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AAV > AAV Drugs > Flashcards

AAV Drugs Flashcards

0
Q

What is the pharmacology of Ketamine?

A

A rapid acting dissociative anaesthetic agent (primarily an NDMA receptor antagonist)

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1
Q

What is the Presentation of Ketamine?

A

200 mg in 2 mL vial

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2
Q

What are the actions of Ketamine?

A

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
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3
Q

What is the metabolism of Ketamine?

A

By the liver and excreted by the kidneys.

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4
Q

What are the primary emergency indications of Ketamine?

A
  • Severe pain unrelieved by Morphine
  • Control of the combative patient during extrication
  • General anaesthetic for pre hospital emergency surgery
  • Induction agent for intubation
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5
Q

What are the contraindications to Ketamine?

A
  • known hypersensitivity

- severe hypertension (BP > 160 mmHg)

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6
Q

What are the precautions to Ketamine?

A

Where significant elevation of BP would be hazardous (eg active IHD).

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7
Q

Route of administration for Ketamine?

A

IV bolus

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8
Q

What are the side effects of Ketamine?

A
  • 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
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9
Q

Onset times for Ketamine?

A

Onset 30 seconds
Peak 12- 25 minutes
Usual preparation 200mg diluted to 20mL with Normal Saline

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10
Q

What is the presentation of Noradrenaline?

A

2 mg in 2 mL ampoule

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11
Q

What is the pharmacology of Noradrenaline?

A

A synthetic adrenergic stimulant with primarily alpha effect.

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12
Q

What is the action of Noradrenaline?

A

Causes peripheral vasoconstriction (alpha).

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13
Q

What is the metabolism of noradrenaline?

A

By monoamine oxidase in the blood, liver and around nerve endings and excreted by the kidneys.

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14
Q

What are the primary emergency indications for noradrenaline?

A
  1. Severe sepsis with inadequate perfusion and mean arterial BP < 70 mmHg.
  2. Neurogenic shock.
  3. Hypotensive intercranial haemorrhage.
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15
Q

What are the contra indications for Noradrenaline?

A

Hypovolemic shock

Patients with mesenteric or peripheral vascular ischemia unless administration is deemed life saving.

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16
Q

What are the precautions of noradrenaline?

A

Since noradrenaline can cause tissue necrosis, care must be taken to avoid extravasation.

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17
Q

What is the route of administration of noradrenaline?

A

IV infusion using syringe pump only

18
Q

Side effects of noradrenaline?

A

Peripheral ischemia
Ventricular arrhythmias
Hypertension

19
Q

Special notes for noradrenaline?

A

Must be administered via a dedicated IV line. If no CVC available Short term administration with care may be undertaken.

20
Q

Preparation of noradrenaline infusion?

A

Noradrenaline 3 mg diluted to 50 mL with 47 mL normal saline.
1mL equals 0.06 mg noradrenaline.

21
Q

What is the presentation of “Dynastat” (Paracoxib Sodium)?

A

40 mg powder plus 2 mL dilutant for IV injection

22
Q

What is the pharmacology of “Dynastat” (Paracoxib Sodium)?

A

A NSAID drug (selective cox 2 inhibitor)

23
Q

What is the metabolism of “Dynastat” (Paracoxib Sodium)?

A

Metabolised by the liver.

24
Q

What is the action of “Dynastat” (Paracoxib Sodium)?

A

An Analgesic

25
Q

Primary emergency indication for “Dynastat” (Paracoxib Sodium)?

A

Severe traumatic of post surgical pain unrelieved by morphine.

26
Q

Contraindications to “Dynastat” (Paracoxib Sodium)?

A

Previous sensitivity to NSAIDs, aspirin or sulphonamides.
Age > 60 years
Known renal impairment
Increased risk of ARF ie crush syndrome (limb compressed > 1 hour) prolonged hypotension (> 1 hour)
Penetrating chest injury
Major bleeding suspected

27
Q

Precautions to “Dynastat” (Paracoxib Sodium)?

A

Nil of significance.

28
Q

Route of administration for “Dynastat” (Paracoxib Sodium)?

A

IV bolus

29
Q

Side effects of “Dynastat” (Paracoxib Sodium)?

A

Renal failure
Gasto intestinal bleeding / ulceration from long term use
Hypertension / hypotension

30
Q

Times for “Dynastat” (Paracoxib Sodium)?

A

Onset 5 mins
Peak 30 mins
Duration 18 hours

In some patients the onset time may be prolonged due to delayed conversion of the drug to the active metabolite.

31
Q

Presentation of Ondansetron?

A

8 mg in 4 mL injection

4 mg wafer

32
Q

Pharmacology of Ondansetron?

A

Centrally acting anti emetic

33
Q

Metabolism of Ondansetron?

A

By the liver.

34
Q

Primary emergency indications of Ondansetron?

A

Nausea unresponsive to metoclopramide or prochlorperazine

35
Q

Precautions to Ondansetron?

A

Nil

36
Q

Contraindications to Ondansetron?

A

Nil

37
Q

Route of administration of Ondansetron?

A

IV bolus

Sublingual wafer

38
Q

Side effects of Ondansetron?

A

Headache

Flushing

39
Q

Presentation of Propofol?

A

200 mg in 20 MAS

40
Q

Pharmacology of Propofol?

A

A sedative anaesthetic agent.

41
Q

Metabolism of Propofol?

A

Metabolised by the liver.

42
Q

Primary emergency indications of Propofol?

A

Induction of anaesthesia - gcs > 9 with airway burns
Sedation during mechanical ventilation
Intercranial haemorrhage with hypertension.

43
Q

Contraindications to Propofol?

A

Allergy to Propofol or component parts (egg, soya bean, glycerol)
Undifferentiated trauma
Sedation or anaesthesia in children < 3 years
Hypotension < 100 mmHg

AAV (3 decks)

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