Pharmacology Flashcards
What are the primary indications for use of adrenaline?
Cardiac arrest, inadequate perfusion, bradycardia with poor perfusion, anaphylaxis, severe asthma (imminent life threat), croup
What are the C/I s for adrenaline?
Hypovolemic shock without adequate fluid replacement
What are the contraindications for use of aspirin?
Hypersensitivity, actively bleeding peptic ulcers, suspected dissecting aortic aneurysm, bleeding disorders, chest pain associated with psycho stimulant OD if SBP >160 mmHg
What is the presentation of dexamethasone?
8 mg in 2 mL
What is the presentation of fentanyl?
100 mcg in 2mL
What are the contraindications for use of fentanyl in pain relief?
History of hypersensitivity, late second stage labour
What are the contraindications for glyceryl trinitrate?
BP < 100 mmHg, HR > 150, HR < 50, VT, PDE 5 inhibitor (current or recent use), riociguat (current use)
What is the mechanism of action of ipratropium bromide?
Anticholinergic bronchodilator blocks the action of the parasympathetic nervous system at the bronchi resulting in reduced bronchoconstriction
What are the contraindications for ketamine?
Suspected nTBI with severe hypertension (SBP > 180)
What are the indications for use of ketamine?
Intubation, analgesia, sedation due to agitation or CPR interfering patient
What are the benefits of methoxyflurane use in pain relief?
Short duration of action ideal for procedural pain such as reduction, patient does not require continuous monitoring after use
What are the contraindications for use of methoxyflurane?
Pre-existing renal disease, known or genetic susceptibility to malignant hyperthermia
What are the contraindications for use of morphine?
History of hypersensitivity, renal impairment/failure, late second stage labour
Why might fentanyl be preferred over morphine?
More potent: less drug for similar response, less likely to cause nausea and vomiting or exacerbate nausea in patient
What is the presentation of naloxone?
0.4 mg in 1 mL
What are the primary indications for use of ondansetron?
Undifferentiated nausea and vomiting, prophylaxis where vomiting may be clinically detrimental e.g spinally immobilised, penetrating eye trauma
What are the two presentations of ondansetron?
4 mg ODT, 8 mg in 4 mL glass ampoule
What are the contraindications for use of ondansetron?
Apomorphine use
What are the indications for use of prochlorperazine (stemetil)?
Nausea and vomiting in pts > 21 years: known allergy or C/I to ondansetron, vestibular nausea.
Headache
What are the contraindications for use of prochlorperazine?
CNS depression, patients < 21 years
What precautions should you be aware of when giving stemetil?
Elderly patients may be more susceptible to adverse effects
Also can worsen symptoms of Parkinson’s disease so should be avoided in these patients if possible
What is the mechanism of action of salbutamol?
Stimulates beta 2 adrenergic receptors to facilitate bronchodilation
What is management and dose for mild pain in a paediatric pt?
Paracetamol 15g/kg
What is first line management for moderate pain in a paediatric patient and what dose regimen is to be used?
Fentanyl IN:
Small child (10-17kgs) - 25 mcg
Medium child (18-39kg) - 25-50 mcg
You attend a 9 YO pt with 10/10 pain post a fall from a bicycle. What medications will you consider giving?
IN fentanyl 25-50 mcg
Methoxyflurane 3 mL
What is the mechanism of action of olanzapine?
Atypical antipsychotic acting as a dopamine, serotonin and histamine antagonist
What is the mechanism of action of naloxone?
Competitive opioid antagonist
What is the mechanism of action of midazolam?
A short-acting CNS depressant acting as an anxiolytic, sedative and anticonvulsant
What is the mechanism of action of ondansetron?
5-Ht3 receptor antagonist blocks the action of dopamine
What is the mechanism of action of TXA?
Antifibrinolytic, binds to plasminogen decreasing its conversion to plasmin whereby preventing the degradation of fibrin mesh in formed clots
What are the precautions for ondansetron?
- Pregnancy first trimester - consult receiving hospital
- Congenital long QT syndrome
- Severe hepatic disease
What are the precautions for adrenaline?
Reduced doses for: elderly/frail, pts with CVD and pts on MAOIs, Increased doses for pts on beta blockers
What are the precautions for morphine?
Respiratory depression, current asthma, elderly/frail, respiratory tract burns, known opioid addiction, acute alcoholism, pts on MAOIs, hypotension
What are the precautions for GTN?
Lower doses for elderly/frail or nil previous administration/recent MI
Right ventricular MI or inferior STEMI with BP < 160
What are the precautions for ketamine?
May exacerbate cardiovascular conditions (uncontrolled hypertension, stroke, recent MI, cardiac failure)
What are the precautions for droperidol?
Elderly/frail pts more susceptible to adverse effects, Parkinson’s disease, Lewy body dementia, QT prolongation
What are the precautions for aspirin?
Any peptic ulcer, asthma, pts on anticoagulants
What are the precautions for ceftriaxone?
Allergy to penicillin antibiotics
What are the precautions for salbutamol?
Large doses can cause intracellular metabolic acidosis
What are the contraindication for fentanyl?
- Late second stage labour
- Pts on MAOIs (last 14 days)
- Suspected serotonin syndrome
- Hypersensitivity
