Pharmacology

Question 1

Nebulisers considerations

Answer 1

Lungs absorbent due to highly vascular pulmonary capillary system
Rapid absorption of drug into systemic circulation
Considerable proportion of the drug swallowed and can therefore metabolise rapidly

Question 2

Salbutamol aka Bronchodilator

Answer 2

Beta2-adrenoreceptor agonist
Acts quickly and directly on the smooth bronchial muscle

Contraindications
Previous sensitivity

Reactions
Tremor
Tachycardia
Cardiac arrhythmias
Headaches, nausea, palpitations, feelings of warmth

Dosage
Adults – 5mg
Children – 4-12yrs – 2.5mgs
Repeat 4-6hrs
PRN – Emergency

Question 3

Ipratopium Bromide aka Bronchodilator

Answer 3

Inhibits bronchomotor tone

Contraindications
Hypersensitivity to atropine/atropine like drugs

Reactions
Tachycardia, arrythmias, SVT, AF
Nausea
Dry mouth/throat
Glaucoma (in direct contact with eye)

Dosage
Adults – 250-500mcg with 2-3 mls saline (1ml if given with salbutamol)
Children – Not given under 12yrs – 250mcg
Repeat 6 hrs

Question 4

Morphine

Answer 4

Analgesia
Opium – binds to receptors in brain, spinal cord and other tissues
Primary effects on CNS and other smooth muscle

Contraindications
Previous sensitivity
Opioid sensitivity
Bronchial asthma/COPD

Reactions
Sedation 
Nausea
Vomiting
Constipation
Blurred vision
Local issue irritation (at site of injection)

Dosage
Adults – 5 - 20mg every 4 – 6 hourly max
Children – 0.1 to 0.2 mg/kg bodyweight Max 15mgs

Question 5

Metoclopromide

Answer 5

Otherwise known as?
Anti emetic
Accelerates gastric emptying, increases peristalsis

Contraindications
GI Haemorrhage
Obstruction
Perforation
Epilepsy

Reactions
Headache
Drowsiness
Fatigue

Dosage
10mg IMI TDS Slow (1-2 Mins)
Children 1-10mg depending on Age

Question 6

Glyceryl trinitrate (GTN)

Answer 6

Otherwise known as
Vasodilator
Increases blood flow from epicardial to endocardial regions

Contraindications
Cerebral haemorrhage
Head injury
Hypersensitivity
Angina caused by obstructive cardiomyopathy

Reactions
Hypotension
Headache
Sedation 
Nausea
Vomiting
Blurred vision
Syncope
Tachycardia

Dosage
600-900mcgs as soon after onset of symptoms
Elderly 300mcgs as starting dose
Buccal mucosa under tongue or in cheek

Question 7

Aspirin

Answer 7

Inhibition of platelet aggregation
Used in patients with known cardiovascular/cerebrovascular disease
Prophylaxis for AMI, Unstable Angina, TIA, CVA

Contraindications
Hepatic/renal disease
Bleeding disorders
Gastric/peptic ulcers
Hypersensitivity

Reactions
GI Distress
Nausea
Vomiting
Occult blood loss
Dizziness

Dosage
75-300mg PO OD

Question 8

Tazopip

Answer 8

Antibacterial combination medication
Broad spectrum semisynthetic penicillin
Active against Gram-positive and Gram-negative aerobic and anaerobic bacteria

Used for: LTI’s, UTI’s, intra abdominal infections, skin infections, gynae infections

Contraindications
Previous allergic reactions to penicillin/cephalosporins

Reactions
Anaphylactic/anaphylactoid
Bleeding manifestations including clotting problems
Raised liver enzymes
Resistance to therapy in prolonged use

Dosage
Slow IV infusion (20-30mins)
4g piperacillin/0.5g tazobactum (Tazopip)
Every 8 hours
Max daily dose 12G (4G TDS)

Question 9

Paracetamol IV

Answer 9

Analgesic, Antipyretic
Not sure why it works – may involve central and peripheral actions

Contraindications
Other paracetamol containing drugs

Reactions
Dizzyness
Allergic reactions
Vomiting
Nausea
Constipation
Pruritis
And others……..