

203
Q

Ondansetron contraindications

A

Known severe allergy

Aged less than one year

204
Q

Ondansetron cautions

A

Player choice.

205
Q

Ondansetron dose

A

4mg IM repeated once after 20 minutes
IV 8mg.
Total of 12mg may be given if IV access gained after an IM dose.

206
Q

Ondansetron adverse effects

A

Headache

Flushing

207
Q

Ondansetron effects

A

IV 2-5 minutes

IM 5-10 minutes

208
Q

Ondansetron duration

A

4-8 hours

209
Q

Oxytocin mechanism

A

Synthetic version of naturally occurring hormone normally released from pituitary gland.
Stimulates receptors in the uterus causing increased contraction and reduced blood loss.

210
Q

Oxytocin indication

A

Following normal birth

Postpartum haemorrhage

211
Q

Oxytocin contraindications

A

Known severe allergy

212
Q

Oxytocin cautions

A

Free square player choice

213
Q

Oxytocin dose

A

10 units IM, neat. May need repeat dose if PPH occurs following administration for normal birth.

214
Q

Oxytocin adverse effects

A

Tachycardia
Flushing
Abdominal cramps

215
Q

Prednisone & prednisolone mechanism

A

Corticosteroid with anti-inflammatory and immunosuppressant actions. Inhibits production of inflammatory mediators including prostaglandins and leukotrienes, resulting in a reduction in inflammatory and immune responses.

216
Q

Prednisone indications

A

Bronchospasm associated with COPD and Asthma
Croup
Prominent rash associated with anaphylaxis where systemic effects have resolved
Minor allergy associated with rash

217
Q

Prednisone contraindications

A

Known severe allergy

218
Q

Prednisone

A

Kids under 5 with asthma, unless previously received them - may not make a difference.

219
Q

Prednisone dose

A

40mg for an adult PO

220
Q

Prednisone adverse effects

A

Fatigue
Sodium and water retention in prolonged use
Gastrointestinal reflux

221
Q

Prednisone onset

A

30-60 minutes

222
Q

Prednisone duration

A

24 hours

223
Q

Salbutamol mechanism

A

Bronchodilator, beta-2 stimulation.

224
Q

Salbutamol indications

A

Bronchospasm secondary to asthma, COPD.
Prominent bronchospasm secondary to airway burns or chest infection
Release syndrome following crush injury

225
Q

Salbutamol contraindications

A

Known severe allergy

226
Q

Salbutamol cautions

A

None

227
Q

Salbutamol dose

A

5mg nebulised (initial dose with ipratropium)

228
Q

Tenecteplase mechanism

A

Fibrinolytic, accelerates breakdown of blood clots by converting plasma protein plasminogen into the active enzyme plasmin which breaks down fibrin

229
Q

Tenecteplase indication

A

STEMI when PCI is not chosen reperfusion strategy.

230
Q

Tenecteplase contraindications

A

Known severe allergy
Suspected aortic dissection
Major surgery, major trauma or severe brain injury within last six weeks.
Intercranial surgery last six months
Ischaemic stroke within last six months
Previous intracerebral haemorrhage
Known cerebral aneurysm, arteriovenous malformation or tumour

231
Q

Tenecteplase cautions

A

Significant bleeding
Ten minutes or more of CPR
Non-compressible vascular puncture within 24 hours
Internal bleeding in last six weeks
Lumbar puncture or epidural within last six weeks
TIA in last three months
Known bleeding disorder
Taking an anticoagulant
Systolic BP more than 180 or diastolic 110.
Know to be pregnant or less than two weeks postpartum
Time of onset greater than 12 hours ago
Dependant on others for ADLs
Another disease significantly shortening life expectancy
Very frail

232
Q

Tenecteplase dose

A

By weight and age: 80-90 kilo person under 75 would receive 45mg.

233
Q

Tenecteplase adverse effects

A

Bleeding

Dysrhythmia (reperfusion arrhythmia)

234
Q

Tenecteplase onset

A

5-10 minutes

235
Q

Tenecteplase duration

A

2-6 hours

236
Q

Tramadol mechanism

A

Synthetic opioid analgesic, also inhibits noradrenaline and serotonin reuptake

237
Q

Tramadol indication

A

Aged 12 or greater with moderate to severe pain particularly where IV pain relief is not available

238
Q

Tramadol cautions

A

Taken within last four hours.
Abdominal pain especially if unwell if vomiting
Aged 75 or over, especially if hx dementia or confusion
Confusion
Pregnancy

239
Q

Tramadol dose

A

50mg PO

240
Q

Tramadol adverse effects

A

Nausea and/or vomiting
Feeling light headed or unusual
Sedation
Dry mouth

241
Q

Tramadol onset

A

30-60 minutes

242
Q

Tramadol duration

A

4-8 hours

243
Q

Tranexamic acid mechanism

A

Antifibrinolytic — blocks conversion of plasminogen to plasmin, reducing fibrinolysis.

244
Q

TXA indications

A

PPH
Hypovolaemia from uncontrolled bleeding
Any other form of bleeding severe enough to cause hypovolaemia requiring fluids

245
Q

TXA contraindications

A

Known severe allergy

Trauma when TXA will be given more than three hours after time of injury.

246
Q

TXA cautions

A

Free square. Player choice.

247
Q

TXA dose

A

1g IV for an adult

248
Q

TXA administration

A

Neat, IV, slowly.

249
Q

TXA adverse effects

A

None??

250
Q

TXA onset

A

30-60 minutes

251
Q

TXA duration

A

8 hours

252
Q

Valproate mechanism

A

Anticonvulsant, blocks sodium channels and enhances GABA activity within central nervous system.

253
Q

Valproate indications

A

Status epilepticus not responding to two doses of midazolam.

254
Q

Valproate contraindications

A

Severe allergy

255
Q

Valproate cautions

A

Free square

256
Q

Valproate dose

A

1200mg IV preferably into running IV line

257
Q

Valproate onset

A

10-20 minutes

258
Q

Valproate duration

A

6-12 hours

Guidelines (1 decks)

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