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Paramedic Drugs > Pharmacology > Flashcards

Pharmacology Flashcards

1
Q

Adrenaline Preparation

A

1mg 1ml

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2
Q

Adrenaline Indications

A 
Cardiac Arrest
Anaphylaxis
Severe Asthma
Moderate-Severe Stridor
Epistaxis
Significant Wound Bleeding
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3
Q

Adrenaline Doses

A 
1mg IV @4/60
0.5mg IM @10/60 or @5/60 if anaphylactic and not improving/deteriorating
2ml per IN
5mg Neb
0.1mg/ml topical
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4
Q

Adrenaline MOA

A

Adrenergic receptor agonist with alpha and beta effects.
a1- smooth muscle contraction, vasoconstriction (epistaxis, bleeding, & stridor), stimulates glycogenolysis in the liver
a2- sedation & vasoconstriction
b1- increases inotropic, chronotropic, & dronotropic effects of the heart (increased force of contractility, increased HR, increased conduction) (cardiac arrest)
b2- smooth muscle relaxation, vasodilation, bronchodilation, Gi smooth muscle relaxation, stabilizes mast cell membranes decreasing histamine release (asthma & anaphylaxis)

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5
Q

Adrenaline Contraindications

A

Nil

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6
Q

Adrenaline Precautions

A

MI

Tachydysrhythmias

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7
Q

Adrenaline Onset

A

IV 5-10sec
IM 2-5min
Neb, topical, & IN on contact with target site

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8
Q

Adrenaline Duration

A

Cardiovascular effects last 2-15min

Mast cell membrane effects last several hours

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9
Q

Adrenaline Adverse Effects

A 
Tachycardia
Tachydysrhythmias
HTN
N&V
Tremor
Headache
Andiety
Dyspnoea
MI
Ventricular Ectopy
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10
Q

Amiodarone MOA

A 
Broadspectrum antidysrhythmic with class III activity, blocks K+ channels.
Prolongs action potential, reduces automaticity, & prolongs the refractory period of atrial, nodal, & ventricular tissues. 
Causes a reduction in abnormal electrical activity (ectopy) and stabilizes nodes
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11
Q

Amiodarone Preparation

A

150mg 3ml

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12
Q

Amiodarone Indication

A

VF or VT arrest post 1st dose of Adrenaline

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13
Q

Amiodarone Contraindication

A

Severe allergy to Iodine

VT secondary to cyclic antidepressant OD

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14
Q

Amiodarone Precautions

A

Nil if in arrest

Poor perfusion
Hypotension
AF associated with severe sepsis
Sick sinus syndrome w/o pacemaker
Pregnancy
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15
Q

Amiodarone Doses

A

300mg IV bolus (x2 ampuoles)

If VF/VT persists after 20/60- 150mg

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16
Q

Amiodarone Onset

A

5-10/60

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17
Q

Amiodarone Duration

A

1-4hrs post single dose, but longer in tissues

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18
Q

Amiodarone Adverse Effects

A 
Hypotension
N&V
Diaphoresis
Lightheadedness
Brady-dysrhythmias
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19
Q

Amoxicillin/clavulanic acid MOA

A

Broadspectrum beta-lactam antibiotic that inhibits production of bacterial cell walls causing cell death.
Clavulanic acid inhibits beta-lactamase enzyme from bacteria, reducing/ eliminating beta-lactam antibiotic resistant bacteria.

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20
Q

Amoxicillin/clavulanic acid Preparation

A

1g of amoxicillin + 200mg of clavulanic acid powder

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21
Q

Amoxicillin/clavulanic acid Indications

A

Sepsis >12yo + 1 high risk factor + greater than 30min to hospital
Cellulitis

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22
Q

Amoxicillin/clavulanic acid Contraindications

A

Severe allergy to Penicillins

Anaphylactic to beta-lactam antibiotics

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23
Q

Amoxicillin/clavulanic acid Precautions

A

Nil

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24
Q

Amoxicillin/clavulanic acid Doses

A

1.2g IV into a running line over 1-2min

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25
Q

Amoxicillin/clavulanic acid Onset

A

30-60min

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26
Q

Amoxicillin/clavulanic acid Duration

A

6-8hr

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27
Q

Amoxicillin/clavulanic acid Adverse Effects

A

Nil

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28
Q

Aspirin MOA

A

NSAID that inhibits the production of COX, decreasing prostaglandin production, creating analgesic, anti-inflammatory, anti-pyretic, & anti-platelet effects

