Shared Health Medications

Question 1

Indications and Contraindications of Olanzapine?

Answer 1

Indications:
-Known or suspected methamphetamine psychosis
Contraindications:
-Uncooperative patient
-Hypotension
-Seizure or acute neurological deficit
Chest pain or Dyspnea

Question 2

Olanzapine
-Class
-Route/Dose/Repeat Dose
-Notes

Answer 2

Class: Antipsychotic, Antimaniac
Route: Oral (PCP and Above)
Dose: 10 mg (12 years and older)
Repeat Dose: None
Notes: Lowers seizure threshold, patient must be cooperative enough to take oral medication.

Question 3

Indications and Contraindications of Tranexamic Acid?

Answer 3

Indications:
-Major trauma and hemorrhage with or without shock within 3 hours of injury
-Post Partum hemorrhage
-Nontraumatic hemorrhage with signs of shock
Contraindications:
-True allergy to tanexamic acid

Question 4

Tranexamic Acid
-Class
-Route/Dose/Repeat Dose
-Notes

Answer 4

Class: Antifibrinolytic Agent
Route: Intravenous (PCP and above)
Dose: 15 mg/kg (1-12 years, max=1 g), 1 g (12 years or older)
Repeat Dose: None
Notes Mix in 100 ml of IV fluid and infuse over 10 minutes, cannot be given in the same line as oxytocin.

Question 5

Indications and Contraindications of Nitroglycerin?

Answer 5

Indications:
-Chest pain consistent with suspicious for myocardial ischemia
-Pulmonary edema
Contraindications:
-Hypotension (SBP less than 90mmhg)
-Use if Viagra, Cialis or Levitra in the las 24 hours
-Increased intercranial pressure
-Hypersensitivity to Nitroglycerin

Question 6

Nitroglycerin
-Class
-Route/Dose/Repeat Dose
-Notes

Answer 6

Class: Nitrates
Route: Sublingual or Transdermal (PCP and above, 17 years and older)
Dose: Sublingual 0.4 mg, transdermal 0.4 to 9.8 mg/hr
Repeat Dose: repeat sublingual every 5 minutes as required
Notes: Nitroglycerin does not prevent thrombus from forming or getting worse. ASA always first drug in patients with ACS symptoms. Nitro is a symptom reliever. If SBO drops more than 30 mmHg stop administering. If more than 3 sublingual doses are given apply transdermal.

Question 7

Indications and Contraindications of Acetylsalicylic Acid (ASA)?

Answer 7

Indications:
-Known or suspected acute coronary syndrome (ACS)
Contraindications:
-Active bleeding that cannot be controlled by basic measures
-True ASA allergy
-Known ASA induced Asthma

Question 8

Acetylsalicylic Acid
-Class
-Route/Dose/Repeat Dose
-Notes

Answer 8

Class: Antiplatelet Agent
Route: Oral (EMR and above)
Dose: 160 mg (17 years and older)
Repeat Dose: None
Notes: Instruct the patient to chew the medication.

Question 9

Indications and Contraindications of Ticagrelor?

Answer 9

Indications:
-Known or suspected ST elevation myocardial infarction (STEMI) if patient is going directly to primary coronary intervention and only after consultation with the STEMI physician
Contraindications:
-Patiemt may be candidate forfibrinolysis
-Active bleeding that cannot be controlled by basic measures
-True allergy to Ticagrelor

Question 10

Ticagrelor
-Class
-Route/Dose/Repeat Dose
-Notes

Answer 10

Class: Antiplatelet Agents
Route: Oral (PCP and above)
Dose: 180 mg (2 tablets, 17 years and older)
Repeat Dose: None
Notes: Requires STEMI and Physician order.

Question 11

Indications and Contraindications of Enoxaparin?

Answer 11

Indications:
-Known or suspected Myocardial Infarction (STEMI) after consultation with the STEMI physician
Contraindications:
-patient may be candidate for fibrinolysis with TNK
-Known hypersensitivity to enoxaparin
-Patient is known to be on an anticoagulant and has taken it that day
-History of heparin induced thrombocytopenia within the past 100 days
-Active bleeding that cannot be controlled by basic measures

Question 12

Enoxaparin
-Class
-Route/Dose/Repeat Dose
-Notes

Answer 12

Class: Anticoagulant
Route: IV or Subcutaneous
Dose: 0.5mg/Kg IV (max 50mg, less than 75 years old) or 1mg/Kg (less than 75, max 100mg), 0.75mg/Kg (older than 75, max75mg)
Repeat: None
Notes: Increased risk of inter cranial bleeding in patients older than 75

Question 13

Indications and Contraindications of Acetaminophen?

Answer 13

Indications:
-Mild to Moderate pain
-Fever
Contraindications:
-True allergy to acetaminophen
-Known liver failure
-Do not administer oral medication if anaesthesia or surgery is anticipated in the next 4 hours

Question 14

Acetaminophen
-Class
-Route/Dose/Repeat Dose
-Notes

Answer 14

Class: Analgesic
Route: Oral
Dose: 72 hrs-12 yrs, 10-15mg/Kg (max = 650mg), or 12 yrs+, 650-1000mg
Repeat: Every 4 hours as required
Notes: Do not give to patients with liver failure, do not administer more than 4g per day

Question 15

Indications and Contraindications of Ibuprofen?

Answer 15

Indications:
-Mild to moderate pain
-Fever
Contraindications:
-True allergy to ibuprofen or aspirin (ASA) induced asthma
-Major trauma or other active bleeding
-Pregnancy
-End stage renal failure
-Do not administer oral medications if anaesthesia or surgery is anticipated within the next 4 hours

Question 16

Ibuprofen
-Class
-Route/Dose/Repeat Dose
-Notes

Answer 16

Class: Non‐steroidal anti‐Inflammatory drug (NSAIDs)
Route: Oral
Dose: 3 months-12 years, 10mg/Kg (max=400mg), 12 yrs+, 400-800mg
Repeat: Every 6 hours as required
Notes: Not safe for renal failure or pregnant patients

Question 17

Indications and Contraindications of Ketoralac?

Answer 17

Indications:
-Moderate to severe pain from an acute illness, injury, or chronic conditions significant enough to require analgesic for safe transport
Contraindications:
-Known/suspected acute coronary syndrome
-Known/suspected intracranial injury or hemorrhage
-True allergy to ketoralac
-History of aspirin (ASA) induced asthma
-Pregnancy
-Known renal failure