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PME 2 Drugs Flashcards

1
Q

Sodium chloride 0.9% Indications

A
  • Inadequate tissue perfusion/ shock
  • Hypovolaemia
  • Significant burns >20% adult >10% Paed
  • To dissolve and dilute drugs
  • As a flush for IV or IO drug administration
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2
Q

Sodium chloride 0.9% Contraindications

A

Nil

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3
Q

Sodium chloride 0.9% Presentations

A
  • Ampule, 10 mL
  • Bag, 100 mL
  • Bag, 500 mL
  • 10 mL pre-filled syringe
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4
Q

Salbutamol Indications

A
  • Bronchospasm
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5
Q

Salbutamol Contraindications

A
  • Allergy
  • Pt < 1 year of age
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6
Q

Salbutamol Presentations

A
  • MDI, 100 microg / puff
  • Nebule, 2.5 mg / 2.5 mL
  • Nebule, 5 mg / 2.5 mL
  • Ampule, 500 microg / 1 mL
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7
Q

Salbutamol MDI dose - Bronchospasm (ADULT)

A

12 (1.2 mg) puffs
Repeated every 10 mins
No max dose

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8
Q

Salbutamol NEB dose - Bronchospasm (ADULT)

A

5 mg
Repeated PRN
No max dose

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9
Q

Salbutamol MDI dose - Bronchospasm (PAED 1-5 years)

A

6 (600 microg) puffs
Repeated every 10 mins
No max dose

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10
Q

Salbutamol MDI dose - Bronchospasm (PAED > 6 years)

A

12 (1.2 mg) puffs
Repeated every 10 mins
No max dose

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11
Q

Salbutamol NEB dose - Bronchospasm (PAED 1-5 years)

A

2.5 mg
Repeated PRN
No max dose

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12
Q

Salbutamol NEB dose - Bronchospasm (PAED > 6 years)

A

5 mg
Repeated PRN
No max dose

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13
Q

Ipratropium bromide indications

A
  • Moderate bronchospasm (unresponsive to initial QAS salbutamol NEB)
  • Severe bronchospasm
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14
Q

Ipratropium bromide contraindications

A
  • Allergy
  • Pt < 1 year
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15
Q

Ipratropium bromide presentation

A

Nebule, 250 microg / 1 mL

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16
Q

Ipratropium bromide NEB dose - Moderate bronchospasm (ADULT)

A

500 microg
Repeated at 20 min intervals
1.5 mg total MAX dose

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17
Q

Ipratropium bromide NEB dose - Severe bronchospasm (ADULT)

A

500 microg
Repeated at 20 min intervals
1.5 mg total MAX dose

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18
Q

Ipratropium bromide NEB dose - Moderate bronchospasm (PAED 1-5 years)

A

250 microg
Repeated at 20 min intervals
750 microg total MAX dose

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19
Q

Ipratropium bromide NEB dose - Severe bronchospasm (PAED 1-5 years)

A

250 microg
Repeated at 20 min intervals
750 microg total MAX dose

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20
Q

Ipratropium bromide NEB dose - Moderate bronchospasm (PAED >6 years)

A

500 microg
Repeated at 20 min intervals
1.5 mg total MAX dose

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21
Q

Ipratropium bromide NEB dose - Severe bronchospasm (PAED >6 years)

A

500 microg
Repeated at 20 min intervals
1.5 mg total MAX dose

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22
Q

Paracetamol indications

A
  • Mild to moderate pain
  • Fever causing distress
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23
Q

Paracetamol contraindications

A
  • Allergy
  • Pt < 1 month of age
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24
Q

Paracetamol presentation

A
  • Tablet, 500 mg
  • Elixir, 120 mg / 5 mL
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25
Q

Paracetamol PO dose - Mild to moderate pain (ADULT)

A

0.5 - 1 g
Repeated every 4 hours
4 g max dose in 24 hours

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26
Q

Paracetamol PO dose - Fever causing distress (ADULT)

A

0.5 - 1 g
Repeated every 4 hours
4 g max dose in 24 hours

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27
Q

Paracetamol PO dose - Fever causing distress (PAED > 1 month of age)

A

15 mg / kg
Single max dose of 1 g
Not to be administered with in 4 hours of previous paracetamol administration

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28
Q

Paracetamol PO dose - Mild to moderate pain (PAED > 1 month of age)

A

15 mg / kg
Single max dose of 1 g
Not to be administered within 4 hours of previous paracetamol administration

