All the things Flashcards

Question

Glucagon Contraindications, Precautions & Side effects Jul 2022

Answer 1

Glucagon ✘ Allergy AND/OR Adverse Drug Reaction ! Nil ֎ Nil

Answer 2

Glucagon ✓ Symptomatic hypoglycaemia (inability to self-administer oral glucose) Paed) IM >25kg - 1mg. SD. Reconstitute with 1mL water in 3mL syringe. 1mg/1mL. Paed) IM <25kg – 0.5mg. SD. Reconstitute with 1mL water in 3mL syringe. 1mg/1mL. Decant 0.5mL to achieve final concentration of 0.5mg/0.5mL. ✓ Refractory anaphylaxis (unresponsive to 3x IM adrenaline and adequate fluid resuscitation) IV > IM Paed) IM >25kg - 1mg. SD. Reconstitute with 1mL water in 3mL syringe. 1mg/1mL. Paed) IM <25kg – 0.5mg. SD. Reconstitute with 1mL water in 3mL syringe. 1mg/1mL. Decant 0.5mL to achieve final concentration of 0.5mg/0.5mL.

Answer 3

Glucose gel Drug class: Hyperglycaemic Presentation: Tube, 15g glucose Glucose gel is a form of pure glucose that is absorbed quickly in the intestinal tract after ingestion. It is the principal energy source for body cells, especially the brain.

Answer 4

Glucose gel ✓ Symptomatic hypoglycaemia (with ability to self-administer oral glucose) Adult) PO 15 g. 15mins (if BGL < 4.0). TMD 30g. Paed) PO 15 g. 15mins (if BGL < 4.0). TMD 30g

Answer 5

Glucose gel ✘ Unconsciousness ✘ Patients with difficulty swallowing ✘ Patients < 2yrs ! Nil ֎ Nausea and/or vomiting ֎ Diarrhoea

Answer 6

Glucose 10% Drug class: Hyperglycaemic Presentation: Viaflex plastic container, 250mL glucose monohydrate 10% Glucose is a sugar that is the principal energy source for body cells, especially the brain.

Answer 7

Glucose 10% ✓ Symptomatic hypoglycaemia (with the inability to self-administer oral glucose) Adult) IV INF 15 g (150 mL). Repeated at 100 mL (10 g) boluses every 5mins until BGL > 4.0 mmol/L. CCP - ✓ Unconscious hypoglycaemia (as specifically authorised in AMP 001/23)

Answer 8

Glucose 10% ✘ Nil ! Hyperglycaemia ֎ Nil

Answer 9

Glucose 10% ✓ Symptomatic hypoglycaemia (with the inability to self-administer oral glucose) Paed) IV INF 0.25g/kg (2.5mL/kg). Repeated at 0.1g/kg (1mL/kg) boluses every 5mins until BGL > 4.0 mmol/L. CCP - ✓ Unconscious hypoglycaemia (as specifically authorised in AMP 001/23)

Answer 10

Glyceryl trinitrate Drug class: Vasodilator Presentation: Spray (sublingual), 400microg/dose, 200 doses, nitrolingual pump spray Glyceryl trinitrate (GTN) is a potent vasodilator that decreases preload by increasing venous capacity, pooling venous blood in the peripheral veins, reducing ventricular filling pressure and decreasing arterial blood pressure (after load). Because of this cascade it also causes vasodilation in coronary arteries that are in spasm and may assist the redistribution of blood flow along the collateral channels in the heart.

