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Para Meds Flashcards

Learning Meds

1
Q

How does Salbutamol work

A

Salbutamol is a Bronchodilator that stimulates the Beta receptors.

It is absorbed through the liver and passed through the urine.

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2
Q

What is the Contras and Indications of Salbutamol

A

Contras: Known severe allergy
Cautions: None
Indications:
Bronchospasm secondary to Asthma or COPD
Bronchospasm secondary to airway burns, smoke inhalation or chest infection
Release syndrome
Hyperkalaemia

Adverse effects:
Tremor
Tachycardia

Usual onset:
2-5 mins
Usual duration:
1-2 hrs

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3
Q

How does Adrenaline work

A

Adrenaline works in 3 different ways
Alpha 1: stimulation causes smooth muscle contraction, vasoconstriction, glycogenolysis and gluconeogensis
Beta 1: stimulation causes cardiac contractility and causes a increase in heart rate
Beta 2: stimulation causes vasodilation, bronchodilation and stabilization of mast cell membranes, reducing histamine release

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4
Q

What are the Contras and Indications of Adrenaline

A

Contraindications: None
Cautions: MI (will increase o2 consumption)
Tachydysthrmias (adrenaline will usually make it worse)
Indications
Cardiac arrest
Anaphylaxsis
Resp arrest from COPD
Severe bradycardia
Stridor

Usual onset:
IM - 2-5mins

Usual duration:
Cardiovascular effects last 5-10mins
Mast cell membrane effects may last several hours

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5
Q

How does Panadol work?

A

Panadol Inhibits the production of prostaglandins resulting in a reduction of pain and fever

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6
Q

What are the Contras and Indications for Panadol

A

Contra: Known severe allergy
Cautions: Pt has taken in the last 4 hours
Known severe liver impairment
Indications: Mild - moderate pain

Common effects:
None

Usual onset:
30-60 mins
Usual duration:
4-6hrs

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7
Q

How does Ibuprofen work

A

Ibuprofen is a NSAID (non-steroidal anti-inflammatory drug
It inhibits the activity prostaglandin synthetease therefore reducing the production of prostaglandin

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8
Q

What are the contras and indications of Ibuprofen

A

Contra: Known severe allergy
Pregnancy
Presence of sepesis, dehydration, shock or significant bleeding. can cause increase risk of bleeding or renal impairment.
Known worsening of bronchospasm with NSAIDS
Cautions:
Pt has taken in the last 4 hours
Abdo pain
Age greater or equal to 75

Adverse effects:
Renal impairment
Increased bleeding
GI bleeding and ulceration (chronic use)

Usual duration:
4-6 hrs
Usual onset
30-60 mins

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9
Q

How does Ipratropium work?

A

Ipratropium is a bronchodilator, It is a anticholingeric agent which primeritaly blocks ACH receptors causing vagal inhibition resulting in bronchodilation

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10
Q

What are the Contras and indications for Ipratropium

A

Contra: Known severe allgergy
Cautions: none
Indications: Bronchospasm secondary to asthma or COPD Prominent bronchospasm secondary to airway burn, smoke inhalation or chest infection.
Usually used with Salbutomal

Adverse effects:
Tachycardia
Dry Mouth
Blurred vision (repeated doses)

Usual onset
2-5 mins
Usual duration
6hrs

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11
Q

How does GTN work

A

GTN is a vasodilator. It works on the smooth muscle causing aterial vasodilation with the predominent effact being on viens.

MOA - this is not clear but GTN results in the formation of nitric oxide (vasodilator)

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12
Q

What are the Contras and Indications for GTN

A

Contras:
Known severe allergy
Systolic BP less than 100 mmHg
HR less than 40/min
HR greater than 150/min
VT
Cautions:
STEMI Involving the right ventricle
Frail patient
Signs of shock
Dysryhthmia
Known aortic or mitral stenosis
Indications:
MI
CPO
Control of hypertension
STEMI

Adverse effects:
Hypotention
Flushing
Headace
Tachycardia
Light headed

Usual onset: 1-2 mins
Usual duration 15-30 mins

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13
Q

Methoxyflurane

A

Methoxyflurane is a inhaled analgesic

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14
Q

What are the Contras and Indications for Methoxy

A

Contras:
Known severe allergy
History of malignant
Known renal impairment
Methoxy administered with in a week
Cautions:
Age greater or equal to 75
Pre-eclampsia (for renal impairment)
Acute exacerbation of chronic pain
Administered in a confined space
Indications:
Moderate to severe pain

Adverse effects:
Sedation
Light headedness

Usual onset:
1-2 mins

Usual duration
2-5 mins

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15
Q

How does Asprin work

A

Asprin is a antiplatelet, anti-inflammatory and analgesic effects. It inhibits the enzyme cyclooxygenase which results in the reduction in prostaglandins and thromboxane

