OSCE Prep - Drugs

Question 1

Adrenaline Indications (OSCE scope)

Answer 1

Anaphylaxis or severe allergic reaction

Drug class: Sympathomimetic

Question 2

Adrenaline Contraindications (OSCE scope)

Answer 2

Nil

Question 3

Adrenaline Dosage (OSCE scope)

Answer 3

5 mg nebulised liquid (5 mL at 1 mg/mL)

Single dose

Question 4

Aspirin Indications

Answer 4

Suspected Acute Coronary Syndrome (ACS)
Acute cardiogenic pulmonary oedema
Drug class: Antiplatelet

Question 5

Aspirin Contraindications

Answer 5

Allergy/adverse reaction (also to any other Non-Steroidal Anti-Inflammatory Drug (NSAID))
Chest pain associated with psychostimulant overdose
Bleeding or clotting disorders
Current GI bleeding or peptic ulcers
Patient <18 years

Question 6

Aspirin Dosage

Answer 6

300 mg PO (1 tablet) to be chewed

Single dose

Question 7

Glucose Gel Indications

Answer 7

Symptomatic hypoglycaemia (with the ability to self-administer oral glucose)
Drug class: Hyperglycaemic

Question 8

Glucose Gel Contraindications

Answer 8

Unconsciousness
Difficulty swallowing
Patient <2 years

Question 9

Glucose Gel Dosage

Answer 9

15 gm gel PO

Repeat at 15 minutes if BGL < 4.0 mmol/L

Question 10

Glyceryl Nitrate Indications

Answer 10

Suspected ACS with pain
Acute cardiogenic pulmonary oedema
Autonomic dysreflexia with systolic BP >160
Irukandji syndrome with a systolic BP >160
Drug class: Vasodilator

Question 11

Glyceryl Nitrate Contraindications

Answer 11

Allergy/adverse reaction
Heart rate <50 or >150 bpm
Systolic BP <100 mmHg
Acute Cerebrovascular Accident (CVA)
Head trauma
Phosphodiesterase 5 inhibitor medication administration: Sildenafil or Vardenafil in last 24 hours or Tadalafil in last 48 hours (erectile dysfunction medications)

Question 12

Glyceryl Nitrate Dosage

Answer 12

400 microg spray sublingual repeated at 5 minute intervals

No max dose

Question 13

Ipratropium Bromide Indications

Answer 13

Moderate bronchospasm unresponsive to nebulised salbutamol
Severe bronchospasm
Drug class: Anticholinergic

Question 14

Ipratropium Bromide Contraindications

Answer 14

Allergy/adverse reaction

Patient <1 year

Question 15

Ipratropium Bromide Dosage

Answer 15

500 microg nebulised repeated at 20 minute intervals

Max dose 1.5 mg (3 doses)

Question 16

Methoxyflurane Indications

Answer 16

Pain

Drug class: Analgesic

Question 17

Methoxyflurane Contraindications

Answer 17

Allergy/adverse reaction
Patient <1 year
History of significant liver or renal disease
History of malignant hyperthermia

Question 18

Methoxyflurane Dosage

Answer 18

3 mL inhaled through green whistle repeated after 20 minutes
Max dose 6 mL
Max total weekly dose 15 mL

Question 19

Ondansetron Indications (OSCE scope)

Answer 19

Significant nausea and/or vomiting

Drug class: Antiemetic

Question 20

Ondansetron Contraindications (OSCE scope)

Answer 20

Allergy/adverse reaction
Congenital long QT syndrome
Current apomorphine therapy (used for severe Parkinson’s disease)
Patient <2 years

Question 21

Ondansetron Dosage (OSCE scope)

Answer 21

4-8 mg (1-2 orally disintegrating tablets, 4 mg each)

Max dose 8 mg

Question 22

Oxygen Indications

Answer 22

A wide range of conditions potentially resulting in systematic and/or localised hypoxia
Drug class: Gas

Question 23

Oxygen Contraindications

Answer 23

Known paraquat poisoning with SpO2 equal to or greater than 88%
History of bleomycin therapy with SpO2 equal to or greater than 88%

Question 24

Oxygen Dosage

Answer 24

Intra-arrest; CO poisoning; cyanide poisoning; preoxygenation for RSI: 100% O2
Paraquat toxicity; bleomycin treatment; obesity; COPD; cystic fibrosis; neuromuscular disease: Titrate to achieve SpO2 88-92%
All other presentations: Titrate to achieve SpO2 92-96%

Question 25

Loratadine Indications

Answer 25

``` Symptomatic urticaria (hives) without evidence of anaphylaxis Drug class: Antihistamine ```

Question 26

Loratadine Contraindications

Answer 26

Allergy/adverse reaction | Anaphylaxis

Question 27

Loratadine Dosage

Answer 27

10 mg PO (1 tablet) Single dose only Not to be administered within 24 hours of previous antihistamines without QAS approval

Question 28

Salbutamol Indications

Answer 28

Bronchospasm Suspected hyperkalaemia with QRS widening and/or AV dissociation Drug class: Beta-adrenergic agonist (bronchodilator)

Question 29

Salbutamol Contraindications

Answer 29

Allergy/adverse reaction | Patient <1 year

Question 30

Salbutamol Dosage

Answer 30

Metered Dose Inhaler (MDI): 12 (1.2mg) inhalations repeated at 10 minutes No max dose Nebulised: 5 mg repeated as needed No max dose

Question 31

Paracetamol Indications

Answer 31

Mild to moderate pain Fever causing distress Drug class: Analgesic, antipyretic

Question 32

Paracetamol Contraindications

Answer 32

Allergy/adverse reaction | Patient <1 month old

Question 33

Paracetamol Dosage

Answer 33

0.5-1 gram PO (1-2 500mg tablets) repeated after 4 hours Must not be administered within 4 hours of previous Total max dose 4 gm in 24 hours

Question 34

Ibuprofen Indications

Answer 34

Moderate pain due to acute inflammations and tissue injury

Question 35

Ibuprofen Contraindications

Answer 35

``` Allergy/adverse reaction (to this, aspirin, or NSAID's) Concomitant NSAID therapy Current GI bleeding or peptic ulcers Dehydration and/or hypovolaemia Renal impairment NSAID induced asthma Heart failure Pregnancy ACE inhibitor or ARB therapy (Angiotensin II receptor blocker( Patient <13 or >65 years Patient taking anticoagulant medications Diuretic treatment ```

Question 36

Ibuprofen Dosage

Answer 36

200-400 mg (1-2-pills) PO | Must not be administered within 6 hours of previous ibuprofen administration