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29
Q

Aspirin Preparation

A

300mg tablets

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30
Q

Aspirin Indication

A

MI

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31
Q

Aspirin Contraindication

A

3rd trimester of pregnancy

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32
Q

Aspirin Precautions

A

Known worsening of bronchospasm with NSAIDs
Known bleeding disorder
Clinically significant bleeding

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33
Q

Aspirin Dose

A

300mg

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34
Q

Aspirin Onset

A

30-60min

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35
Q

Aspirin Duration

A

The life of the platelet, 3-5 days

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36
Q

Aspirin Adverse Effects

A

Bronchospasm in pts with COPD/Asthma
Chronic use- indigestion, GI ulceration, & bleeding
Increases activity of Warfarin

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37
Q

Ceftriaxone MOA

A

Broadspectrum cephalosporin antibiotic that inhibits bacterial cell wall synthesis, leading to cell death

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38
Q

Ceftriaxone Preparation

A

1g/2g powder

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39
Q

Ceftriaxone Indication

A

Suspected meningococcal septicaemia

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40
Q

Ceftriaxone Dose

A

2g IV/IM

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41
Q

Ceftriaxone Contraindication

A

Anaphylaxis to cephalosporins

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42
Q

Ceftriaxone Precaution

A

Nil

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43
Q

Ceftriaxone Onset

A

30-60min

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44
Q

Ceftriaxone Duration

A

24hrs

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45
Q

Ceftriaxone Adverse Effects

A

Nil

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46
Q

Droperidol MOA

A

Central dopamine & alpha receptor antagonist, resulting in sedation, reduced agitation, and a state of mental detachment

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47
Q

Droperidol Preparation

A

2.5mg 1ml

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48
Q

Droperidol Indication

A

> 12yo with agitated delirium causing mild-moderate risk to safety when Olanzapine has not been administered/ has been ineffective.

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49
Q

Droperidol Contraindication

A

Nil

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50
Q

Droperidol Precautions

A

Parkinsons
Concurrent administration of other sedatives
Intoxication
Elderly/frail

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51
Q

Droperidol Dose

A

10mg IM/IV
Reduce to 5mg if frail
Repeat once after 20/60

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52
Q

Droperidol Duration

A

4-6hrs

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53
Q

Droperidol Onset

A

5-10min

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54
Q

Droperidol Adverse Effects

A

Hypotension- especially if IV dose administered rapidly

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55
Q

Fentanyl MOA

A

Opiate receptor agonist in the brain & spinal cord causing analgesia

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56
Q

Fentanyl Preparation

A

100mcg 2mls

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57
Q

Fentanyl Indication

A

Moderate-severe pain
CPO with severe anxiety
Symptom control during end of life care

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58
Q

Fentanyl Contraindications

A

Unable to obey commands

Current respiratory depression

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59
Q

Fentanyl Precautions

A

<1yo
High risk of respiratory depression
Labor

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60
Q

Fentanyl Doses

A

10-50mcg IV @3-5/60
100mcg IN <80kg repeat 50mcg @10/60
200mcg IN >80kg repeat 100mcg @10/60

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61
Q

Fentanyl Onset

A

2-5min IV -max analgesic & resp effects may take 10-15min

5-10min IN

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62
Q

Fentanyl Duration

A

30-60min

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63
Q

Fentanyl Adverse Effects

A 
Respiratory depression 
Bradycardia
Hypotension 
Sedation 
N&V
Itch
Euphoria
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64
Q

Gentamicin MOA

A

Aminoglycoside antibiotic with broad activity against gram-negative bacteria. Inhibits bacterial cell protein synthesis causing cell death.

