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Paramedic drugs > Paramedic drugs (second half) > Flashcards

Paramedic drugs (second half) Flashcards

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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
Q

dose of NaCl in blunt trauma/head trauma/penetrating limb trauma (SBP <90 and signs of poor perfusion)

A

250ml

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

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26
Q

dose of NaCl for penetrating torso trauma (SBP <60 and signs of poor perfusion)

A

250ml

max dose: 2L
dose interval: PRN
repeat dose: 250ml

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27
Q

dose of NaCl for burns if

  1. total body surface area (TBSA) between 15-25% and time to hosp >30 mins
  2. TBSA >25%
A

1L

max dose: 1L

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28
Q

dose of NaCl in limb crush injury

A

2L

Max dose: 2L

29
Q

Indications for salbutamol (4)

A
  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
Q

Action of salbutamol

A

relaxant effect on smooth muscle in medium/smaller airways

those in spasm in acute asthma attack

31
Q

which receptors do salbutamol work on?

A

selective b2 adrenoreceptor stimulant

32
Q

care should be given when administrating salbutamol to pts with (6)

A
  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
Q

side effects of salbutamol (8)

A
  1. tremor
  2. tachycardia
  3. palps
  4. headache
  5. feeling of tension (lol)
  6. peripheral vasodilation
34
Q

side effects of salbutamol (8)

A
  1. tremor
  2. tachycardia
  3. palps
  4. headache
  5. feeling of tension (lol)
  6. peripheral vasodilation
  7. muscle cramps
  8. rash
35
Q

what should be given in acute severe or life-threatening asthma after the first dose of salbutamol

A

ipatropium

36
Q

in more severe resp attacks what could be used following initial relief of salbutamol

A

steroids (IM/PO)

further nebs

37
Q

route of salbutamol

A

nebulise with 6-8L per minute of oxygen

38
Q

dose of salbutamol

A

5mg in 5ml or 2.5ml

Max dose: no limit
Dose interval: 5 mins
repeat dose: 5mg

39
Q

paracetamol actions (2)

A
  1. analgesic

2. antipyretic

40
Q

paracetamol oral dose

A

1g

2x500mg tab
dose interval: 4-6hrs
max dose: 4g in 24hrs

41
Q

paracetamol IV infusion dose

A

1g in 100ml

given over 5-10 mins
dose interval: 4-6 hrs
max dose: 4g in 24hrs

42
Q

ondansetron indications (2)

A
  1. prevention/treatment opiate induced nausea/vomiting

2. treatment of n/v

43
Q

action of ondansetron

A

anti-emetic
blocks 5-HT receptors
centrally and in GI tract

44
Q

cautions with ondansetron

A

QT interval prolongation

45
Q

route of ondansetron (2)

A
  1. Slow IV injection over 2 mins

2. IM

46
Q

dose of ondansetron

A

4mg in 2ml

max dose: 4mg

47
Q

narloxone hydrochloride (narcan) indications

A

opioid overdose

respiratory arrest

48
Q

action of narcan

A

antagonism of effects (incl. resp depression) of opioid durgs

49
Q

routes of narcan

A

IV
IO
IM (undiluted to outer aspect of thigh or upper arm)

50
Q

dose of narcan (IV/IO)

A

400 mcg

in 1ml (slowly)
max dose: 4400mcg
dose interval: 3 mins
repeat doses: 400mcg
51
Q

morphine sulphate actions

A
  1. strong opioid analgesic

2. histamine release follows administration -> vasodilatory effects

52
Q

morphine sulphate bad actions

A

depress respiration

induce hypotension

53
Q

routes of morphine

A

IV/IO
PO
IM/SC

54
Q

dose of morphine IV/IO

A

10mg in 10ml

max dose: 20mg
dose interval: 5 mins
repeat dose: 10mg

55
Q

dose of morphine (PO)

A

20mg in 10ml

max dose: 40mg
dose interval: 60 mins
repeat dose: 20mg

56
Q

dose of morphine (IM/SC)

A

10mg in 1ml

max dose: 20mg
dose interval: 60 mins
repeat dose: 10mg

57
Q

misoprostol indications (2)

A
  1. PPH within 24 hrs of delivery (where uterine massage has failed)
  2. miscarriage with life-threatening bleeding and confirmed diagnosis
58
Q

when syntometrine and ergometrine are contraindicated in HTN (BP >140/90) then use

A

misoprostol

59
Q

action of misoprostol

A

stimulates contraction of uterus

60
Q

onset of misoprostol action

A

7-10 mins

61
Q

routes of misoprostol

A

oral

rectal

62
Q

dose of misoprostol (PO)

A

600mcg

3x200mcg tabs
max dose is 600mcg

63
Q

dose of misoprostol (rectal)

A

1mg

5x200mcg tabs
max dose: 1mg

64
Q

metoclopramide (maxolon) indications

A
  1. treatment of nausea/vomiting in adults 20 and over

2. prevention/treatment of nausea and vomiting following morphine

65
Q

action of metoclopramide

A

anti-emetic

acts centrally and on GI tract

66
Q

routes of metoclopramide

A

IV

67
Q

dose of metoclopramide

A

10mg in 2ml

max dose is that

68
Q

side effects of metoclopramide

A

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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