SJA Drugs Flashcards
1
Q
Aspirin presentation
A
300mg tablet
2
Q
Aspirin’s four actions
A
Analgesic
3
Q
Aspirin indications for use
A
Chest pain of presumed cardiac origin
4
Q
Aspirin dose and administration
A
Oral administration - preferably chewed
5
Q
Aspirin contraindications
A
Known hypersensitivity to aspirin or salicylates
6
Q
Aspirin precautions
A
Actively bleeding peptic ulcers
7
Q
Aspirin side effects
A
Heartburn
8
Q
Adrenaline presentation
A
1mg in 1ml (1:1000 solution)
9
Q
Aspirin pharmacology and action
A
Minimises platelet aggregation and thrombus formation to slow progression of coronary artery thrombosis
10
Q
Adrenaline pharmacology and action
A
Naturally occurring sympathomimetic agent
11
Q
Adrenaline IV/IO onset time?
A
30 seconds
12
Q
Adrenaline IM onset time?
A
30-90 seconds
13
Q
Adrenaline IV/IO peak action time?
A
3-5 minutes
14
Q
Adrenaline IM peak action time?
A
5-10 minutes
15
Q
Duration of adrenaline IV/IO
A
5-10 minutes
16
Q
Duration of adrenaline IM
A
5-10 minutes
17
Q
Indications for use of adrenaline
A
Cardiac arrest
18
Q
Contraindications for use of adrenaline
A
None absolute
19
Q
Precautions for use of adrenaline
A
Ischaemic heart disease
20
Q
Side effects of adrenaline
A
Palpitations
21
Q
Adult dose of adrenaline in cardiac arrest
A
1mg in 1ml 1:1000 solution IV/IO every 3-5 minutes
22
Q
Paediatric and newborn doses of adrenaline in cardiac arrest
A
10mcg/kg IV/IO to a max 1mg IV/IO every 3-5 minutes (newborns 10-30mcg)
23
Q
Solution strength of adrenaline to be used in paediatric cardiac arrest
A
1:10,000
24
Q
Adult dose of adrenaline in anaphylaxis or severe asthma
A
0.5mg in 0.5ml 1:1000 solution IM into lateral mid-thigh (repeated every 5-10mins as clinically required)
25
Paediatric dose of adrenaline in anaphylaxis or severe asthma...age < 1 year (5-10kg)
0.05mg-0.1mg in 0.05-0.1ml 1:1000 solution IM into lateral mid-thigh (repeated every 5-10mins as clinically required)
26
Paediatric dose of adrenaline in anaphylaxis or severe asthma...age 1-2 (10kg)
0.1mg in 0.1ml 1:1000 solution IM into lateral mid-thigh (repeated every 5-10mins as clinically required)
27
Paediatric dose of adrenaline in anaphylaxis or severe asthma...age 2-3 (15kg)
0.15mg in 0.15ml 1:1000 solution IM into lateral mid-thigh (repeated every 5-10mins as clinically required)
28
Paediatric dose of adrenaline in anaphylaxis or severe asthma...age 4-6 (20kg)
0.2mg in 0.2ml 1:1000 solution IM into lateral mid-thigh (repeated every 5-10mins as clinically required)
29
Paediatric dose of adrenaline in anaphylaxis or severe asthma...age 7-10 (30kg)
0.3mg in 0.3ml 1:1000 solution IM into lateral mid-thigh (repeated every 5-10mins as clinically required)
30
Paediatric dose of adrenaline in anaphylaxis or severe asthma...age 10-12 (40kg)
0.4mg in 0.4ml 1:1000 solution IM into lateral mid-thigh (repeated every 5-10mins as clinically required)
31
Paediatric dose of adrenaline in anaphylaxis or severe asthma...age 12+ (50kg +)
0.5mg in 0.5ml 1:1000 solution IM into lateral mid-thigh (as per adult dose) (repeated every 5-10mins as clinically required)
32
Adult and paediatric dose of adrenaline in severe croup with retractive breathing
5mg in 5mls 1:1000 solution nebulised once only with O2 at 8LPM
33
Presentation of heparin sodium
5000 International Units in 5ml ampoule
34
Onset of action time of IV heparin
Immediate
35
Pharmacology and action of heparin
Naturally occurring anticoagulant
36
Indications for use of heparin sodium
