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AV CPGs > Section 5.2: MICA Pharmacology > Flashcards

Section 5.2: MICA Pharmacology Flashcards

1
Q

Adenosine – Presentation/s

A
  • 6mg in 2mL glass ampoule
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2
Q

Adenosine – Pharmacology

A

A naturally occurring purine nucleoside found in all body cells

Actions:

  • Slows conduction through the A-V node, resulting in termination of re-entry circuit activity within or including the A-V nodal pathway
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3
Q

Adenosine – Metabolism

A
  • By adenosine deaminase in red blood cells and vascular endothelium
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4
Q

Adenosine – Primary emergency indication/s

A
  1. AVNRT with adequate or inadequate perfusion but not deteriorating rapidly
  2. AVRT and associated Wolff-Parkinson-White (WPW) or other accessory tract SVT with adequate or inadequate perfusion but not deteriorating rapidly
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5
Q

Adenosine – Contraindication/s

A
  1. Second or third degree A-V block (may produce prolonged sinus arrest / A-V blockade)
  2. Atrial fibrillation
  3. Atrial flutter
  4. Ventricular tachy-arrhythmias
  5. Known hypersensitivity
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6
Q

Adenosine – Precaution/s

A
  1. Adenosine may provoke bronchospasm in the asthmatic Pt
  2. Adenosine is antagonized by methylxanthines (e.g. caffeine or theophyllines). The drug may not be effective in Pts with large caffeine intake or those on high doses of theophylline medication
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7
Q

Adenosine – Route/s of administration

A
  • IV
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8
Q

Adenosine – Side effects

A

Usually brief and transitory:

  • Transient arrhythmia (including asystole, bradycardia or ventricular ectopy) may be experienced following reversion
  • Chest pain
  • Dyspnoea
  • Headache or dizziness
  • Nausea
  • Skin flushing
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9
Q

Adenosine – Special notes

A
  • Adenosine has a very short half life. It should be administered through an IV as close to the heart as practicable, such as the cubital fossa
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10
Q

Adenosine – Onset, Peak & Duration times

A

IV effects:

  • Onset: N/A
  • Peak: N/A
  • Duration: < 10 sec
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11
Q

Amiodarone – Presentation/s

A
  • 150mg in 3mL glass ampoule
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12
Q

Amiodarone – Pharmacology

A
  • Class III anti-arrhythmic agent
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13
Q

Amiodarone – Metabolism

A
  • By the liver
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14
Q

Amiodarone – Primary emergency indication/s

A
  1. VF / pulseless VT refractory to cardioversion
  2. Sustained or recurrent VT
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15
Q

Amiodarone – Contraindication/s

A
  1. VF / pulseless VT refractory to cardioversion:
    * Nil of significance in this indication

2. VT (conscious):

  • Inadequate perfusion
  • Pregnancy

3. Tri-cyclic Antidepressant (TCA) Overdose

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16
Q

Amiodarone – Precaution/s

A
  1. Following Fentanyl administration
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17
Q

Amiodarone – Route/s of administration

A
  • IV
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18
Q

Amiodarone – Side effects

A
  • Hypotension
  • Bradycardia
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19
Q

Amiodarone – Special notes

A
  • Amiodarone is incompatible with saline. Glucose 5% must be used as dilutant when preparing an IV infusion.
  • An IV infusion of Amiodarone may be required during inter-hospital transfer. This will be prescribed by the referring physician and will normally be at a dose of 10 – 20mg / kg run over 24hrs.
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20
Q

Amiodarone – Onset, Peak & Duration times

A

IV effects (bolus):

  • Onset: 2min
  • Peak: 20min
  • Duration: 2hr
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21
Q

Atropine – Presentation/s

A
  • 0.6mg in 1mL polyamp
  • 1.2mg in 1mL polyamp
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22
Q

Atropine – Pharmacology

A

An anti-cholinergic agent

Actions:

  • Inhibits the actions of acetylcholine on post-ganglionic cholinergic nerves at the neuro-effector site, e.g. as a vagal blocker, and allows sympathetic effect to:
    • Increase HR by increasing SA node firing rate
    • Increase the conduction velocity through the A-V node
  • Antidote to reverse the effects of cholinesterase inhibitors (e.g. organophosphate insecticides) at the post-ganglionic neuro-effector sites of cholinergic nerves to:
    • Reduce the excessive salivary, sweat, GIT and bronchial secretions; and
    • Relax smooth muscles
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23
Q

