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Clinical Practise 2016 > Drugs > Flashcards

Drugs Flashcards

1
Q

Adrenaline presentation

A

1mg in 1ml

1mg in 10ml

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2
Q

Adrenaline contras

A

hypovolaemic shock without adequate fluid replacement

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3
Q

Adrenaline precautions

A

consider reduced doses for: elderly, pts with CVD, pts on monoamine oxidase inhibitors
beta blockers

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4
Q

Side effects of Adrenaline

A

Sinus tachy, supraventricular arrhythmias, ventricular arrhythmias, hypertension, pupillary dilation, may increase size of MI, feeling of anxiety/palpitations in the conscious pt

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5
Q

Presentation of Aspirin

A

300mg tablet

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6
Q

PEI Aspirin

A

ACS

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7
Q

Contras of Aspirin

A

hypersensitivity, actively bleeding peptic ulcers, bleeding disorders, suspected dissecting aortic aneurysm, chest pain assoc with psychostim OD if SBP greater than 160

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8
Q

Precautions of Aspirin

A

peptic ulcer
asthma
pts on anticoagulants

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9
Q

Side effects of Aspirin

A

heartburn, nausea, GI bleeding, increased bleeding time, hypersensitivity reactions

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10
Q

Dextrose 10% presentation

A

25g in 250ml soft pack

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11
Q

contras of Dextrose 10%

A

nil

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12
Q

Precautions of Dxtrose 10%

A

nil

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13
Q

Side effects of Dextrose 10%

A

nil

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14
Q

Presentation of Fentanyl

A

100mcg in 2ml
200mcg in 1ml
600mcg in 2ml

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15
Q

PEI of Fentanyl

A

sedation to facilitate intubation
sedation to maintain intubation
drug facilitated intubation
analgesia

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16
Q

contras of Fentanyl

A

known hypersensitivity

IV amiodarone

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17
Q

precautions of Fentanyl

A 
elderly
impaired renal function
resp depression
current asthma
pts on MOA inhibitors
known addition to opioids
rhinitis, rhinorrhea or facial trauma
oral amiodarone
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18
Q

Side effects of Fentanyl

A

resp depression
apnoea
rigid diaphragm
bradycardia

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19
Q

Fentanyl presentation used for Adult IN

A

600mcg in 2ml

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20
Q

Fentanyl Presentation used for Paed IN

A

100mcg in 2ml

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21
Q

GTN presentation

A

0.6mg tablets

50mg patch

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22
Q

PEI for GTN

A 
chest pain with ACS
acute LVF
hypertension assoc with ACS
autonomic dysreflexia
preterm labour
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23
Q

contras for GTN

A 
hypersensitivity 
SBP less than 110 tablet
SBP less than 90 patch 
viagra or levitra in 24 hours or cialis in 4 days 
HR greater than 150
HR less than 50
VT
inferior STEMI with SBP less than 160 
right ventricular MI
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24
Q

Precautions of GTN

A

no previous admin
elderly pts
recent MI
concurrent use with other tocolytics

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25
Q

Side effects of GTN

A

tachycardia, hypotension, eadache, skin flushing, bradycardia

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26
Q

Presentation of Ipratropium Bromide

A

250mcg in 1ml

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27
Q

PEI for Ipratropium Bromide

A

severe resp distress associated with bronchospasm

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28
Q

contras of Atrovent

A

known hypersensitivity to Atropine or its derivatives

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29
Q

Precautions of Atrovent

A

glaucoma

avoid contact with eyes

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30
Q

Side effects of Atrovent

A

headache, nausea, dry mouth, skin rash, tahcycardia, palpitations, acute angle closure glaucoma

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31
Q

Methoxy presentation

A

3ml

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32
Q

PEI of Methoxyflurane

A

pain relief

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33
Q

contras of Methoxy

A

preexisting renal disease
concurrent use with tetracycline antibiotics
exceeding total dose in 24 hours

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34
Q

Precautions of Methoxy

A

penthrox held by pt
pre-eclampsia
concurrent use with oxytocin

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35
Q

Side effects of Methoxy

A

drowsiness, decrease in BP and bradycardia, renal toxicity

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36
Q

Presentaiton of Metoclopramide

A

10mg in 2ml

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37
Q

PEI for Metoclopramide

A

nausea and vomiting assoc with chest pain, opioid admin for pain, cytotoxic or radiotherapy, previously diagnosed migraine, severe gastro
awake spinal immobilized pts, eye trauma