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16
Q

What are the Contras and Indications for Asprin

A

Contras:
Known severe allergy
Third trimester pregnancy
Cautions:
Known bleeding disorder
Clinically significant bleeding
Known worsening of bronchospasm with NSAID’s
Indications:
MI
STEMI

Adverse effects:
Increased bleeding
Indigestion and gastrointestinal ulceration (long term use)
Usual duration:
3-5 days antiplatlet activity

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17
Q

How does Ceftriaxone work

A

Cerftriaxone is a broad spectrum antibiotic inhibiting the production of the bacterial cell wall causing the bacteria to die

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18
Q

What are the contras and indications for Ceftriaxone

A

Contras:
Anaphylaxis to cephalosporins
Cautions:
None
Indications:
Suspected meningococcal septicemia
Sepsis where cefazolin is not indicated

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19
Q

What are the contras and indication for Glucose gel

A

Contras: None
Cautions: None
Indications:
Hypoglycemia in adults and children providing they can swallow
Hypoglycemia in neonates

Adverse effects: None
Usual onset: 5-10 mins
Usual duration: 30-60 mins

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20
Q

How does Glucagon work

A

Glucagon increases the blood glucose levels by stimulating glycogenolysis (the breakdown of glycogen into glucose)

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21
Q

What are the contras and indications for Glucagon

A

Contras: known severe allergy
Cautions: None
Indications:
Hypoglycemia when the patient can not safely swallow food and IV can not be obtained

Adverse effects: None
Usual onset: 5-10 mins
Usual duration: 15-60 mins

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22
Q

How does Loratadine work

A

Loratadine is a non-sedating antihistamine which blocks the peripheral histamine receptors, therefore blocking the action of histamine

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23
Q

What are the contras and indications for Loratadine

A

Contras:
Known severe allergy
Age less than 1
Cautions:
Pregnancy
Indications:
Minor allergic reaction confined to skin involvement
Prominent itch associated with anaphylaxis provided all systemic signs of anaphylaxis are resolved

Adverse effects: None
Usual onset: 30-60 mins
Usual duration: 12-24 hrs

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24
Q

What is Midazolam used for

A

Midazloam is a benzodiazepine, it enhances the activity of gamma-aminobutyric acid (GABA). At these receptors in the nervous system it results in anticonvulsant activity, sedation, amnesia, anxiolysys and muscle relaxation