Answer 11

Glyceryl trinitrate ✓ Suspected ACS (with pain) ✓ Acute cardiogenic pulmonary oedema ✓ Autonomic dysreflexia (with a systolic BP > 160 mmHg) ✓ Irukandji syndrome (with a systolic BP > 160 mmHg) Adult) SUBLING 400 microg. 5mins. NMD. Paed) SUBLING *** call QAS Consultation

Answer 12

Glyceryl trinitrate ✘ Allergy AND/OR Adverse Drug Reaction ✘ Heart rate < 50 OR > 150 beats per minute ✘ Systolic BP < 100 mmHg ✘ Acute CVA ✘ Head trauma ✘ Phosphodiesterase inhibitor medication administration: - Sildenafil OR vardenafil in the previous 24 hours - Tadalafil in the previous 48 hours ! Suspected inferior AMI ! Cerebral vascular disease ! Risk of hypotension and/or syncope ! Intoxication (GTN effects are enhanced) ! Phosphodiesterase inhibitor medication administration in the previous 4 days ֎ Dizziness ֎ Hypotension ֎ Syncope ֎ Reflex tachycardia ֎ Vascular headaches

Answer 13

Hydrocortisone Drug class: Corticosteroid Presentation: Vial (powder), 100mg hydrocortisone sodium succinate Hydrocortisone is an adrenocorticoid steroid with multiple mechanisms of action including anti-inflammatory activity, immunosuppressive properties and anti-proliferative actions.

Answer 14

Hydrocortisone ✓ Asthma (excluding mild) ✓ Acute exacerbation of COPD (with evidence of respiratory distress) ✓ Suspected, or at risk of, an acute adrenal insufficiency (adrenal crisis) Adult) IM 100 mg. SD. Adult) IV 100 mg. SD. Slow push over 1 minute. ✓ Refractory anaphylaxis with persistent wheeze (and unresponsive to 3 x IM adrenaline (epinephrine)) Adult) IM 200 mg. SD. Adult) IV 200 mg. SD. Slow push over 1 minute.

Answer 15

Hydrocortisone ✘ Allergy and/or Adverse Drug Reaction ! Hypertension ֎ Nil

Answer 16

Hydrocortisone ✓ Asthma (excluding mild) ✓ Refractory anaphylaxis with persistent wheeze (and unresponsive to 3 x IM adrenaline (epinephrine)) Paed) IM 4mg/kg (100mg). SD. Paed) IV 4mg/kg (100mg). SD. Slow push over 1 minute. ✓ Suspected, or at risk of, an acute adrenal insufficiency (adrenal crisis Paed) IM 0-4yrs – 25 mg. SD. IM 5-10yrs – 50 mg. SD. IM >10yrs – 100 mg. SD. Paed) IV 0-4yrs – 25 mg. SD. Slow push over 1 minute. IV 5-10yrs – 50 mg. SD. Slow push over 1 minute IV >10yrs – 100 mg. SD. Slow push over 1 minute

Answer 17

Ibuprofen Drug class: Non-steroidal anti-inflammatory drug (NSAID) Presentation: Tablet, 200 mg ibuprofen Ibuprofen is a non-selective NSAID that inhibits the synthesis of prostaglandins resulting in analgesic, antipyretic and anti-inflammatory actions.

Answer 18

Ibuprofen ✓ Moderate pain due to acute inflammation and tissue injury Adult) PO 200-400 mg. Must not be administered within 6 hours of previous ibuprofen administration.

Answer 19

Ibuprofen ✘ Allergy and/or Adverse Drug Reaction to any NSAID OR aspirin ✘ Concurrent NSAID therapy ✘ Current GI bleeding OR peptic ulcers ✘ Dehydration AND/OR hypovolaemia ✘ Renal impairment ✘ NSAID induced asthma ✘ Heart failure ✘ Pregnancy ✘ Angiotensin converting enzyme (ACE) inhibitor OR Angiotensin II receptor blocker (ARB) therapy ✘ Patients less than 13 years OR older than 65 years of age ✘ Patients taking anticoagulant medications ✘ Diuretic treatment ! Asthma ! Hepatic dysfunction ! History of GI bleeding or peptic ulcers ֎ Nausea ֎ Dyspepsia ֎ GI bleeding ֎ Dizziness

Answer 20

Ipratropium bromide Drug class: Anticholinergic agent Presentation: Nebule, 250microg/1mL ipratropium bromide monohydrate Ipratropium bromide is an antimuscarinic agent which promotes bronchodilation by inhibiting cholinergic bronchomotor tone.

