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ASNSW ICP STUDY > Pharmacology > Flashcards

Pharmacology Flashcards

1
Q

ADRENALINE - Adverse effects

A
  • Tachycardia
  • Dysrhythmias, including ventricular fibrillation
  • Hypertension
  • Pupillary dilation
  • Anxiety
  • Nausea and vomiting
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2
Q

ADRENALINE - Preparation

A

1mg in 1mL ampoule (1:1,000)

1mg in 10mL Min-I-Jet (1:10,000)

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3
Q

ADRENALINE – type

A

Sympathomimetic

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3
Q

ADRENALINE – action

A

Stimulates the ALPHA and BETA subdivisions of the sympathetic nervous system to produce the “Fight” or “Flight” reaction

  • ALPHA stimulation causes peripheral vasoconstriction. It raises the perfusion pressure of vital organs during cardiac arrest and it decreases capillary permeability and increases blood pressure in anaphylaxis
  • BETA 1 stimulation causes increased myocardial excitability, tachycardia, and increased myocardial contractility
  • BETA 2 stimulation causes bronchodilation
            **Onset**                    **Peak**              **Duration**

IM 30-90sec 4-10min 5-10min

IV 30sec 3-5min 5-10min

NEB 1-5min n/a up to 20min

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4
Q

ADRENALINE – USE

A
  • Cardiac arrest
  • Bradycardia
  • Cardiogenic shock
  • Severe/life threatening asthma
  • Anaphylaxis
  • Severe croup (nebulised)
  • Newborn Care
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5
Q

AMIODARONE – actions

A
  • Slows the sinus rate and increases the refractory period of the AV node.
  • Decreases peripheral vascular resistance

IV

onset- 2 mi

Peak- 20 min

Duration - 120 min

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6
Q

AMIODARONE – adverse effects

A
  • Hypotension
  • bradycardia
  • dysrhythmias
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7
Q

AMIODARONE – preparation

A

150mg in 3mL ampoule (50mg per mL)

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8
Q

AMIODARONE – type

A

Antiarrhythmic

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9
Q

AMIODARONE – use

A
  • Ventricular fibrillation/ pulseless tachycardia refractory to DC shocks and adrenaline
  • Dysrhythmias - tachycardia
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10
Q

ASPIRIN - Actions

A
  • Inhibits platelet aggregation thereby limiting thrombus enlargement in acute coronary syndrome
  • Reduces production of prostaglandins thereby relieving pain and fever
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11
Q

ASPIRIN - Adverse Effects

A
  • Allergic reactions, e.g. asthma, angioneurotic oedema, rhinitis, urticaria, laryngeal oedema and shock. Always check for history of previous reaction
  • Aggravation of any bleeding tendency
  • Gastric irritation (unlikely to be significant with one tablet)
  • Bleeding may take longer to stop
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12
Q

ASPIRIN - Contraindications

A
  • Allergy or hypersensitivity to aspirin
  • Active, suspected or known bleeding tendency
  • Patients < 16 years of age
  • Patients meeting T1 Major Trauma criteria
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13
Q

ASPIRIN - Type

A

Non‐steroidal anti‐inflammatory drug

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14
Q

ASPIRIN - Use

A

Suspected acute coronary syndrome

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15
Q

ASPIRIN - Preparation

A

300mg tablet

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16
Q

ATROPINE - Adverse effects

A
  • Dry mouth
  • Blurred vision
  • Tachycardia
  • Nausea and vomiting
  • Hyperthermia
  • Dysrhythmias
  • Agitation, delirium, hallucinations, seizure and coma may occur in high doses
  • Urinary retention
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17
Q

ATROPINE - Use

A
  • Bradycardia
  • Excessive parasympathetic effects resulting from organophosphate poisoning or funnel-web spider envenomation
  • Nerve agent/organophosphate poisoning if authorised by HSFAC
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18
Q

ATROPINE - Action

A

Antagonises the parasympathetic effects of acetylcholine on muscarinic receptors resulting in:

  • Increased heart rate via increasing intrinsic rate of the sino-atrial node andconduction through the atrio-ventricular node
  • Reducing smooth muscle contraction resulting in pupillary dilation, reducedgastrointestinal motility and reduced bladder tone
  • Blocks exocrine gland activity causing decreased salivary, bronchial, gastric andsweat secretions
               **Onset**           **Peak**                 ** Duration**

IM Depends on perfusion

IV

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19
Q

ATROPINE - Preparation

A

600mcg in 1mL polyampoule

600mcg in 1mL polyampoule diluted to 6mL (100mcg in 1mL) with 5mL 0.9% normal saline