Atropine – Metabolism

A
  • By the liver. Excreted mainly by the kidneys.
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24
Q

Atropine – Primary emergency indication/s

A
  • Bradycardia with poor perfusion
  • Organophosphate poisoning with excessive cholinergic effects
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25
Q

Atropine – Contraindication/s

A
  • Officially, nil of significance in the above indications
  • ? Known hypersensitivity to Atropine or its derivatives.
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26
Q

Atropine – Precaution/s

A
  1. Atrial flutter
  2. Atrial fibrillation
  3. Do not increase HR above 100bpm except in children under 6 years
  4. Glaucoma
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27
Q

Atropine – Route/s of administration

A
  • IV
  • ETT
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28
Q

Atropine – Side effects

A
  • Tachycardia
  • Palpitations
  • Dry mouth
  • Dilated pupils
  • Visual blurring
  • Retention of urine
  • Confusion, restlessness (in large doses)
  • Hot, dry skin (in large doses)
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29
Q

Atropine – Special notes

A

N/A

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30
Q

Atropine – Onset, Peak & Duration times

A

IV effects:

  • Onset: < 2min
  • Peak: < 5min
  • Duration: 2 – 6hr
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31
Q

Dexamethasone – Presentation/s

A
  • 8mg in 2mL glass vial
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32
Q

Dexamethasone – Pharmacology

A

A corticosteroid secreted by the adrenal cortex

Actions:

  • Relieves inflammatory reactions
  • Provides immunosuppression
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33
Q

Dexamethasone – Metabolism

A
  • By the liver and other tissues. Excreted predominantly by the kidneys
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34
Q

Dexamethasone – Primary emergency indication/s

A
  1. Bronchospasm associated with acute respiratory distress not responsive to nebulised Salbutamol
  2. Anaphylaxis
  3. Acute exacerbation of COPD
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35
Q

Dexamethasone – Contraindication/s

A
  1. Known hypersensitivity
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36
Q

Dexamethasone – Precaution/s

A
  1. Solutions which are not clear or are contaminated should be discarded
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37
Q

Dexamethasone – Route/s of administration

A
  • IV
  • IM
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38
Q

Dexamethasone – Side effects

A
  • Nil of significance in the above indication
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39
Q

Dexamethasone – Special notes

A
  • Does not contain an antimicrobial agent, therefore use the solution immediately and discard any residue
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40
Q

Dexamethasone – Onset, Peak & Duration times

A

IV effects:

  • Onset: 30 – 60min
  • Peak: 2hr
  • Duration: 36 – 72hr
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41
Q

Dextrose 5% – Presentation/s

A
  • 100mL infusion soft pack
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42
Q

Dextrose 5% – Pharmacology

A

An isotonic crystalloid solution

Composition:

  • Sugar – 5% dextrose
  • Water

Actions:

  • Provides a small source of energy
  • Supplies body water
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43
Q

Dextrose 5% – Metabolism

A

Dextrose:

  • Broken down in most tissues
  • Stored in the liver and muscle as glycogen

Water:

  • Distributed throughout total body water, mainly in the extracellular fluid compartment
  • Excreted by the kidneys
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44
Q

Dextrose 5% – Primary emergency indication/s

A
  1. Vehicle for dilution and administration of IV emergency drugs
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45
Q

Dextrose 5% – Contraindication/s

A
  • Nil of significance in the above indication
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46
Q

Dextrose 5% – Precaution/s

A
  • Nil of significance in the above indication
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47
Q

Dextrose 5% – Route/s of administration

A
  • IV infusion
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48
Q

Dextrose 5% – Side effects

A
  • Nil of significance in the above indication
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49
Q

Dextrose 5% – Special notes

A

IV half life:

  • Approximately 20 – 40min
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50
Q

Dextrose 5% – Onset, Peak & Duration times

A
  • Onset: N/A
  • Peak: N/A
  • Duration: N/A
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51
Q

Enoxaparin (Clexane) – Presentation/s

A
  • 100mg in 1mL pre-filled syringe with graduated markings (SC injection)
  • 40mg in 0.4mL glass ampoule (IV bolus)
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52
Q

Enoxaparin (Clexane) – Pharmacology

A
  • Binds to and accelerates the action of antithrombin III which inactivates clotting factors IIa (thrombin) and Xa, inhibiting the conversion of prothrombin to thrombin
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53
Q

Enoxaparin (Clexane) – Metabolism

A
  • Metabolised by the liver
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54
Q