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65
Q

Gentamicin Preparation

A

80mg 2ml

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66
Q

Gentamicin Indication

A

Sepsis where infection is urinary, abdo, or unknown, >12yo + 1 high risk factor + greater than 30min to hospital

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67
Q

Gentamicin Contraindication

A

Pregnancy

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68
Q

Gentamicin Precautions

A

Nil

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69
Q

Gentamicin Doses

A

<60kg 240mg (x3 amps)
60-80kg 320mg (x4 amps)
>80kg 400mg (x5 amps)
Diluted to 10-20mls and given into running IV line over 1-2min

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70
Q

Gentamicin Onset

A

30-60min

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71
Q

Gentamicin Duration

A

24hrs

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72
Q

Gentamicin Adverse Effects

A

Nil

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73
Q

GTN MOA

A

Universal vasodilator that causes peripheral blood pooling, decreasing venous return & preload. Decreasing ventricular filling & cardiac output. Decreasing myocardial work & oxygen demand.

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74
Q

GTN Preparation

A

0.4mg doses

TTS 10 patch 0.5mg per hr

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75
Q

GTN Indications

A

MI
CPO
HTN associated with autonomic dysreflexia

Patch if not responding to SL doses in CPO or AD

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76
Q

GTN Contraindications

A

SBP <100
HR <40
HR >150
VT

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77
Q

GTN Precautions

A 
Frail 
Inferior STEMI or STEMI involving R ventricle
Poor perfusion 
Dysrhythmia
ED medication in last 24hrs
Known aortic/mitral stenosis
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78
Q

GTN Doses

A

MI- 0.4mg
CPO- 0.8mg
AD- 0.4-0.8mg
repeat @3-5min

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79
Q

GTN Onset

A

1-2min SL

10-20min TTS

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80
Q

GTN Duration

A

15-30min SL in some pts BP effects last several hrs

18hrs TTS but dissipate 10-20min once removed

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81
Q

GTN Adverse Effects

A 
Hypotension
Headache
Tachycardia
Light-headed
Flushing
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82
Q

Glucagon MOA

A

Stimulates glycogenolysis & gluconeogenesis in the liver. Stored glycogen breaks down into glucose.

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83
Q

Glucagon Preparation

A

1mg powder

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84
Q

Glucagon Indication

A

Hypoglycaemia when pt can’t swallow or no IV access

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85
Q

Glucagon Contraindication

A

Nil

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86
Q

Glucagon Precautions

A

Will be ineffective if pt has undergone strenuous exercise, not eaten food for >12hrs, has adrenal insufficiency, chronic hypoglycaemia, or alcohol-induced hypoglycaemia

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87
Q

Glucagon Dose

A

> 5yo 1mg IM

<5yo 0.5mg IM

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88
Q

Glucagon Onset

A

5-10min

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89
Q

Glucagon Duration

A

15-60min

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90
Q

Glucagon Adverse Effects

A

Nil

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91
Q

Glucose MOA

A

Simple carbohydrate readily absorbed (10% & oral) -hypertonic solution
Vehicle for drug delivery (5%) -isotonic solution

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92
Q

Glucose Preparation

A

10-20g sachet
500ml 10% bag
100ml 5% bag

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93
Q

Glucose Indication

A

Hypoglycaemia & Crush Injury (10%)

Gentamicin & Sodium Valproate (5%)

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94
Q

Glucose Contraindication

A

Nil

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95
Q

Glucose Precaution

A

Nil

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96
Q

Glucose Dose

A 
10-20g oral
100ml IV hypo
500ml 10% IV crush
Gentamicin admin pts >20kgs 5%
Valproate admin 5%
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97
Q

Glucose Onset

A

Immediate

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98
Q

Glucose Duration

99
Q

Glucose Adverse Effects

A

Necrosis if not flushed well

100
Q

Ibuprofen MOA

A

Non-selective NSAID that inhibits prostaglandin production & release, causing analgesic & anti-pyretic effects