2mg in Atropen® Auto-Injector

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20
Q

ATROPINE - Type

A

Anticholinergic

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21
Q

CALCIUM GLUCONATE - Type

A

Electrolyte

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22
Q

CALCIUM GLUCONATE – action

A

Antagonises the effect of hyperkalaemia on the heart

IV

Onset - 30 sec

Peak- N/A

Duration- 30min - 2hrs

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23
Q

CALCIUM GLUCONATE – adverse effects

A
  • May increase myocardial and cerebral damage by increasing intracellular calcium levels
  • Tissue necrosis if extra visitation from vain occurs
  • Dysrhythmias
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24
Q

CALCIUM GLUCONATE – preparation

A

2.2mmol (10mL) ampoule (approximately 1g per 10mL)

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25
Q

CALCIUM GLUCONATE – use

A

Emergency treatment of hyperkalaemia as a cardio protectant

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26
Q

FENTANYL - Adverse Effects

A
  • Respiratory depression
  • Hypotension
  • Nausea and vomiting
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27
Q

FENTANYL - Contraindications

A
  • Active labour
  • Altered LOC (V,P or U)
  • Epistaxis or occluded nasal passages
  • Patients < 1 year of age
  • Previous known allergy or adverse reaction

Note: Allergy to morphine is not a contraindication to fentanyl administration

P A L L E

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28
Q

FENTANYL - Preparation

A

600mcg in 2mL in a sealed vial

Route of administration
Intranasal (IN) via mucosal atomising device

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29
Q

FENTANYL - Type

A

Opioid analgesic

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30
Q

FENTANYL - Use

A
  • First line moderate to severe pain management patients
  • Patients >16 years of age where morphine is ineffective or contraindicated
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31
Q

FENTANYL - Action

A
  • Potent analgesic
  • Effective drug for intranasal use because it is rapidly absorbed across mucous membranes
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32
Q

FEXOFENADINE - Action

A

Non‐sedating anti‐histamine

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33
Q

FEXOFENADINE - Adverse Effects

A
  • Headache
  • Drowsiness
  • Nausea
  • Dry mouth
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34
Q

FEXOFENADINE - Contraindications

A
  • Allergy or hypersensitivity to fexofenadine
  • Patients < 12 years of age
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35
Q

FEXOFENADINE - Preparation

A

180mg tablet

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36
Q

FEXOFENADINE - Type

A

Anti-histamine

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37
Q

FEXOFENADINE - Use

A

Allergic reactions (localised, minor in severity)

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38
Q

FRUSEMIDE - Type

A

Diuretic

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39
Q

FRUSEMIDE - Action

A

A potent loop diuretic which produces increased urine output

IV

Onset - 5 min

Peak - 20 -60 min

Duration - 2-3 hours

IM

Onset - 10 min

Peak - 30 min

Duration - 2-3 hrs

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40
Q

FRUSEMIDE - Adverse Effects

A
  • Excessive diuresis can lead to hypovolaemic shock
  • Potassium loss can precipitate dysrhythmias
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41
Q

FRUSEMIDE - Contraindications

A
  • BP < 100mmHg systolic
  • Patients < 16 years of age
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43
Q

FRUSEMIDE - Use

A

Cardiogenic pulmonary oedema provided BP ≥ 100 mmHg systolic, to increase urine output and decrease venous return

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43
Q

FRUSEMIDE - Preparation

A

40mg per 4mL ampoule

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44
Q

GLUCAGON - Action

A

Converts liver glycogen to glucose. Glucagon may not work if liver glycogen is depleted due to starvation or chronic liver disease

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45
Q

GLUCAGON - Adverse Effects

A
  • Nausea and vomiting
  • Allergic reactions rarely occur
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46
Q

GLUCAGON - Preparation

A

1mg vial & syringe containing 1mL of sterile water

Dissolve the glucagon powder by adding the entire contents of the syringe to thevial containing the glucagon.

The solution must be prepared immediately prior to use

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47
Q

GLUCAGON - Type

A

Pancreatic hormone

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48
Q

GLUCAGON - Use

A

Hypoglycaemia if unable to cannulate for administration of Glucose 10%

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49
Q

GLUCOSE 10% - Action

A

Principle energy source for body cells, especially the brain.

