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Paramedic Drugs > Paramedic Drugs > Flashcards

Paramedic Drugs Flashcards

1
Q

Fentanyl - Indications

A
  • Moderate to severe pain
  • Anxiety with CPO
  • Agitation, pain or SOB with end of life care
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2
Q

Fentanyl - Contraindications

A
  • Known severe allergy
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3
Q

Fentanyl - cautions

A
  • ALOC
  • Age <1
  • Respiratory depression
  • Labour
  • Concurrent administration of other opiates
  • Age greater or equal to 75
  • Signs of shock
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4
Q

Mechanism of action of Fentanyl

A

Fentanyl is an opiate analgesic, it is an opiate agonist (or stimulator) that binds to opiate receptors in the brain and spinal cord causing analgesia

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5
Q

Route of fentanyl

A
  • IV, IM, IN, SC
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6
Q

Doses of fentanyl

A
  • IV 10-50mcg every 5 minutes using a lower dose in the range if the pt is frail or signs of shock
  • IN as per paediatric drug table every 20 minutes up to 3 doses
  • IM / SC 50-100mcg every 20 minutes up to 3 doses halving if pt frail or shocked
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7
Q

Side effects of fentanyl

A
  • Respiratory depression
  • Bradycardia
  • Hypotension
  • Sedation
  • Nausea and vomiting
  • Itch
  • Euphoria
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8
Q

Indications for ketamine

A
  • Severe pain that has not been adequately controlled with an opiate
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9
Q

Contraindications for ketamine

A
  • Known severe allergy
  • Aged < 1
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10
Q

Cautions of ketamine

A
  • ALOC
  • Signs of shock
  • Current myocardial ischaemia
  • Concurrent administration of opiates
  • Aged greater or equal to 75
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11
Q

Mechanism of action of ketamine

A
  • Ketamine has complex actions but is predominantly an N-methyl-d-aspartate (NMDA) receptor antagonist (blocker) resulting in inhibition of excitatory neurotransmitter in the brain.
  • Low doses cause analgesia, large doses cause amnesia and dissociation and high doses cause anaesthesia
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12
Q

Route of ketamine

A
  • IV
  • IM
  • PO
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13
Q

Dose of ketamine

A
  • IV 0.25mg/kg max of 25mg over approximately 15 minutes repeat as required
  • IM or PO 0.5mg/kg max of 50mg repeated once after 20 minutes
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14
Q

Side effects of ketamine

A
  • Transient hypertension
  • Tachycardia
  • Apnoea
  • Nausea and vomiting
  • Sedation
  • Hallucinations
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15
Q

Indications of Lignocaine 1%

A
  • SC for prophylaxis of pain associated with IV
  • SC for digital ring block for analgesia when transport is less than 60 minutes or ropivacaine is not available
  • IO for significant bone pain associated with IO administration
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16
Q

Contraindications of Lignocaine

A
  • Known severe allergy
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17
Q

Cautions of Lignocaine

A
  • Taking an anticoagulant (Ring Block)
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18
Q

Mechanism of action of Lignocaine

A
  • Lignocaine is local anaesthetic
  • Lignocaine blocks the initiation and transmission of nerve impulses by blocking the movement of sodium ions across the nerve cell membranes
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19
Q

Route of lignocaine

A
  • SC
  • IO
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20
Q

Dose of lignocaine

A
  • SC Max dose of 200mg may be repeated once after 30 minutes
  • IO 50mg for adult repeated once after 15 minutes
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21
Q

Side effects of Lignocaine

A

None

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22
Q

Indications for Midazolam

A
  • Prolonged seizures
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23
Q

Contraindications of Midazolam

A
  • Known severe allergy
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24
Q

Cautions of Midazolam

A
  • ALOC
  • Respiratory depression
  • Concurrent administration of other opiates
  • Age greater or equal to 75
  • Signs of shock
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25
Q