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29
Q

What is the formula for drug calculations

A

Dose x Volume / Stock strength

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30
Q

Ibuprofen indications

A

Moderate pain due to acute inflammation and tissue injury

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31
Q

Ibuprofen contraindications

A
  • Allergy to any NSAID or aspirin
  • Concurrent NSAID treatment
  • Current GI bleed to peptic ulcers
  • Dehydration and/ or hypovolamemia
  • Renal impairment
  • NSAID induced asthma
  • Heart failure
  • Pregnancy
  • ACE or ARB treatment
  • Pt < 13 years
  • Pt taking anticoagulant medications
  • Diuretic treatment
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32
Q

Ibuprofen presentation

A

Tablet, 200 mg

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33
Q

Ibuprofen PO dose - Moderate pain due to acute inflammation and tissue injury

A

200 - 400 mg
Must not be administered within 6 hours of previous dose

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34
Q

Ibuprofen PO dose (PEAD)

A

Ibuprofen is not indicated for paediatric patients

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35
Q

Methoyflurane indications

A

Pain

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36
Q

Methoxyflurane contraindications

A
  • Allergy
  • Pts < 1 year
  • Hx of significant liver or renal disease
  • Hx of malignant hyperthermia
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37
Q

Methoxyflurane presentation

A

Bottle, 3 mL

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38
Q

Methoxyflurane INH dose - Pain (ADULT)

A

3 mL
Repeat after 20 mins
6 mL total max dose

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39
Q

Methoxyflurane INH dose - Pain (PAED > 1 year)

A

3 mL
Single dose only

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40
Q

Morphine indications

A
  • Significant pain
  • Sedation
  • Autonomic dysreflexia
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41
Q

Morphine contraindications

A
  • Allergy
  • Kidney disease (renal failure)
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42
Q

Morphine presentation

A

Ampule, 10 mg / 1 mL

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43
Q

Morphine IM dose - Significant pain & Autonomic Dysreflexia (ADULT > 70 years)

A

2.5 - 5 mg
Repeated at up to 5 mg every 10 mins
10 mg total max dose

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44
Q

Morphine IM dose - Significant pain & Autonomic Dysreflexia (ADULT < 70 years)

A

2.5 - 5 mg
Repeated at up to 5 mg every 10 mins
20 mg total max dose

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45
Q

Morphine IV dose - Significant pain & Autonomic Dysreflexia (ADULT < 70 years)

A

2.5 - 5 mg
Repeated at up to 5 mg every 10 mins
20 mg total max dose

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46
Q

Morphine IV dose - Significant pain & Autonomic Dysreflexia (ADULT > 70 years)

A

2.5 - 5 mg
Repeated at up to 5 mg every 10 mins
10 mg total max dose

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47
Q

Morphine IM dose - Significant pain & Autonomic Dysreflexia (PAED > 1 year)

A

100-200 microg / kg
Single max dose 5 mg
Total max dose 200 microg / kg

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48
Q

Morphine IV dose - Significant pain & Autonomic Dysreflexia (PAED > 1 year)

A

100 microg / kg
Single max dose 2.5 mg
Total max dose 200 microg / kg

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49
Q

Ondensetron indications

A

Significant neausa and/ or vomiting

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50
Q

Ondansetron contraindications

A

ABSOLUTE
- Allergy
- Congenital long QT syndrome
- Apomorphine treatment
- Pt < 2 years

RELATIVE
- First trimester pregnancy

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51
Q

Ondansetron presentation

A
  • Ampule, 4 mg / 2 mL
  • ODT, 4 mg
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52
Q

Ondansetron IM dose - Significant nausea/ vomiting (ADULT)

A

4-8 mg
8 mg total max dose
Not to be given within 8 hours of previous dose

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53
Q

Ondansetron PO dose - Significant nausea/ vomiting (ADULT)

A

4-8 mg
8 mg total max dose
Not to be given within 8 hours of previous dose

54
Q

Ondansetron IV dose - Significant nausea/ vomiting (ADULT)

A

4-8 mg
Slow push over 2 - 3 mins
8 mg total max dose
Not to be given within 8 hours of previous dose

55
Q

Ondansetron PO dose - Significant nausea/ vomiting (PAED 2-4 years)

A

2 mg
Single dose only

56
Q

Ondansetron PO dose - Significant nausea/ vomiting (PAED > 5 years)