IV

Onset - 30sec

Peak - 30sec

Duration - Dependant on severity of hypoglycaemic episode

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50
Q

GLUCOSE 10% - Adverse Effects

A
  • Tissue necrosis if extravasation from vein occurs
  • May aggravate brain damage in head injuries and strokes
  • May precipitate Wernicke’s encephalopathy in alcoholics with thiamine deficiency
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52
Q

GLUCOSE 10% - Type

A

Hypertonic sugar solution for intravenous use

52
Q

GLUCOSE 10% - Preparation

A

10% ‐ 50g per 500mL bag

54
Q

GLUCOSE 10% - Use

A

Hypoglyceamia

55
Q

GLUCOSE GEL - Action

A

Principle energy source for body cells, especially the brain

PO: Onset within 15 minutes

55
Q

GLUCOSE GEL - Adverse Effects

A

May precipitate Wernicke’s encephalopathy in alcoholics with thiamine deficiency

56
Q

GLUCOSE GEL - Contraindications

A
  • ↓LOC or altered gag reflex
  • Patients < 2 years of age
57
Q

GLUCOSE GEL - Preparation

A

37.5g tube containing glucose gel 40% (15g glucose)

58
Q

GLUCOSE GEL - Type

A

Hypertonic sugar solution for oral use

59
Q

GLUCOSE GEL - Use

A

Correction of hypoglycaemia

61
Q

GLYCERYLTRINITRATE - Type

A

Vasodilator

61
Q

GLYCERYLTRINITRATE - Action

A
  • Dilates coronary arteries
  • Dilates systemic veins and arteries
  • Decreases preload, afterload and blood pressure

Onset is within 2 minutes and lasts up to 30 minutes

63
Q

GLYCERYLTRINITRATE - Contraindications

A
  • BP
  • Heart rate 150/min
  • Patients
  • Use of drugs to treat erectile dysfunction e.g.
    • Sildenafil ‐ Viagra® ‐ within 24 hours
    • Vardenafil ‐ Levitra® ‐ within 24 hours
    • Tadalafil ‐ Cialis® ‐ within 96 hours
64
Q

GLYCERYLTRINITRATE - Use

A
  • Suspected acute coronary syndrome
  • Cardiogenic pulmonary oedema
  • Autonomic dysreflexia
65
Q

GLYCERYLTRINITRATE - Preparation

A

600mcg tablet

65
Q

HARTMANN’S - Action

A

Following intravenous infusion it is distributed throughout the extracellular fluid space. Approximately 25% of the volume infused stays in the intravascular space

67
Q

HARTMANN’S - Administration

A
  • Patients > 16 years of age via pump set
  • Patients < 16 years of age via autostart burette and pump set
68
Q

HARTMANN’S - Adverse Effects

A
  • Cardiogenic pulmonary oedema
  • Coagulopathy, hypothermia and acidosis in the trauma patient
69
Q

HARTMANN’S - Preparation

A

500mL bag

70
Q

HARTMANN’S - Type

A

Crystalloid solution

71
Q

HARTMANN’S - Use

A
  • Traumatic hypovolaemia with head injury
  • Traumatic hypovolaemia with no head injury
  • Non-traumatic hypovolaemia
    • Anaphylaxis
    • Suspected sepsis with hypotension
    • Meningococcal septicaemia
  • Burns
  • Cardiogenic shock
  • Rehydration/fluid replacement
    • Dehydration
    • Diving emergencies
    • Hyperglycaemia
    • Newborn care
  • To keep IV patent and flush drugs
    • Limb realignment
    • Dysrhythmias
    • Cardiac arrest
72
Q

IPRATROPIUM BROMIDE - Action

A
  • Bronchodilation
  • Blocks vagal reflexes which mediate bronchoconstriction

Onset 3-5min

Duration 2-4hrs

73
Q

IPRATROPIUM BROMIDE - Adverse Effects

A

Mild anticholinergic effects, e.g. urine retention

73
Q

IPRATROPIUM BROMIDE - Contraindications

A
  • Allergy or hypersensitivity to ipratropium bromide
  • Glaucoma
75
Q

IPRATROPIUM BROMIDE - Preparation

A

500mcg in 1mL nebule for patients ≥ 6 years of age

250mcg in 1mL nebule for patients < 6 years of age

76
Q

IPRATROPIUM BROMIDE - Type

A

Anticholinergic bronchodilator

77
Q

IPRATROPIUM BROMIDE - Use

A
  • Moderate to severe asthma
  • COPD
78
Q

LIGNOCAINE - ACTION

A

Blocks sodium channels reducing ventricular excitability and pain transmission

IV

Onset 1-4min

Peak 5-10 min

Duration 20 min

79
Q

LIGNOCAINE - TYPE

A

Antiarrhythmic and local anaesthetic agent.