STEMI patients going directly to cath lab as per receiving hospital's interpretation of 12 lead ECG
37
Contraindications for use of heparin sodium
Hypersensitivity
38
Precautions in use of heparin sodium
Haemorrhagic risks in case of possible trauma
39
Side effects of heparin sodium
Haemorrhage
40
Presentation of ipratroprium bromide
250mcg in 1ml nebule
41
Pharmacology and action of ipratroprium bromide
Anticholinergic bronchodilator - inhibits vagal reflexes that mediate bronchospasm
42
Benefit of using atrovent with salbutamol nebs
Combination of beta-2 antagonist and anticholinergic bronchodilator = greater bronchodilation than salbutamol alone
43
Indications for use of atrovent
Severe bronchospasm and SOB in asthma and COPD
44
Side effects of atrovent
Headache
45
Contraindications in use of atrovent
Hypersensitivity
46
Precautions in the use of atrovent
Glaucoma
47
Adult dose of ipratroprium bromide
500mcg in 2ml nebulised with salbutamol once only
48
Paediatric dose of ipratroprium bromide
250mcg in 1ml nebulised with salbutamol once only
49
Presentation of ketamine
200mg in 2ml ampoule
50
IM onset time of ketamine
5-10 minutes
51
IV onset time of ketamine
1 minute
52
What is ketamine?
Rapid acting dissociative anaesthetic
53
Indications for use of ketamine
2nd line agent for severe pain traumatic origin
54
Contraindications for use of ketamine
Hypersensitivity
55
Side effects of ketamine
BP and pulse elevation
56
Dose of ketamine for IM analgesia
1mg per kg initially
57
Dilution of ketamine for adult IV use
200mg in 2ml ampoule added to 18ml NaCl New solution is 10mg per 1ml
58
Dilution of ketamine for paed IV use
200mg in 2ml ampoule added to 18ml NaCl
59
Dose of ketamine for IV analgesia in adults
10-20mg in 1-2ml initial dose
60
Dose of ketamine for IV analgesia in paediatrics
0.1mg/kg administered slowly titrated to effect
61
(ASMO medical consult required!!!!)
2mg/kg initial dose to maximum 200mg
62
(ASMO medical consult required!!!)
0.5mg/kg repeated every 5 minutes until required level of sedation achieved
63
What colour label and dosage are adult EpiPens?
Yellow
64
What colour label and dosage are paediatric EpiPens?
Green
65
Amiodarone presentation?
150mg in 3ml ampoule
66
Mechanism of amiodarone...
Class III antidysrhythmic which prolongs action potential duration and therefore refractory period of atrial, nodal and ventricular tissue.
67
Onset time of amiodarone?
Immediate
68
Peak time of amiodarone effects?
< 10 minutes
69
Duration of amiodarone effects?
30-60 minutes
70
Indications for use of amiodarone?
Cardiac arrest - with persistent/shock resistant ventricular fibrillation or ventricular tachycardia (post 3 consecutive shocks only).
71
Amiodarone dose for adult cardiac arrest?
300mg in 6ml IV/IO once (2 vials)
72
Amiodarone dose for paediatric cardiac arrest?
5mg per kg IV/IO once
73
CCP - Amiodarone dose for CCP use only in tachydysrhythmias?
300mg infusion over 20 mins
74
Contraindications for amiodarone use?
CCP use only:
75
Precautions for amiodarone use?
#NAME?
76
Side effects of amiodarone?
Bradycardia
77
CCP - Presentation of atropine sulphate?
0.6mg in 3ml ampoule
78
CCP - Mechanism in action of atropine sulphate?
Anticholinergic that inhibits action of acetylcholine on post ganglionic nerves at neuroeffector site.
79
CCP - Indications for use of atropine sulphate?
#NAME?
80
CCP - Adult dose of atropine sulphate for bradycardia?
0.6mg in 3ml IV/IO every 1-5 mins titrated to effect.