A

4 mg
Single dose only

57
Q

Ondansetron IM dose - Significant nausea/ vomiting (PAED > 2 years)

A

100 microg / kg (rounded to nearest 5 kg)
Single dose only
4 mg total max dose

58
Q

Ondansetron IV dose - Significant nausea/ vomiting (PAED > 2 years)

A

100 microg / kg
Single dose only
4 mg total max dose

59
Q

Hydrocortisone indications

A
  • Asthma (excluding mild)
  • Acute exacerbation of COPD with signs of respiratory distress
  • Refractory Anaphylaxis with persistent wheeze (refractory to 3 x IM adrenaline)
  • Suspected or at risk of acute adrenal insufficiency
60
Q

Hydrocortisone contra indications

61
Q

Hydrocortisone presentation

A

Vial (powder or powder and solvent), 100 mg

62
Q

Hydrocortisone preparation

A

Each 100 mg vial is to be reconstituted with 2 mL of water for injection

63
Q

Hydrocortisone IM dose - Asthma, acute exacerbation of COPD & adrenal crisis (ADULT)

A

100 mg
Single dose only

64
Q

Hydrocortisone IV dose - Asthma, acute exacerbation of COPD & adrenal crisis (ADULT)

A

100 mg
Slow push over 1 min
Single dose only

65
Q

Hydrocortisone IM dose - Refractory anaphylaxis (ADULT)

A

200 mg
Single dose only

66
Q

Hydrocortisone IV dose - Refractory anaphylaxis (ADULT)

A

200 mg
Slow push over 1 min
Single dose only

67
Q

Hydrocortisone IV dose - Asthma & Refractory anaphylaxis (PAED)

A

4 mg / kg
Not to exceed 100 mg
Single dose only

68
Q

Hydrocortisone IV dose - Asthma & Refractory anaphylaxis (PAED)

A

4 mg / kg
Not to exceed 100 mg
Slow push over 1 min
Single dose only

69
Q

Hydrocortisone IM dose - Adrenal crisis (PAED 0 - 4 years)

A

25 mg
Single dose only

70
Q

Hydrocortisone IM dose - Adrenal crisis (PAED 5 - 10 years)

A

50 mg
Single dose only

71
Q

Hydrocortisone IM dose - Adrenal crisis (PAED > 10 years)

A

100 mg
Single dose only

72
Q

Hydrocortisone IV dose - Adrenal crisis (PAED 0 - 4 years)

A

25 mg
Slow push over 1 min
Single dose only

73
Q

Hydrocortisone IV dose - Adrenal crisis (PAED 5 - 10 years)

A

50 mg
Slow push over 1 min
Single dose only

74
Q

Hydrocortisone IV dose - Adrenal crisis (PAED > 10 years)

A

100 mg
Slow push over 1 min
Single dose only

75
Q

Fentanyl indications

A
  • Significant pain
  • Autonomic dysreflexia with systolic BP > 160 mmHg
76
Q

Fentanyl contraindications

77
Q

Fentanyl presentation

A

Ampule, 100 microg / 2 mL

78
Q

Fentanyl NAS dose - Significant pain & Autonomic dysreflexia systolic BP > 160 mmHg (ADULT > 70 years)

A

25 - 50 microg
Repeated at up to 50 microg every 10 mins
100 microg total max dose

79
Q

Fentanyl NAS dose - Significant pain & Autonomic dysreflexia systolic BP > 160 mmHg (ADULT < 70 years)

A

50 - 100 microg
Repeated at up to 100 microg every 10 mins
200 microg total max dose

80
Q

Fentanyl IM dose - Significant pain & Autonomic dysreflexia systolic BP > 160 mmHg (ADULT > 70 years)

A

25 - 50 microg
Repeated at up to 50 microg every 10 mins
100 microg total max dose

81
Q

Fentanyl IM dose - Significant pain & Autonomic dysreflexia systolic BP > 160 mmHg (ADULT > 70 years)

A

50 - 100 microg
Repeated at up to 100 microg every 10 mins
200 microg total max dose

82
Q

Fentanyl IV dose - Significant pain & Autonomic dysreflexia systolic BP > 160 mmHg (ADULT > 70 years)

A

25 microg
Repeated at up to 25 microg every 10 mins
100 microg total max dose

83
Q

Fentanyl IV dose - Significant pain & Autonomic dysreflexia systolic BP > 160 mmHg (ADULT > 70 years)

