Pharmocology Flashcards
Can you name the 7 drugs used in cardiac management
Aspirin
GTN
Ondansetron
Morphine
Furosemide
Amiodarone
Atropine
Can you name the 7 drugs used in cardiac management
Aspirin
GTN
Ondansetron
Morphine
Furosemide
Amiodarone
Atropine
Explain the pharmacology of Aspirin
Aspiring Is an anti-platelet drug, inhibiting the COX1 and COX2 enzymes
COX1 is responsible for prostaglandins formation, these are required to activate thromboxane.
Thromboxane attracts more platelets to it and activates the calciumm cascade in the platelets causing it to form fibrinogen dendrites
COX2 is responsible for the metabolism of arachidonic acid into prostaglandins, responsible for sensitising neurons to pain and causing inflammation and fever
Explain the pharmacology of GTN
GTN - Glyceral Trinitrate
It is a potent vasodilator
Once absorbed it undergoes denitrification where it becomes nitric acid
This nitric acid causes the increased production of cGMP in smooth muscle cells that line the arteries and veins, causing them to relax and allowing vasodilation to occur
Explain the pharmacology of Ondansetron
It is a highly specific serotonin 5-HT3 receptor agonist. It is used in the prevention and treatment of nausea and vomiting
It prevents serotonin released from the small intestine from binding and activating the vomiting reflex
Explain the pharmacology of Morphine
It binds to several opioid receptors in the CNS but most strongly the mu-opioid receptors
This mimics the effects of endorphins, which are responsible for analgesia and feelings of pleasure
However, strong affinity also causes respiratory depression and sedation to occur.
Morphine also causes the release of histamine which could account for its vasodilatory effect
Explain the pharmacology of Furosemide
Furosemide is a loop diuretic that inhibits sodium reabsorption by the distal and proximal tubules and also in the loop of Henle
This causes a decrease in circulatory pressure as water molecules follow the sodium
This can help relieve pulmonary oedema
Adult does is 40mg, YAS provides 50mg in 5ml so only 4ml to be given
Explain the pharmacology of Amiodarone
It is an antiarrhythmic drug that prolongs the duration of cardiac action potential
It blocks potassium currents that cause depolarisation of the heart
As a result, this increases the duration of the action potential as well as the effective refractory period for cardiac cells
Therefore, cardiac muscle cell excitability is reduced, preventing and treating abnormal rhythms
It also blocks sodium and potassium channels in cardiac muscle, acts to stabilise and reduce electrical irritability of cardiac muscle
The initial dose of Amiodarone is 300mg, 2 vials are needed
Ideally drawn up with 5% glucose
Explain the pharmacology of Atropine
It is a muscarinic receptor agonist that is used to inhibit the effects of excessive vagal activation of the heart.
It inhibits acetylcholine at parasympathetic neuro-effector sites
For paramedic use, it blocks vagal nerve activity on the heart causing increased HR
Atropine may also lessen the degree of partial heart bock when vagal activity is a etiologic factor
Should be administered as a rapid bolus
Which drugs would be used in the management of a STEMI?
Aspirin - 300mg chewed - sublingual
GTN - 2 sprays - 400-800mcg - sublingual
Ondansetron
Morphine
Oxygen if needed (<94%)
Which medications are stored in ampoules?
Adrenaline 1:1,000, Amiodarone, Atropine,
Chlorphenamine, Diazemuls, Furosemide, Morphine,
Naloxone, Ondansetron, TXA
Which is the only medication carried in a pre-filled syringe?
Adrenaline 1:10,000
What medications require reconstitution? What is used for reconstitution?
Benzylpenicillin,
Hydrocortisone, and Glucagon
Water for injection
What is the dose for Adrenaline 1:1,000 for anaphylaxis/asthma
0.5ml
What is the initial dose for Amiodarone? What should it be drawn up with?
Initial dose is 300mg which is two vials, should be drawn up with 5% glucose