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38
Q

contras of Metoclopramide

A

children
suspected bowel obstruction
GI haemorrhage

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39
Q

precautions of Metoclopramide

A

undiagnosed abdo pain
adolescents
admin slowly over 1min

40
Q

side effects of metoclopramide

A 
drowsiness
lethargy
dry mouth
muscle tremor 
extrapyrimidal reactions
41
Q

Midazz presentations

A

5mg in 1ml

15mg in 3ml

42
Q

PEI of Midaz

A 
status epilepticus
sedation to enable intubation
post intubation sedation
sedation to enable synchronized cardioversion
sedation in the agitated pt
sedation in psychostim OD
43
Q

Contras for Midaz

A

known hypersensitivity to benzos

44
Q

Precautions for Midaz

A

reduced doses may be required for the elderly, renal failure, CCF or shock
CNS depressant effects enhanced in the presence of narcotics
can causes severe resp depression in COPD
pts with myasthenia gravis

45
Q

Side effects of Midaz

A

depressed level of consciousness
resp depression
loss of airway control
hypotension

46
Q

Presentation of Morphin

A

10mg in 1ml

47
Q

PEi for Morphine

A 
pain relief
acute LVF with SOB and FF crackles
sedation to maintain intubation
sedation to enable intubation
RSI
48
Q

contras of Morphine

A

known hypersensitivity

late second stage labour

49
Q

Precautions of Morphine

A 
elderly
hypotension
resp depression
asthma
resp tract burns
known addiction to opioids
alcoholism
MOA inhibitors
50
Q

Side effects of Morphine

A 
drowsiness
resp depression
euphoria
n+v
addication
pin point pupils
hypotension
bradycardia
51
Q

NAloxone presentation

A

0.4mg in 1ml

52
Q

contras of Naloxone

A

nil

53
Q

Precautions of NAloxone

A

physical dependence

neonates

54
Q

side effects of naloxone

A

sweating, goosebumps, tremor

n+v, agitation, dilation of pupils, convulsions

55
Q

Presentation of stemitil

A

12.5mg in 1ml

56
Q

Contras of Stemitil

A

circulatory collapse
CNS depression
previous hypersensitivity
children

57
Q

precautions of Stemitil

A

hypotension
epilepsy
pts affected by alcohol or antidepressants

58
Q

side effects of Stemitil

A

drowsiness, blurred vision, hypotension, sinus tachy, skin rash, extrapyrimidal reactions

59
Q

Presentation of salbutamol

A

5mg in 2.5ml
500mcg in 1ml
5mg in 5ml

60
Q

Contras of Salbutamol

A

IV

61
Q

Precautions of Salbutamol

A

large doses of IV cause intracellular metabolic acidosis

62
Q

PEI of Salbutamol

A

resp distress with suspected bronchospasm, asthma, severe allergic reactions, COPD, smoke inhalation, capsicum spray exposure

63
Q

Side effects of Salbutamol

A

sinus tachy

muscle tremor

64
Q

Actual Time Critical

A

Moderate or severe resp distress
Oxygen sats less than 90% room air
Less than adequate perfusion
GCS less than 13

65
Q

Emergent Time Critical

A 
ACS
Acute stroke
Severe sepsis, including suspected meningococcal disease
Possible AAA
Undiagnosed severe pain 
Need for hyperbaric treatment
Hypo or hyperthermia
66
Q

Causes of PEA

A 
Hypoxia 
Exsanguination 
Asthma
TPT
Anaphylaxis 
Airway obstruction
67
Q

Contras for LMA

A

intact gag reflex or resistance to insertion
strong jaw tone and/or trismus
suspected epiglottitis or upper airway obstruction
the use of sedation to assist placement

68
Q

Precautions of LMA

A

inability to prepare pt in sniffing position
pts who require high airway pressures
Pts less than 14
significant volume of vomit

69
Q

RSI preparation

A 
Optimise position
C-spine considerations 
Oxygen supply sufficient 
Nasal prongs
IV/IO access x2
Normal saline at least 10ml/kg 
Suction tested
O.P airway
70
Q

