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PHECC meds Flashcards

1
Q

Amiodarone class and descriptions

A

class 3 antiarrythmic used to treat ventricular arrythmias

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2
Q

Amiodarone presentation

A

150 mg 3 ml solution

pre filled syringes 10ml (30mg/ml)

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3
Q

Amiodarone administration

A

IV/IO

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4
Q

Amiodarone indications

A

VF and pulseless VT

Symptomatic tachycardia >150bpm

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5
Q

Amiodarone contraindications

A

known hypersensitivity to iodine

known severe allergic reaction

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6
Q

Amiodarone dose

A

Adult - VT/VF: 5mg/kg IV/IO with a loading dose of 300mg and one supplimental dose of 150mg
Paeds - VT/VF: 5mg/kg IV/IO

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7
Q

Amiodarone pharmacology/action

A 
Antiarrhythmic
Prolongs action potential
Prolongs refactory period
Prolongs atrioventricular conduction
Prolongs QT interval
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8
Q

Amiodarone side effects

A

Inflammation of peripheral veins
Bradycardia
AV conduction abnormalities

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9
Q

Amiodarone notes

A

If dilution needed, dilute with Dextrose 5% (for infusion use 100mL D5W)
Can be flushed with NaCl
Cardiac arrest - nil dilution, follow with flush
Paed calcs - Add 2ml D5W making concentration 150mg/5ml

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10
Q

Asprin class and description

A

Platelet aggregation inhibitor
anti inflammatory agent and inhibitor of platelet function
Useful agent in the treatment of various thrombo-embolotic disease such as AMI

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11
Q

Asprin presentation

A

300mg dispersable tablet

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12
Q

Asprin administration

A

orally - dispersed in water or chewed if not dispersible form

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13
Q

Asprin indications

A

cardiac chest pain or suspected MI

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14
Q

Asprin contraindications

A

active, symptomatic gastrointestinal (GI) ulcer
Bleeding disorder (e.g. haemophillia)
Known sever allergic reaction
pts

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15
Q

Asprin doses

A

Adult - 300 mg tablet

Paeds - Contraindicated

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16
Q

Asprin pharmacology/action

A

Antithrombotic
inhibits the formation of thromboxane A2, which stimulates platelet aggregation and artery constriction. this reduces clot/throbus formation in AMI

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17
Q

Asprin side effects

A 
SHORT TERM
epigastric pain/discomfort
bronchospasm
gastrointestinal haemorrhage
LONG TERM
mild and infrequent but incidence of gastro-intestinal irritation with slight asymptomatic blood loss, increased bleeding time, bronchospasm and skin reaction in hypersensitive pts
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18
Q

Asprin info

A

indicated regardless of patient is on anticoagulants or asprin
enteric coated with nil chewing - regard as nil administration

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19
Q

Atropine class and description

A

Anticolinergic (parasympatholytic) that is derived from the atropa belladonna plant

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20
Q

Atropine presentation

A

pre-filled disposable syringe - 1mg/10ml

ampoule - 0.6mg/1ml

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21
Q

Atropine administration

A

IV/IO

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22
Q

Atropine indications

A

symptomatic bradycardia

cholinergic poisioning with bradycardia and salivation

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23
Q

Atropine contraindications

A

known severe allergic reaction

post - cardiac transplantation

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24
Q

Atropine dose

A

ADULT - cholinergic poisoning with bradycardia/salivation
1mg IV, repeat 5 min intervals to ensure minimal salivation
symptomatic bradycardia - 0.6mg IV repeat 3-5 min intervals to a max of 3 mg
NOT INDICATED FOR PAEDS

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25
Q

Atropine pharmacology/action

A 
Anticolinergic agent
blocks acetylcholine receptors
- enhances SA !ode automaticity
- enhances AV node conduction
- increases HR
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26
Q

Atropine side effects

A

tachycardia
dry mouth
dilated pupils
accidental exposure to the eyes can cause blurred vision

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27
Q

Benzylpenicillin class and description

A

antibiotic and antibacterial agent

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28
Q

Benzylpenicillin presentation

A

600mg powder in vial reconsitution

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29
Q

Benzylpenicillin administration

A

IV/IO
IM if no IV access possible
IV/IO : reconsitute each 600mg vial with 4ml water for injection and give slow push over 3-5min
IM : reconsitute each 600mg vial with 2ml water for injection

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30
Q

Benzylpenicillin indications

A

severe sepsis - adult

suspected/confirmed meningococcal sepsis - paeds

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31
Q

Benzylpenicillin contraindications

A

known severe allergic reaction

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32
Q

Benzylpenicillin dose

A

Adult : 1200mg IV/IO/IM
Paeds: >8 yrs:1200mg IV/IO/IM
1-8 yrs: 600mg IV/IO/IM

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33
Q

Benzylpenicillin pharmacology and action

A

antibacterial

Gram positive cocci antibiatoic

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34
Q

Benzylpenicillin side effects

A

gastro interstinal disturbances

hypersensitivity reactions

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35
Q

Clopidogrel class and description

A

Platelet aggregation inhibitor that inhibts platelet function

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36
Q

Clopidogrel presentation

A

300mg tablet

75 mg tablet

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37
Q

Clopidogrel administration

A

Oral

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38
Q

Clopidogrel indications

A

STEMI where pt not suitable for PPCI

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39
Q

Clopidogrel contraindications

A

known sever adverse reaction
Active pathological bleeding
severe liver impairement

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40
Q

Clopidogrel dose

A

Adult: 300mg PO
> 75 yrs; 75mg PO
Paeds: not indicated

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41
Q

Clopidogrel pharmacology/action

A

selectively inhibits the binding of adenosine diphosphate (ADP) to its platelet receptor and the subsequent ADP-mediated activation of GPIIb/IIa complex therby inhibiting platelet aggregation. Biotransformation of clopidogrel is necessary to produce inhibition of platelet aggregation. clopidogrel acts by irreversibly modifying the platelet ADP receptor

