AAV Drugs Flashcards
(44 cards)
What is the pharmacology of Ketamine?
A rapid acting dissociative anaesthetic agent (primarily an NDMA receptor antagonist)
What is the Presentation of Ketamine?
200 mg in 2 mL vial
What are the actions of Ketamine?
Produces a dissociative state characterised by:
- a trance-like state with eyes open but not responsive
- nystagmus
- profound analgesia
- normal airway reflexes
- normal or slightly increased skeletal muscle tone
- transient and minimal respiratory depression
What is the metabolism of Ketamine?
By the liver and excreted by the kidneys.
What are the primary emergency indications of Ketamine?
- Severe pain unrelieved by Morphine
- Control of the combative patient during extrication
- General anaesthetic for pre hospital emergency surgery
- Induction agent for intubation
What are the contraindications to Ketamine?
- known hypersensitivity
- severe hypertension (BP > 160 mmHg)
What are the precautions to Ketamine?
Where significant elevation of BP would be hazardous (eg active IHD).
Route of administration for Ketamine?
IV bolus
What are the side effects of Ketamine?
- Increased BP and heart rate
- respiratory depression or apnoea following rapid IV administration
- diplopia and nystagmus (slight increase in intra-ocular pressure)
- emergent reactions
- enhanced skeletal tone
- nausea and vomiting
- local pain at the injection site
Onset times for Ketamine?
Onset 30 seconds
Peak 12- 25 minutes
Usual preparation 200mg diluted to 20mL with Normal Saline
What is the presentation of Noradrenaline?
2 mg in 2 mL ampoule
What is the pharmacology of Noradrenaline?
A synthetic adrenergic stimulant with primarily alpha effect.
What is the action of Noradrenaline?
Causes peripheral vasoconstriction (alpha).
What is the metabolism of noradrenaline?
By monoamine oxidase in the blood, liver and around nerve endings and excreted by the kidneys.
What are the primary emergency indications for noradrenaline?
- Severe sepsis with inadequate perfusion and mean arterial BP < 70 mmHg.
- Neurogenic shock.
- Hypotensive intercranial haemorrhage.
What are the contra indications for Noradrenaline?
Hypovolemic shock
Patients with mesenteric or peripheral vascular ischemia unless administration is deemed life saving.
What are the precautions of noradrenaline?
Since noradrenaline can cause tissue necrosis, care must be taken to avoid extravasation.
What is the route of administration of noradrenaline?
IV infusion using syringe pump only
Side effects of noradrenaline?
Peripheral ischemia
Ventricular arrhythmias
Hypertension
Special notes for noradrenaline?
Must be administered via a dedicated IV line. If no CVC available Short term administration with care may be undertaken.
Preparation of noradrenaline infusion?
Noradrenaline 3 mg diluted to 50 mL with 47 mL normal saline.
1mL equals 0.06 mg noradrenaline.
What is the presentation of “Dynastat” (Paracoxib Sodium)?
40 mg powder plus 2 mL dilutant for IV injection
What is the pharmacology of “Dynastat” (Paracoxib Sodium)?
A NSAID drug (selective cox 2 inhibitor)
What is the metabolism of “Dynastat” (Paracoxib Sodium)?
Metabolised by the liver.
