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ASNSW Pharmacology > Adult Dose > Flashcards

Adult Dose Flashcards

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1
Q

Adrenaline
Cardiac Arrest
>= 16
IV

A

Preparation: 1mg in 1ml ampoule (1:1,000)
1mg in 10ml ampoule (1:10,000)
Route: IV
Initial Dose: 1mg (1:10,000) bolus
Repeat: 2nd cycle (~ 4min)
Max Total: No Max

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2
Q

Adrenaline
Cardiac Arrest
>= 16
ETT

A

Preparation: 1mg in 1ml ampoule (1:1,000)
1mg in 10ml ampoule (1:10,000)
Route: ETT
Initial Dose: 3mg (1:1,000)
Repeat: 2nd cycle (~ 4min)
Max Total: 10mg
NB ETT Adrenaline must only be used if IV/IO access is unavailable.

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3
Q

Adrenaline
Life Threatening Asthma
>= 16
IM

A

Preparation: 1mg in 1ml ampoule (1:1,000)
1mg in 10ml ampoule (1:10,000)
Route: IM
Initial Dose: 500mcg (1:1,000) bolus into lateral thigh
Repeat: 5 min
Max Total: No Max

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4
Q

Adrenaline
Life Threatening Asthma
>= 16
IV

A

Indication: Unresponsive after 4x IM bolus injections.
Preparation: 1mg in 1ml ampoule (1:1,000)
1mg in 10ml ampoule (1:10,000)
Route: IV
Initial Dose: 50mcg (1:10,000) bolus
Repeat: 1 min
Max Total: No Max

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5
Q

Adrenaline
Severe/Life Threatening Anaphylaxis
>= 16
IM

A

Preparation: 1mg in 1ml ampoule (1:1,000)
1mg in 10ml ampoule (1:10,000)
Route: IM
Initial Dose: 500mcg (1:1,000) bolus into lateral thigh
Repeat: 5 min
Max Total: No Max

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6
Q

Adrenaline
Severe/Life Threatening Anaphylaxis
>= 16
INFUSION

A

Indication: Unresponsive after 4x IM bolus injections.
Preparation: 1mg in 1ml ampoule (1:1,000)
1mg in 10ml ampoule (1:10,000)
Route: Infusion
Initial Dose: 1mg (1:10,000) diluted in 90ml
compound sodium lactate via burette
with micro drip. Commence 5mcg/min
(30 drops/min)
Repeat: Titrate whilst indicated
Max Total: No Max

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7
Q

Adrenaline
Severe/Life Threatening Anaphylaxis
>= 16
NEB

A

Indication: Continuing signs of upper airway obstruction
post IM Adrenaline
Preparation: 1mg in 1ml ampoule (1:1,000)
1mg in 10ml ampoule (1:10,000)
Route: NEB
Initial Dose: 5mg (1: 1,000)
Repeat: 30 min
Max Total: No Max

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8
Q

Adrenaline
Bradycardia
>= 16

A

Preparation: 1mg in 1ml ampoule (1:1,000)
1mg in 10ml ampoule (1:10,000)
Route: IV
Initial Dose: 50mcg (1:10,000) bolus
Repeat: 1 min until PR > 40 and/or perfusion is
adequate or a continuous Adrenaline
infusion is running
Max Total: No Max

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9
Q

Adrenaline
Cardiogenic Shock
>= 16

A

Preparation: 1mg in 1ml ampoule (1:1,000)
1mg in 10ml ampoule (1:10,000)
Route: IV
Initial Dose: 50mcg (1:10,000)
Repeat: 1 min until systolic BP > 100mmHg or
Adrenaline infusion insitu
Max Total: No Max

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10
Q

Amiodarone
Cardiac Arrest
>= 16

A 
Preparation: 150mg in 3ml ampoule (50mg:1ml)
Route:           IV
Initial Dose:  300mg bolus
Repeat:         once 150mg
Max Total:     450mg
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11
Q

Amiodarone
Dysrhythmias - Tachycardia
>= 16

A 
Preparation: 150mg in 3ml ampoule (50mg:1ml)
Route:          IV
Initial Dose: 50mg bolus
Repeat:        3 min
Max Total:    300mg
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12
Q

Aspirin
Acute Coronary Syndrome
>= 16

A 
Preparation: 300mg tablet
Route:          PO
Initial Dose: 300mg chewed
Repeat:        Nil
Max Total:    300mg
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13
Q

Atropine
Bradycardia
>= 16
IV

A

Preparation: 600mcg in 1ml polyampoule (600mcg:1ml)
Diluted to 6ml (100mcg:1ml) with 5ml NaCl
Route: IV
Initial Dose: 600mcg undiluted bolus
Repeat: 1 min
Max Total: 3mg