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42
Q

Clopidogrel side effects

A

abdo pain
dysprepsia
diarrhoea

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43
Q

clopidogrel notes

A

should not have clopidogrel if other anti platelet medication previously administered (other than asprin)

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44
Q

cyclizine class and description

A

Antiemetic used for management of nausea and vomiting

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45
Q

cyclizine presentation

A

50mg/1ml ampoule

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46
Q

cyclizine administration

A

IV/IO

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47
Q

cyclizine indications

A

management, prevention and treatment of nausea and vomiting

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48
Q

cyclizine contraindications

A

known severe adverse reaction

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49
Q

cyclizine dose

A

Adult: 50mg slow IV
Paed: not indicated

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50
Q

cyclizine pharmacology and action

A

Antiemetic

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51
Q

cyclizine side effects

A

tachycardia
dry mouth
sedation

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52
Q

Dextrose 10% Solution class and description

A

carbohydrate, used to describe the six-carbon sugar d-glucose, which is the principal form of carbohydrate used by the body D10W is hypertonic

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53
Q

Dextrose 10% Solution presentation

A

soft pack for infusion 250ml/500ml

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54
Q

Dextrose 10% Solution administration

A

IV Infusion / bolus
IO
paramedic can maintain once commenced

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55
Q

Dextrose 10% Solution indications

A

hypoglycemic emergency

BGL

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56
Q

Dextrose 10% Solution pharmacolgy and action

A

hypertonic glucose solution

dextrose is a redily utilisable energy source

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57
Q

Dextrose 10% Solution side effects

A

necrosis of tissue around infusion site

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58
Q

Dextrose 10% Solution notes

A

also called glucose

cannula patency will reduce effect of tissue necrosis

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59
Q

Dextrose 5% solution class and description

A

carbohydrate
dextrose is sused to describe the six-carbon sugar d-glucose, which is the prinipal form of carbohydrate used by the bosy. D5W is a hypertonic solution and used as an infusion medium for amioderone

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60
Q

Dextrose 5% solution presentation

A

soft pack of infusion 100ml/500ml

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61
Q

Dextrose 5% solution administration

A

IV/IO

paramedic can maintain infusion onced commenced

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62
Q

Dextrose 5% solution indications

A

used as a dilutant for amioderone

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63
Q

Dextrose 5% solution contraindications

A

known severe adverse reaction

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64
Q

Dextrose 5% solution dose

A

Adult: dilute appropriate dose of amiodarone
Paed: not indicated

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65
Q

Dextrose 5% solution pharlacology and action

A

Dextrose 5% (D5W) is used as an infusion medium for amiodarone

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66
Q

Dextrose 5% solution side effects

A

necrosis of tissue around IV access

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67
Q

Dextrose 5% solution notes

A

paraedics are authorised to conitinue infusion in absence of AP or DR

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68
Q

Diazapam injection class and description

A

benzodiazapine used to terminate seizures

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69
Q

Diazapam injection presentation

A

10mg/2ml ampoule

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70
Q

Diazapam injection administration

A

IV/IO

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71
Q

Diazapam injection indications

A

seizures

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72
Q

Diazapam injection contraindications

A

known severe adverse reaction
respiratory depression
shock
depressed vital signs or ETOH related altered GCS

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73
Q

Diazapam injection dose

A

Adult: 5mg IV/IO repeat X1 PRN
Paeds: 0.1mg/kg IV/IO repeat X 1 PRN

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74
Q

Diazapam injection pharmacolgy/action

A

benzodiazapine sedative
inhibits the fireing of the hyperexcitable neurons through the enhancement of the action of the inhibitory transmitter GABA
results in CNS depression, anticonvulsant, sedative, skeletal muscle relaxant effects

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75
Q

Diazapam injection side effects

A 
SHORT TERM
hypotension
resp depression
drowsy/lightheaded (the next day)
LONG TERM
confusion and ataxia especially in elderly
amnesia
dependence,
paradoxial increase in aggression
muscle weakness
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76
Q

Diazapam injection notes

A

titrate to effect

max dose includes any given by others prior to arrival

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77
Q

diazapam rectal solution class and description

A

benzodiazapine used to terminate seizures

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78
Q

diazapam rectal solution presentation

A

rectal tube
2.5mg/1.25 ml (2mg/ml)
5mg/2.5ml (2mg/ml)
10mg/2.5ml (4mg/ml)

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79
Q

diazapam rectal solution administration

A

PR

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80
Q

diazapam rectal solution indications

A

seizure

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81
Q

diazapam rectal solution contraindications

A

known severe adverse reaction
resp depression
shock
depressed vital signs or ETOH related altered GCS

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82
Q

diazapam rectal solution dose

A

Adult: 10mgPR repeat X1PRN max 20mg
Peads: 8 yrs 10mg PR

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83
Q

diazapam rectal solution pharmocology/action

A

benzodiazapine sedative
inhibits the fireing of the hyperexcitable neurons through the enhancement of the action of the inhibitory transmitter GABA
results in CNS depression, anticonvulsant, sedative, skeletal muscle relaxant effects

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84
Q

diazapam rectal solution side effects

A 
SHORT TERM
hypotension
resp depression
drowsy/lightheaded (the next day)
LONG TERM
confusion and ataxia especially in elderly
amnesia
dependence,
paradoxial increase in aggression
muscle weakness
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85
Q

diazapam rectal solution notes

A

be aware of pt modesty
should be administered in presence of 2nd person
egg/soya beans used in manufacture and allergies may be encountered
max dose includes any meds given prior to arrival

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86
Q

epinepherine 1:10000 class and description

A

sympathetic agonist naturally occuring catecholamine. potent alpha and beta adrenergic stimulant however effects on beta receptors is more profound

