Paramedic Drugs

Question 1

Adrenaline

Answer 1

Alpha and Beta adrenergic receptor agonists
Alpha 1 - Peripheral vasoconstriction - Raising perfusion pressure
Beta 1 - on cardiac cells increases cAMP = Ca2+ influx causing positive inotropic and chronotropic effect (causes increased myocardial excitability, tachycardia and increase myocardial contractility)
Beta 2 - Bronchodilation - Increasing cAMP & decreasing Ca2+ resulting in smooth muscle relaxation

Stabilises mast cells in anaphylaxis

Arrest >16years: 1mg (1:1000) IV - every 2nd cycle (4mins)
Arrest <16 years: 10mcg/kg (1:10000) – every 2nd cycle (4mins)
Asthma & Anaphylaxis >16 years: 0.5mg IM (1:1000)
Asthma & Anaphylaxis <16 years: 10mcg/kg IM (1:1000)
Croup <6mth 2.5mg (add 2.5 mL Saline) NEB
Croup >6mth 5mg NEB

Question 2

Amiodarone

Answer 2

class III antiarrhythmic – K+ channel blocker – prolongs action potential duration by blocking sodium, potassium and calcium pumps, which slows the sinus rate and increases the refractory period of the AV node.

Cardiac Arrest
Adult - 300mg IV after 3rd shock
Paed - 5mg/kg up to a ma of 300mg

Question 3

Aspirin

Answer 3

Cox 1 & 2 inhibitor
reduces production of prostaglandins and thromboxane A2 by irreversibly inactivating the cyclooxygenase COX enzyme. Therefore, inhibits platelet aggregation (causes by TXA2), inflammation and fever.

Question 4

Atropine

Answer 4

anticholinergic, antagonises the parasympathetic effects of acetylcholine on muscarinic receptors on cardiac myocytes. Increase in cAMP, causes Ca2+ influx which leads to increased contraction, as well as an increase in funny current which promotes and increase HR and CO. Reduces smooth muscle contraction resulting in pupillary dilation, reduced GIT motility and reduced bladder tone. Blocks M3 receptors in salivary glands resulting in decreases secretions.

Question 5

Adenosine

Question 6

Benzylpenicillin

Answer 6

Inhibits bacterial cell wall synthesis in GRAM POSITIVE bacteria and causes cytolysis when bacterium try to divide

Adults or children > 40kg - 2400mg Slow push over 2-3 minutes
Paeds < 40kg - 60mg/kg

Question 7

Droperidol

Question 8

Fentanyl

Question 9

Fexofenadine

Answer 9

second generation, H1 receptor antagonist that competes for binding in GI tract, large blood vessels and bronchial smooth muscle. Blocks action of endogenous histamine, which subsequently leads to temporary relief. Does not cross BBB so less drowsiness
Onset: 15-30 mins

Question 10

Glucagon

Question 11

Glucose 10%

Question 12

GTN

Question 13

Ipratropium Bromide

Question 14

Ketamine

Question 15

Lorazepam

Question 16

Methoxyflurane

Question 17

Midazolam

Answer 17

binds to allosteric binding site on GABA receptor to potentiate the effects of GABA, controlling the Cl- channels. This results in a change in threshold and lowers resting potential making the cell more negative.

Question 18

Morphine

Question 19

Naloxone

Answer 19

competitive antagonist for opiate receptor sites in the CNS and reverses the effects of opioid overdose

Adult 50-100mcg bolus IV
400mcg IM
120mcg IN

Question 20

Ondansetron

Question 21

Paracetamol

Question 22

Prednisolone

Question 23

Salbutamol

Question 24

Sodium Chloride 0.9%

Question 25

Tranexamic Acid