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14
Q

Atropine
Bradycardia
>= 16
IM

A

Preparation: 600mcg in 1ml polyampoule (600mcg:1ml)
Diluted to 6ml (100mcg:1ml) with 5ml NaCl
Route: IM
Initial Dose: 600mcg undiluted bolus
Repeat: 3 min
Max Total: 3mg
NB Should only be used where IV access is not available

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15
Q

Atropine
Organophosphate Poisoning
>= 16
IV

A

Indication: PR<80/min and/or
SBP <80mmHg and/or
[+] secretions/crackles or chest crepitation.
Preparation: 600mcg in 1ml polyampoule (600mcg:1ml)
Diluted to 6ml (100mcg:1ml) with 5ml NaCl
Route: IV
Initial Dose: 600mcg undiluted bolus
Repeat: 1 min
Max Total: No Max

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16
Q

Atropine
Organophosphate Poisoning
>= 16
IM

A

Indication: PR<80/min and/or
SBP <80mmHg and/or
[+] secretions/crackles or chest crepitation.
Preparation: 600mcg in 1ml polyampoule (600mcg:1ml)
Diluted to 6ml (100mcg:1ml) with 5ml NaCl
Route: IM
Initial Dose: 2mg undiluted bolus
Repeat: 3 min
Max Total: No Max
NB Should only be used where IV access is not available

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17
Q

Atropine
Nerve Agent Poisoning
>= 16
IV

A

Indication: ALL ages: Mild nerve agent poisoning
symptoms.
>=6yrs: Moderate - Severe Nerve Agent
poisoning symptoms unresponsive to
maximum dose of Pralidoxime
Chloride/Atropine Autoinjector
and/or Pralidoxime Chloride/Atropine
Autoinjector is not available.
Preparation: 600mcg in 1ml polyampoule (600mcg:1ml)
Diluted to 6ml (100mcg:1ml) with 5ml NaCl
Route: IV
Initial Dose: 600mcg undiluted bolus
Repeat: 1 min
Max Total: No Max

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18
Q

Atropine
Nerve Agent Poisoning
>= 16
IM

A

Indication: ALL ages: Mild nerve agent poisoning
symptoms.
>=6yrs: Moderate - Severe Nerve Agent
poisoning symptoms unresponsive to
maximum dose of Pralidoxime
Chloride/Atropine Autoinjector
and/or Pralidoxime Chloride/Atropine
Autoinjector is not available.
Preparation: 600mcg in 1ml polyampoule (600mcg:1ml)
Diluted to 6ml (100mcg:1ml) with 5ml NaCl
Route: IM
Initial Dose: 2mg undiluted bolus
Repeat: 3 min
Max Total: No Max
NB Should only be used where IV access is not available

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19
Q

Benzyl Penicillin
Meningococcal Septicaemia
>= 10

A

Preparation: 600mg as powder.
IV / IO dissolve 600mg in 10ml NaCl
IM dissolve 600mg in 2ml NaCl
Route: IV / IO / IM
Initial Dose: 1200mg
Repeat: Nil
Max Total: 1200mg

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20
Q

Calcium Gluconate
Hyperkalaemia
>= 16

A 
Preparation: 2.2mmol in 10ml ampoule (~1g per 10ml)
Route:           IV
Initial Dose:  1g over 2 min
Repeat:         5 min
Max Total:     3g
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21
Q

Clopidogrel
Cardiac Reperfusion - PHT
>=18 - <75

A 
Preparation: 75mg tablet
Route:           PO
Initial Dose:  300mg (4x tablets)
Repeat:         Nil
Max Total:     300mg
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22
Q