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87
Q

epinepherine 1:10000 presentation

A

pre-filled syringe

1mg/10ml (1:10000) as 0.1mg/ml

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88
Q

epinepherine 1:10000 indications

A

Cardiac arrest

Peadiatric bradycardia unresponsive to other measures

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89
Q

epinepherine 1:10000 contraindications

A

known severe adverse reaction

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90
Q

epinepherine 1:10000 dose

A

ADULT: CARDIAC ARREST: 1mg (1:10000) IV/IO repeat 3-5 mins
PAEDS: CARDIAC ARREST: 0.01mg/kg (10mcg/kg) (0.1ml/kg) repeat 3-5 mins
BRADYCARDIA: 0.01mg/kg (10mcg/kg) (0.1ml/kg) of 1:10000 IV/IO every 3-5 mins

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91
Q

epinepherine 1:10000 pharmacology/action

A

alpha and beta adrenergic stimulant
increase HR - chronotropic effect
increase myocardial contractions - inotropic effects
increase BP
Increase electrical activity in myocardium
increase cerebral / coronary blood flow
dilation of bronchioles

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92
Q

epinepherine 1:10000 side effects

A

in non cardiac arrest patients
palpatations
tachyarrythmias
hypertension

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93
Q

epinepherine 1:10000 notes

A

double check concentrations on packet prior to use

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94
Q

Fentanyl class and description

A

synthetic narcotic analgesic with rapid onset and short duration of action
half life of 6.5mins when IN route used

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95
Q

Fentanyl presentation

A

100mcg/2ml ampoule (0.1mg/2ml)

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96
Q

Fentanyl indications

A

acute severe pain in patients greater than/equal to 1 yr old

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97
Q

Fentanyl contraindications

A 
known fentanyl hypersensitivity
ALoC (altered Level of conciousness)
Bilateral occluded nasel passage
Nasal trauma
epistaxis
hypovolemia
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98
Q

Fentanyl dose

A

ADULT: 0.1mg IN repeat once after 10mins PRN
PAED: 0.0015mg/kg (1.5mcg/kg) IN repeat once after 10 mins PRN

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99
Q

Fentanyl pharmacology/action

A

fentanyl provides some of the effects typical of other opioids through its agonism of the opioid receptors. it’s strong potency in relation to that of morphine is largely due to its high lipophilicity. because of this, it can easily penetrate into the CNS.
fentanyl binds to u-opioid G-protein-coupled receptors which inhibit pain nuerotransmitter release by decreasing intracellular Ca2+ levels.

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100
Q

Fentanyl side effects

A 
SHORT TERM
sedation
nausea
vomiting
LONG TERM
vomiting
resp depression
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101
Q

Fentanyl notes

A

USE IN CAUTION IF PT HAS TRANSDERMAL FENTANYL PATCH
include an aditional 0.1ml to allow for the dead space in the mucosal atomisation device (MAD) in the calculated volume required
Administer 50% volume into each nostril if more than 1ml

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102
Q

Frusomide injection class and description

A

a loop diuretic

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103
Q

Frusomide injection

A

2ml, 5ml and 25ml ampoule

10mg/ml per ampoule

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104
Q

Frusomide injection administration

A

IV

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105
Q

Frusomide injection indications

A

pulmonary oedema

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106
Q

Frusomide injection contraindications

A

pregnancy
hypokalaemia
known severe adverse reaction

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107
Q

Frusomide injection dose

A

adult : 40mg slow IV

Paeds: not indicated

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108
Q

Frusomide injection pharmacology/action

A

Acts on the acending loop of henle by inhibiting the reabsorption of cloride and sodium ions into the interstitial fluid. results in reletive hypertonic state. water is therfore retained in the loop and eliminated via the bladder
causes venodilation which reduces venous return to the heart

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109
Q

Frusomide injection side effects

A 
SHORT TERM
headache                 transient deafness
dizziness                  diarrhoea
hypotension             nausea
arrhythmias              vomiting
LONG TERM
hyperuricaemia       gout
hypokaelemia         hyperglycaemia
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110
Q

Frusomide injection notes

A

frusomide should be protected from light

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111
Q

Glucagon class and description

A

hormone and antihypoglaecaemic
Glucagon is a protein secreted by the alpha cells of the islets of langerhans in the pancreas. it is used to increase the blood glucose level in cases of hypoglycaemia in which an IV cannot immediatly be placed

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112
Q

Glucagon presentation

A

1mg vial powder and solution for reconstitution (1ml)

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113
Q

Glucagon asministration

A

IM

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114
Q

Glucagon indications

A

hypoglycaemia in patients unable to take oral glucose or unable to gain IV access with a BGL

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115
Q

Glucagon contraindications

A

known severe adverse reactions

phaeochromocytoma

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116
Q

Glucagon dose

A

ADULT: 1mg IM
PAEDS: 8 1mg IM

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117
Q

Glucagon pharmacology/action

A

glycogenisis

increases plasma glucose by mobilising gycogen stored within the liver

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118
Q

Glucagon side effects

A

rare, may cause hypertension, dizziness, headache, nausea, vomiting

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119
Q

Glucagon notes

A

may be ineffective in patients with low stored glycogen eg prior use in 24hrs, alcoholic patients or liver disease
store in refridgerator
protect from light

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120
Q

glucose gel class and description

A

antihypoglycaemic

synthetic glucose paste

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121
Q

glucose gel presentation

A

glucose gel in a tube or sachet

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122
Q

glucose gel administration

A

buccal administration

administer gel inside patients cheek and gently massage outside of cheek

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123
Q

glucose gel indications

A

hypoglycaemia

BGL

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124
Q

glucose gel contraindications

A

known severe adverse reactions

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125
Q

glucose gel dose

A

ADULT: 10-20g buccal
repeat PRN
PAEDS 8 yrs 10-20g buccal
repeat PRN

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126
Q

glucose gel pharmacology and action

A

increase blood glucose levels

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127
Q

glucose gel side effects

A

may cause vomiting in pts

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128
Q

glucose gel notes

A

glucose gel will maintain glucose levels once raised but should be used secondary to Dextrose to reverse hypogycaemia
PROCEED WITH CAUTION
pts with airway compromise
pts with altered GCS

