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Qas ACPII main drug review Flashcards

1
Q

Adrenaline

indications

A

ACP level use
- Croup (with stridor at rest)
- Severe or life threatening bronchospasm (speaking in single words/ALOC/haemodynamic compromise)
- Cardiac arrest
- Anaphylaxis or severe allergic reaction

CCP level use
- Bradycardia with poor perfusion (unresponsive to atropine or TCP)
- Shock unresponsive to adequate fluid resus

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2
Q

Adrenaline (epinephrine)

PRESENTATION

A

Ampoule, 1 mg/1 mL (1:1,000) adrenaline (epinephrine)
Ampoule, 1 mg/10 mL (1:10,000) adrenaline (epinephrine)

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3
Q

Adrenaline

contraindications

A

Nil

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4
Q

Adrenaline

Dosage for cardiac arrest

A

IV (ACP, CCP)
1mg every 3-5 minutes
No max dose

IO (CCP)
1mg every 3-5 minutes
No max dose

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5
Q

Adrenaline

Dosages for anaphylaxis or severe allergic reaction

A

ACP1, ACP2, CCP
IM - 500 microg
Repeated at 5 minute intervals. No maximum dose.

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6
Q

Adrenaline

Dosages for severe to life threatening bronchospasm

A

ACP1, ACP2, CCP
IM - 500 microg
Repeated at 5 minute intervals. No maximum dose.

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7
Q

Aspirin

Indications

A

Suspected ACS
Acute cardiogenic pulmonary oedema

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8
Q

Aspirin

PRESENTATION

A

Tablet (white), 300 mg aspirin

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9
Q

Aspirin

CONTRAINDICATIONS

A

Allergy AND/OR Adverse Drug Reaction to aspirin OR any non-steroidal anti-inflammatory drug (NSAID)
Bleeding OR clotting disorders (e.g. haemophilia)
Current GI bleeding OR peptic ulcers
Patients < 18 years

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10
Q

Aspirin

Dosage for Suspected ACS
Acute cardiogenic pulmonary oedema

A

PO (ACP1, ACP2, CCP)
300mg single dose
Max dose 450mg
Chew with small amount of water.

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11
Q

Ceftriaxone

Presentation

A

Vial (powder), 1 g ceftriaxone

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12
Q

Ceftriaxone

Indications

A

Suspected meningococcal septicaemia
(with a non-blanching petechial AND/OR purpuric rash)
Acute upper GI bleeding
(with a history of liver or oesophageal varices)

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13
Q

Ceftriaxone

Contraindications

A

Absolute contraindications:
Allergy AND/OR Adverse Drug Reaction to cephalosporin antibiotics
Known immediate OR severe hypersensitivity to penicillin OR carbapenem based drugs
Relative contraindications (requires consultation with the QAS Clinical Consultation & Advice Line):
Patients less than 1 month of age

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14
Q

Ceftriaxone
Dosage for Suspected meningococcal septicaemia
(with a non-blanching petechial AND/OR purpuric rash)

A

IM (ACP1, ACP2, CCP)

2 g (2 x 1 g IM injections)
Single dose only.
Syringe preparation: Reconstitute two separate vials each containing 1 g of ceftriaxone with 2.4 mL of water for injection or lidocaine 1% (lignocaine) in a 3 mL syringe to achieve a final concentration of 1 g/3 mL.

IV (ACP2, CCP)
2 g Slow push over 5 minutes.
Single dose only.
Syringe preparation: Reconstitute 2 g of ceftriaxone with 18.8 mL of water for injection in a 20 mL syringe to achieve a final concentration of 2 g/20 mL. Ensure syringe is appropriately labelled.

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15
Q

Ceftriaxone
Acute upper GI bleeding
(with a history of liver disease or oesophageal varices)

A

IV (ACP2 CCP)
1 g
Slow push over 5 minutes.
Single dose only.
Syringe preparation: Reconstitute 1 g of ceftriaxone with 9.4 mL of water for injection in a 10 mL syringe to achieve a final concentration of 1 g/10 mL. Ensure syringe is appropriately labelled.