81
CCP - Paediatric dose of atropine sulphate for bradycardia?
0.02mg/kg IV/IO every 1-5 mins titrated to effect.
82
CCP - Adult dose of atropine sulphate for organophosphate poisoning?
Large doses may be required in excess of 5mg IV/IO.
83
CCP - Paediatric dose of atropine sulphate for organophosphate poisoning?
0.02mg/kg IV/IO titrated against decrease in cholinergic secretions.
84
CCP - Contraindications for use of atropine sulphate?
Third degree heart block.
85
CCP - Precautions for use of atropine sulphate?
Atrial flutter
86
CCP - Side effects of atropine sulphate?
Tachycardia
87
Presentation of cophenylcaine?
Topical pump spray containing:
88
Mechanism in action of cophenylcaine?
Local anaesthetic and haemorrhage control agent for the relief of surface pain, nasal and oral bleeding.
89
Indications for cophenylcaine?
Local pain, abrasions, small cuts and wounds
90
Adult intranasal dose of cophenycaine?
Max 10 squirts (5 per nostril)
91
Adult topical dose of cophenylcaine?
Max 5 squirts
92
Paediatric intranasal dose of cophenylcaine?
2-4 years = 1 squirt per nostril
93
Adult and paediatric oral dose of cophenylcaine?
One spray then wait 1-2 mins and repeat if required.
94
Contraindications of cophenylcaine?
Hypersensitivity to lignocaine or other anaesthetics.
95
Precautions for use of cophenylcaine?
#NAME?
96
Side effects of cophenylcaine?
Transient bitter taste in oral use.
97
CCP - Presenation of dextrose 5%
100ml infusion soft pack
98
CCP - Half life of dextrose 5%
20-30 minutes
99
CCP - What type of solution is dextrose 5%?
Isotonic crystalloid solution
100
CCP - indications for dextrose 5%?
Vehicle for diluting and administering emergency drugs.
101
CCP - dose of dextrose 5%?
N/A - use as a diluent and for drug administration only.
102
CCP - contraindications of dextrose 5%?
Not for volume replacement.
103
CCP - precautions and side effects of dextrose 5%?
Nil
104
Presentation of fentanyl citrate or sublimaze?
100mcg in 2ml ampoule
105
Presentation of IN fentanyl?
600mcg in 2ml
106
Indications for fentanyl use?
Moderate to severe pain
107
Adult IV/IO dose fentanyl citrate?
10-25mcg titrated to effect every 5 minutes
108
Paediatric IV/IO dose fentanyl citrate?
1 mcg/kg titrated to effect every 5 minutes
109
How to dilute fentanyl citrate to 10mcg/1ml?
Dilute 2ml with 8ml NaCl in 10ml syringe
110
How to dilute fentanyl citrate to 5mcg/1ml?
Dilute 2ml with 18ml NaCl in 20ml syringe
111
IN fentanyl dose < 5 years / < 20kg
1 x 15mcg in 0.05ml initial dose
112
IN fentanyl dose 6-10 years / 21-30kg
1 x 30mcg in 0.10ml initial dose
113
IN fentanyl dose 11-15 years / 31-40kg
1 x 45mcg in 0.15ml initial dose
114
IN fentanyl dose small/elderly/frail
2 x 60mcg in 0.2ml (120mcg total) initial dose
115
IN fentanyl dose normal sized adult
3 x 60mcg in 0.2ml (180mcg total) initial dose
116
Contraindications for use of fentanyl?
H = Hypersensitivity to fentanyl
117
Precautions for use of fentanyl?
Elderly patients
118
Side effects of fentanyl use?
#NAME?
119
Glucagon presentation?
1mg in 1ml vial with diluent for injection
120
Glucagon mechanism of action?
Hyperglycaemic agent which converts stored liver glycogen to glucose to increase blood glucose concentration.
121
Glucagon onset time?
4-7 minutes
122
Glucagon duration time?
10-30 minutes
123
Glucagon indications?
Demonstrated hypoglycaemia where oral glucose cannot be administered and IV access cannot be obtained in a safe and timely manner:
124
Glucagon adult dose?