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129
Q

Glyceryl Trinitrate (GTN) clas snad description

A

Nitrate
special preperation of Glyceryl Trinitrate (In an aerosel form that delivers precisily 0.4mg of Glyceryl Trinitrate per spray

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130
Q

Glyceryl Trinitrate (GTN) presentation

A

aerosol spray: metered dose 0.4mg (400mcg)

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131
Q

Glyceryl Trinitrate (GTN) administration

A

Sublingual
hold pump spray vertically with valve uppermost
place as close to mouth as possible and spray under tongue
mouth should be closed after each dose

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132
Q

Glyceryl Trinitrate (GTN) indications

A

angina
suspected MI
Pulmonary oedema

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133
Q

Glyceryl Trinitrate (GTN) contraindications

A

SBP

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134
Q

Glyceryl Trinitrate (GTN) dose

A

ADULT: AMI/Angina - 0.4mg (400mcg) SL repeat 3-5 min intervals Max 1.2mg (3doses)
Pulmonary oedema 0.8mg (800mcg) SL repeat once

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135
Q

Glyceryl Trinitrate (GTN) pharmacology/action

A

vasodilator
releases nitric oxide which acts as a vasodilator.
dilates coronary arteries particularly if in spasm increasing blood flow to myocardium
dilates systemic veins reducing venous return to the heart (preload) and thus reducing hearts workload
reduces BP

136
Q

Glyceryl Trinitrate (GTN) side effects

A

headache
transient HTN
flushing
dizziness

137
Q

Glyceryl Trinitrate (GTN) notes

A

if new pump of 1/7 since last use, first spray should be administered into the air

138
Q

Hartmann’s Solution description and class

A

Isotonic crystalloid solution containing Sodium cloride 0.6%, Sodium lactate 0.25% Potassium chloride 0.04%, Calcium chloride 0.027%

139
Q

Hartmann’s Solution presentation

A

soft pack for infusion 500ml and 1000ml

140
Q

Hartmann’s Solution administration

141
Q

Hartmann’s Solution indications

A

when NaCl is unavailable it may be substituted with Hartmann’s IV/IO, except for crush injuries, burns, renal failiure and hyperglycaemia

142
Q

Hartmann’s Solution contraindications

A

known severe adverse reactions

143
Q

Hartmann’s /NaCl Dose for Crush injury/suspension trauma/PEA/Asystole

A

20ml/kg IV/IO

hypothermia

144
Q

Hartmann’s /NaCl Dose for hypothermia

ADULTS and PAEDS

A

ADULTS: 250ml IV/IO (warm fluids to 40oC) repeat max 1L
PAEDS: 10ml/kg IV/IO (warm fluids to 40oC) repeat PRN X1

145
Q

Hartmann’s /NaCl dose for # NOF, sepsis, symptomatic bradycardia

A

250ml IV infusion

146
Q

Hartmann’s /NaCl dose for decompression illness, sepsis with poor perfusion

A

500ml IV/IO infusion

147
Q

Hartmann’s /NaCl dose for shock from blood loss

A

500ml IV/IO infusion. Repeat in 250ml bolus PRN to maintain SBP of 90-100mmHg
120mmHg for head injury GCS

148
Q

Hartmann’s /NaCl dose for Burns for adults

A

> 25% TBSA and/or 1hr from time of injury to ED, 1000ml IV/IO infusion
10% TBSA consider 500ml IV/IO

149
Q

Hartmann’s /NaCl dose for Burns for paeds

A

> 25% TBSA and/or 1hr from time of injury to ED,
5-10 yrs 250ml IV/IO
.10 yrs 500ml IV/IO

150
Q

Hartmann’s /NaCl dose for adrenal insufficiency, Glycaemic emergency, Heat -related emergency, sickle cell crisis for adults

A

100ml IV/IO

151
Q

Hartmann’s /NaCl dose for adrenal insufficiency, Glycaemic emergency, Heat -related emergency, sickle cell crisis for paeds

A

20ml/kg IV/IO

152
Q

Hartmann’s /NaCl dose for anaphylaxis

A

ADULTS: 100ml IV/IO repeat X 1 PRN
PAEDS: 20ml/kg IV/IO repeat X 1 PRN

153
Q

Hartmann’s /NaCl dose for post resus care

A

ADULTS: 1000ml IV/IO infusin cooled to 4oC if persistant to maintain SBP > 90mmHg
PAEDS: 20ml/kg IV/IO infusion if persistant poor perfusion

154
Q

Hartmann’s pharmacology/action

A

increases extracellular volume

155
Q

Hartmann’s side effects

A

if admistered in large amounts can cause oedema

156
Q

Hartmann’s notes

A

observe in pts with phx of CCF
also called solium lactate or compound ringer lactate
warm prior to administration if possile

157
Q

Hydrocortisone class and description

A

Potent Corticosteroid wth anti-inflammatory properties

158
Q

Hydrocortisone presentation

A

powder and solvent for solution for injection or infusion. Vial conaining off-white powder and vial containing water forinjections. Prepare the olution aseptically by addin not more than 2ml of sterile water for injection to contnts of one 100g vial. Shake and withdraw use.