Enoxaparin (Clexane) – Primary emergency indication/s

A
  1. Acute STEMI
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55
Q

Enoxaparin (Clexane) – Contraindication/s

A
  1. Known allergy or hypersensitivity
  2. Active bleeding (eg peptic ulcer, intracranial haemorrhage)
  3. Bleeding disorders
  4. Severe hepatic impairment / disease
  5. Heparin-induced thrombocytopenia (HIT)
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56
Q

Enoxaparin (Clexane) – Precaution/s

A
  1. Renal impairment
  2. If Pt > or = 75yo, omit the initial IV bolus dose and only administer 0.75mg / kg SC injection with a maximum 75mg SC
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57
Q

Enoxaparin (Clexane) – Route/s of administration

A
  • Enoxaparin 30mg IV followed 15min later by 1mg / kg SC not exceeding 100mg SC
58
Q

Enoxaparin (Clexane) – Side effects

A
  • Bleeding
  • Bruising
  • Pain at injection site
  • Hyperkalaemia
  • Mild reversible thrombocytopenia

Infrequent

  • Transient elevation of liver aminotransferases
  • Severe thrombocytopenia

Rare

  • Skin necrosis at injection site
  • Osteoporosis with long term use
  • Allergic reactions including urticaria and anaphylaxis
  • Hypersensitivity reactions
59
Q

Enoxaparin (Clexane) – Special notes

A
  • STEMI – 12 lead ECG shows ST elevation > or = 1mm in two contiguous limb leads (I, II, III, aVR, aVL, aVF) or ST elevation > or = 2mm in two contiguous chest leads (V1, V2, V3, V4, V5, V6), new LBBB
60
Q

Enoxaparin (Clexane) – Onset, Peak & Duration times

A
  • Onset: Within 3hrs
  • Peak: 3 – 6hrs
  • Duration: > or = 12hrs
61
Q

Frusemide – Presentation/s

A
  • 40mg in 4mL glass ampoule
62
Q

Frusemide – Pharmacology

A

A diuretic

Actions:

  • Causes venous dilatation and reduces venous return
  • Promotes diuresis
63
Q

Frusemide – Metabolism

A
  • Excreted by the kidneys
64
Q

Frusemide – Primary emergency indication/s

A
  1. Acute LVF with SOB and audible fine crackles (bases, mid-zones or full field)
65
Q

Frusemide – Contraindication/s

A
  • Nil of significance in the above indication
66
Q

Frusemide – Precaution/s

A
  1. Hypotension
67
Q

Frusemide – Route/s of administration

A
  • IV
68
Q

Frusemide – Side effects

A
  • Hypotension
69
Q

Frusemide – Special notes

A
  • The effect of vasopressor drugs will often be reduced after Rx with Frusemide
70
Q

Frusemide – Onset, Peak & Duration times

A

IV effects:

  • Onset: 5min
  • Peak: 20 – 60min
  • Duration: 2 – 3hr
71
Q

Ketamine – Presentation/s

A
  • 200mg in 2mL vial
72
Q

Ketamine – Pharmacology

A

A rapid acting dissociative anaesthetic agent (primarily an N-methyl-D-aspartate [NMDA] receptor antagonist)

Actions:

Produces a dissociative state characterised by:

  • A trance-like state with eyes open but not responsive
  • Nystagmus
  • Profound analgesia
  • Normal pharyngeal and laryngeal reflexes
  • Normal or slightly enhanced skeletal muscle tone
  • Occasionally a transient and minimal respiratory depression
73
Q

Ketamine – Metabolism

A
  • By the liver and excreted by the kidneys
74
Q

Ketamine – Primary emergency indication/s

A
  1. Rapid sequence intubation
  2. Intubation facilitated by sedation
75
Q

Ketamine – Contraindication/s

A
  1. Known hypersensitivity
  2. Severe hypertension (SBP > 180mmHg)
76
Q

Ketamine – Precaution/s

A
  1. Any condition where significant elevation of BP would be hazardous:
  • Hypertension
  • CVA
  • Recent AMI
  • CCF
  1. If being administered for analgesia, inject slowly over 1/60 to minimize risk of respiratory depression and hypertension
77
Q

Ketamine – Route/s of administration

A
  • IV
  • IO
78
Q

Ketamine – Side effects

A

Cardiovascular:

  • Increase BP and HR

CNS:

  • Respiratory depression or apnoea
  • Emergent reactions (nightmares, restlessness, vivid dreams, confusion, hallucinations, irrational behaviour)
  • Enhanced skeletal tone
  • Nausea and vomiting

Ocular:

  • Diplopia and nystagmus with slight increase in intraocular pressure

Other:

  • Local pain at injection site
  • Lacrimation
  • Salivation
79
Q

Ketamine – Special notes

A

N/A

80
Q

Ketamine – Onset, Peak & Duration times

A

IV / IO effects:

  • Onset: 30sec
  • Peak: 12 – 25min
  • Duration: N/A
81
Q

Lignocaine 1% (IO Administration) – Presentation/s

A
  • 50mg in 5mL amp (1%)
82
Q

Lignocaine 1% (IO Administration) – Pharmacology

A

A local anaesthetic agent

Actions:

  • Prevents initiation and transmission of nerve impulses (local anaesthesia)
83
Q

Lignocaine 1% (IO Administration) – Metabolism

A
  • By the liver (90%)
  • Excreted unchanged by the kidneys (10%)
84
Q

Lignocaine 1% (IO Administration) – Primary emergency indication/s

A
  1. To reduce the pain of IO drug and fluid administration in the responsive Pt
85
Q

Lignocaine 1% (IO Administration) – Contraindication/s

A
  1. Known hypersensitivity
86
Q

Lignocaine 1% (IO Administration) – Precaution/s

A
  1. Hypotension and poor perfusion
  2. Chronic LVF
  3. Liver disease
87
Q

Lignocaine 1% (IO Administration) – Route/s of administration

A
  • IO
88
Q

Lignocaine 1% (IO Administration) – Side effects

A

CNS effects (common):

  • Drowsiness
  • Disorientation
  • Decreased hearing
  • Blurred vision
  • Change or slurring of speech
  • Twitching and agitation
  • Convulsions

Cardiovascular effects (uncommon):

  • Hypotension
  • Bradycardia
  • Sinus arrest
  • AV block

Respiratory effects (uncommon):

  • Difficulty in breathing
  • Respiratory arrest
89
Q

Lignocaine 1% (IO Administration) – Special notes

A

N/A

90
Q

Lignocaine 1% (IO Administration) – Onset, Peak & Duration times

A

IO effects:

  • Onset: 1 – 4min
  • Peak: 5 – 10min
  • Duration: 20min
91
Q

Oxytocin – Presentation/s

A
  • 10 units (IU) in 1mL glass ampoule
92
Q

Oxytocin – Pharmacology

A

A synthetic oxytocic

Action:

  • Stimulates smooth muscle of the uterus producing contractions
93
Q

Oxytocin – Metabolism

A
  • By the liver; excreted by the kidneys
94
Q

Oxytocin – Primary emergency indication/s

A
  1. PPPH
95
Q

Oxytocin – Contraindication/s

A
  1. Previous hypersensitivity
  2. Severe toxaemia (pre-eclampsia)
  3. Cord prolapse
  4. Exclude multiple pregnancy before drug administration
96
Q

Oxytocin – Precaution/s

A
  1. If given IV may cause transient hypotension
  2. Concurrent use with Methoxyflurane may cause hypotension
97
Q

Oxytocin – Route/s of administration

A
  • IM
98
Q

Oxytocin – Side effects

A

Uncommon via IM route:

  • Tachycardia
  • Bradycardia
  • Nausea
99
Q

Oxytocin – Special notes

A

Concomitant use with prostaglandins (Misoprostol) may potentiate uterotonic effect

Must be stored between 2 – 8 °C

100
Q

Oxytocin – Onset, Peak & Duration times

A

IM effects:

  • Onset: 2 – 4 min
  • Peak: N/A
  • Duration: 30 – 60min
101
Q

Pancuronium – Presentation/s

A
  • 4mg in 2mL polyamp
102
Q

Pancuronium – Pharmacology

A

A non-depolarising neuromuscular blocking agent

Actions:

  • Blocks transmission of impulses at the neuromuscular junction of striated muscles resulting in skeletal muscle paralysis
  • Due to weak vagolytic action, a slight rise in HR and mean arterial pressure may be expected
103
Q

Pancuronium – Metabolism

A
  • By the kidneys; excreted mainly unchanged in the urine
104
Q

Pancuronium – Primary emergency indication/s

A
  1. To maintain skeletal muscle paralysis and allow mechanical ventilation in intubated Pts following IFS, RSI or during inter-hospital transfer of ventilated Pts.
105
Q

Pancuronium – Contraindication/s

A
  1. Pancuronium must not be given if continuous monitoring of Pt vital signs, including pulse oximetry and EtCO2 monitoring, is not available.
  2. Status epilepticus
106
Q