1mg in 1ml IM to deltoid or mid-lateral thigh
125
Glucagon paediatric dose?
< 5 years 0.5mg in 0.5ml IM once only
126
Glucagon contraindications?
Hypersensitivity
127
Glucagon precautions?
Only effective in treating hypoglycaemia if sufficient liver glycogen present (does not work on alcohol or anorexia induced hypoglycaemia)
128
Glucagon side effects?
Nausea and vomiting
129
Glucose oral gel presentation?
15g in plastic tube
130
Glucose oral gel mechanism in action?
Rapidly absorbed from oral/buccal mucosa to increase blood glucose concentration
131
Glucose oral gel time of onset?
2-5 minutes
132
Glucose oral gel duration of action?
12-25 minutes
133
Glucose oral gel indications?
Demonstrated hypoglycaemia in:
134
Glucose oral gel adult dose?
Squeeze as much of tube contents as possible into lower cheek pouch over gums/cheek and massage cheek externally
135
Glucose oral gel paediatric dose?
Squeeze proportion of tube contents into lower cheek pouch over gums/cheek and massage cheek externally
136
Glucose oral gel contraindications?
Nil
137
Glucose oral gel precautions?
- Have patient's airway patent and in lateral position if unconscious
138
Glucose oral gel side effects?
Airway obstruction
139
Normal saline presentation?
NaCl 0.9% in 1000ml soft plastic bag
140
Normal saline description?
A sterile isotonic crystalloid solution
141
Normal saline indications?
Fluid replacement in treatment of shock, fluid loss and cardiac arrest
142
Normal saline KVO dose?
20 drops per minute (20 drops = 1ml)
143
Normal saline adult shock dose?
500ml boluses to a maximum of 2000ml
144
Normal saline small adult/elderly shock dose?
250ml boluses to a maximum of 1000ml
145
Normal saline paediatric shock dose?
20ml/kg over 5-10 minutes
146
Normal saline cardiac arrest dose?
20ml/kg bolus as a reversible cause of hypovolaemia
147
Normal saline contraindications?
Circulatory overload
148
Normal saline precautions?
IV access / fluid administration to be avoided (unless if lifesaving) in patient's on the side of:
149
Normal saline side effects?
Circulatory overload
150
IV glucose presentation?
10% glucose (10g per 100ml) in 500ml bag
151
IV glucose description?
A hypertonic crystalloid solution which provides a readily available source of energy or glucose
152
IV glucose onset time?
Within 1 minute
153
IV glucose indications?
Demonstrated hypoglycaemia where oral glucose administration is inappropriate in:
154
IV glucose adult dose?
10g (100ml of 10% solution) IV/IO
155
IV glucose paediatric dose?
2.5ml/kg (0.25g/kg) up to 10g (100ml) IV/IO
156
IV glucose contraindications?
#NAME?
157
IV glucose precautions?
#NAME?
158
IV glucose side effects?
Hyperglycaemia
159
Isordil correct name and presentation?
Isosorbide Dinitrate 5mg tablet
160
GTN presentation?
0.4mg atomised spray
161
GTN name?
Glyceryl Trinitrate
162
GTN mechanism in action?
Vasodilation
163
GTN indications?
Chest pain/discomfort of presumed cardiac origin not relieved by rest and reassurance, with systolic BP >90mmHg
164
GTN dose for cardiac chest pain?
1 x 0.4mg spray sublingually.
165
Isordil dose for cardiac chest pain?
1 x 5mg tablet sublingually.
166
GTN dose for APO?
1 x 0.4mg spray sublingually every 5 mins to a maximum of 3 doses.
167
Isordil dose for APO?
1 x 5mg tablet sublingually every 5 mins to a maximum of 3 doses.
168
Nitrate additional doses for long transport?
Further doses may be given every 30 mins where indicated and criteria met.
169
Nitrates contraindications?
Hypersensitivity
170
Nitrates precautions?
#NAME?
171
Nitrates side effects?
Hypotension (rare)
172
Ketamine presentation?
200mg in 2ml ampoule
173
What is ketamine?