159
Q

Hydrocortisone administration

A

IV infuion - preffered for initial emergency use

IM injection

160
Q

Hydrocortisone indications

A

Sverof reoccurrent anaphylactic reactions
Asthma refactory to Salbutamol and Ipatropium Bromide
Exacerbation of COPD
Adreal insufficiency

161
Q

Hydrocortisone contraindicatios

A

No acute containdications in acute management of anaphylaxis

162
Q

Hydrocortisone dose for anaphylactic reactions

ADULT: exacebation of COPD

A

ADULT: 200g IV (infsion in 100ml NaCl) or IM
PAEDS: 5 yrs100mg IV infusion in 100ml

163
Q

Hydrocortisone dose for Asthma

A

ADULT: 100mg IV infusion in 100ml
PAEDS: 5 yrs100mg IV infusion in 100ml

164
Q

Hydrocortisone pharmacology/action

A

Potent anti-inflammatory properties and inhibits many substances tha cause inflammaton

165
Q

Hydrocortisone side effects

A

SHORT TERM
CCF nausea
Hypertension malaise
abdominal distension hiccups
vertigo headache
LONG TERM
Adrenal cortical atrophy develops during prolonged therepy and may persst for months after stopping treatment

166
Q

Hydrocortisone notes

A

IM injection sould avoid deltoid area due to possibility of tissue atrophy
Dose should not be less thn 25mg
IV is perfered route for adrenal crisis

167
Q

Ibuprofen class and description

A

Non-Steroial Anti-Inflammatory Drugs NSAIDS analgesic

168
Q

Ibuprofen presentation

A

suspension 100mg/5ml
200mg tablet
400mg tablt

169
Q

Ibuprofen administration

170
Q

Ibuprofen indications

A

Mild to Moderate pain

171
Q

Ibuprofen contraindications

A

not suitabe for children

172
Q

Ibuprofen dose

A

ADULT: 400mg PO
PAEDS: 10mg/kg PO

173
Q

Ibuprofen pharmacology/action

A

Supresses prostaglandins which cause pai via the inhibition of cyclooxgenase (COX). Prostgrandlins are released by cell damage and inflammation

174
Q

Ibuprofen side effects

A

SHORT TERM
skin rashes GIT intolerence
bleeding
LONG TERM
Occasional GIT bleeding an ulceration can occur. May be also cause of acute renal failure, intestitial nephritis and NSAIDS-associated nephropathy

175
Q

Ibuprofen notes

A

if Ibuprofen given inperious 6 hrs, adjust dose downward by mount given by other sourcesresulting in max 10mg/kg
Caution with significant burns or poor perfusion due to risk of kidney failure
Caution ith oncurrent NSAID use

176
Q

Ipratropium Bromide descripton and class

A

Anticholinergic

Parasympatholytc bronchodilator that is chemically related to atropine

177
Q

Ipratropium Bromide presentation

A

Nebuised solution 0.25mg (250mcg) in 1ml

178
Q

Ipratropium Bromide administration

A

Nebulised (NEB) mixed with age specific dose of salbutamol

179
Q

Ipratropium Bromide indications

A

Acute moderate asthma or exacerbation of COPD not responding to iniial sulbutamol dose

180
Q

Ipratropium Bromide contraindications

A

Known severe adverse reaction

181
Q

Ipratropium Bromide pharmacology/action

A

It bloks muscarinic receptors associated with prasympathetic stimulation of the bronchial air passageways. Thisresults in bronchiol dilation and reduced brochial secretions

182
Q

Ipratropium Bromide side effects

A

transient dry mouth,
blurred vision,
tachycardia
headache

183
Q

Lidocaine class and description

A

Ventricular antiarrhythmic agent

184
Q

Lidocaine presentation

A

Lidocaine injection minijet 1%w/v 100mg/10ml

185
Q

Lidocaine administration

186
Q

Lidocaine indications

A

When amiodarone is not available it may bsubstituted with Lidocaine for VF/VT arrest

187
Q

Lidocaine contraindications

A

Nil in cardiac arrests

188
Q

Lidocaine dose

A

ADULT: 1-1.5mg/kg IV/IO
PAEDS: not indicated

189
Q

Lidocaine pharmacolgy/actions

A

redces automacticity by decreasing rateof diastolic depolarisation. Stabalises the neuronal membranes and prevents the initiation and transmissin of nerve impulses, action is rapid and blockade an last up to 2 hrs

190
Q

Lidocaine side effects

A

drowsiness dizziness twitching
paraesthesia convulsions bradycardia
resp depression

191
Q

Lidocaine notes

A

Lidocaine cannot be dministered if Amiodarone has been administered

192
Q

Lorazepam class and description

A

Benzodiazepine

anxiolytic used as sedative

193
Q

Lorazepam presentation

A

1mg tablet

194
Q

Lorazepam administration

195
Q

Lorazepam indications

A

combative with hullucinations or paranoia and risk to self/others

196
Q

Lorazepam contraindications

A

History f sensitivity to benzodiazapines
Severe hpatic or pulmonary insufficiency
suspected significant ETOH and/or other sedatives injested
Known severe adverse reaction

197
Q

Lorazepam dose

A

ADULT: 2mg PO
PAEDS:not indicated

198
Q

Lorazepam pharmacology/action

A

acts CNS receptors to potentiate the inhibitory action of GABA

199
Q

Lorazepam side effects

A

Drowsiness confusion headache
dizziness blurred vision nausea/vomiting
RARE: hypotension
hypertension

200
Q

Magnesium Sulphate injection description and class

A

Electrolyte and Tocolytic agent

A salt that is essential element in numerous biochemical reactions that occur within the body

201
Q

Magnesium Sulphate injection presentation

A

5g/10ml ampoule

202
Q

Magnesium Sulphate injection administration

203
Q

Magnesium Sulphate injection indications

A

Torsades de pointes
persistant brochospasm
seizure associated with eclampsia

204
Q

Magnesium Sulphate injection contraindications

A

Nil in cardiac arrest

Known severe adverse reaction

205
Q

Magnesium Sulphate injection dose

A

pulseless torsades de pointes: 2g IV/IO Torsades de pointes/bronchospasm: 2g IV/IO infusion in 100ml NaCl
seizure associated with eclampsia: 4g IV/IO infusion in 100ml NaCl