Answer 21

Ipratropium bromide ✓ Moderate bronchospasm (unresponsive to initial QAS salbutamol NEB) ✓ Severe bronchospasm Adult) NEB 500 microg. 20mins. TMD 1.5mg.

Answer 22

Ipratropium bromide ✘ Allergy and/or Adverse Drug Reaction ✘ Patients less than 1 year of age ! Glaucoma ֎ Dilated pupils ֎ Dry mouth ֎ Palpitations

Answer 23

Ipratropium bromide ✓ Moderate bronchospasm (unresponsive to initial QAS salbutamol NEB) ✓ Severe bronchospasm Paed) NEB >6yrs - 500 microg. 20mins. TMD 1.5mg. Paed) NEB 1-5yrs – 250 microg. 20mins. TMD 750 microg.

Answer 24

Loratadine Drug class: Antihistamine (less sedating) Presentation: Tablet, 10 mg loratadine Loratadine is a long-acting, second generation peripheral histamine H1-receptor antagonistic used to treat allergies.

Answer 25

Loratadine ✓ Symptomatic urticaria (without evidence of anaphylaxis) Adult) PO 10 mg. SD. Not to be administered within 24 hours of previous antihistamine administration unless approval gained from QAS Clinical Consultation and Advice Line.

Answer 26

Loratadine ✘ Allergy and/or Adverse Drug Reaction ✘ Anaphylaxis ✘ Patients less than 8 years of age ! Severe hepatic impairment ! Increased risk of sedation and anticholinergic effects in older people ֎ Drowsiness ֎ Fatigue ֎ Headache ֎ Nausea ֎ Dry mouth

Answer 27

Loratadine ✓ Symptomatic urticaria (without evidence of anaphylaxis) Paed) PO > 8 years – 10 mg. SD. Not to be administered within 24 hours of previous antihistamine administration unless approval gained from QAS Clinical Consultation and Advice Line.

Answer 28

Methoxyflurane Drug class: Analgesic (at low doses) Presentation: Bottle, 3mL methoxyflurane Methoxyflurane is a volatile, self-administered inhalation analgesic indicated for short-term pain relief. Methoxyflurane is more susceptible to metabolism than other halogenated ethers and has a greater propensity to diffuse into fatty tissue.

Answer 29

Methoxyflurane ✓ Pain Adult) INH 3 mL. 20mins. TMD 6mL. Paed) INH > 1 year – 3 mL. SD.

Answer 30

Methoxyflurane ✘ Allergy and/or Adverse Drug Reaction ✘ Patients < 1 year ✘ History of significant liver or renal disease ✘ History of malignant hyperthermia ! ALOC ! Intoxicated or drug affected patients ! Cardiovascular instability ! Respiratory depression ֎ ALOC ֎ Cough ֎ Renal/hepatic failure (following repeated high dose exposure)

Answer 31

Midazolam Drug class: Benzodiazepine (short acting) Presentation: Ampoule, 5mg/1mL midazolam Midazolam hydrochloride is a short acting CNS depressant that induces amnesia, anaesthesia, hypnosis and sedation. It achieves this by enhancing the action of the inhibitory neurotransmitter gamma-amino butyric acid (GABA). Depressant effects occur at all levels of the CNS.

Answer 32

Midazolam ✓ Generalised seizures/focal seizure (GCS < 12) Adult) NAS/IM 5 mg. 10mins. TMD 20mg. Adult) IV 5mg. 5mins. TMD 20mg. ✓ Acute behavioural disturbance (with a SAT score > 2) unresponsive to droperidol (max dose) administration Adult) IM/IV *** call QAS Consultation CCP - ✓ Sedation - For maintenance of an established LMA/ETT - For procedures (e.g. TCP or cardioversion) - CPR induced consciousness - To facilitate safe assessment and treatment of agitated head injured patient - As an adjunct to opiate analgesia (fracture splinting/ extrication/ burns) - For ketamine emergence