A rapid acting dissociative anaesthetic.
174
What is the IM onset time of ketamine?
5-10mins
175
What is the IV onset time of ketamine?
1min
176
Ketamine indications?
Second line agent for severe pain of traumatic origin.
177
Ketamine IM dose for analgesia?
Initial dose 1mg/kg
178
Ketamine IV adult dose for analgesia?
Initial dose 10-20mg (1-2ml)
179
How must ketamine be diluted for IV use and what dose will be contained in 1ml of diluted solution?
200mg in 2ml ketamine + 18ml NaCL = 10mg/ml
180
Ketamine IV paediatric dose for analgesia?
0.1mg/kg administered slowly titrated to effect
181
What must be obtained prior to using ketamine for sedation?
ASMO medical consult authorisation
182
Ketamine dose for sedation?
#NAME?
183
Ketamine contraindications?
1) Hypersensitivity
184
Ketamine precautions?
1) Use with caution in pt with stable psych disorders such as schizophrenia (unless pre-treated with midazolam)
185
Ketamine side effects?
1) BP and pulse frequently elevated
186
Lignocaine strength and alternative name?
1%
187
Lignocaine presentation
20mg/2ml (1%) in plastic ampoule
188
Lignocaine indications?
Local anaesthesia for:
189
Lignocaine intradermal dose?
0.1ml
190
Lignocaine IO adult dose?
40mg in 4ml (2 ampoules)
191
Lignocaine IO small adult/large child dose?
20mg in 2ml (1 ampoule)
192
Lignocaine IO small child dose?
10mg in 1ml (half an ampoule)
193
Lignocaine contraindications?
Hypersensitivity
194
Lignocaine precautions?
Adverse reactions are rare when used as local anaesthetic and administered correctly
195
Lignocaine side effects?
Tinnitus
196
Methoxyflurane presentation?
3ml ampoule
197
Methoxyflurane mechanism of action?
Halogenated ether
198
Methoxyflurane onset time?
6-8 breaths or 1-2 minutes
199
Methoxyflurane maximum level time?
2-4 minutes
200
Methoxyflurane indications?
Pain
201
Methoxyflurane dose?
Initial dose 1 x 3ml ampoule
202
Maximum dose of methoxyflurane in 24 hours?
6ml (2 ampoules)
203
Maximum dose of methoxyflurane in 7 days?
15ml (5 ampoules)
204
Methoxyflurane contraindications?
1) Pt unable to understand or cooperate
205
Methoxyflurane precautions?
1) Use penthrox inhaler with charcoal filter
206
Methoxyflurane side effects?
1) Lightheadedness
207
CCP - Maxalon alternative name?
Metoclopramide
208
CCP - Maxalon presentation?
10mg in 2ml ampoule
209
CCP - Maxalon mechanism in action?
Anti-emetic
210
CCP - Maxalon metabolism?
Via liver and excreted by kidneys
211
CCP - Maxalon indications?
1) Nausea and vomiting associated with pain and/or GI disturbance
212
CCP - Maxalon precautions?
Children < 12 years
213
CCP - Maxalon dose?
10mg IV or IM
214
CCP - Maxalon side effects?
1) Drowsiness
215
CCP - Maxalon IV onset time?
3-5 mins
216
CCP - Maxalon IV peak time?
10-15 mins
217
CCP - Maxalon IV duration?
30-60 mins
218
CCP - Maxalon not effective for?
1) Established motion sickness
219
Midazolam alternative name?
Hypnovel
220
Midazolam presentation?
15mg in 3ml ampoule
221
Midazolam mechanism in action?
Water soluble benzodiazepine with anxiolytic, sedative and anti-convulsant characteristics.
222
Midazolam indications?
1) Seizures
223
Midazolam seizure/sedate non-TBI adult IM dose?
5-10mg IM
224
Midazolam seizure/sedate non-TBI adult IV dose?
1-5mg IV/IO
225
Midazolam seizure/sedate non-TBI paediatric IM dose?
2.5-5m IM
226
Midazolam seizure/sedate non-TBI paediatric IV dose?