Clopidogrel
Cardiac Reperfusion - PHT
>75

A 
Preparation: 75mg tablet
Route:           PO
Initial Dose:  75mg
Repeat:         Nil
Max Total:     75mg
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23
Q 
Compound Sodium Lactate
Dehydration
ALL ages
Pump set: >=16
Autostart Burette + Pump set: <16
A 
Preparation: 500ml bag
Route:           IV/IO
Initial Dose:  10ml/kg bolus
Repeat:         No Repeat
Max Total:     10ml/kg
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24
Q 
Compound Sodium Lactate
Crush Injuries & Trapped/Hyperkalaemia/Hyperglycaemia
ALL ages
Pump set: >=16
Autostart Burette + Pump set: <16
A 
Preparation: 500ml bag
Route:           IV/IO
Initial Dose:  10ml/kg bolus
Repeat:         whilst indicated
Max Total:     No Max
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25
Compound Sodium Lactate Traumatic Hypovolaemia >=16 Pump set
Indication: 1. Non Head Injured: Absence of a radial pulse 2. Head Injured: SBP < 100mmHg 3. Penetrating trauma decreased LOC and/or absent radial pulse. Preparation: 500ml bag Route: IV Initial Dose: 250ml bolus Repeat: 250ml until radial pulse restored (Non Head Injured) or SBP > 100mmHg (Head Injured) Max Total: No Max
26
Compound Sodium Lactate Traumatic Cardiac Arrest >=16 Pump set
Indication: Traumatic cardiac arrest with no palpable central pulse (carotid or femoral) Preparation: 500ml bag Route: IV/IO Initial Dose: 250ml bolus Repeat: whilst indicated Max Total: 1000ml
27
``` Compound Sodium Lactate Medical Hypoperfusion/Hypovolaemia ALL ages Pump set: >=16 Autostart Burette + Pump set: <16 ```
Indication: 1. >= 2 key signs of shock 2. meningococcal disease 3. suspected sepsis patient with hypotension 4. moderate to severe anaphylaxis with signs of shock Preparation: 500ml bag Route: IV/IO Initial Dose: 20ml/kg bolus Repeat: whilst indicated Max Total: No Max
28
``` Compound Sodium Lactate Trauma in Pregnancy ALL ages Pump set: >=16 Autostart Burette + Pump set: <16 ```
Indication: Trauma + 1 or more key signs of shock Preparation: 500ml bag Route: IV/IO Initial Dose: 250ml bolus Repeat: 250ml to maintain SBP > 90mmHg Max Total: No Max
29
Compound Sodium Lactate Cardiogenic Shock >=16 Pump set
Indication: Haemodynamic compromise and SBP < 90mmHg Preparation: 500ml bag Route: IV Initial Dose: 10ml/kg bolus Repeat: Once - 10ml/kg per hr if indicated AND no response to Adrenaline infusion Max Total: 20ml/kg
30
``` Compound Sodium Lactate Burns ALL ages Pump set: >=16 Autostart Burette + Pump set: <16 ```
Indication: >20% TBSA in patients >=16 >10% TBSA in patients <16 Preparation: 500ml bag Route: IV/IO Initial Dose: 10ml/kg bolus Repeat: 10ml/kg per hour Max Total: No Max
31
Droperidol Behavioural Disturbance - all indications >=14 - < 65
``` Indication: >=14 yrs Preparation: 10mg in 2ml vial Route: IM/IV Initial Dose: 10mg bolus Repeat: Once after 15 min Max Total: 20mg ```
32
Droperidol Palliative Care >= 16
``` Indication: Palliative care patient with nausea and vomiting Preparation: 10mg in 2ml vial Route: SC Initial Dose: 0.5mg Repeat: 8hrs Max Total: 3mg in 24hrs ```
33
Enoxaparin Sodium Cardiac Reperfusion - PHT >=18 - <75
Preparation: 60mg (0.6ml) pre-filled orange syringe 100mg (1ml) pre-filled black syringe Initial Dose: Discard 30mg (0.3ml) and attach NaCl 0.9% primed microbore extension set prior to administering the remaining 30mg (0.3ml) IV as a bolus and flush with 30ml NaCl 0.9%. To be administered 15min after Tenectaplase. 2nd Dose: Weight adjusted 1mg/kg SC (to a max of 100mg) administered 15 min after the 1st dose of Enoxaparin Sodium.
34
Enoxaparin Sodium Cardiac Reperfusion - PHT >=75
Preparation: 60mg (0.6ml) pre-filled orange syringe 100mg (1ml) pre-filled black syringe Initial Dose: No IV dose 2nd Dose: Weight adjusted 0.75mg/kg SC (to a max of 75mg) administered 15 min after the 1st dose of Enoxaparin Sodium.
35
Fentanyl Pain Management >=16
Preparation: 450mcg (1.5ml) sealed vial Route: IN Initial Dose: 240mcg undiluted 1. 120mcg (0.4ml) - patient receives 90mcg 2. 90mcg (0.3ml) - patient receives 90mcg 3. 60mcg (0.2ml) - patient receives 60mcg Repeat: 60mcg (0.2ml) undilted every 5min while indicated Max Total: No Max
36
Fentanyl Pain Management >=65 and/or limited physiological reserves