A

25 - 50 microg
Repeated at up to 50 microg every 10 mins
200 microg total max dose

84
Q

Fentanyl NAS dose - Significant pain (PAED > 1 year)

A

1.5 microg / kg
Single max dose of 50 microg
Repeated at 1 microg / kg at 10 mins
100 microg total max dose

85
Q

Fentanyl IM dose - Significant pain (PAED > 1 year)

A

1 - 2 microg / kg
Single max dose of 50 microg
2 microg / kg total max dose

86
Q

Fentanyl IV dose - Significant pain (PAED > 1 year)

A

1 microg / kg
Single max dose of 25 microg
Repeated at 0.5 microg / kg (max 25 microg) at 5 mins
2 microg / kg total max dose of

87
Q

Midazolam indications

A
  • Generalised seizures / Focal seizure (GSC < 12)
  • Acute behavioural disturbances ( SAT score ≧ 2 )
88
Q

Midazolam contraindications

89
Q

Midazolam presentation

A

Ampule, 5 mg / 1 mL

90
Q

Midazolam NAS dose - Generalised/ focal seizure (ADULT)

A

5 mg
Repeated every 5 mins
20mg total max dose

91
Q

Midazolam IM dose - Generalised/ focal seizure (ADULT)

A

5 mg
Repeated every 5 mins
20mg total max dose

92
Q

Midazolam IV dose - Generalised/ focal seizure (ADULT)

A

5 mg
Repeated every 5 mins
20mg total max dose

93
Q

Midazolam NAS dose - Generalised/ focal seizure (PAED)

A

Refer to QAS DTP

94
Q

Midazolam IM dose - Generalised/ focal seizure (PAED)

A

Refer to QAS DTP

95
Q

Glyceryl trinitrate ( GTN ) indications

A
  • Suspected ACS with pain
  • Acute cardiogenic pulmonary oedema
  • Autonomic dysreflexia ( SYS BP > 160 mmHg )
  • Irukandji syndrome ( SYS BP > 160 mmHg )
96
Q

Glyceryl trinitrate ( GTN ) contrindications

A
  • Allergy
  • HR < 50 or > 150 BPM
  • SYS BP < 100 mmHg
  • Acute CVA
  • Head trauma
  • Viagra type drugs in the pas 48 hours
97
Q

Glyceryl trinitrate ( GTN ) presentation

A
  • Spray, 400 microg / dose
  • Ambule, 50 mg / 10 mL
98
Q

Glyceryl trinitrate ( GTN ) dose (ADULT)

A

400 microg
Repeated every 5 mins
NO max dose

99
Q

Glyceryl trinitrate ( GTN ) dose (PAED)

A

QAS Clinical consult for approval

100
Q

Glucagon indications

A
  • Symptomatic hypoglycaemia (with inability to self administer oral glucose)
  • Refractory Anaphylaxis with persistent hypotension/ shock (Unresponsive to 3 x IM adrenaline injections and adequate fluid challenges)
101
Q

Glucagon contraindications

102
Q

Glucagon presentation

A

Vial (powder & solvent), 1 mg of glucagon

103
Q

Glucagon IM dose - Symptomatic hypoglycaemia (ADULT)

A

1 mg
Single dose only

104
Q

Glucagon IV dose - Refractory anaphylaxis (ADULT)

A

1 mg
Single dose only

105
Q

Glucagon IM dose - Symptomatic hypoglycaemia (PAED)

A

> 25 kg
1 mg
Single dose only

≦ 25 kg
0.5 mg
Single dose only

106
Q

Glucagon IM dose - Refractory anaphylaxis (PAED)

A

> 25 kg
1 mg
Single dose only

≦ 25 kg
0.5 mg
Single dose only

107
Q

Glucagon IV dose - Refractory anaphylaxis (PAED)

A

> 25 kg
1 mg
Single dose only

≦ 25 kg
0.5 mg
Single dose only

108
Q

Adrenaline indications

A
  • Cardiac arrest
  • Anaphylaxis OR severe allergic reaction
  • Severe life-threatening bronchospasm OR silent chest
  • Shock unresponsive to adequate fluid resuscitation (CCP)
  • Bradycardia (unresponsive to atropine AND/ OR transcutaneous pacing) (CCP)
  • Croup (moderate to severe)
109
Q