0.1mg/kg IV/IO to maximum bolus of 5mg
227
Midazolam combative TBI adult IV dose?
1mg IV/IO every 3 mins to maximum 5mg
228
Midazolam combative TBI paed IV dose?
0.1mg/kg IV/IO bolus up to max 1mg
229
Midazolam adult back spasm IM dose?
2.5-5mg IM
230
Midazolam adult back spasm IV dose?
1mg IV every 2-3 mins to max 5mg
231
Midazolam contraindications?
Hypersensitivity
232
Midazolam precautions?
1) If small, frail or over 65 try half adult dose first
233
Midazolam dilution for 1mg/1ml via 10ml syringe?
Draw up 10mg in 2ml with 8ml NaCl = 10mg in 10mls
234
Midazolam dilution for 1mg/1ml via 20ml syringe?
Draw up 15mg in 3ml with 12ml NaCl = 15mg in 15mls
235
Midazolam side effects?
1) Resp depression
236
Naloxone presentation?
0.4mg in 1ml ampoule
237
Naloxone action?
Pure narcotic antagonist which exerts effect by competitive inhibition at opioid receptor sites. Prevents or reverses effects of opioids inc resp depression, sedation and hypotension. No pharmacological activity of naloxone in absence of opioids.
238
Naloxone indications?
Reversal of respiratory depression in suspected narcotic overdose.
239
Naloxone dilution for IV use?
Dilute 0.4mg/1ml ampoule with 9mls NaCl = 0.04mg per ml.
240
Naloxone adult IM dosage?
0.4mg every 5-10 mins as required up to max 2mg (5 ampoules).
241
Naloxone adult IV dosage?
0.04mg in 1ml IV/IO increments every 2 minutes titrated to effect up to 2mg.
242
Naloxone paediatric IM dose?
0.4mg every 5-10 mins as required up to max 2mg (5 ampoules)
243
Naloxone paediatric IV dosage?
0.01mg per kg (10mcg per kg) initial dose.
244
Naloxone contraindications?
Responsive pt with adequate respirations and who are protecting their own airway.
245
Naloxone precautions?
1) Polypharmacy overdose
246
Naloxone side effects?
Withdrawal symptoms eg aggression, agitation, nausea, vomiting, dilated pupils, lacrimation.
247
Ondansetron presentation?
4mg in 2ml ampoule
248
Ondansetron pharmacology?
Anti-nauseant and anti-emetic.
249
Ondansetron onset of action duration?
Up to 30 minutes
250
Ondansetron indications?
1) Moderate to severe nausea
251
Ondansetron adult dose IM or IV?
4mg in 2ml or slow IV/IO
252
Ondansetron paed dose IM 2-5 years?
1mg in 0.5ml IM
253
Ondansetron paed dose IM 6-9 years?
2mg in 1ml IM
254
Ondansetron paed dose 10-12 years?
3mg in 1.5ml IM
255
Ondansetron paed dose >12 or >40kg?
4mg in 2ml IM
256
Ondansetron contraindications?
1) Paed less than 2 years old
257
Ondansetron precautions?
Administer IV/IO slowly over 2 mins neat or diluted to prevent blurred vision and dizziness
258
Ondansetron side effects?
1) Headache
259
Paracetamol presentation?
500mg tablets or 125mg/5ml suspension
260
Paracetamol pharmacology?
Oral analgesia for relief of mild to moderate pain and fever
261
Paracetamol indications?
1) Headache
262
Paracetamol contraindications?
1) Known allergy to paracetamol
263
Paracetamol adult dose?
500-1000mg (1-2 tablets) with water
264
Paracetamol paed 7-12 dose?
250-500mg (0.5-1 tablets) with water or crushed
265
Paracetamol paed <7 dose?
As per directions on bottle administered by parents
266
Paracetamol time of onset?
20-30 minutes
267
Paracetamol side effects?
Nil known at therapeutic doses?
268
Paracetamol precautions?
Advise not to take more paracetamol during next 4 hours
269
Paracetamol toxicity dose?
10-15g
270
CCP - Promethazine alternative name?