Preparation: 450mcg (1.5ml) sealed vial Route: IN Initial Dose: 120mcg undiluted 1. 90mcg (0.3ml) - patient receives 60mcg 2. 60mcg (0.2ml) - patient receives 60mcg Repeat: 30mcg (0.1ml) undilted every 5min while indicated Max Total: No Max
37
Fexofenadine Allergic Reactions >=12
``` Preparation: 180mg tablet Route: PO Initial Dose: 180mg Repeat: Nil Max Total: 180mg ```
38
Frusemide Cardiogenic Pulmonary Oedema >=16 Not taking oral diuretics
``` Preparation: 40mg (4ml) ampoule Route: IV/IM Initial Dose: 40mg Repeat: Once after 10min Max Total: 80mg ```
39
Frusemide Cardiogenic Pulmonary Oedema >=16 Taking oral diuretics
``` Preparation: 40mg (4ml) ampoule Route: IV/IM Initial Dose: 80mg Repeat: Once after 10min Max Total: 160mg ```
40
Glucagon Hypoglycaemia >=16
Indication: BGL <4mmol and [-] LOC and unable to be cannulated for glucose 10% Preparation: 1mg vial and syringe containing 1ml of sterile water. Dissolve glucagon powder by adding the entire contents of the syringe to the vial containing the glucagon. Solution must be prepared immediately prior to use. Route: SC/IM Initial Dose: 1mg Repeat: Nil Max Total: 1mg
41
Glucagon Anaphylaxis >=16
Indication: Persistent hypovolaemia post administration of compound sodium lactate. Preparation: 1mg vial and syringe containing 1ml of sterile water. Dissolve glucagon powder by adding the entire contents of the syringe to the vial containing the glucagon. Solution must be prepared immediately prior to use. Route: IV Initial Dose: 2mg Repeat: Nil Max Total: 2mg
42
Glucose 10% Hypoglycaemia >=10
``` Indication: BGL <4mmol and [-] LOC Preparation: Glucose 10% - 50g per 500ml bag Route: IV/IO Initial Dose: 15g (150ml) bolus Repeat: whilst indicated Max Total: No Max ```
43
Glucose Gel | >=1
Indication: >28 days of age with BGL <4mmol and conscious and able to swallow. Preparation: 15g glucose in a 37.5g tube containing glucose gel 40% Route: PO Initial Dose: 15g bolus Repeat: 15min Max Total: 30g
44
Glyceryl Trinitrate Acute Coronary Syndrom/Cardiogenic Pulmonary Oedema >=16
``` Preparation: 300mcg tablet Route: PO Initial Dose: 600mcg Repeat: 5 min Max Total: 1.8mg ```
45
Glyceryl Trinitrate Autonomic Dysreflexia >=16
``` Preparation: 300mcg tablet Route: PO Initial Dose: 300mcg Repeat: 5 min Max Total: 900mcg ```
46
Hydrocortisone Adrenal Crisis >=16
Indication: Symptomatic patients with Adrenal Insufficiency. Patients with existing Dr or hospital care plan should be administered the dose state on the plan. Preparation: 100mg vial reconstituted with 2ml NaCl (50mg:1ml) Route: IM/IV Initial Dose: 100mg bolus Repeat: Nil Max Total: 100mg
47
Hydrocortisone Asthma/Anaphylaxis/COPD Exacerbation >=16
Indication: >= 6yrs moderate - severe/life threatening Asthma. Anaphylaxis patients with persistent wheeze post salbutamol. Preparation: 100mg vial reconstituted with 2ml NaCl (50mg:1ml) Route: IM/IV Initial Dose: 100mg bolus Repeat: Nil Max Total: 100mg
48
Ibuprofen Pain Management >=12
``` Preparation: 200mg tablet Route: PO Initial Dose: 200-400mg Max dose: 400mg Repeat: 4-6hrs Max Total: 1.2g in 24 hrs ```
49
Influenza Vaccine Influenza prophylaxis >=16
``` Indication: Prophylaxis for staff during influenza pandemic Preparation: 0.5ml pre-filled syringe Route: IM Initial Dose: 0.5ml bolus Repeat: Nil Max Total: 0.5ml ```
50
Ipratropium Bromide Asthma/COPD >=6
Indication: Moderate - Severe/Life threatening asthma and symptomatic patients with COPD Preparation: 500mcg in 1ml nebule Route: NEB Initial Dose: 500mcg mixed with Salbutamol Repeat: Once Max Total: 1mg
51
Ketamine Pain Management/Behavioural Disturbance >=14 - <65 IV
Preparation: 200mg in a 2ml vial: diluted to 20ml (10mg:1ml) with 18ml NaCl Route: IV Initial Dose: 0.25mg/kg diluted bolus (max bolus: 30mg) Repeat: 3-5min May be repeated 60min after last administration Max Total: 200mg
52
Ketamine Pain Management/Behavioural Disturbance >=14 - <65 IM
``` Preparation: 200mg in a 2ml vial Route: IM Initial Dose: 1mg/kg undiluted bolus (max bolus: 100mg) Repeat: 10min May be repeated 60min after last administration. Max Total: 2mg/kg up to 200mg ```
53
Ketamine Pain Management/Behavioural Disturbance >=65 IV
Preparation: 200mg in a 2ml vial: diluted to 20ml (10mg:1ml) with 18ml NaCl Route: IV Initial Dose: 0.125mg/kg diluted bolus (max bolus: 15mg) May be repeated 60min after last administration. Repeat: 3-5 min Max Total: 100mg