Mechanism of action of Midazolam

A
  • Midazolam is a benzodiazepine
  • Midazolam enhances the activity of gamma-aminobutyric acid (GABA) at GABA receptors within the CNS resulting in anticonvulsant activity, sedation, amnesia, anxiolytics and muscle relaxation
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26
Q

Route of Midazolam

27
Q

Dose of Midazolam

A
  • IV 5mg reduced to 3 if pt is frail repeating once after 5 minutes
  • IM 10mg reduced to 5mg if frail repeating once every 10 minutes
28
Q

Side effects of Midazolam

A
  • Sedation
  • Respiratory depression
  • Hypotension
  • Amnesia
29
Q

Indications of Ondansetron

A
  • clinically significant Nausea or Vomiting
30
Q

Contraindications of ondansetron

A
  • Known severe allergy
  • Age < 1
31
Q

Cautions of Ondansetron

32
Q

Mechanism of action of Ondansetron

A
  • Ondansetron is a antiemetic
  • Ondansetron antagonises (blocks) serotonin receptors centrally in the brain and peripherally in the GI tract resulting in reduction of nausea and vomiting
33
Q

Route of Ondansetron

34
Q

Dose of Ondansetron

A
  • IV 8mg in addition to 1 IM dose totally 12mg max
  • IM 4mg can be repeated after 20 minutes
35
Q

Indications of Tranexamic Acid

A
  • Postpartum haemorrhage
  • Hypovolaemia from uncontrolled bleeding
  • Any other form of bleeding severe enough to cause hypovolaemia requiring sodium chloride to the administered
36
Q

Contraindications of Tranexamic Acid

A
  • Known severe allergy
  • Trauma when TXA will be administered more than three hours after time of injury. this appears to increase mortality rates the cause of which is not clear
37
Q

Cautions of Tranexamic Acid

38
Q

Mechanism of action of Tranexamic Acid

A
  • TXA is a antifibrinolytic medicine. It blocks the conversion of plasminogen to plasma reducing fibrinolysis ( breakdown of blood clots) and bleeding
39
Q

Routes of Tranexamic Acid

40
Q

Doses of Tranexamic Acid

41
Q

Side effects of TXA

42
Q

Indications for sodium valproate

A
  • Status epilepticcus that is not responsive to 2 doses of Midazolam
43
Q

Contraindications for sodium valproate

A
  • known severe allergy
44
Q

Cautions of sodium valproate

45
Q

Action of sodium valproate

A
  • Anticonvulsant, predominantly blocks sodium channels but also enhances the activity of GABA receptors in the CNS
46
Q

Route of sodium valproate

A

IV
IO - make sure the IO is not extraivasating prior to administration and it can cause tissue necrosis

47
Q

Dose of sodium valproate

A

1200mg for adult
Paediatric drug doses

48
Q

Side effects of sodium valproate

49
Q

Side effects of ondansetron

A

Headache
Flushing

50
Q

Indication of fluids

A
  • Shock
  • Hypovolemia
  • Crush injury
  • To Flush IV drugs
51
Q

Contraindications of fluids

52
Q

Cautions of fluids

A
  • Cardiogenic shock,
  • CPO
53
Q

Actions of fluids

A
  • Expands intravascular volume and extracellular fluid volume
54
Q

Route of Fluids

55
Q

Dose of fluids

A
  • Uncontrolled bleeding 500ml repeat as needed
  • Controlled bleeding 500ml repeat as needed
  • Hyperglycaemia 1000ml / 1 hr
  • Cardiogenic Shock 250-500ml max 1L
  • Neurogenic shock 1000ml max
  • crush injury 2-3L Minimum of 2 L
  • Other as per CPG
56
Q

Side effects of fluids

57
Q

Glucose Indications

A
  • Hypoglycaemia <3.5 if IV access can be obtained and PO not appropriate
58
Q

Glucose contraindications

59
Q

Glucose Caution

60
Q

Glucose action

A
  • Increases blood glucose level in the blood
61
Q

Glucose route

62
Q

Glucose dose

A
  • IV 100ml adult, 2ml/kg child
63
Q

Side effects of glucose

Paramedic Drugs (2 decks)

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