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16
Q

Fentanyl

Presentation

A

Ampoule, 100 microg/2 mL fentanyl

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17
Q

Fentanyl

Indications

A

Significant pain
Sedation
Autonomic dysreflexia (with systolic BP > 160 mmHg)

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18
Q

Fentanyl

Contraindications

A

Allergy AND/OR Adverse Drug Reaction

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19
Q

Fentanyl

Dosages for significant pain and autonomic dysreflexia (with a systolic BP > 160 mmHg)

A

ACP2 NAS
≥ 70 yrs/cachectic or frail – 25 – 50 microg
Repeated at up to 50 microg every 10 minutes.
Total maximum dose 100 microg (or MME).
< 70 yrs – 50 – 100 microg
Repeated at up to 100 microg every 10 minutes.
Total maximum dose 200 microg (or MME).

ACP2 IM
≥ 70 yrs/cachectic or frail – 25 – 50 microg
Repeated at up to 50 microg every 10 minutes.
Total maximum dose 100 microg (or MME).
< 70 yrs – 25 – 100 microg
Repeated at up to 50 microg every 10 minutes.
Total maximum dose 200 microg (or MME).

ACP2 IV
≥ 70 yrs/cachectic or frail – 25 microg
Repeated at up to 25 microg every 5 minutes.
Total maximum dose 100 microg (or MME).
< 70 yrs – 25 – 50 microg
Repeated at up to 50 microg every 5 minutes.
Total maximum dose 200 microg (or MME

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20
Q

Glucagon

PRESENTATION

A

Vials (powder and solvent), 1 mg glucagon

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21
Q

Glucagon

INDICATIONS

A

Symptomatic hypoglycaemia
(with the inability to self-administer oral glucose)

Refractory anaphylaxis with persistent hypotension/shock
(unresponsive to 3 x IM adrenaline injections and adequate fluid challenges)

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22
Q

Glucagon

CONTRAINDICATIONS

A

Allergy AND/OR Adverse Drug Reaction

23
Q

Glucagon

Symptomatic hypoglycaemia
(with the inability to self-administer oral glucose)

A

IM
1 mg
Single dose only.
Syringe preparation: Reconstitute 1 mg of glucagon with 1 mL of water for injection in a 3 mL syringe to achieve a final concentration of 1 mg/1 mL.

24
Q

Glucagon

Refractory anaphylaxis with persistent hypotension/shock
(unresponsive to 3 x IM adrenaline injections and adequate fluid challenges)

A

IM
May be administered when paramedics are unable to achieve IV access.
1 mg
Single dose only.
Syringe preparation: Reconstitute 1 mg of glucagon with 1 mL of water for injection in a 3 mL syringe to achieve a final concentration of 1 mg/1 mL.

IV
1 mg
Single dose only.
Syringe preparation: Reconstitute 1 mg of glucagon with 1 mL of water for injection in a 3 mL syringe to achieve a final concentration of 1 mg/1 mL.