Answer 33

Midazolam ✘ Allergy and/or Adverse Drug Reaction ! Reduced dosages must be considered in: - Low body weight, older or frail patients - Patients with chronic renal failure, congestive cardiac failure or shock ! Can cause severe respiratory depression in patients with COPD ! Myasthenia gravis ! Multiple sclerosis ֎ Hypotension ֎ Respiratory depression particularly when associated with other CNS depressants including alcohol and narcotics

Answer 34

Midazolam ✓ Generalised seizures/focal seizure (GCS < 12) Paed) ✓ Acute behavioural disturbance (with a SAT score > 2) unresponsive to droperidol (max dose) administration Paed) IM/IV *** call QAS Consultation CCP - ✓ Sedation - For maintenance of an established LMA/ETT - For procedures (e.g. TCP or cardioversion) - CPR induced consciousness - To facilitate safe assessment and treatment of agitated head injured patient - As an adjunct to opiate analgesia (fracture splinting/ extrication/ burns) - For ketamine emergence

Answer 35

Morphine Drug class: Narcotic analgesic Presentation: Ampoule, 10mg/1mL morphine sulphate pentahydrate Morphine is a narcotic analgesic that acts on the central nervous system by binding with opioid receptors, altering processes affecting pain perception and emotional response to pain. It also combines to cause respiratory depression, vasodilation, decreases in the gag reflex and slows AV node conduction.

Answer 36

Morphine ✓ Significant pain ✓ Autonomic dysreflexia (with a systolic BP > 160 mmHg) Adult) IM > 70 – 2.5-5mg. 10mins. TMD 10mg. IM < 70 – 2.5-10mg. 10mins (5mg). TMD 20mg. Adult) IV > 70 – 2.5mg. 5mins. TMD 10mg. Adult) IV < 70 – 2.5-5mg. 5mins. TMD 20mg. CCP - ✓ Sedation NOTE: Morphine is the preferred narcotic agent except under the following circumstances: - Allergy and/or Adverse Drug Reaction to morphine; - Haemodynamic instability; - Known/suspected kidney disease; - When NAS narcotic administration is the preferred treatment; AND/OR - Suspected ACS.

Answer 37

Morphine ✘ Allergy and/or Adverse Drug Reaction ✘ Kidney disease (renal failure) ! Hypotension ! Respiratory tract burns ! Respiratory depression and/or failure ! Known addiction to narcotics ! Concurrent MAOI therapy ! Cardiac chest pain ֎ Bradycardia ֎ Drowsiness ֎ Hypotension ֎ Nausea and/or vomiting ֎ Pin point pupils ֎ Respiratory depression

Answer 38

Morphine ✓ Significant pain ✓ Autonomic dysreflexia (with a systolic BP > 160 mmHg) Paed) IM > 1 year – 100-200 microg/kg (5mg). 10mins. TMD 200 microg/kg. Paed) IV > 1 year – 100 microg/kg (2.5mg). 5mins. TMD 200 microg/kg. Paed) IM/IV < 1 *** call QAS Consultation. CCP - ✓ Sedation NOTE: Morphine is the preferred narcotic agent except under the following circumstances: - Allergy and/or Adverse Drug Reaction to morphine; - Haemodynamic instability; - Known/suspected kidney disease; - When NAS narcotic administration is the preferred treatment; AND/OR - Suspected ACS.

Answer 39

Naloxone Drug class: Opioid antagonist Presentation: Ampoule, 400microg/mL naloxone hydrochloride dihydrate Naloxone is an opioid antagonist that prevents or reverses the effects of opioids including respiratory depression, sedation and hypotension. Naloxone antagonises the opioid effects by competing for the same receptor sites.

Answer 40

Naloxone ✓ Respiratory depression (secondary to the administration of narcotic drugs) Adult) IM 1.6mg. SD.

