Meds Flashcards
Adrenaline
I)
- Anaphylaxis
- life-threatening asthma
- cardiac arrest
- post-ROSC
- severe croup
C/I)
- there are no absolutebcontraindications in adrenaline
1 mg/1 mL (1:1,000) ampoule
Amiodarone
I)
- cardiac arrest w/ persistent/shock resistant VT/VF post 3rd shock
C/I)
- none in cardiac arrest
Not compatible w/ saline (infusion)
150mg in 3mL ampoule
Amiodarone
I)
- cardiac arrest w/ persistent/shock resistant VT/VF post 3rd shock
C/I)
- none in cardiac arrest
Not compatible w/ saline (infusion)
150mg in 3mL ampoule
Aspirin
I)
- pts w/ suspected ACS
C/I)
- known hypersensitivity to aspirin/salicylates/NSAIDs
- children <16
300mg chewable/dispersible aspirin
Atropine
I)
- symptomatic bradycardia (hypotension, ALOC, diaphopresis, SOB/cyanosis, syncope)
- organophosphate poisoning w/ cholinergic affects
C/I)
- hypersensitivity
- cardiac transplant
1.2mg /1mL Ampoule
Coohenylcaine
I)
- local pain: abrasions, small cuts and wounds
- relief of mild and moderate epistaxis
- post tonsillectomy haemorrhage
- intra-oral haemorrhage
C/I)
- hypersensitivity to phenylephrine, lidocaine or other anaesthetic
- children <2
- pregnancy
Pump spray w/ nozzle
Droperidol
I)
- disturbed and abnormal behaviour (RASS 1-3) if considered appropriate and risk to safety is evident and de-escalation has not been effective
- dementia and frail where olanzapine cannot be administered or is ineffective
C/I)
- known allergy
- Parkinson’s disease
- where ketamine has been administered to sedate this episode
- age <6
- post-octal ABD
10mg/2ml (5mg/ml)
Fentanyl
I)
- moderate to severe pain
- ACS w/ GTN ineffective
C/I)
- hypersensitivity
- child <1 (IV/IO only)
- occluded nasal passage or epistaxis (IN)
IN 450mcg/1.5ml
IV/IO 100mcg/2ml or 500mcg/10ml
Glucagon
I)
- hypoglycaemia when cannot oral glucose and IV unable
- ALOC in diabetics or not <4mmol/L
C/I)
- Hypersensitivity
- known pheochromocytoma, insulinoma, glucagonoma
1mg in 1ml
Glucose Gel
I)
- hypoglycaemia ALOC in diabetics, <4mmol/L in unk medical cause
C/I)
- nil
15g glucose gel
Glucose IV
I)
- hypoglycaemia by ALOC in known or not known diabetics <4mmol/L
- cardiac arrest if hypoglycaemia expected cause
C/I)
- not be used when no patent IV
500ml bag 10% glucose (10g per 100mL)
GTN
I)
- chest pain from presumed cardiac cause where sys BP >90 mmhg and HR 50-150 bpm
- ACPO w/ sys BP >90mmHg
- autonomic dysreflexia w/ SYS BP >160 mmhg
C/I)
- hypersensitivity
- hypotension SYS <90mmHg
- VT
- Recent erectile dysfunction meds
: sildanefil, vardenafil, avanafil <24hrs
: tadalafil <3 days
Spray bottle 200x sprays, 400mcg per spray
Heparin
I)
- pts w/ STEMI going to Cath lab as per receiving hospital 12-lead ECG interpretation
C/I)
- hypersensitivity
- active bleeding (excluding menses) or disease states w/ incr risk of bleeding (e.g. haemophilia)
5,000 IU in 5ml
IV crystalloid solutions (normal saline)
I)
- fluid replacement (volume expansion) for the treatment of shock, fluid loss, and cardiac arrest
C/I)
- severe pulmonary oedema
1L bags, 250ml bags, 10ml vials, 5ml pre-filled
Ipratropium Bromide (Atrovent)
I)
- severe bronchospasm
ADULT - severe to life-threatening asthma or COPD
PAEDS - severe to life-threatening asthma
C/I)
- hypersensitivity
250mcg/ml nebule OR MDI 20mcg per puff
Ketamine
I)
- IV: 2nd line treatment of pain from traumatic origin. ASMA consult if minimum Fentanyl amount hasn’t been given yet
- IM: first line treatment of pain if other means unable or unavailable
- combative TBI
- RASS 4 first line for rapid tranq and no other methods have been administered
C/I)
- hypersensitivity
- active cardiovascular disease (CP, HF, severe or poorly controlled hypertension)
- delayed transfer of care (Ramped)
- anything below RASS 4 or other sedatives have been given (ASMA consult)
- Rapid tranq ONLY <16
- age <1
200mg/2ml
Lignocaine 1%
I)
- local anaesthesia (IV, IO, suturing, finger thoracostamy on conscious pt)
- Cardia Arrest (persistent Vf/Vt and max dose Ami given)
C/I)
- hypersensitivity
20mg/2ml OR 50mg/5ml
Methoxyflurane
I)
- pain
C/I)
- unable to understand or cooperate
- w/ severe renal impairment
- injury or ALOC preventing cooperation
- hypersensitivity e.g. malignant hyperthermia
3mL ampoule via penthrox inhaler
Midazolam
I)
- prolonged seizure activity - generalised seizure >=5mins OR recurrent / status seizure activity as per CPG
- focal seizure activity which is prolonged (>=5mins) and associated w/ GCS >=12 as per CPG
- second line IV agent for maintenance of sedation after Droperidol for ABD
C/I)
- hypersensitivity
- use of Midaz for sedation after ketamine requires ASMA consult
15mg/3ml ampoule
Naloxone
I) reversal of respiratory depression in a suspected narcotic overdose
C/I)
- Hypersensitivity
400mcg in 1mL vial
Olanzapine
I)
- disturbed and abnormal behaviour (RASS 1-3) if considered appropriate where risk to safety is evident and de-escalation not effective
- pt is able to tolerate and self-administer wafer
- preferred first line sedation agent in frail pts and dementia
C/I)
- known allergy
- Parkinson’s disease
- age <6
5mg oral dispersible tablet
Ondansteron
I)
- moderate to severe nausea
- active vomiting
- prophylaxis of eye and spinal injury
C/I)
- paeds <2
- hypersensitivity
4mg/2mL OR 4mg wafer
Oxygen
I)
ADULTS - titrated to achieve 94-98% (88-92% for COPD), achieved through different masks and flow rates
PAEDS - all pts w/ significant illness or injury should receive O2. Newborn resus ideally commenced w/ RA first few breaths
C/I)
- normoxia
- explosive or flammable environments
490L or 1640L bottles
Paracetamol
I)
- mild to moderate pain
- as a component of multi model analgesic regime
C/I)
- hypersensitivity
- cannot exceed max single dose or max daily dose (24hrs)
- taken in last 4hrs
500mg Tablets
100mg/mL (2000/20mL) suspension