54
Ketamine Pain Management/Behavioural Disturbance >=65 IM
``` Preparation: 200mg in a 2ml vial Route: IM Initial Dose: 0.5mg/kg undiluted bolus (max bolus: 50mg) Repeat: 10 min May be repeated 60min after last administration Max Total: 1mg/kg up to 100mg ```
55
Ketamine | CPR Induced Consciousness
Indication: CPR induced consciousness with the exception of minor isolated movements interfering with resuscitation Preparation: 200mg in a 2ml vial: diluted to 20ml (10mg:1ml) with 18ml NaCl Route: IV Initial Dose: 20mg bolus diluted dose Repeat: 3 min Max Total: 100mg
56
Lignocaine VF or Pulseless VT and Torsades de Pointes >=16
Indication: VF, pulseless VT unresponsive to Amiodarone Torsades de Pointes Preparation: 2% - 100mg (5ml) polyampoule (IV use only) Route: IV Initial Dose: 100mg bolus Repeat: Once Max Total: 200mg
57
Lignocaine Post Intraosseous Procedure Pain >=16
Indication: Localised pain post intraosseous insertion. Allow 1 min for effect once Lignocaine introduced into medullary space Preparation: 2% - 100mg (5ml) polyampoule (IV use only) Route: IO Initial Dose: 40mg slow infusion Repeat: Nil Max Total: 40mg
58
Lignocaine Local Anaesthesia prior to cannulation ALL ages
Preparation: 1% - 20mg (2ml) ampoule (local anaesthesia only) Route: SC Initial Dose: small amount until skin is slightly raised
59
Methoxyflurane Pain Management >=1
Indication: 1. Mild pain >= 1 to < 12 yrs 2. > 1 where paramedic is not authorised to administer an opioid or an opioid is contraindicated, ineffective or refused. 3. Multiple ...NOT FINISHED !!!!! Preparation: 3ml bottle with external inhaler Route: INH Initial Dose: 3ml via inhaler Repeat: Once Max Total: 6ml in 24hrs, 15ml in 7 days
60
Metoclopramide Nausea, Vomiting & Eye Injuries >=16
Indication: 1. Severe nausea and/or active vomiting where Ondansetron is contraindicated or ineffective after 10min. 2. Suspected penetrating eye injury where Ondansetron in contraindicated or ineffective after 10min. Preparation: 10mg (1ml) ampoule Route: IM/IV Initial Dose: 10mg bolus Repeat: Nil Max Total: 10mg
61
Midazolam Post Ketamine Administration >=14
Indication: Patients experiencing distressing psychological reactions post Ketamine administration who are unresponsive to reassurance. Preparation: 5mg (1ml) ampoule Dilution: 5mg (1ml) diluted with 4ml NaCl to 5ml (1mg:1ml) Route: IV Initial Dose: 0.5 - 1mg diluted bolus Repeat: Nil Max Total: 0.5 - 1mg
62
Midazolam Limb realignment and/or difficult extrication >=10 - <65
Indication: To facilitate limb realignment and/or difficult extrication post analgesia to provide effective pain management at rest for the patient. Preparation: 5mg (1ml) ampoule Dilution: 5mg (1ml) diluted with 4ml NaCl to 5ml (1mg:1ml) Route: IV Initial Dose: 1mg diluted bolus Repeat: 3min Max Total: 5mg
63
Midazolam Seizures >=16 IM
``` Preparation: 5mg (1ml) ampoule Route: IM Initial Dose: 5mg undiluted bolus Repeat: 5min Max Total: 15mg ```
64
Midazolam Seizures >=16 IV
``` Preparation: 5mg (1ml) ampoule Dilution: 5mg (1ml) diluted with 4ml NaCl to 5ml (1mg:1ml) Route: IV Initial Dose: 2.5mg diluted slow bolus Repeat: 5min Max Total: 15mg ```
65
Midazolam Behavioural Disturbance >=14 - <65 IM
Indication: 1. Non head injured: Droperidol ineffective 15min AFTER the maximum total dose or is contraindicated. 2. Acute traumatic brain injured patients where Ketamine is ineffective or contraindicated. 3. Authorised to administer a single dose between initial and repeat doses of Droperidol (MH28, MH6) ONLY if the patient is PHYSICALLY aggressive. Preparation: 5mg (1ml) ampoule Route: IM Initial Dose: 5 - 10mg undiluted bolus Repeat: 5min Max Total: 15mg
66
Midazolam Behavioural Disturbance >=14 - <65 IV
Indication: 1. Non head injured: Droperidol ineffective 15min AFTER the maximum total dose or is contraindicated. 2. Acute traumatic brain injured patients where Ketamine is ineffective or contraindicated. 3. Authorised to administer a single dose between initial and repeat doses of Droperidol (MH28, MH6) ONLY if the patient is PHYSICALLY aggressive. Preparation: 5mg (1ml) ampoule Dilution: 5mg (1ml) diluted with 4ml NaCl to 5ml (1mg:1ml) Route: IV Initial Dose: 2.5mg diluted slow bolus Repeat: 3min Max Total: 15mg
67
Midazolam Behavioural Disturbance >65 IM