80
Q

Lignocaine – adverse effects

A
  • Lignocaine may cause or exacerbate ventricular dysrhythmias
  • In high doses, may cause:
    1. Neurological side effects - (drowsiness, disorientation, agitation, muscle twitching, fits and coma)
    2. Cardiac effects - (hypotension, bradycardia, heart block(s) and asystole)
81
Q

Lignocaine – contraindications

A

Allergy or hypersensitivity to lignocaine.

81
Q

LIGNOCAINE – preparation

A
  • Lignocaine 2% ‐ 100mg in 5mL polyampoule for IV bolus doses
  • Lignocaine 1% ‐ 20mg in 2mL ampoule for local anaesthesia

As two concentrations are available: Read the label carefully and check with your partner

83
Q

Lignocaine – use

A
  • If ventricular fibrillation/pulseless VT persists after the maximum dose of amiodarone
  • Local anaesthesia of the skin prior to cannulation (1% preparation only)
84
Q

METHOXYFLURANE - Action

A

Central nervous system depressant

  • Onset 2-3min
  • Duration 30min
85
Q

METHOXYFLURANE - Contraindications

A
  • Malignant hyperthermia
  • ↓LOC – V,P or U
  • Pre-eclampsia or eclampsia
  • Concurrent tetracycline use (e.g. doxycycline)
  • Untreated renal failure
  • Patients < 1 year of age
  • Acute behaviourally disturbed patients
86
Q

METHOXYFLURANE - Preparation

A

3mL amber bottle sealed, with external inhaler

87
Q

METHOXYFLURANE - Type

A

Inhaled analgesic

88
Q

METHOXYFLURANE - Use

A
  • Moderate to severe pain in patients where a paramedic is not authorised to administer an opioid or an opioid is contraindicated
  •  Mild pain in patients > 1year of age and < 12 years of age
  • Multiple victim situations
89
Q

METHOXYFLURANE - Adverse effects

A
  • ↓LOC
  • Renal damage in high doses
90
Q

METOCLOPRAMIDE - Action

A

Blocks central dopamine receptors

IM

ONSET – 10 to 15 minutes

DURATION – 1 to 2 hours

IV

ONSET – 3 to 5 minutes

DURATION – 1 to 2 hours

91
Q

METOCLOPRAMIDE - Type

A

Anti-nauseant and anti-emetic

92
Q

METOCLOPRAMIDE – Contraindications

A
  • suspected bowel obstruction
  • suspected or known haematemesis or melaena
  • previous history of extrapyramidal/dystonic reaction
  • Allergy or hypersensitivity to metoclopramide
  • patients less than 16 years of age
93
Q

METOCLOPRAMIDE – use

A

Severe nausea and/or active vomiting in patients > 16 years of age where ondansetron has been ineffective after 10 minutes or is contraindicated

94
Q

METOCLOPRAMIDE – preparation

A

10mg (2mL) ampoule

95
Q

MIDAZOLAM - Action

A

Reduces seizure activity and has a tranquillising and amnesic effect

** Onset, Peak, Duration**

IM 5‐10 min, 15 min, 30 min

IV 1‐3 min, 10 min, 20 min

I**N ** 1‐3 min, 12 min, 20 min

96
Q

MIDAZOLAM - Adverse Effects

A
  • ↓LOC resulting in upper airway obstruction
  • Respiratory and cardiovascular depression

**Vital signs must be carefully monitored and equipment to support respiration must be available. Apnoea can often occur following parenteral use especially in the elderly and those with respiratory disease. Adverse effects are increased in the presence of other sedating drugs such as opiates and alcohol **

97
Q

MIDAZOLAM - Preparation

A

5mg in 1mL ampoule

5mg in 1mL ampoule diluted to 5mL with 4mL 0.9% NaCl2 (1mg:1mL)

Paediatric bolus must not exceed the adult dose

Oxygen must be administered to all patients receiving midazolam

98
Q

MIDAZOLAM - Type

A

Benzodiazepine

99
Q

MIDAZOLAM - Use

A
  • Control seizures
  • Post intubation sedation
  • Limb realignment and/or difficult extrication
  • Patient management

**Midazolam MUST NOT be used to assist intubation **

100
Q

MORPHINE - Action

A
  • Decreases pain perception and anxiety
  • Causes peripheral vasodilation

IM

Onset 5-10 min

Peak 25-40 min

Duration 1-2 hrs

IV

Onset 2-5 min

Peak 10 min

Duration 1-2 hrs

101
Q

MORPHINE - Adverse Effects

A
  • ↓LOC
  • Respiratory depression
  • Hypotension
  • Nausea and vomiting
102
Q