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25
What are the contras and indication for Midazolam
Contras: Known severe allergy Ages less than 12 (analgesia only) Cautions: Altered level of consciousness Respiratory depression May worsen signs of shock Concurrent administration of opiates or ketamine Aged greater or equal to 75 Indications: Generalised seizures that continue for more than 5 mins, or seizures that are recurrent Acute behavioural disturbance (Where droperidol is ineffectvie or unavaliable) Pain associated with severe muscle spasm Sedation Severe anxiety accociated with COPD Control of anxiety or shorthness of breath that does not respond to opiate during end of life care Adverse effects: Sedation Respiatory depression Hypotention Amnesia Usual onset: 30-60 mins Usual duraiton: 30-60 mins
26
How does Ondansetron work
This is an antiemetic. It antagonizes (blocks) serotonin receptors centrally in the brain and peripherally in the gastrointestinal tract resulting in reduction in nausea and vomiting
27
What are the Contras of Ondansetron
Contras: Known severe allergy, Age less than one, Suspected serotonin syndrome Cautions: None Adverse effects: Headache Flushing Usual onset: IV 2-5 mins IM 5-10 mins Usual duration: 4-8 hrs
28
How does Prednisone work
This is a prodrug that is metabolized to prednisolone in the liver. Prednisolone is a corticosteroid with ani-inflammatory and immunosuppressant actions. It inhibits the production of inflammatory mediators, including prostaglandins and leukotrienes, resulting in reduction in inflammatory and immune response
29
What are the contras/ cautions for Prednisone
Contras: Known severe allergy Cautions: Age less than 5 with asthma Indications: Bronchospasm associated with asthma or COPD Croup Prominent rash associated with anaphylaxis provided all systemic signs of anaphylaxis are resolved Minor allergy associated with rash Adverse effects: Fatigue Sodium and water retention Gastro reflux Usual onset: 30-60 mins Usual duration 24 hrs
29
How does Tramadol work
This is an analgesic. It has multiple actions within the central nervous system, including opiate receptor stimulation and inhibition of the re-uptake of noradrenaline and serotonin.
30
What are the contras/cautions for Tramadol
Contras: Known severe allergy Age less than 12 Cautions: Taken in the last 4 hours Abdo pain, particularly if vomiting or nauseated Age greater or equal to 75, particularly is there is a previous history of dementia or confusion Confusion Pregnancy Indications: Moderate to severe pain, particularlylarly if an opiate or ketamine is not going to be administered
31
How does Amiodarone work
Amiodarone is an antidysrhythmic. It predominately has a class 3 activity and prolongs the action potential. This reduces the automaticity and prolongs the refractory period of atrial nodal and ventricular tissues
32
What are the contras for Amiodarone
Indications (Para): Cardiac arrest with VT/VF after first dose of adrenaline Adults with sust ain VT in the absence of cardiac arrest Adults with moderate cardiovascular compromise as a results of fast AF or atrial fluttter Contras: Known severe allergy Known severe allergy to iodine VT secondary to cyclic antidepressant poising Cautions: None if in cardiac arrest Poor perfusion or lowered CO Hypotension AF Known sick sinus rythum without internal pacemaker Previous 2nd or 3rd degree heart block Pregnancy
33
How does Cefazolin work
Cefazolin is a first-generation cephalosporin antibiotic with activity against gram Negative and gran Positive bacteria. It inhibits the production of the cell wall causing the bacteria to die
34
What are the indications and contras for Cefazolin
Indications: Sepsis where source of infection appears to be soft tissue or joint and (greater than 12 years old, has 1 or more clinical features indication antibiotics, time to hospital or more than 30 mins) Compound fracture Large contaminated wound Following chest decrompression Following amputation Cellulitis Contras: Known severe allergy to cephalosporins Cautions: None
35
How does Ceftriaxone work
Ceftriaxone is a cephalosporin antibiotic with broad activity against gram neg and gram pos bacteria. It inhibits the production of the cell wall causing the bacteria to die.
36
What are the indications and Contras for Ceftriaxone
Indications: Suspected meningococcal septicaemia Sepsis where Cefazolin is not indicated Contras: Anaphylaxsis to cephalosporins Cautions: None
37
How does Clopidogrel work
Clopidogrel has antiplatlet activity. It blocks the binding of adenosine diphosphate to platelets and impairs platelet funtion
38
What are the contras and indications of clopidogrel
Indications: STEMI in conjunction with fibrinolytic therapy Contras: Known severe allergy Cautions: Clinically significant bleeding At risk of bleeding Pregnancy
39
How does Droperidol work
Droperidol blocks dopamine and alpha receptors centrally, resulting in sedation, reduced agitation and a state of mental detachment and antiemetic action
40
What are the Contras for Droperidol
Indications: Pt’s 12 years or older with a true behavioural disturbance causing mild to moderate risk to safety when olanzapine has not been administered or ineffective Moderate to severe pain despite opiate analgesia and ketamine is not indicated associated with (chronic or complex pain, chronic use of opiates, severe headache, severe pain accounted with agitation, pain associated with severe nausea or vomiting) Management of agitation or pain that does not respond to opiate during end of life care Nausea/vomiting that persists despite Ondansatron Contras: Known severe allergy Age less than 12 Pregnancy (analgesia. And nausea/vomiting only) Cautions: Alerted LOC Parkinson’s Concurrent administration of Ketamine or midazolam Age greater or = to 75 Signs of shock
41
How does Enoxaprin work
Enoxaprin is a low molecular weight heparin anticoagulant. It potentiates the activity of anti thrombin 3 causin inhibition of multiple coagulation factors
42
What are the contras for Enoxaprin
Indications: STEMI in conjunction with fibrinolytic therapy Contras: Known severe allergy Cautions: Clinically significant bleeding At risk of bleeding Pregnancy