Indication: 1. Non head injured: Droperidol ineffective 15min AFTER the maximum total dose or is contraindicated. 2. Acute traumatic brain injured patients where Ketamine is ineffective or contraindicated. 3. Authorised to administer a single dose between initial and repeat doses of Droperidol (MH28, MH6) ONLY if the patient is PHYSICALLY aggressive. Preparation: 5mg (1ml) ampoule Route: IM Initial Dose: 2.5 - 5mg undiluted bolus Repeat: 5min Max Total: 7.5mg
68
Midazolam Behavioural Disturbance >65 IV
Indication: 1. Non head injured: Droperidol ineffective 15min AFTER the maximum total dose or is contraindicated. 2. Acute traumatic brain injured patients where Ketamine is ineffective or contraindicated. 3. Authorised to administer a single dose between initial and repeat doses of Droperidol (MH28, MH6) ONLY if the patient is PHYSICALLY aggressive. Preparation: 5mg (1ml) ampoule Dilution: 5mg (1ml) diluted with 4ml NaCl to 5ml (1mg:1ml) Route: IV Initial Dose: 1.25mg diluted slow bolus Repeat: 5min Max Total: 7.5mg
69
Midazolam Distress/Pain post TCP initial and capture >=16
Indication: Distress/Pain post initiation of TCP Preparation: 5mg (1ml) ampoule Dilution: 5mg (1ml) diluted with 4ml NaCl to 5ml (1mg:1ml) Route: IV Initial Dose: 1mg diluted bolus Repeat: 3min IV regimen may be repeated 20min post last administration Max Total: 5mg
70
Midazolam | Palliative Care
Indication: Palliative care patients with agitation/anxiety caused by pain and/or tachypnoea/dyspnoea. Preparation: 5mg (1ml) ampoule Route: SC Initial Dose: 2.5mg - 5mg undiluted bolus Repeat: Nil Max Total: 2.5 - 5mg
71
Midazolam ROSC or Post intubation/SGA sedation >=16 IM
Indication: ROSC or Post Intubation/SGA sedation Preparation: 5mg (1ml) ampoule 10mg (2ml) Midazolam mixed with 10mg (1ml) Morphine and diluted with 7ml NaCl 0.9% to 10ml total volume. Morphine/Midazolam solution: 1ml = 1mg Midazolam + 1mg Morphine Route: IM Initial Dose: 5ml Morphine/Midazolam solution bolus if IV not available. Repeat: 15min Max Total: 15ml
72
Midazolam ROSC or Post intubation/SGA sedation >=16 IV
Indication: ROSC or Post Intubation/SGA sedation Preparation: 5mg (1ml) ampoule 10mg (2ml) Midazolam mixed with 10mg (1ml) Morphine and diluted with 7ml NaCl 0.9% to 10ml total volume. Morphine/Midazolam solution: 1ml = 1mg Midazolam + 1mg Morphine Route: IV Initial Dose: 2.5ml Morphine/Midazolam solution bolus Repeat: 3min IV regimen for Post Intubation/SGA sedation may be repeated 20min after the last administration. Max Total: 15ml
73
Morphine Palliative Care >=16 SC
Indication: Palliative care patients with pain and/or tachypnoea/dyspnoea Preparation: 10mg (1ml) ampoule Route: SC Initial Dose: 2.5mg - 5mg undiluted bolus Repeat: Nil Max Total: 2.5 - 5mg
74
Morphine Pain Management >=16 - <65 IV
Indication: Pain Management Preparation: 10mg (1ml) ampoule 10mg (1ml) diluted with 9ml NaCl 0.9% to a total volume of 10ml (1mg:1ml) Route: IV Initial Dose: 2.5 - 5mg diluted bolus Repeat: 5min IV regimen may be repeated 30min post last administration. Max Total: 0.5mg/kg
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Morphine Pain Management >=16 - <65 IM/SC
``` Indication: Pain Management IM Morphine should only be used where IV access or IN Fentanyl is not available. Preparation: 10mg (1ml) ampoule Route: IM/SC Initial Dose: 5 - 10mg undiluted bolus Repeat: 15min Max Total: 2 doses ```
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Morphine Pain Management >65 IV
Indication: Pain Management Preparation: 10mg (1ml) ampoule 10mg (1ml) diluted with 9ml NaCl 0.9% to a total volume of 10ml (1mg:1ml) Route: IV Initial Dose: 1.25 - 2.5mg diluted bolus Repeat: 5min Max Total: 0.25mg/kg
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Morphine Pain Management >65 IM/SC
``` Indication: Pain Management IM Morphine should only be used where IV access or IN Fentanyl is not available. Preparation: 10mg (1ml) ampoule Route: IM/SC Initial Dose: 2.5 - 5mg undiluted bolus Repeat: 15min Max Total: 2 doses ```
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Morphine Distress/Pain post TCP initiation and capture >=16
Indication: Distress/Pain post initiation of TCP Preparation: 10mg (1ml) ampoule 10mg (1ml) diluted with 9ml NaCl 0.9% to a total volume of 10ml (1mg:1ml) Route: IV Initial Dose: 2.5mg diluted bolus Repeat: 2-5min IV regimen may be repeated 20min post last administration. Max Total: 15mg
