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Paramedic drugs (second half) Flashcards

1
Q

Tranexamic acid (TXA) indications

A

TIME CRITICAL injury with sign. internal/external haemorrhage suspected

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2
Q

TXA actions

A

Anti-fibrinolytic: reduces the breakdown of blood clot

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3
Q

TXA contraindications

A

1) isolated head injury

2) bleeding stopped

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4
Q

TXA side effects

A

Rapid injection rarely causes hypotension

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5
Q

TXA route

A

IV only

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6
Q

How to give TXA?

A

SLOWLY over 10 mins

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7
Q

TXA dose in adult?

A

1g (in 10mls)

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8
Q

TXA max dose?

A

1g

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9
Q

Do you repeat dose of TXA?

A

No

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10
Q

Syntometrine actions

A

stimulates contraction of uterus

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11
Q

syntometrine onset of action

A

7-10 mins

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12
Q

syntometrine contraindications (3)

A
  1. known hypersensitivity to syntometrine
  2. active labour
  3. severe cardiac/liver/kidney disease
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13
Q

Route of syntometrine

A

IM

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14
Q

What is the initial dose of syntometrine?

A

500mcg of ergometrine

5 units of oxytocin

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15
Q

What is the initial dose of syntometrine?

A

500mcg of ergometrine

5 units of oxytocin in 1ml

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16
Q

do you give repeat doses with syntometrine?

A

no

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17
Q

0.9% sodium chloride indications (6)

A
  1. medical conditions without haemorrhage
  2. medical conditions with haemorrhage
  3. trauma related haemorrhage
  4. burns
  5. limb crush injury (adult)
  6. flush (post drug administer, IV/IO cannula)
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18
Q

0.9% sodium chloride actions

A

increase vascular fluid volume
which raises CO
improves perfusion

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19
Q

0.9% sodium chloride route

A

IV

IO

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20
Q

Dose for sodium chloride flush

A

2-5ml PRN

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21
Q

dose of sodium chloride if infusing glucose

A

10-20ml PRN

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22
Q

dose of NaCl for gen med conditions without haemorrhage e.g. anaphylaxis, DKA, dehydration

A

250ml

Max dose: 2L
Repeat dose: 250ml
Dose interval: PRN

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23
Q

dose of NaCl with sepsis (clinical signs of infection AND SBP <90 AND tachypnoea

A

1L

Max dose: 2L
Dose interval: 30mins

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24
Q

dose of NaCl for med conditions with haemorrhage (SBP <90 and signs of poor perfusion)

A

250ml

max dose: 2L
Dose interval: PRN
Repeat dose: 250ml

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25
dose of NaCl in blunt trauma/head trauma/penetrating limb trauma (SBP <90 and signs of poor perfusion)
250ml max dose: 2L interval dose: PRN Repeat dose: 250ml
26
dose of NaCl for penetrating torso trauma (SBP <60 and signs of poor perfusion)
250ml max dose: 2L dose interval: PRN repeat dose: 250ml
27
dose of NaCl for burns if 1. total body surface area (TBSA) between 15-25% and time to hosp >30 mins 2. TBSA >25%
1L max dose: 1L
28
dose of NaCl in limb crush injury
2L Max dose: 2L
29
Indications for salbutamol (4)
1. acute asthma attack 2. expiratory wheeze assoc with allergy, anaphylaxis, smoke inhalation, lower airway cause 3. exacerbation COPD 4. SOB due to LVF (secondary Rx)
30
Action of salbutamol
relaxant effect on smooth muscle in medium/smaller airways | those in spasm in acute asthma attack
31
which receptors do salbutamol work on?
selective b2 adrenoreceptor stimulant
32
care should be given when administrating salbutamol to pts with (6)
1. HTN 2. angina 3. overactive thyroid 4. late pregnancy (relaxes uterus) 5. severe HTN may occur in pt on BB 6. COPD is possibility then limit nebs to six mins
33
side effects of salbutamol (8)
1. tremor 2. tachycardia 3. palps 4. headache 5. feeling of tension (lol) 6. peripheral vasodilation
34
side effects of salbutamol (8)
1. tremor 2. tachycardia 3. palps 4. headache 5. feeling of tension (lol) 6. peripheral vasodilation 7. muscle cramps 8. rash
35
what should be given in acute severe or life-threatening asthma after the first dose of salbutamol
ipatropium
36
in more severe resp attacks what could be used following initial relief of salbutamol
steroids (IM/PO) | further nebs
37
route of salbutamol
nebulise with 6-8L per minute of oxygen
38
dose of salbutamol
5mg in 5ml or 2.5ml Max dose: no limit Dose interval: 5 mins repeat dose: 5mg
39
paracetamol actions (2)
1. analgesic | 2. antipyretic
40
paracetamol oral dose
1g | 2x500mg tab dose interval: 4-6hrs max dose: 4g in 24hrs
41
paracetamol IV infusion dose
1g in 100ml given over 5-10 mins dose interval: 4-6 hrs max dose: 4g in 24hrs
42
ondansetron indications (2)
1. prevention/treatment opiate induced nausea/vomiting | 2. treatment of n/v
43
action of ondansetron
anti-emetic blocks 5-HT receptors centrally and in GI tract
44
cautions with ondansetron
QT interval prolongation
45
route of ondansetron (2)
1. Slow IV injection over 2 mins | 2. IM
46
dose of ondansetron
4mg in 2ml max dose: 4mg
47
narloxone hydrochloride (narcan) indications
opioid overdose | respiratory arrest
48
action of narcan
antagonism of effects (incl. resp depression) of opioid durgs
49
routes of narcan
IV IO IM (undiluted to outer aspect of thigh or upper arm)
50
dose of narcan (IV/IO)
400 mcg ``` in 1ml (slowly) max dose: 4400mcg dose interval: 3 mins repeat doses: 400mcg ```
51
morphine sulphate actions
1. strong opioid analgesic | 2. histamine release follows administration -> vasodilatory effects
52
morphine sulphate bad actions
depress respiration | induce hypotension
53
routes of morphine
IV/IO PO IM/SC
54
dose of morphine IV/IO
10mg in 10ml max dose: 20mg dose interval: 5 mins repeat dose: 10mg
55
dose of morphine (PO)
20mg in 10ml max dose: 40mg dose interval: 60 mins repeat dose: 20mg
56
dose of morphine (IM/SC)
10mg in 1ml max dose: 20mg dose interval: 60 mins repeat dose: 10mg
57
misoprostol indications (2)
1. PPH within 24 hrs of delivery (where uterine massage has failed) 3. miscarriage with life-threatening bleeding and confirmed diagnosis
58
when syntometrine and ergometrine are contraindicated in HTN (BP >140/90) then use
misoprostol
59
action of misoprostol
stimulates contraction of uterus
60
onset of misoprostol action
7-10 mins
61
routes of misoprostol
oral | rectal
62
dose of misoprostol (PO)
600mcg | 3x200mcg tabs max dose is 600mcg
63
dose of misoprostol (rectal)
1mg | 5x200mcg tabs max dose: 1mg
64
metoclopramide (maxolon) indications
1. treatment of nausea/vomiting in adults 20 and over | 2. prevention/treatment of nausea and vomiting following morphine
65
action of metoclopramide
anti-emetic | acts centrally and on GI tract
66
routes of metoclopramide
IV
67
dose of metoclopramide
10mg in 2ml max dose is that
68
side effects of metoclopramide
extra-pyramidal effects (more common in children/young adults) 1. drowsy and restless 2. cardiac conduction abnorms with IV 3. diarrhoea 4. rash

Paramedic drugs (1 decks)

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