Pancuronium – Precaution/s

A
  1. Ensure patency of IV access
  2. Sedatives must always be administered prior to Pancuronium
  3. ETT placement, adequacy of ventilation, Sp02, EtCO2, HR and BP must be continuously monitored
  4. Pts with myasthenia gravis should be given much smaller doses and monitored carefully due to the potential of increased degree of neuromuscular block
  5. Care should be exercised in Pts with renal impairment
107
Q

Pancuronium – Route/s of administration

A
  • IV
  • IO
108
Q

Pancuronium – Side effects

A
  • Slight increase in HR
  • Slight increase in mean arterial pressure
  • Localised reaction at injection site (rare)
109
Q

Pancuronium – Special notes

A
  • Allergic reactions such as urticaria, laryngeal oedema, bronchospasm and anaphylactic shock have been reported.
  • Pancuronium infusions required during inter-hospital transfers are to be prescribed and signed by the referring hospital medical officer. The initial dose is usually 0.1mg / kg.
110
Q

Pancuronium – Onset, Peak & Duration times

A

IV effects:

  • Onset: 2 – 3min
  • Peak: 8 – 10min
  • Duration: 35 – 45min
111
Q

Sodium Bicarbonate 8.4% – Presentation/s

A
  • 50mL prepared syringe
  • 100mL glass bottle
112
Q

Sodium Bicarbonate 8.4% – Pharmacology

A

A hypertonic crystalloid solution

Composition:

  • Contains sodium and bicarbonate ions in a solution of high pH

Action:

  • Raises pH
113
Q

Sodium Bicarbonate 8.4% – Metabolism

A
  • Sodium: Excreted by the kidneys
  • Bicarbonate: Excreted by the kidneys as bicarbonate ion and by the lungs as CO2
114
Q

Sodium Bicarbonate 8.4% – Primary emergency indication/s

A
  1. Cardiac arrest, after 15min of AV CPR
  2. Symptomatic TCA OD
115
Q

Sodium Bicarbonate 8.4% – Contraindication/s

A
  1. Hypothermia < 30°C
116
Q

Sodium Bicarbonate 8.4% – Precaution/s

A
  1. Administration of Sodium Bicarbonate 8.4% must be accompanied by effective ventilation and ECC if required
  2. Since Sodium Bicarbonate 8.4% causes tissue necrosis, care must be taken to avoid leakage of the drug into the tissues
  3. Because of the high pH of this solution, do not mix or flush any other drug or solution with Sodium Bicarbonate 8.4%
117
Q

Sodium Bicarbonate 8.4% – Route/s of administration

A
  • IV
118
Q

Sodium Bicarbonate 8.4% – Side effects

A
  • Sodium overload may provoke pulmonary oedema
  • Excessive doses of Sodium Bicarbonate 8.4%, especially without adequate ventilation and circulation, may cause an intracellular acidosis
119
Q

Sodium Bicarbonate 8.4% – Special notes

A

N/A

120
Q

Sodium Bicarbonate 8.4% – Onset, Peak & Duration times

A

IV effects:

  • Onset: 1 – 2min
  • Peak: N/A
  • Duration: Depends on cause and Pt’s perfusion
121
Q

Suxamethonium – Presentation/s

A
  • 100mg in 2mL polyamp
122
Q

Suxamethonium – Pharmacology

A

Depolarising neuromuscular blocking agent

Actions:

  • Short acting muscular relaxant
123
Q

Suxamethonium – Metabolism

A
  • Pseudo-cholinesterase in plasma
124
Q

Suxamethonium – Primary emergency indication/s

A
  1. Complete muscle relaxation to allow endotracheal intubation
125
Q

Suxamethonium – Contraindication/s

A
  1. Known hypersensitivity
  2. Known history of Suxamethonium apnoea
  3. Known history of malignant hyperthermia
  4. Upper airway obstruction
  5. Severe respiratory distress
  6. Penetrating eye injury
  7. Burns > 24hr post injury
  8. Ruptured AAA
  9. Organophosphate poisoning
  10. ECG signs of hyperkalaemia in conditions such as muscle necrosis and renal failure
126
Q

Suxamethonium – Precaution/s

A
  1. Elderly Pts
  2. Liver disease
  3. Crush injuries
  4. Pts who have not fasted
  5. Airway trauma
127
Q

Suxamethonium – Route/s of administration

A
  • IV
  • IO
128
Q

Suxamethonium – Side effects

A
  • Muscular fasciculation
  • Increased intraocular pressure
  • Increased intragastric pressure
  • Elevated serum potassium levels
129
Q