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Morphine ROSC or Post Intubation/SGA sedation >=16 IV
Indication: ROSC or Post Intubation/SGA sedation Preparation: 10mg (1ml) ampoule 10mg (2ml) Midazolam mixed with 10mg (1ml) Morphine and diluted with 7ml NaCl 0.9% to 10ml total volume. Morphine/Midazolam solution: 1ml = 1mg Midazolam + 1mg Morphine Route: IV Initial Dose: 2.5ml Morphine/Midazolam solution bolus Repeat: 3min IV regimen may be repeated 20min post last administration. Max Total: 15ml
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Morphine ROSC or Post Intubation/SGA sedation >=16 IM
Indication: ROSC or Post Intubation/SGA sedation Preparation: 10mg (1ml) ampoule 10mg (2ml) Midazolam mixed with 10mg (1ml) Morphine and diluted with 7ml NaCl 0.9% to 10ml total volume. Morphine/Midazolam solution: 1ml = 1mg Midazolam + 1mg Morphine Route: IM Initial Dose: 5ml Morphine/Midazolam solution bolus IF IV not available. Repeat: 15min Max Total: 15ml
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Naloxone Opioid Overdose >=16 IV
``` Preparation: 400mcg (1ml) ampoule 400mcg (1ml) diluted to 4ml with 3ml of NaCl 0.9% (100mcg:1ml) Route: IV Initial Dose: 100mcg diluted bolus Repeat: 2min Max Total: 2mg ```
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Naloxone Opioid Overdose >=16 IM
``` Preparation: 400mcg (1ml) ampoule Route: IM Initial Dose: 400mcg undiluted bolus Repeat: 2min Max Total: 2mg ```
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Naloxone Etorphine or Buprenorphine Overdose >=16 IM/IV
``` Preparation: 400mcg (1ml) ampoule 400mcg (1ml) diluted to 4ml with 3ml of NaCl 0.9% (100mcg:1ml) Route: IM/IV Initial Dose: 2mg undiluted bolus Repeat: 5min Max Total: No Max ```
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Ondansetron Nausea & Vomiting/Eye Injuries >=8
``` Preparation: 4mg (2ml) ampoule Route: IM/IV Initial Dose: 4mg bolus Repeat: Nil Max Total: 4mg ```
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Oxygen
Preparation: White cylinders with white markings on the shoulders containing 490L or 1500L of 100% medical oxygen. Supplemental O2 is required for all patients with SpO2 <=94% on room air, with the exception of the conditions below, and should be titrated to meet the targeted outcomes.
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Oxygen Respiratory Distress Hypoxia Acute Coronary Syndrome
Targeted Outcome: Maintain SpO2% >= 94 - 98%
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Oxygen | Chronic Obstructive Pulmonary Disease
Targeted Outcome: Maintain SpO2% >= 88 - 92%
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``` Oxygen Cardiac/Respiratory Arrest Carbon Monoxide Poisoning Cyanide Poisoning Diving Emergencies Prolapsed Umbilical Cord ```
Targeted Outcome: 100% Oxygen delivery
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Oxygen | Cardiogenic Pulmonary Oedema
Targeted Outcome: 100% Oxygen delivery via IPPV
90
Oxytocin Maternal Postpartum Care ALL ages IM
``` Indication: Prophylaxis post childbirth - ensure ALL foetuses have been delivered prior to administration. Preparation: 10 IU (1ml) ampoule Route: IM Initial Dose: 10 IU Repeat: Nil Max Total: 10 IU ```
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Oxytocin Postpartum Haemorrhage ALL ages IM
Indication: Prophylaxis post childbirth - ensure ALL foetuses have been delivered prior to administration. Preparation: 10 IU (1ml) ampoule Route: IM Initial Dose: IM bolus followed by Oxytocin infusion. Repeat: Nil Max Total: 10 IU
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Oxytocin Postpartum Haemorrhage ALL ages INF
Indication: Prophylaxis post childbirth - ensure ALL foetuses have been delivered prior to administration. Preparation: 10 IU (1ml) Oxytocin diluted to 60ml with 59ml NaCl 0.9% via burette with microdrip (1 IU:6ml). Route: INF Initial Dose: 60 drops/min (10 IU/hr) Repeat: Once Max Total: 20 IU over 2 hrs
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Paracetamol Pain Management/Febrile patients >=12
Indication: Mild pain. Antipyretic in patients with temp>=38.5C. Preparation: 500mg tablet Route: PO Initial Dose: 500mg - 1g (max 1g per dose) Repeat: 4hrs Max Total: 4g in 24hrs