MORPHINE - Contraindications

A
  • Altered LOC (V,P or U with the exception of patients requiring post intubation sedation)
  • Active labour
  • Allergy or hypersensitivity to morphine
  • Patients < 6 months of age

P A L L

103
Q

MORPHINE - Preparation

A

10mg in 1mL ampoule
10mg in 1mL ampoule diluted to 10mL with 9mL 0.9% normal saline – (1mg in 1mL)

104
Q

MORPHINE - Type

A

Opioid analgesic

105
Q

MORPHINE - Use

A
  • Pain management
  • Post intubation sedation
106
Q

NALOXONE - Action

A

Reverses symptoms caused by opioid analgesics:

  • Respiratory depression
  • Sedation
  • Hypotension
107
Q

NALOXONE - Additional Information

A

Opioid effects may exceed that of naloxone and renarcotisation is possible. Therefore repeat doses may be required

Naloxone is contraindicated in neonatal patients of opioid addicted mothers as serious withdrawal effects may occur

Hypoventilating newborns, due to maternal opiate use, will be hypercapnoeic and naloxone may provoke dysrhythmias, seizures and pulmonary oedema

108
Q

NALOXONE - Adverse Effects

A
  • Opioid withdrawal (nausea, vomiting, sweating, tachycardia, hypertension, combative behaviour)
  • Pulmonary oedema in patients with pre existing cardiac disease
  • Dysrhythmias (VT, VF)
109
Q

NALOXONE - Contraindications

A

Patients < 30 days of age

110
Q

NALOXONE - Preparation

A
  • 400mcg in 1mL ampoule
  • 400mcg in 1mL ampoule diluted to 4mL (100mcg in 1mL ) with 3mL of 0.9% normal saline
111
Q

NALOXONE - Type

A

Opioid antagonist

112
Q

NALOXONE - Use

A
  • Life threatening opioid overdose
  • Opioid overdose
  • Etorphine or Buprenorphine overdose
113
Q

ONDANSETRON - Action

A

Blocks central and peripheral 5-HT3 receptors

IM

Onset 10-15 min

Duration 1-2 hrs

IV

Onset 3-5min

Duration 1-2 hrs

114
Q

ONDANSETRON - Adverse Effects

A
  • Headache and/or flushing
  • Seizures and movement disorders
  • Visual disturbance
  • Hypersensitivity reactions (including anaphylaxis)
115
Q

ONDANSETRON - Contraindications

A
  • Allergy or hypersensitivity to ondansetron
  • Patients
116
Q

ONDANSETRON - Preparation

A

4mg in 2mL ampoule

117
Q

ONDANSETRON - Type

A

Anti‐emetic and anti‐nauseant

118
Q

ONDANSETRON - Use

A
  • For first line management of severe nausea and/or vomiting
  • **Suspected penetrating eye injury **
119
Q

SALBUTAMOL - Action

A

Stimulates beta 2 receptors in bronchial smooth muscle resulting in bronchodilation

NEB

Onset - 2-5 min

Peak - 5 -10 min

Duration - 1-2 hours

120
Q

SALBUTAMOL - Adverse Effects

A
  • Dysrhythmias in large doses
  • Shakes and tremors
121
Q

SALBUTAMOL - Preparation

A 
5mg in (2.5mL) nebule 
 2.5mg in (2.5mL) nebule
122
Q

SALBUTAMOL - Type

A

Sympathomimetic

123
Q

SALBUTAMOL - Use

A

To relieve bronchospasm

124
Q

SODIUM BICARBONATE – actions

A
  • Reverses metabolic acidosis by buffering hydrogen ions
  • Reduces plasma potassium by altering pH and causing intracellular movements of potassium ions
  • Alters protein binding of tricyclics by acting on trans‐membrane sodium channels
125
Q

SODIUM BICARBONATE – adverse effects

A
  • Metabolic alkalosis (may cause dysrhythmias)
  • Hypokalaemia(maycausedysrhythmias)
  • Heartfailure
126
Q

SODIUM BICARBONATE – type

A

Alkalising solution

127
Q

SODIUM BICARBONATE – use

A
  • Emergency treatment of hyperkalaemia
  • Tricyclic overdoses with conduction delay (wide QRS complex) presenting with IV Onset Immediate shock, fitting or coma
128
Q

SODIUM BICARBONATE – preparation

A

8.4% 50mL (1mmol/mL) Min‐I‐Jet

129
Q

GLYCERYLTRINITRATE - Adverse Effects

A
  • Hypotension
  • Flushing
  • Headache

ASNSW ICP STUDY (10 decks)

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