43
How does Fentanyl work
Fentanyl is an opiate analgesic. It is a opiate stimulator that binds to opitate receptors in the brain and spinal cord
44
What are the contras of fentanyl
Indications: Moderate to severe pain CPO with severe anxiety RSI Sedation post intubation Control of pain, agitation, or SOB during end of life care Contras: Known severe allergy Cautions: Altered LOC Age less than 1 Respiratory depression or at high risk of respiratory depression Labour Concurrent administration of opiates, ketamine or midazolam Age greater or = to 75 Signs of shock
45
How does Heparin work
Heparin is a anticoagulant, It potentiates the activity of antithrombin 3 causing inhibition of multiple coagulation factors
46
What are the contras for Heparin
Indications: STEMI in conjunction with fibrinolytic therapy Contras: Known severe allergy Age greater or = to 75 (higher risk for intra cerebral heamorage Cautions Clinically significant bleeding At risk of bleeding Pregnancy
47
How does Ketamine work
Ketamine has many actions but it predominately an N-methyl-d-aspartate (NMDA) receptor blocker resulting in inhibition of excitatory neurotransmitters in the brain
48
What are the contras for Ketamine
Indications(PARA only analgesia) Severe pain that has not been adequately controlled with an opiate Inducing dissociation Acute behavioural disturbance causing threat to safety RSI Significant movement in CPR interfering with resus Asthma with severe agitation Contras: Known severe allergy Age less than 1 Cautions Altered LOC Signs of shock Current MI Concurrent Administration of opiates or midazolam Age greater or = to 75
49
How does levetiracetam work
Levetiracetam is an anticonvulsant. It is thought to inhibit siezure activity by blocking some calcium channels and also binding synaptic proteins to modulate neurotransmitter release
50
What are the contras for levetiracetam
Indications: Siezure that continues or recurs after 2 douses of midazolam Siezure activity associated with severe TBI even if seizure activity has ceased following midazolam Contras: Known severe allergy Cautions: None
51
How does Lignocaine 1% work
Lignocaine is a local anaesthetic. It blocks the initiation and transmission of nerve impulses by blocking the movement of sodium ions across the nerve cell membrane
52
What are the contras for Lignocaine PARA’s need to seek clinical advice before administration
Indications: Subcutaneous injection for prophylaxis’s of pain associated with IV Subcutaneous injection for digital rings blocks for analgesia when transport time is less than 60 mins or Ropivacaine is not available IO injection for significant bone pain with IO administration Contras: Known severe allergy Local infection in the area of injection Cautions: Taking an anticoagulant (ring block)
53
How does Metoprolol Tartate work
Metoprolol is an immediate release beta blocker. It blocks beta receptors in the heart causing a decrease in heart rate and CO
54
What are the contras for Metoprolol
Indications: Adults with mild or no cardiovascular compromise as a result of fast AF or atrial flutter Adults with moderate cardiovascular compromise as a result of fast AF or atrial flutter if amiodrone is not available or is contraindicated Contras: Known severe allergy Hypotension Cautions: 1st degree heart block Known sick sinus syndrome Previous 2nd or 3rd degree heart block Asthma or COPD Hear failure Pregnancy
55
How does Midazolam work
Midazolam is a benzodiazepine. It enhances the activity of gamma-aminobutyruc acid GABA. At GABA receptors with in the CNS resulting in anticonvulsant activity, sedation, amnesia, anxiolysis and muscle relaxation
56
What are the contras for Midazolam
Para (IM & IV for seizures and IM for Acute behavioural distrubance) Indications: Generalised seizures that continue for more than 5 mins or are recurrent Acute behavioural disturbance causing mild to moderate risk to safety Pain accociated with severe muscle spasm or severe anxiety Sedation Sedation post intubation Severe anxiety associated with COPD Control of anxiety or SOB that does not respond to opiate during end of life care Contras: Known severe allergy Age less than 12 (analgesia only) Cautions: Altered LOC Resp depression or at high risk of resp depression Signs of shock Concurrent administration of opiates or ketamine Age greater or = to 75
57
How does Naloxone work
Naloxone is an opiate receptor blocker. By blocking opiate receptors it reversers the effects of opiates
58
What are the contras of Naloxone
Indications: Opiate poisoning is suspected and the pt has a significantly impaired LOC or significantly impaired breathing Excess adverse effects from administrations of opiates Contras: Known severe allergy Cautions: Chronic opiate use
59
How does Olanzapine work
Olanzapine is an atypical antipsychotic. It has actions at multiple receptors with in the brain causing a reduction in agitation, sedation, anxiolysis and stabilisation of mood
60
What are the contras for Olanzapine
Indications: Pt’s aged more or = to 12 with acute behavioural disturbance causing a mild to modaerate risk to safety with the pt will take oral medicine. Contras: Known severe allergy Poisoning with antipsychotic Cautions: Pregnancy Intoxication Age greater or = to 75
61
How does oxytocin work
Oxytocin is a synthetic version of the hormone made in the pituitary gland. It stimulates oxytocin receptors on the uterus, causing increased uterine contraction and deducting blood loss from uterus
62
What are the contras for Oxytocin
Indications: Following normal birth PPH Contra: Known severe allergy Cautions: None
63
How does TXA work
Tranexamic acid is an anti fibrinolytic. It blocks the conversion of plasminogen to plasmin, reducing fibrinolysis and bleeding
64
What are the contras for TXA
Indications: PPH Clinically significant bleeding or signs of hypovolemia following trauma Non-traumatic bleeding and shock is severe Cardiac arrest secondary to trauma Bleeding following tonsillectomy Crush injury Contras: Known severe allergy Trauma when TXA will be administered more than 3 hours after time of injury Cautions: Non

St John/ Uni (36 decks)

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