Answer 41

Naloxone ✘ Allergy and/or Adverse Drug Reaction ✘ The newly born patient ! Use with caution on patients with pre-existing cardiac disease ֎ Narcotic reversal can cause combativeness, vomiting, sweating, tachycardia and hypertension ֎ May produce acute withdrawal convulsions in the chronic narcotic user ֎ Pulmonary oedema

Answer 42

Naloxone ✓ Respiratory depression (secondary to the administration of narcotic drugs) Paed) IM 20 microg/kg (800 microg). SD.

Answer 43

Ondansetron Drug class: Anti-emetic – 5-HT3 antagonist Presentation: Ampoule, 4mg/2mL ondansetron Orally Disintegrating Tablet (ODT), 4mg ondansetron Ondansetron is a serotonin 5-HT3 receptor antagonist. It works by blocking the action of serotonin, a natural substance that may cause nausea and vomiting.

Answer 44

Ondansetron ✓ Significant nausea AND/OR vomiting Adult) PO/IM 4-8mg. TMD 8mg. Adult) IV 4-8mg. Slow push 2-3mins. TMD 8mg.

Answer 45

Ondansetron ✘ Allergy and/or Adverse Drug Reaction ✘ Congenital long QT syndrome ✘ Current apomorphine therapy (used in severe Parkinson’s disease) ✘ Patients less than 2 years of age ✘ First trimester pregnancy (may only be administered for extreme and uncontrolled hyperemesis) ! Hepatic impairment ! Elderly patients ! Intestinal obstruction ! Patients with risk factors for QT interval prolongation or cardiac arrhythmias ֎ Headache ֎ Constipation ֎ Hypersensitivity reactions (including anaphylaxis) ֎ ECG changes

Answer 46

Ondansetron ✓ Significant nausea AND/OR vomiting Paed) PO > 5 years – 4 mg. SD. PO 2-4 years – 2 mg. SD. Paed) IM > 2 years – 100 microg/kg (rounded to nearest 5 kg[4 mg]). Paed) IV > 2 years – 100 microg/kg (4 mg). Slow push 2-3mins. SD. Must not be given within 8 hours of previous ondansetron administration.

Answer 47

Oxytocin Drug class: Oxytocic Presentation: Ampoule, 10 International units (IU) / 1 mL Synthetic oxytocin is a uterine stimulant that causes uterine contractions by changing calcium concentrations within uterine muscle cells. Oxytocin administered during the third stage of labour assists with placental separation, raises the tone of the uterine musculature and minimises further uterine blood loss.

Answer 48

Oxytocin ✓ Active management of the third stage of labour (following confirmed of delivery of all fetuses) AND the prevention of primary post-partum haemorrhage Adult) IM 10 International Units. SD ✓ Management of uncontrolled primary or secondary post-partum haemorrhage Adult) IV Loading dose – 10 International Units. Slow push over 2-5 minutes. May be given in addition to a dose that may have been administered for: Active management of the third stage of labour/the prevention of primary PPH.

Answer 49

Oxytocin ✘ Allergy and/or Adverse Drug Reaction ✘ Undelivered fetuses ! Myocardial ischaemia ! May potentiate hypotension when administered with analgesia ֎ Nausea and/or vomiting ֎ Headache ֎ Bradycardia ֎ Tachycardia

Answer 50

Paracetamol Drug class: Analgesic, Antipyretic Presentation: Tablet, 500mg paracetamol Elixir, 120mg/5mL paracetamol Paracetamol is a rho-aminophenol derivative that exhibits analgesic and antipyretic activity. It does not possess significant anti-inflammatory activity.

Answer 51

Paracetamol ✓ Mild to moderate pain ✓ Fever (causing distress) Adult) PO 0.5-1g. 4hrs. TMD 4g in 24hrs. Must not be administered within 4 hours of previous paracetamol administration.