Adrenaline contraindications

110
Q

Adrenaline presentation

A
  • Ampule, 1 mg/ 1 mL (1:1,000)
  • Ampule, 1 mg/ 10 mL (1:10,000)
  • EpiPen, 300 microg auto-injector
  • EpiPen Jr 150 microg auto-injector
111
Q

Adrenaline IV dose - Cardiac arrest (ADULT)

A

1 mg
Repeat every 3 - 5 mins
NO max dose

112
Q

Adrenaline IM does - Anaphylaxis OR severe allergic reaction (ADULT)

A

500 microg
Repeat every 5 mins
NO max dose

113
Q

Adrenaline NEB dose - Anaphylaxis OR severe allergic reaction (ADULT)

A

FOR UPPER AIRWAY OBSTRUCTION
5 mg
Single dose only
Refractory to 3 x IM adrenaline injections

114
Q

Adrenaline IM dose - Severe life-threatening bronchospasm or silent chest (ADULT)

A

500 microg
Repeat every 5 mins
NO max dose

115
Q

Adrenaline IV dose - Cardiac arrest (PAED)

A

10 kg or more (> 1 year) - 10 microg / kg
Repeat every 3-5 mins
NO max dose

Less then 10 kg (excluding newly born) - 100 microg
Repeated every 3-5 mins
NO max dose

Newly born - 50 microg
Repeated every 3-5 mins
NO max dose

116
Q

Adrenaline IM dose - Anaphylaxis OR severe allergic reaction (PAED)

A

6 years or older - 300 microg
Repeated every 5 mins
NO max dose

1 to 6 years - 150 microg
Repeated every 5 mins
NO max dose

6 months to 1 year - 100 microg
Repeated every 5 mins
NO max dose

Less than 6 months - 50 microg
Repeated every 5 mins
NO max dose

117
Q

Adrenaline NEB dose - Anaphylaxis OR severe allergic reaction (PAED)

A

5 mg
Single dose only

May be administered for upper airway obstruction that is refractory to 3 x IM adrenaline injections

118
Q

Adrenaline IM dose - Severe life-threatening bronchospasm OR silent chest (PAED)

A

6 years or older - 300 microg
Repeated every 5 mins
NO max dose

1 to 6 years - 150 microg
Repeated every 5 mins
NO max dose

6 months to 1 year - 100 microg
Repeated every 5 mins
NO max dose

Less than 6 months - 50 microg
Repeated every 5 mins
NO max dose

119
Q

Adrenaline NEB dose - Croup (PAED)

A

5 mg
Single dose only

120
Q

Amiodarone indications

A

Cardiac arrest refractory to 3 x DCCS

121
Q

Amiodarone contraindications

A

Tricyclic antidepressant overdose

122
Q

Amiodarone presentation

A

Ampule, 150 mg/ 3 mL

123
Q

Amiodarone IV dose - Cardiac arrest Refractory to 3 x DCCS

A

300 mg first dose
Slow push over 1-2 mins

150 mg second dose refractory to 5 x DCCS

450 mg total max dose

124
Q

Ceftriaxone indications

A

Suspected meningococcal septicaemia

125
Q

Ceftriaxone contraindications

A

ABSOLUTE
Allergy
Known immediate OR severe hypersensitivity to penicillin OR carbapenem base drugs

RELATIVE
PT < 1 month of age (QAS Clinical consult required)

126
Q

Ceftraxone presentation

A

Vial (powder), 1 g

127
Q

Ceftriaxone IM dose - Meningococcal septicaemia (ADULT)

A

2 g
Single dose only

128
Q

Ceftriaxone IV dose - Meningococcal septicaemia (ADULT)

A

2 g
Single dose only
Slow push over 5 mins

129
Q

Ceftriaxone IM dose - Meningococcal septicaemia (PAED)

A

50 mg/ kg rounded to the nearest 5 kg
1 g total max dose
Single dose only

≦ 5 kg - 250 mg
> 5 - 10 kg - 500 mg
> 10 - 15 kg - 750 mg
> 15 kg - 1 g

130
Q

Ceftriaxone IV dose - Meningococcal septicaemia (PAED)

A

Greater than 20 kg

50 mg/ kg rounded to the nearest 5 kg
Slow push over 5 mins
2 g total max dose
Single dose only

> 20 - 25 kg - 1.25 g
25 - 30 kg - 1.5 g
30 - 35 kg - 1.75 g
35 kg - 2 g

QAS Drugs (2 decks)

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