Phenergan
271
CCP - Promethazine presentation?
25mg in 1ml ampoule
272
CCP - Promethazine pharmacology?
Long acting H1 blocker with mild atropine like anticholinergic effects
273
CCP - Promethazine action?
1) Antihistamine
274
CCP - Promethazine metabolised by?
Liver
275
CCP - Promethazine indication?
Motion sickness
276
CCP - Promethazine contraindications?
Known severe adverse reaction
277
CCP - Promethazine precautions?
1) Children < 6 years
278
CCP - Promethazine side effects?
1) Dry mouth
279
CCP - Promethazine adult dose IV?
12.5mg IV given over at least 2 minutes
280
CCP - Promethazine adult dose IM?
25-50mg deep IM
281
CCP - Promethazine paed dose >6 yrs?
0.25mg/kg IM or IV
282
CCP - Promethazine onset IM & IV?
20 mins IM / 5-10 mins IV
283
CCP - Promethazine peak IM & IV?
30 mins
284
CCP - Promethazine duration IM & IV?
2-8 hours
285
Salbutamol sulphate neb presentation?
5mg in 2.5ml plastic nebular
286
Salbutamol sulphate MDI presentation?
100mgc dose per puff
287
Salbutamol sulphate pharmacology?
Short acting sympathomimetic agent - beta 2 adrenoreceptor stimulant causes relaxation of bronchial smooth muscle.
288
Salbutamol sulphate initial effect onset?
2-5 minutes
289
Salbutamol sulphate indications?
Bronchospasm and resp distress associated with wheeze:
290
Salbutamol sulphate MDI dose?
4 puffs with 4 breaths each puff every 4 mins
291
Salbutamol sulphate neb dose?
1 x 5mg in 2.5ml nebula with 8L/min oxygen
292
Salbutamol sulphate contraindications?
1) Hypersensitivity
293
Salbutamol sulphate precautions?
1) Tachycardia
294
Salbutamol sulphate side effects?
1) Muscle tremor
295
CCP - Suxamethonium chloride presentation?
100mg in 2ml ampoule
296
CCP - Suxamethonium chloride pharmacology?
Depolarising neuromuscular blocking agent
297
CCP - Suxamethonium chloride indications?
Complete muscle relaxation to facilitate endotracheal intubation
298
CCP - Suxamethonium chloride contraindications?
1) Known hypersensitivity to suxamethonium
299
CCP - adult and paediatric suxamethonium chloride dosages?
Adults = 1-2mg/kg IV/IO repeat dose if indicated
300
CCP - Suxamethonium chloride precautions?
Sedation is required prior to use
301
CCP - Suxamethonium chloride side effects?
1) Muscular fasciculations
302
CCP - Suxamethonium chloride special notes?
1) Atropine should be administered prior to six administration if bradycardic
303
List 4 indicators of mild to moderate allergic reactions which may require EpiPen or Anapen use?
1) Swelling of lips, face or eyes
304
List 7 indicators of anaphylaxis which may indicate the need to use an EpiPen or Anapen?
1) Difficult or noisy breathing
305
What positioning must be maintained when using an EpiPen or Anapen and why?
Lateral position if unconscious for secretion drainage
306
What must a patient not be allowed to do after administration of adrenaline or EpiPens...even if they appear to have recovered?
Stand up or walk
307
How long must a patient be monitored in hospital for post-adrenaline administration?
At least four hours after the last does of adrenaline
308
How often can an Epipen or Anapen be repeated if necessary?
Every five minutes as clinically indicated
309
CCP - what is the alternative name for metaraminol tartrate?
Aramine
310
CCP - describe aramine and its actions?
A synthetic adrenergic stimulant with primarily alpha effects...causes:
311
CCP - what are the indications for aramine use?
Adjunctive treatment of hypotension (<90mmHg after adequate fluid resuscitation) due to:
312
CCP - what is the presentation of aramine?
10mg in 1ml ampoule
313
CCP - what IV bolus and ongoing dose of aramine is appropriate?
0.5-1mg titrated to effect (continuously re-checking BP) administered every 3-5mins
314
CCP - how is aramine diluted?
