OSCE Prep - Drugs Flashcards
Adrenaline Indications (OSCE scope)
Anaphylaxis or severe allergic reaction
Drug class: Sympathomimetic
Adrenaline Contraindications (OSCE scope)
Nil
Adrenaline Dosage (OSCE scope)
5 mg nebulised liquid (5 mL at 1 mg/mL)
Single dose
Aspirin Indications
Suspected Acute Coronary Syndrome (ACS)
Acute cardiogenic pulmonary oedema
Drug class: Antiplatelet
Aspirin Contraindications
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
Aspirin Dosage
300 mg PO (1 tablet) to be chewed
Single dose
Glucose Gel Indications
Symptomatic hypoglycaemia (with the ability to self-administer oral glucose) Drug class: Hyperglycaemic
Glucose Gel Contraindications
Unconsciousness
Difficulty swallowing
Patient <2 years
Glucose Gel Dosage
15 gm gel PO
Repeat at 15 minutes if BGL < 4.0 mmol/L
Glyceryl Nitrate Indications
Suspected ACS with pain
Acute cardiogenic pulmonary oedema
Autonomic dysreflexia with systolic BP >160
Irukandji syndrome with a systolic BP >160
Drug class: Vasodilator
Glyceryl Nitrate Contraindications
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)
Glyceryl Nitrate Dosage
400 microg spray sublingual repeated at 5 minute intervals
No max dose
Ipratropium Bromide Indications
Moderate bronchospasm unresponsive to nebulised salbutamol
Severe bronchospasm
Drug class: Anticholinergic
Ipratropium Bromide Contraindications
Allergy/adverse reaction
Patient <1 year
Ipratropium Bromide Dosage
500 microg nebulised repeated at 20 minute intervals
Max dose 1.5 mg (3 doses)
Methoxyflurane Indications
Pain
Drug class: Analgesic
Methoxyflurane Contraindications
Allergy/adverse reaction
Patient <1 year
History of significant liver or renal disease
History of malignant hyperthermia
Methoxyflurane Dosage
3 mL inhaled through green whistle repeated after 20 minutes
Max dose 6 mL
Max total weekly dose 15 mL
Ondansetron Indications (OSCE scope)
Significant nausea and/or vomiting
Drug class: Antiemetic
Ondansetron Contraindications (OSCE scope)
Allergy/adverse reaction
Congenital long QT syndrome
Current apomorphine therapy (used for severe Parkinson’s disease)
Patient <2 years
Ondansetron Dosage (OSCE scope)
4-8 mg (1-2 orally disintegrating tablets, 4 mg each)
Max dose 8 mg
Oxygen Indications
A wide range of conditions potentially resulting in systematic and/or localised hypoxia
Drug class: Gas
Oxygen Contraindications
Known paraquat poisoning with SpO2 equal to or greater than 88%
History of bleomycin therapy with SpO2 equal to or greater than 88%
Oxygen Dosage
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%
Loratadine Indications
Symptomatic urticaria (hives) without evidence of anaphylaxis Drug class: Antihistamine
Loratadine Contraindications
Allergy/adverse reaction
Anaphylaxis
Loratadine Dosage
10 mg PO (1 tablet)
Single dose only
Not to be administered within 24 hours of previous antihistamines without QAS approval
Salbutamol Indications
Bronchospasm
Suspected hyperkalaemia with QRS widening and/or AV dissociation
Drug class: Beta-adrenergic agonist (bronchodilator)
Salbutamol Contraindications
Allergy/adverse reaction
Patient <1 year
Salbutamol Dosage
Metered Dose Inhaler (MDI): 12 (1.2mg) inhalations repeated at 10 minutes
No max dose
Nebulised: 5 mg repeated as needed
No max dose
Paracetamol Indications
Mild to moderate pain
Fever causing distress
Drug class: Analgesic, antipyretic
Paracetamol Contraindications
Allergy/adverse reaction
Patient <1 month old
Paracetamol Dosage
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
Ibuprofen Indications
Moderate pain due to acute inflammations and tissue injury
Ibuprofen Contraindications
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
Ibuprofen Dosage
200-400 mg (1-2-pills) PO
Must not be administered within 6 hours of previous ibuprofen administration