101
Q

Ibuprofen Preparation

A

200mg tablets

20mg/ml syrup

102
Q

Ibuprofen Indication

103
Q

Ibuprofen Contraindication

A

3rd trimester of pregnancy

104
Q

Ibuprofen Precautions

A 
Taken in the last 4hrs
Abdo pain- especially if unwell or vomiting
>75yo
Dehydrated or shocked
Known renal impairment
Known bleeding disorder
Clinically significant bleeding
Known worsening of bronchospasm with NSAIDS 
Taking Warfarin
Pregnancy
105
Q

Ibuprofen Doses

A

> 80kgs 600mg (x3 tablets)

<80kgs 400mg (x2 tablets)

106
Q

Ibuprofen Onset

107
Q

Ibuprofen Duration

108
Q

Ibuprofen Adverse Effects

A 
N&V
Epigastric pain
Indigestion
Diarrhoea
Bloating
Ulcers- with chronic use
109
Q

Ipratropium MOA

A

Anticholinergic agent with long lasting beta2 effects. It inhibits the parasympathetic response by antagonizing acetylcholine binding. This results in bronchodilation & decreased mucosal plugging

110
Q

Ipratropium Preparation

111
Q

Ipratropium Indication

A

Bronchospasm secondary to asthma/COPD/

airway burns/smoke inhalation/chest infection in conjunction with Salbutamol

112
Q

Ipratropium Contraindications

113
Q

Ipratropium Precautions

114
Q

Ipratropium Dose

A

0.5mg once

115
Q

Ipratropium Onset

116
Q

Ipratropium Duration

117
Q

Ipratropium Adverse Effects

A 
Nausea
Dry mouth
Blurred vision (existing glaucoma)
Tachycardia
Palpitations
118
Q

Ketamine MOA

A

N-methyl-d-aspartate (NMDA) receptor antagonist, inhibits excitatory neurotransmitters in the brain

119
Q

Ketamine Preparation

120
Q

Ketamine Indication

A

Severe pain- especially musculoskeletal or burns if uncontrolled by an opiate

121
Q

Ketamine Contraindication

122
Q

Ketamine Precautions

A 
Unable to obey commands
Active psychosis
HTN
Conditions that may be worsened by HTN
MI
Concurent sedatives
Elderly/frail
123
Q

Ketamine Doses

A

> 80kgs 30mg IV
50-80kgs 20mg IV
0.5mg/kg IM/PO

124
Q

Ketamine Onset

A

1-2min IV
5-10min IM
10-20min PO

125
Q

Ketamine Duration

126
Q

Ketamine Adverse Effects

A 
HTN
Tachycardia
Apnoea
N&V
Sedation
Hallucinations
127
Q

Lignocaine MOA

A

Local anaesthetic that blocks initiation & transmission of nerve impulses by blocking the movement of Na+ ions across cell membranes

128
Q

Lignocaine Preparation

129
Q

Lignocaine Indication

A

IV pain
Ring blocks
IO bone pain associated with NaCl infusion

130
Q

Lignocaine Contraindications

A

Local infection at injection site

131
Q

Lignocaine Precautions

A

Pts taking anticoagulants

132
Q

Lignocaine Doses

A

1-2ml blebs either side of digit

50mg IO

133
Q

Lignocaine Onset

A

1-2min for IV pain

5-10min for ring block

134
Q

Lignocaine Duration

135
Q

Lignocaine Adverse Effects

136
Q

Loratadine MOA

A

Long acting selective peripheral H1 receptor antagonist that blocks the action of histamine, decreasing itching, redness, & hives

137
Q

Loratadine Preparation

A

10mg tablets

138
Q

Loratadine Indication

A

Minor allergic reactions confined to skin involvement

Prominent itch associated with anaphylaxis

139
Q

Loratadine Contraindication

140
Q

Loratadine Precautions

141
Q

Loratadine Doses

A

> 11yo 10mg

<11yo 5mg

142
Q

Loratadine Onset

143
Q

Loratadine Duration

144
Q

Loratadine Adverse Effects

145
Q

Methoxyflurane MOA

A

GABA receptor antagonist with analgesic effects on the CNS

146
Q

Methoxyflurane Preparation

147
Q

Methoxyflurane Indications

148
Q

Methoxyflurane Contraindications

A

Unable to obey commands
pHx or fHx of malignant hyperthermia
Known renal impairment
Had in the last week