Answer 52

Paracetamol ✘ Allergy and/or Adverse Drug Reaction ✘ Patients < 1 month old ! Hepatic dysfunction ! Soluble tablets - Patients with sodium restriction (heart failure, chronic kidney disease) - Phenylketonuria ֎ Nausea

Answer 53

Paracetamol ✓ Mild to moderate pain ✓ Fever (causing distress) Paed) PO > 1 month – 15 mg/kg (1g). Must not be administered within 4 hours of previous paracetamol administration.

Answer 54

Salbutamol Drug class: Beta-adrenergic agonist Presentation: Metered Dose Inhaler, 100 microg/puff salbutamol Nebule, 2.5 mg/2.5 mL salbutamol Nebule, 5 mg/2.5 mL salbutamol Ampoule, 500 mcg/1 mL salbutamol Salbutamol is a direct acting sympathomimetic agent which mainly affects β2 – adrenoceptors. It primarily acts as a bronchodilator but also has inotropic and chronotropic actions. Additionally, it lowers serum potassium levels through its direct stimulation of the sodium/potassium ATPase pump, drawing potassium into cells.

Answer 55

Salbutamol ✓ Bronchospasm Adult) MDI 12 (1.2mg) inhalations. 10mins. NMD. Adult) NEB 5mg. PRN. NMD. CCP - ✓ Suspected hyperkalaemia (with QRS widening AND/OR AV dissociation)

Answer 56

Salbutamol ✘ Allergy and/or Adverse Drug Reaction ✘ Patients less than 1 year ! Acute pulmonary oedema ! Ischaemic heart disease ֎ Anxiety ֎ Tachyarrhythmias ֎ Tremors ֎ Hypokalaemia and metabolic acidosis

Answer 57

Salbutamol ✓ Bronchospasm Paed) MDI 1-5 years – 6 (600 microg) inhalations. 10mins. NMD. MDI > 6 years – 12 (1.2 mg) inhalations. 10mins. NMD. Paed) NEB 1-5 years – 2.5mg. PRN. NMD. NEB > 6 years – 5mg. PRN. NMD. CCP - ✓ Suspected hyperkalaemia (with QRS widening AND/OR AV dissociation)

Answer 58

Sucrose 24% Drug class: N/A Presentation: Twist-tip vial, 2 mL 24% sucrose Sucrose 24% is an oral, sterile, liquid preparation used as a short-term analgesic in infants. When small amounts of sucrose are placed on an infant’s tongue it causes an increase of endogenous opioids resulting in approximately 5-8 mins of analgesia.

Answer 59

Sucrose 24% ✓ Short term procedural pain management (e.g. IV cannulation) ✓ Distress due to pain Paed) PO Initial dose of sucrose 24% must be administered using the following scale: May be repeated once at 5 minutes.

Answer 60

Sucrose 24% ✘ Patients greater than 12 months of age ✘ Sucrose intolerance - Congenital sucrase-isomaltase deficiency (CSID) ✘ Fructose intolerance ✘ Glucose-galactose malabsorption ✘ Concurrent muscle relaxant/paralysis therapy ! Nil ֎ Hyperglycaemia

Answer 61

Tenecteplase Drug class: Fibrinolytic Presentation: Injection, (powder and solvent) 50 mg (10,000 IU) graduated syringe tenecteplase Tenecteplase is a thrombolytic agent which combines with the fibrin component of the thrombus and converts thrombus-bound plasminogen to plasmin. This degrades the fibrin matrix of the thrombus.

Answer 62

Tenecteplase ✓ Patient with STEMI who meet the criteria for pre-hospital Tenecteplase administration (as defined by the relevant QAS coronary artery reperfusion checklist) Adult) IV Weight calculated dose (as listed below) administered into a pre-existing IV line containing sodium chloride 0.9% over 10 seconds.