Not indicated for Paeds

206
Q

Magnesium Sulphate injection pharmacology/action

A

it acts as a physiological calcium channel blocker and blocks neurotransmitter transmission

207
Q

Magnesium Sulphate injection side effects

A

decreased deep tendon reflexes
resp depression
bradycardia
hypothermia

208
Q

Midazolam solution class and description

A

Benzodiazapine

potent sedative agent 3-4 X more potent than diazapam

209
Q

Midazolam solution presentation

A 
10mg/2ml ampoule
10mg/5ml ampoule
Buccal liquid 50mg/5ml
pre-filled syringe 2.5mg/0.5ml
pre-filled syringe 5mg/1ml
pre-filled syringe 7.5mg/1.5ml
pre-filled syringe 10mg/2ml
pre-filled syringe 10mg/1ml
210
Q

Midazolam solution administration

A

IN
buccal
IV/IO
IM

211
Q

Midazolam solution indications

A

seizures

combative with hullucinations/paranonia and risk to self/others

212
Q

Midazolam solution contraindications

A

Shock
depressed vital signs or ETOH related altered GCS
Resp depression
known severe adverse reaction

213
Q

Midazolam solution adult dose

A

seizure/combative pt

2.5 mg IV/IO or 10mg buccal or 5mg IN repeat X 1 PRN

214
Q

Midazolam solution paeds dose

A 
Seizure
 10yrs: 10mg buccal
or
0.2mg/Kg IN or 0.1mg/kg IV/IO
repeat X1 PRN
215
Q

Midazolam solution pharmacology/action

A

affects the activity of a chemical that transmits impulses across synapses called Gamma-AminioButyric Acid (GABA) GABA is an inhibitory neurotransmitter.
Midazolam works by increasing the effect of GABA at these receptors

216
Q

Midazolam solution side effects

A

resp depression
headache
hypotension
drowsiness

217
Q

Midazolam solution notes

A

titrate to effect
ensure resus equipment and 02 available prior to administration
no more than 2 doses by practitioners
take into account doses given prior to paramedic arrival
contraindications other than KSAR refer to non seizing pts

218
Q

Morphine Sulphate class and description

A

Narcotic analgesic

CNS depressant and potent analgesic with haemodynamic properties that make it extremely usefull in emergency medicine

219
Q

Morphine Sulphate presentation

A

10mg/1ml ampoule (dilute with 9ml NaCl to make 10mg/10ml

suspension 10mg/5ml

220
Q

Morphine Sulphate administration

A

PO
IM
IV/IO

221
Q

Morphine Sulphate indications

A

ADULT: severe pain > 7/10
PAEDS: severe pain > 7/10

222
Q

Morphine Sulphate contraindications

223
Q

Morphine Sulphate adult dose

A

2mg IV/IO

repeat at not

224
Q

Morphine Sulphate paeds dose

A

0.3mg/kg (300mcg/kg) PO max dose 10mg
0.05 mg/kg (50mcg/kg) IV/IO
repeat not at

225
Q

Morphine Sulphate pharmacology/action

A

Opiate analgesic
acts on central nervous system to reduce pain/anxiety
vasodilation resulting in reduced preload to myocardium

226
Q

Morphine Sulphate side effects

A 
resp depression
drowsiness
nausea/vomiting
constipation
long term use can lead to drug dependence
227
Q

Morphine Sulphate notes

A

use with extreme caution particularly with elderly/young
caution with acute resp depression
caution with reduced GCS
not recommended for headache
controlled under Misuse of drugs act (1977,1984)

228
Q

Naloxone class and description

A

narcotic analgesic which is effective in management and reversal of overdose caused by narotic or sythetic narotic agents

229
Q

Naloxone presentation

A

0.4mg/1ml (400mcg/1ml) ampoule or pre loaded syringe

230
Q

Naloxone administration

A

IN
SC
IM
IV/IO

231
Q

Naloxone indications

A

inadequate respirations and/or altered GCS following known or suspected narcotic overdose

232
Q

Naloxone contraindications

A

known severe adverse reaction

233
Q

Naloxone adult dose

A

0.4mg (400mcg) IV/IO/IM/SC
0.8mg (800mcg) IN
repeat dose after 3 min PRN max 2mg

234
Q

Naloxone paeds dose

A

0.01mg/kg (10mcg) IV/IO,IM/SC
0.02mg/kg (20mcg) IN
Repeat dose PRN to maintain opioid reversal to max 0.1mg/kg or 2mg

235
Q

Naloxone pharmacology/action

A

narcotic antagonist that reverses the resp and analgesic effects of narcotics

236
Q

Naloxone side effects

A

acute reversal of narotic effects ranging from nausea/vomiting to agitation and seizures

237
Q

Naloxone notes

A

use in caution with pregnancy
administer with caution to patients who have taken large doses of narcotics or are physically dependant
prepare to deal with aggressive pts

238
Q

Nifedipine class and description

A

tocolytic agent

dihydropyridine calcium channel blocker

239
Q

Nifedipine presentation

A

20mg tablet

240
Q

Nifedipine administration

241
Q

Nifedipine indications

A

prolapsed cord

242
Q

Nifedipine contraindications

A

hypotension

known severe adverse reaction

243
Q

Nifedipine dose

A

20mg PO

not indicated in paeds

244
Q

Nifedipine pharmacology/action

A

inhibits muscle contraction by interfering with the movement of calcium ions through the slow channels of active cell membranes

245
Q

Nifedipine side effects

A

hypotension
headache
bradycardia
nausea/vomiting

246
Q

Nifedipine notes

A

close monitoring of maternal pulse/BP is required

continous fetal monitoring should be carried out if possible

247
Q

Entonox class and description

A

potent analgesic gas contains a mix of nitous oxide and oxygen

248
Q

Entonox presentation

A

cylinder, coloured blue with white and triangles on cylinder shoulders
medical gas Nitrous Oxide 50% Oxygen 50%