149
Q

Methoxyflurane Precautions

A

> 75yo
Pre-eclampsia
Confined space

150
Q

Methoxyflurane Doses

A

3ml

Adult max of 6ml, child max of 3ml

151
Q

Methoxyflurane Onset

152
Q

Methoxyflurane Duration

A

2-5min after stopping administration

153
Q

Methoxyflurane Adverse Effects

A

Drowsiness
Lightheadedness
Nausea
Headache

154
Q

Midazolam MOA

A

Benzodiazepine, GABA agonist at GABA receptors in CNS causing anticonvulsant activity, sedation, amnesia, anxiolysis, & muscle relaxation

155
Q

Midazolam Preparation

156
Q

Midazolam Indication

A

Prolonged seizures

Agitated delirium with risk to safety and Droperidol is ineffective or unavailable

157
Q

Midazolam Contraindications

158
Q

Midazolam Precautions

A

Concurrent use of opiates/sedatives
Intoxication
Elderly/frail

159
Q

Midazolam Doses

A 
Seizures: 
5mg IV (3mg if frail) repeat once after 5/60
10mg IM (5mg if frail) repeat once after 10/60

Agitated Delirium:
2-3mg IV (1-2mg if frail) repeat after 5/60 as required
10mg IM repeat once after 20/60

160
Q

Midazolam Onset

A

2-3min IV

3-5min IM

161
Q

Midazolam Duration

162
Q

Midazolam Adverse Effects

A

Sedation
Respiratory depression
Hypotension
Amnesia

163
Q

Naloxone MOA

A

Opiate receptor antagonist that reverses the effects of opiates, especially respiratory depression and sedation

164
Q

Naloxone Preparation

165
Q

Naloxone Indication

A

Opiate overdose with altered level of consciousness or respiratory depression
Excess adverse effects from opiate administration

166
Q

Naloxone Contraindications

167
Q

Naloxone Precautions

A

Chronic opiate use

168
Q

Naloxone Doses

A
  1. 1-0.4mg IV repeat after 5min

0. 8mg IM repeat after 20min

169
Q

Naloxone Onset

A

1-2min IV

5-10min IM

170
Q

Naloxone Duration

171
Q

Naloxone Adverse Effects

A

Sweating
Tachycardia
HTN

172
Q

Olanzapine MOA

A

Atypical anti-psychotic, acts at multiple receptors in the brain causing a reduction in agitation, sedation, anxiolysis, and stabilization of mood

173
Q

Olanzapine Preparation

A

5mg wafers

174
Q

Olanzapine Indication

A

> 12yo with agitated delirium and a risk to safety

175
Q

Olanzapine Contraindication

A

Antipsychotic poisoning

176
Q

Olanzapine Precaution

A

Pregnancy

Elderly

177
Q

Olanzapine Dose

A

10mg (x2 wafers) (5mg if frail) repeat once after 20/60

178
Q

Olanzapine Onset

179
Q

Olanzapine Duration

180
Q

Olanzapine Adverse Effects

181
Q

Ondansetron MOA

A

Antiemetic with selective 5HT receptor antagonism centrally in the brain and peripherally in the GI.

182
Q

Ondansetron Preparation

183
Q

Ondansetron Indication

A

Significant N&V

184
Q

Ondansetron Contraindication

185
Q

Ondansetron Precautions

186
Q

Ondansetron Doses

A

8mg IV
4mg IM
One IV dose may be administered in addition to one IM dose if N&V persists, max 12mg

187
Q

Ondansetron Onset

A

2-5min IV

5-10min IM

188
Q

Ondansetron Duration

189
Q

Ondansetron Adverse Effects

A

Headache
Flushing
Metallic taste

190
Q

Oxytocin MOA

A

Stimulates oxytocin receptors on the uterus causing increased uterine contraction and reducing blood loss from the uterus