25
Glucose 10% Indication
Symptomatic hypoglycaemia (with the inability to self-administer oral glucose)
26
Glucose 10% Symptomatic hypoglycaemia (with the inability to selfadminister oral glucose)
IV INF 15 g (150 mL) Repeated at 100 mL (10 g) boluses every 5 minutes until BGL > 4.0 mmol/L.
27
Glucose 10% PAEDIATRIC DOSAGES Symptomatic hypoglycaemia (inability to self administer oral glucose)
IV INF 0.25 g/kg (2.5 mL/kg) Repeated at 1 mL/kg (0.1 g/kg) boluses every 5 minutes until BGL > 4.0 mmol/L.
28
Glucose gel INDICATIONS
Symptomatic hypoglycaemia (with the ability to self-administer oral glucose)
29
Glucose gel CONTRAINDICATIONS
Unconsciousness Patients with difficulty swallowing Patients < 2 years
30
GTN Indications
Suspected ACS (with pain) Acute cardiogenic pulmonary oedema Autonomic dysreflexia (with a systolic BP ≥ 160 mmHg) Irukandji syndrome (with a systolic BP ≥ 160 mmHg)
31
GTN Contraindications
Allergy AND/OR Adverse Drug Reaction Heart rate < 50 OR > 150 beats per minute Systolic BP < 100 mmHg Acute CVA Head trauma Phosphodiesterase 5 inhibitor medication administration: Silenafil OR vardenafil in the past 24 hours Tadalafil in the previous 48 hours Patients currently taking Riociguat
32
GTN Adult dosages (all indications)
Sublingual 400mcg Repeat at 5 min No max
33
Ipratropium Bromide Indications
Moderate bronchospasm (unresponsive to initial QAS salbutamol NEB) Severe bronchospasm
34
Ipratropium bromide PRESENTATION
Nebule, 250 microg/1 mL ipratropium bromide monohydrate
35
Ipratropium Bromide Contraindications
Allergy AND/OR Adverse Drug Reaction Patients less than 1 year of age
36
Ipratropium Bromide Dosages
NEB 500 microg Repeated at 20 minute intervals. Total maximum dose – 1.5 mg.
37
Methoxyfleurane Indications
Pain (with the ability to self-administer inhaled methoxyflurane)
38
Methoxyfleurane Contraindications
Allergy AND/OR Adverse Drug Reaction Patients less than 1 year of age Known liver OR renal disease Malignant hyperthermia (known or genetic susceptibility)
39
Methoxyfleurane Dosages
INH 3 mL Repeated once after 20 minutes. Total maximum dose 6 mL in 24 hours. Total maximum dose 15 mL in 7 days. The administration of methoxyflurane on consecutive days is not recommended.
40
Midazolam Indications
Generalised seizures/focal seizures (GSC ≤ 12) Acute behavioural disturbance (with a SAT score ≥ 2) unresponsive to droperidol (max dose) administration
41
Midazolam Contraindications
Allergy AND/OR Adverse Drug Reaction
42
Midazolam Adult dosages for generalised or focal seizures
NAS/IM 5.0 mg Repeated every 10 minutes. Total maximum dose 20 mg. IV 5.0 mg Repeated every 5 minutes. Total maximum dose 20 mg.
43
Morphine Indications
Significant pain Sedation Autonomic dysreflexia (with a systolic BP > 160 mmHg)
44
Morphine CONTRAINDICATIONS
Allergy and/or Adverse Drug Reaction Kidney disease (renal failure)
45
Morphine Dosages for significant pain
IM ≥ 70 yrs/cachectic or frail: 2.5 – 5 mg Repeated at up to 5 mg every 10 minutes. Total maximum dose 10 mg (or MME). < 70 yrs: 2.5 – 10 mg Repeated at up to 5 mg every 10 minutes. Total maximum dose 20 mg (or MME). IV ≥ 70 yrs/cachectic or frail: 2.5 mg Repeated at up to 2.5 mg every 5 minutes. Total maximum dose 10 mg (or MME). < 70 yrs: 2.5 – 5 mg. Repeated at up to 5 mg every 5 minutes. Total maximum dose 20 mg (or MME).
46
Naloxone Indications
Respiratory depression secondary to administration of narcotic drugs
47
Naloxone Contraindications
Allergy AND/OR Adverse Drug Reaction The newly born patient
48
Naloxone DOSAGES
IM 1.6 mg Single dose only.
49
Ondansetron Indications
Significant nausea and/or vomiting
50
Ondansetron contraindications
Abolute contraindications: Allergy AND/OR Adverse Drug Reaction Congenital long QT syndrome Current apomorphine therapy (used in severe Parkinson's disease) Patients < 2 years of age Relative contraindications: First trimester pregnancy (may only be administered for extreme and uncontrolled hyperemesis)
51
Ondansetron adult dosages
PO/IM 4-8 mg - total max 8mg IV 4-8 mg - total max 8mg
52
Salbutamol INDICATIONS
Bronchospasm Suspected hyperkalaemia (with QRS widening AND/OR AV dissociation)
53
Salbutamol CONTRAINDICATIONS
Allergy AND/OR Adverse Drug Reaction Patients less than 1 year of age
54
Salbutamol Dosage
NEB 5 mg Repeated PRN. No maximum dose.

Qas Drugs (1 decks)

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