Suxamethonium – Special notes

A
  • Sedation is required prior to use
  • Atropine 600mcg should be administered prior to Suxamethonium administration in adult Pts with a HR < 60
  • Atropine 20mcg / kg should be administered prior to Suxamethonium administration in children
  • A second dose of Suxamethonium usually causes profound bradycardia
  • Refrigeration of Suxamethonium is required – requires weekly rotation or disposal when not refrigerated
  • Usual dosage:
    • Adults: 1.5mg / kg IV (max. dose 150mg)
130
Q

Suxamethonium – Onset, Peak & Duration times

A

IV effects:

  • Onset: 20 – 40sec
  • Peak: 60sec
  • Duration: 4 – 6min
131
Q

Tenecteplase (Metalyse) – Presentation/s

A
  • 50mg in glass vial with weight marked and pre-filled syringe containing water for IV administration (must reconstitute all drug then discard unwanted amount according to weight)
132
Q

Tenecteplase (Metalyse) – Pharmacology

A
  • Fibrinolytic, a modified form of tissue plasminogen activator (tPA) that binds to fibrin and converts plasminogen to plasmin
133
Q

Tenecteplase (Metalyse) – Metabolism

A
  • By the liver
134
Q

Tenecteplase (Metalyse) – Primary emergency indication/s

A
  1. Acute STEMI
135
Q

Tenecteplase (Metalyse) – Contraindication/s (Exclusion Criteria)

A
  1. Blood pressure Systolic > 180mmHg; or Diastolic > or = 110mmHg
  2. Known allergy or hypersensitivity to Tenecteplase or Gentamicin
  3. Anticoagulant therapy eg. Warfarin, Heparin, Dabigatran, Rivaroxaban, Apixaban
  4. Glycoprotein IIb / IIIa inhibitors eg. Abciximab, Eptifibatide, Tirofiban
  5. Active bleeding or bleeding tendency (excluding menses)
  6. GI bleed within last 1/12
  7. Active peptic ulcer
  8. Acute pancreatitis
  9. Suspected aortic dissection
  10. Non compressible vascular puncture
  11. Recent major surgery (< 3/52)
  12. Traumatic or prolonged (>10min) CPR
  13. Acute pericarditis
  14. Subacute bacterial endocarditis
  15. History of CNS damage eg neoplasm, aneurysm, spinal surgery
  16. New neurological symptoms
  17. Significant closed head or facial trauma in past 3/12
136
Q

Tenecteplase (Metalyse) – Precaution/s (Relative contraindications)

A
  1. Age > or = 75 years
  2. Low body weight
  3. Renal impairment
  4. Dementia
  5. History of stroke or TIA
  6. Diabetes
  7. Heart failure
  8. Tachycardia
  9. Pregnancy
  10. Within 1/52 post-partum
  11. Anaemia
  12. Advanced liver disease
  13. Blood pressure between 160 – 180mmHg systolic
  14. History of bleeding or known prolonged INR
  15. Peripheral vascular disease
  16. Administration of Enoxaparin 48 hours prior
  17. Recent invasive procedures associated with bleeding such as femoral artery puncture; right heart catheterisation
137
Q

Tenecteplase (Metalyse) – Route/s of administration

A
  • IV, using vial adapter on pre-prepared syringe, as single bolus over 10 seconds
138
Q

Tenecteplase (Metalyse) – Side effects

A
  • Bleeding – including injection sites, ICH, internal bleeding
  • Transient hypotension

Infrequent:

  • Allergic reactions including fever, chills, rash, nausea, headache, bronchospasm, vasculitis, nephritis and anaphylaxis

Rare:

  • Cholesterol embolism
139
Q

Tenecteplase (Metalyse) – Special notes

A
  • STEMI – 12 lead ECG shows ST Elevation > or = 1mm in two contiguous limb leads (I, II, III, aVR, aVL, aVF) or ST Elevation > or = 2mm in two contiguous chest leads (V1, V2, V3, V4, V5, V6), new LBBB
  • Weight optimised dosing improves efficacy and safety outcomes in drugs with narrow therapeutic index eg. Fibrinolytics
  • Other drugs which affect the clotting process may increase risk of bleeding associated with Tenecteplase
140
Q

Tenecteplase (Metalyse) – Onset, Peak & Duration times

A

IV effects:

  • Onset: N/A
  • Peak: N/A
  • Duration: N/A

AV CPGs (3 decks)

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