191
Q

Oxytocin Preparation

A

10units 1ml

192
Q

Oxytocin Indication

A

Following normal birth

PPH

193
Q

Oxytocin Contraindications

194
Q

Oxytocin Precautions

195
Q

Oxytocin Doses

A

10units IM

196
Q

Oxytocin Onset

197
Q

Oxytocin Duration

198
Q

Oxytocin Adverse Effects

A

Abdominal cramping
Tachycardia
Flushing

199
Q

Paracetamol MOA

A

Inhibits the production of prostaglandins resulting in a reduction in pain and fever

200
Q

Paracetamol Preparation

A

500mg tablet

50mg/ml syrup

201
Q

Paracetamol Indication

202
Q

Paracetamol Contraindications

203
Q

Paracetamol Precautions

A

Taken in the last 4hrs
Abdo pain, especially if unwell with vomiting
Known severe liver disease

204
Q

Paracetamol Doses

A

> 80kg 1.5g (x3 tablets)

50-80kg 1g (x2 tablets)

205
Q

Paracetamol Onset

206
Q

Paracetamol Duration

207
Q

Paracetamol Adverse Effects

208
Q

Prednisone MOA

A

Prednisone is a prodrug that is metabolised to prednisolone in the liver.

Prednisolone is a corticosteroid with anti-inflammatory and immunosuppressant actions. It inhibits the production of inflammatory mediators, including prostaglandins and leukotrienes, resulting in a reduction in the inflammatory and immune response.

209
Q

Prednisone Preparation

A

20mg tablets

5mg/ml syrup

210
Q

Prednisone Indications

A

Bronchospasm associated with Asthma/COPD
Croup
Prominent rash associated with anaphyalxis
Minor allergy associated with rash

211
Q

Prednisone Contraindications

212
Q

Prednisone Precautions

A

<5yo with asthma

213
Q

Prednisone Dose

A

40mg (x2 tablets)

214
Q

Prednisone Onset

215
Q

Prednisone Duration

216
Q

Prednisone Adverse Effects

A 
Reflux
N&V
Dizziness
Headache
HTN
217
Q

Salbutamol MOA

A

Short acting beta2 adrenergic receptor agonist causing smooth muscle bronchodilation & sympathomemetic effects

218
Q

Salbutamol Preparation

219
Q

Salbutamol Indication

A

Bronchospasm associated with asthma/COPD/airway burns/smoke inhalation/chest infection
Release syndrome following crush injury

220
Q

Salbutamol Contraindications

221
Q

Salbutamol Precautions

222
Q

Salbutamol Doses

223
Q

Salbutamol Onset

224
Q

Salbutamol Duration

225
Q

Salbutamol Adverse Effects

A

Tremor
Tachycardia
Tachydysrhythmias
Headache

226
Q

Tranexamic acid MOA

A

Anti-fibrinolytic that blocks the conversion of plasminogen to plasmin, reducing fibrinolysis & bleeding

227
Q

Tranexamic acid Preparation

228
Q

Tranexamic acid Indications

A

Postpartum Haemorrhage
Hypovolaemia from uncontrolled bleeding
Other form of bleeding severe enough to cause hypovolaemia requiring IV NaCl

229
Q

Tranexamic acid Contraindications

A

Trauma when TXA will be administered 3hrs after time of injury

230
Q

Tranexamic acid Precautions

231
Q

Tranexamic acid Dose

232
Q

Tranexamic acid Onset

233
Q

Tranexamic acid Duration

234
Q

Tranexamic acid Adverse Effects

235
Q

Sodium Valporate MOA

A

Anticonvulsant that blocks Na+ channels & enhances activity of GABA at GABA receptors in the CNS

236
Q

Sodium Valporate Preparation

A

400mg powder

237
Q

Sodium Valporate Indication

A

Status epilepticus that has not responded to x2 doses of midazolam

238
Q

Sodium Valporate Contraindication

239
Q

Sodium Valporate Precaution

240
Q

Sodium Valporate Doses

A

1.2g IV (x3 amps)

241
Q

Sodium Valporate Onset

242
Q

Sodium Valporate Duration

243
Q

Sodium Valporate Adverse Effects

Paramedic Drugs (2 decks)

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