249
Q

Entonox administration

A

self administered

250
Q

Entonox indications

A

pain relief

251
Q

Entonox contraindications

A 
altered GCS
chest injury/pneumothorax
shock
recent scuba dive
decompression sickness
intestinal obstruction
inhalation injury
Carbon monixide poisoning
known sever adverse reaction
252
Q

Entonox dose

A

adults and paeds

self administer until pain relieved

253
Q

Entonox pharmacology and action

A

analgesic agent gas
CNS depressant
pain relief

254
Q

Entonox side effects

A

disinhibition
decreased GCS
lightheadedness

255
Q

Entonox notes

A

dont use if patient cannot understand instructions
in cold temp warm cylinder and invert to ensure gas mixture
AP can use with descretion for minor chest injuries
brand name Entonox
has addictive properties
caution in using > 1 hr for sickle cell crisis

256
Q

Ondansetron class and description

A

Antiemetic used in management of nausea/vomiting

potent, highly selective 5 HT3 receptor antagonist

257
Q

Ondansetron presentation

A

4mg/2ml ampoule

258
Q

Ondansetron administration

259
Q

Ondansetron indications

A

management, preventiona and treatment of nausea/vomiting

260
Q

Ondansetron contraindications

A

known severe adverse reaction

261
Q

Ondansetron pharmacology/action

A

precise action in the control of nausea/vomiting is unknown

262
Q

Ondansetron side effects

A

headache
sensation of warmth
flushing
hiccups

263
Q

Oxygen class and description

A

odourless, colourless, tasteless gas necessary to life

264
Q

Oxygen presentation

A

D, E, F cylinders coloured black with white shoulders
CD cylinder (White)
medicsl gas

265
Q

Oxygen administration

A 
inhalation via:
high concentration reservoir (non rebreather) mask
simple face mask
venturi mask
tracheostomy mask
nasal cannulae
BVM
266
Q

Oxygen indications

A

adbsent/inadequate ventilation following acute medicsl or traumatic event
SpO2

267
Q

Oxygen contraindications

A

bleomycin lung injury

268
Q

Oxygen dose adults

A

cardiac, resp arrest, sicke cell crisis; 100%
life threats identified in primary survey 100% until reliable SpO2 reading obtained the titrate to achieve SpO2 of 94-98%
COPD exasebation administer O2 titrate to achive SpO2 92% or as specified on COPD O2 alert card
all other medical/trauma titrate to achive SpO2 94-98%

269
Q

Oxygen dose paeds

A

cardiac, resp arrest, sicke cell crisis; 100%
life threats identified in primary survey 100% until reliable SpO2 reading obtained the titrate to achieve SpO2 of 96-98
all other medical/trauma titrate to achive SpO2 94-98%

270
Q

Oxygen pharmacology/action

A

oxygenation of tissues/organs

271
Q

oxygen side effects

A

Oxygen prolonged use of O2 in pts with chronic COPD may lead to reduction in venntilation stimulis

272
Q

oxygen notes

A

written record of what O2 therepy administered to each pt
document sats with RA or on O2 as applicable
consider humidifier if 02 terepy for paeds > 30 mins duration
caution with paraquat poisoning -administerO2 if SpO2

273
Q

Paracetamol class and description

A

analgesic and antipyretic used to reduce pain and body temperature

274
Q

Paracetamol presentation

A

rectal suppository - 180mg, 90mg, 60mg
suspension - 120mg/5ml, 250mg/5ml
500mg tablet

275
Q

Paracetamol administration

276
Q

Paracetamol indications

A

pyrexia

minor to moderate pain 1-6/10 for adult/paeds

277
Q

Paracetamol contraindications

A

known severe adverse reaction

chronic liver disease

278
Q

Paracetamol dose adult

A

1g (2xtablets) PO

279
Q

Paracetamol Dose paeds

280
Q

Paracetamol pharmacology/action

A

Analgesic - prostgrandlin inhibitor

antipyretic - prevents a hypothalmus from synthesising prostgrandlin E, inhibiting the body temp from rising further

281
Q

Paracetamol side effects

A

long term damage at high doses can cause liver damage and less frequently, renal damage

282
Q

Paracetamol notes

A

paracetamol is contained in paracetamol suspension and other over the counter drugs
consult with parent/gaurdian in relation to medication prior to arrival on scene
PR- beware of modesty of pt, should be administered in presence of 2nd person
if paracetamol administered within previous 4 hrs, adjust dose downward by the amount given by other sources resulting in max dose 20mg/kg

283
Q

Salbutamol class and description

A

sypathetic agonist that is selective to beta-2 adrenergic receptors

284
Q

Salbutamol presentation

A

2.5mg/5ml nebule
5mg/2.5ml nebule
aerosol inhaler: metered dose 0.1mg (100mcg)

285
Q

Salbutamol administration

A

nebuliser

inhalation via aerosol inhaler

286
Q

Salbutamol indications

A

bronchospasm
exacerbation of COPD
resp distress folowing submersion incident

287
Q

Salbutamol contraindications

A

known severe adverse reaction

288
Q

Salbutamol dose adult

A 
5mg NEB (or 0.1mg metered aerosol spray) X5
repeat at 5 min intervals
289
Q

Salbutamol dose paeds

A

5 yrs - 5mg NEB ( or 0.1mg metered aersosol spray X5)

repeat at 2 mins PRN

290
Q

Salbutamol pharmacolody/action

A

Beta-2 agonist
bronchodilation
smooth muscle relaxation

291
Q

Salbutamol side effects

A

Tachycardia
tremors
tachyarrhymias
high doses can cause hypokalaemia

292
Q

Salbutamol notes

A

more efficiant to use volumiser in conjuction with aerosol inhaler when administering salbutamol
if an 02 driven nebuliser is used to administer salbutamol fora patient with acute exaserbation of COPD, it should be limited to 6 mins max