Causes of APO

A 
LVF
nutritional deficiency
liver disease
renal disease
fluid overload
71
Q

Adult initial dose of Fentanyl IN for all adults (ml)

A

200mcg in 0.75ml

72
Q

Adult Subsequent dose of Fentanyl IN for all adults (ml)

A

50mcg in 0.25ml

73
Q

Adults initial dose of Fentanyl IN for frail adults (ml)

A

100mcg in 0.45ml

74
Q

Adults subsequent dose of Fentanyl IN for frail adults (ml)

A

50mcg in 0.25ml

75
Q

Morphine doses for adults

A

IV - up to 5mg repeat after 5 mins
IM - over 60kg 10mg repeat 5mg after 15 mins
under 60kg 0.1mg/kg once only

76
Q

Severe headache doses

A

Methoxy 3ml and Stemitil 12.5mg IM
Morphine 2.5mg IV every 5mins
Fentanyl 25mcg IV every 5mins
Elderly or frail: 50mcg IN Fentanyl repeat 25mcg after 5 mins
Other adults: 100mcg IN Fentanyl repeat 25mcg after 5mins

77
Q

Contras for CPAP

A 
GCS less than 13
Facial trauma
Pneumothorax
Active vomiting
Life threatening arrhythmias
Pts requiring airways management
Hypoventilation
78
Q

Seizure treatment

A

Midaz 10mg IM (2 ampoules)

OXYGEN

79
Q

Anaphylaxis symptoms

A

R-resp distress
A-abdo symptoms
S-skin/mucosal symptoms
H-hypotension

80
Q

Anaphylaxis treatment

A

500mcg Adrenaline IM repeat after 5 mins
300mcg for elderly or frail
neb adrenaline 5mg in 5ml if required

81
Q

Evidence of Opioid overdose

A 
altered consious state
resp depression
substance involved
exclude other causes
pin point pupils
track marks
82
Q

Treatment of Opioid overdose

A

Naloxone 1.6-2mg (4-5 ampoules)

repeat 0.8mcg after 10mins (2ampoules)

83
Q

Assessment of the agitated patient

A 
Alcohol
Epilepsy
Insulin 
Overdose
Underdose
Trauma
Infection/sepsis
Pain/psycho
Stroke/TIA
84
Q

Sedation of the agitated pt

A

Midaz 5-10mg IM
lower doses for elderly
repeat after 10 mins

85
Q

Autonomic Dysreflexia symptoms

A

previous CI at T6 or above
severe headache
SBP greater than 160

86
Q

Stroke Mimics

A 
H-hypo/hyperglycaemia
I-intoxication
B-brain tumour
E-electrolyte imbalance
S-sepsis
S-subdural haematoma
S-seizure
S-syncope
M-migraine
M-middle ear disorder
87
Q

Modifying Factors of hypovolaemia

A 
SCI
chest injury
penetrating trunk injury 
AAA
uncontrolled external heamorrhage 
GI haemorrhage
88
Q

Paed weights

A 
Newborn 3.5kg
2  months 5kg
5 months 7kg 
1 year 10kg
1-9yrs age x2 + 8
10-14 age x 3.3
89
Q

Paed perfusion

A 
HR:
120-160
100-160
80-120
80-100
BP
N/a
70
80
90
RR:
40-60
20-50
20-35
15-25
90
Q

Paed GCS verbal

A 
Appropriate words, social smiles, fixes
cries but consolable
Persistently irritable
Restless and agitated
None
91
Q

Paed dose of Fentanyl IN initial

A

small child 25mcg in 0.6ml

large child 50mcg in 1.1ml

92
Q

Unconsciouos asthma ventilation rates

A

infant 15-20
small child 10-15
large child 8-12

93
Q

Unconscious asthma adrenaline dose

A

10mcg/kg IM repeat after 20mins (max 30mcg/kg)

94
Q

Seizure of a paed

A 
large child 5mg in 1ml Midaz 
small child 2.5mg in 0.5ml
infant 1mg in 0.2ml
newborn 0.5mg in 0.1ml 
repeat after '10 mins once only
95
Q

Anaphylaxis treatment for paeds

A

Adrenaline 10mcg/kg IM repeat after 5 mins

Clinical Practise 2016 (12 decks)

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