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Pralidoxime Chloride/Atropine Moderate Nerve Agent Poisoning >=16
Preparation: Auto-injector contains a sterile solution of Atropine (2.1mg/0.7ml) and a sterile solution of Pralidoxime Chloride (600mg/2ml) in two separate internal chambers. Route: IM Initial Dose: One injection into mid-lateral thigh Repeat: 15min (2 injections) Max Total: 3 injections NB max dose and pt still symptomatic admin Atropine
95
Pralidoxime Chloride/Atropine Severe Nerve Agent Poisoning >=16
Preparation: Auto-injector contains a sterile solution of Atropine (2.1mg/0.7ml) and a sterile solution of Pralidoxime Chloride (600mg/2ml) in two separate internal chambers. Route: IM Initial Dose: 3x injections into mid-lateral thigh in rapid succession. Repeat: Nil Max Total: 3 injections NB max dose and pt still symptomatic admin Atropine
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Salbutamol Asthma/Anaphylaxis/COPD/Palliative Care >=5 NEB
Indications: Asthma - moderate to severe/life threatening. Anaphylaxis - bronchospasm COPD - symptomatic patients with COPD Palliative Care - Dyspnoea/Tachypnoea Preparation: 5mg (2.5ml) nebule Route: NEB Initial Dose: 5mg Repeat: whilst indicated Max Total: No Max
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``` Salbutamol Mild - Moderate: Asthma/Anaphylaxis/COPD/Palliative Care >=5 CFC-Free Inhaler ```
Indication: In circumstances where O2 and nebulised Salbutamol are not available. Preparation: 100mcg per actuation Route: CFC-Free Inhaler Initial Dose: 4-12 puffs Repeat: whilst indicated Max Total: No Max
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``` Salbutamol Severe/Life Threatening: Asthma/Anaphylaxis/COPD/Palliative Care >=5 CFC-Free Inhaler ```
Indication: In circumstances where O2 and nebulised Salbutamol are not available. Preparation: 100mcg per actuation Route: CFC-Free Inhaler Initial Dose: 12 puffs Repeat: whilst indicated Max Total: No Max
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Sodium Bicarbonate Hyperkalaemia/Tricyclic Antidepressant OD ALL ages
Indications: 1. Actual or suspected Hyperkalaemia with progression of ECG changes (T waves becoming tall and peaked, P wave disappearing, QRS widening. Presence of a sine wave pattern and Asystole/VT/VF). 2. Tricyclic OD with conduction delay (wide QRS complex) presenting with shock, coma or convulsions. Preparation: 8.4% 100ml (1mmol:1ml) bottle Route: IV Initial Dose: 1mmol/kg bolus (max bolus:100mmol) Repeat: Nil Max Total: 1mmol/kg (up to 100mmol) NB Sodium Bicarbonate and Calcium Gluconate precipitate when mixed together. Flush the line between administration of these medications.
100
Tenecteplase Cardiac Reperfusion - PHT >=18 - <75
Indication: Confirmed ST Elevation Myocardial Infarction. Preparation: 50mg vial and syringe containing 10ml sterile water. Reconstitute by adding the sterile water to the Tenecteplase powder in the vial. The solution must be prepared immediately prior to use. Avoid foaming the solution. Route: IV Initial Dose: Weight adjusted dose (see table). Bolus to a max of 50mg administered 15min prior to the first does of Enoxaparin Sodium. Repeat: No repeat Max Total: One dose maximum NB DO NOT administer through a line that may have contained Glucose. Flush with 10ml NaCl 0.9% prior to administering Tenecteplase. Flush with 30ml NaCl 0.9% between administering Tenecteplase and Enoxaparin Sodium.
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Tenecteplase Cardiac Reperfusion - PHT >75
Indication: Confirmed ST Elevation Myocardial Infarction. Preparation: 50mg vial and syringe containing 10ml sterile water. Reconstitute by adding the sterile water to the Tenecteplase powder in the vial. The solution must be prepared immediately prior to use. Avoid foaming the solution. Route: IV Initial Dose: Weight adjusted dose (see table). Bolus to a max of 25mg administered 15min prior to the first does of Enoxaparin Sodium. Repeat: No repeat Max Total: One dose maximum NB DO NOT administer through a line that may have contained Glucose. Flush with 10ml NaCl 0.9% prior to administering Tenecteplase. Flush with 30ml NaCl 0.9% between administering Tenecteplase and Enoxaparin Sodium.

ASNSW Pharmacology (8 decks)

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