293
Q

Sodium Bicarbonate class and description

A

a salt that is an alkalinizing agent and electolyte supplement

294
Q

Sodium Bicarbonate presentation

A

glass vial 8.4% in 100 ml

295
Q

Sodium Bicarbonate administration

296
Q

Sodium Bicarbonate indications

A

wide complex arrhythmias and/or seizures following trycyclic antidepresant (TCA) OD
cardiac arret following TCA OD
cardiac arrest following harness induced suspension trauma

297
Q

Sodium Bicarbonate contraindications

A

known severe adverse reaction

298
Q

Sodium Bicarbonate pharmacology/action

A

TCA excretion is ehnaced by making the urine more alkaline ( raising pH)

299
Q

Sodium Bicarbonate dose

A

1 mEq/kg (1ml/kg 8.4% solution) Max 50 mEq (50ml 8.4%)

300
Q

Sodium Bicarbinate side effects

A

nil when used in emergency

301
Q

Sodium Chloride 0.9% (NaCl) description and class

A

isotonic crystalloid solution of sodium and chloride

known also as Normal saline

302
Q

Sodium Chloride 0.9% (NaCl presentationn

A

soft pack for infusion 100ml, 500ml, 1000ml

ampoules of 10ml

303
Q

Sodium Chloride 0.9% (NaCl administration

A

IV infusion
IV flush
IO

304
Q

Sodium Chloride 0.9% (NaCl indications

A

IV/IO Fluid for pre-hospital care

305
Q

Sodium Chloride 0.9% (NaCl contraindications

A

known severe adverse reactions

306
Q

Sodium Chloride 0.9% (NaCl pharmacology/action

A

Isotonic crystalloid solution

fluid replacement

307
Q

Sodium Chloride 0.9% (NaCl side effects

A

excessive volume replacement can lead to heart failure

308
Q

Sodium Chloride 0.9% (NaCl notes

A

NACl is the IV/IO fluid of choice for pre-hospital emergency care
for TKVO use 500ml pack only

309
Q

Syntometrine class and description

A

sythetic hormone

ergometrine malaeate 0.5mg and sythetic oxytocin 5 units/ml

310
Q

Syntometrine presentation

A

1ml ampoule

311
Q

Syntometrine administration

312
Q

Syntometrine indications

A

control post-partum haemhorrage

313
Q

Syntometrine contraindications

A

severe liver, kidney or cardiac dysfunction
sepsis
known severe adverse reaction

314
Q

Syntometrine dose

A

1ml IM

not indicated in paeds

315
Q

Syntometrine pharmacology/action

A

causes rythmic contraction of uterine smooth muscle, thereby constricting uterine blood vessels

316
Q

Syntometrine side effects

A 
nausea/vomiting
abdo pain
headache
dizzines
cardiac arrhythmias
317
Q

Syntometrine notes

A

ensure that a second foetus in not in uterus prior to administration

318
Q

Ticagrelor class and description

A

platelet aggregation inhibitor

inhibits platelet function

319
Q

Ticagrelor presentation

A

90mg tablet

320
Q

Ticagrelor administration

321
Q

Ticagrelor indications

A

identification of STEMI IF TRANSPORTING TO PPCI centre

322
Q

Ticagrelor contraindications

A

hypersensitivity to the active substance (Ticagrelor) or to any other excipients
active pathological bleeding
Hx of intercranial haemhorrage
moderate to severe hepatic impairement

323
Q

Ticagrelor dose

A

loading dose 180mg PO

not indicated in paeds

324
Q

Ticagrelor pharacology/action

A

selective adenosine diphosphate (ADP) receptor antagonist
acting on P2Y12 ADP-receptor which can prevent ADP- mediated platelet activation and aggregation.
Ticagrelor is orally active
reversibly interacts with platelet P2Y12 ADP receptor
Ticagrelor does not interact with ADP binding site itself, but interacts with platelet P2Y12 ADP receptor to prevent signal transduction

325
Q

Ticagrelor side effects

A

COMMON:
dysponea, epistaxis, GIT haemhorrage, SC or dermal bleeding, bruising and procedual site haemhorrage
other undesirable effects include :
Intercranial bleeding, elevations of serum creatinine and uric acid levels
consult SmPC for full list

326
Q

Ticagrelor notes

A

AP/P authoristed to administer Ticagrelor 180 mg PO following ID of STEMI and medical practitioner instructions
If pt has been loaded with antiplatelent medication (other than asprin) prior to arrival of practitioner, pt should not receive Ticagrelor

327
Q

Tranexamic Acid description and class

A

Anti-fibrinolytic which reduces breakdown of clots

328
Q

Tranexamic Acid presentation

A

500mg/5ml ampoule

329
Q

Tranexamic Acid administration

330
Q

Tranexamic Acid indications

A

suspected significant internal/external haemhorrage assosciated with trauma

331
Q

Tranexamic Acid contraindications

A

hypersensitivity to active substance or its excipients
Acute venous or arterial thrombosis
hx of convulsions
severe hepatic impairement

332
Q

Tranexamic Acid dose

A

1g IV/IO infusion in 100ml NaCl

not indicated for paediatrics

333
Q

Tranexamic Acid pharmacology/action

A

TXA exerts an anti haemhorrage activity by inhibiting the activation of plasminogen to plasmin, by binding to specific sites of both plasminogen and plasmin, a molecule responsible for degradation of fibrin, a protein that forms the framework for blood clots

334
Q

Tranexamic Acid side effects

A

COMMON: Diarrhoea, vomiting, nausea

otehr undesirable effects include visual disturbances, impaired colour vision, dizziness and headache

335
Q

Tranexamic Acid

A

caution with head injury

DRUGS (4 decks)

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