Answer 63

Tenecteplase ✘ Patients less than 18 OR greater than 75 years of age ✘ Uncontrolled hypertension (systolic BP > 180 mmHg AND/OR diastolic BP > 110 mmHg at any stage during current acute episode) ✘ Allergy AND/OR Adverse Drug Reaction to any of: Tenecteplase, enoxaparin OR clopidogrel ✘ Left BBB identified on 12-Lead ECG ✘ Current OR history of thrombocytopenia ✘ Active tuberculosis ✘ Known cerebral disease, in particular a malignant intracranial neoplasm OR arteriovenous malformation ✘ Prior intracranial haemorrhage ✘ Ischaemic stroke OR Transient Ischaemic Attack (TIA) within last 3 months ✘ History of significant closed head OR facial trauma within last 3 months ✘ Suspected aortic dissection (including new neurological symptoms) ✘ History of major trauma OR surgery (including laser eye surgery) within last 6 weeks ✘ Internal bleeding (e.g. gastrointestinal (GI)/urinary tract bleed) within last 6 weeks (excluding menses) ✘ Bleeding OR clotting disorder (e.g. haemophilia) ✘ Current use of anticoagulants (e.g. warfarin) ✘ Non-compressible vascular punctures ✘ Prolong (> 10 minutes) cardio pulmonary resuscitation (CPR) ✘ Known to be pregnant OR delivered within the last 2 weeks ✘ History of serious systemic disease (e.g. advanced/terminal cancer, severe liver OR kidney disease) ✘ Resident of an aged care facility requiring significant assistance with activities of daily living ✘ Acute myocardial infarction in the setting of trauma ! Nil ֎ Haemorrhage ֎ Post-administration dysrhythmias

Answer 64

Ticagrelor Drug class: Antiplatelet Presentation: Tablet, 90 mg ticagrelor Orally Disintegrating Tablet (ODT), 90 mg ticagrelor Ticagrelor is a reversibly binding, direct-acting adenosine diphosphate (ADP) receptor antagonist that inhibits platelet activation and aggregation.

Answer 65

Ticagrelor ✓ Patients with STEMI (as defined by the relevant QAS coronary artery reperfusion checklist) who have been accepted for pPCI (as an adjunct medication to aspirin and heparin) AND the receiving interventional cardiologist is requesting ticagrelor administration Adult) PO > 18 years – 180 mg

Answer 66

Ticagrelor ✘ Allergy and/or Adverse Drug Reaction ✘ Patient currently taking ticagrelor OR clopidogrel ✘ Patient less than 18 years of age ✘ Active bleeding (excluding menses) ✘ Prior intercranial haemorrhage ✘ History of hepatic impairment ! Concurrent medication known to induce bradycardia (e.g. β blocker, calcium channel blocker, digoxin) ! Symptomatic bradycardia (HR less than 60) ֎ Haemorrhage ֎ Bradycardia

Answer 67

Tranexamic acid Drug class: Antifibrinolytic Presentation: Ampoule, 1 g/10 mL tranexamic acid Tranexamic acid (TxA) is a competitive inhibitor of plasminogen activation through the formation of a reversible complex displacing plasminogen from fibrin. This inhibits the process of fibrinolysis in addition to the protein breakdown caused by plasma.

Answer 68

Tranexamic acid ✓ Recent traumatic injuries (3 hours or less) with a COAST score of 3 or greater ✓ Management of uncontrolled primary post-partum haemorrhage (3 hours or less) Adult) IV 1g. Slow push over 10 minutes. SD Adult) IV INF 1 g over 10 minutes. SD Infusion preparation: Mix 1 g of tranexamic acid in a 100 mL bag of sodium chloride 0.9%. Ensure bag is appropriately labelled. Administer over 10 minutes (approx. 3 dops/second).

Answer 69

Tranexamic acid ✘ Allergy and/or Adverse Drug Reaction ! Nil ֎ Headache ֎ Hypotension ֎ Nausea and/or vomiting ֎ Seizures

Answer 70

Tranexamic acid ✓ Recent traumatic injuries (3 hours or less) with a COAST score of 3 or greater Paed) QAS Clinical Consultation and Advice Line approval required in all situations. Paed) 15 mg/kg. Slow push over 10 minutes. SD. TMD 1g.

All the things Flashcards

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