10mg in 1ml added to 19ml NaCl 0.9% to provide a 0.5mg per 1ml solution
315
CCP - onset time of aramine?
1-2 minutes
316
CCP - contraindications of aramine?
Hypersensitivity
317
CCP - precautions for aramine use?
Avoid extravasation as aramine causes tissue necrosis.
318
CCP - side effects of aramine?
Rapidly induced hypertensive response may cause:
319
CCP - presentation of morphine sulphate?
15mg in 1ml ampoule
320
CCP - what is morphine sulphate?
A narcotic analgesic
321
CCP - IM onset, peak and duration times of morphine?
Onset 10-30 minutes
322
CCP - IV/IO onset, peak and duration times of morphine sulphate?
Onset 2-5 minutes
323
CCP - indications for morphine sulphate use?
Analgesia
324
CCP - contraindications for use of morphine?
Hypersensitivity
325
CCP - precautions in morphine sulphate use?
1) Elderly patients
326
CCP - complications or side effects of morphine?
1) Bradycardia
327
CCP - adult dose of morphine sulphate for analgesia?
5-10mg IM
328
CCP - adult dose of morphine sulphate for sedation to maintain intubation?
1-10mg/kg/hr IV/IO
329
CCP - paed dose of morphine sulphate for analgesia?
0.1-0.2mg/kg IM
330
CCP - paed dose of morphine sulphate for sedation to maintain intubation?
0.1-0.2mg/kg/hr IV/IO
331
CCP - alternative name for Rocuronium Bromide?
Esmeron
332
CCP - presentation of esmeron?
50mg in 5ml ampoule
333
CCP - description of esmeron?
A non-depolarising neuromuscular blocking agent...due to a weak vagolytic action, a slight rise in pulse rate and MAP may be expected.
334
CCP - onset and peak time of esmeron?
Onset 2-3 minutes
335
CCP - indications for use of esmeron?
To maintain skeletal muscle paralysis to allow mechanical ventilation in intubated patients following RSI or during interhospital transport of ventilated patients
336
CCP - contraindications for use of esmeron?
Status epilepticus
337
CCP - precautions in use of esmeron?
#NAME?
338
CCP - complications or side effects of esmeron?
Slight increase in HR
339
CCP - IV/IO initial dose, maintenance dose and infusion dose?
Initial = 0.6mg/kg (usually 50mg in adults)
340
CCP - duration of esmeron?
30-40 minutes
341
Adrenaline IV dose for newborns in cardiac arrest?
10-30mcg/kg
342
NaCl dose for newborns in cardiac arrest?
10ml/kg
343
Oxygen is a treatment for what specifically?
Hypoxemia
344
What does oxygen have no effect on?
Breathlessness in non-hypoxemic patients
345
What parameters of oxygen saturations are desirable in normal adults and adults with COPD?
Normal adults = 94-98%
346
When should children receive oxygen?
In all cases of significant illness or injury
347
When is oxygen therapy to be commenced in newborn resuscitation?
After the first few breaths of room air only
348
What percentage of oxygen is delivered by nasal cannulas at 1-4 LPM?
24-35%
349
What percentage of oxygen is delivered by a therapy mask at 5-8 LPM?
40-60%
350
What percentage of oxygen is delivered by a non-rebreather mask at 15 LPM?
60-100%
351
What percentage of oxygen is delivered by a bag-valve-mask at 15 LPM?
95-100%
352
What are the contraindications of oxygen use?
Normoxia
353
What are the precautions in use of oxygen?
If target saturations cannot be maintained with nasal cannula or therapy mask then change to non-rebreather mask.
354
What are the side effects of oxygen?
Patients with acute COPD are at risk of developing CO2 retention if given excessive supplemental oxygen - this can cause acidosis and subsequent organ dysfunction.
355
Which three medications can easily be calculated at 0.01mg per kg in paediatric patients and at what dilution for each?
Ketamine 0.01mg per kg of 2:18ml dilution
356
What is the quick calculation of the four main drugs formula for paediatric cardiac arrest?
NaCl 20ml per kg to max 1000ml no repeat
