Anaesthetics and A&E

Question 1

What are common uses of lidocaine?

Answer 1

local anaesthetic

uncommon - antiarrythmic for VT/VF

Question 2

How does lidocaine work?

Answer 2

blocks voltage-gated sodium channels to prevent initiation of action potentials in nerves and muscles

Question 3

What are important adverse effects of lidocaine?

Answer 3

stinging, drowsiness, restlessness, tremor, fits

Question 4

What are some warnings for lidocaine?

Answer 4

redcued cardiac output

Question 5

What are some important interactions for lidocaine?

Answer 5

adrenaline can prolong effect

Question 6

What is the indication for naloxone?

Answer 6

opioid overdose

Question 7

How does nalaxone work?

Answer 7

it is competitive antagonist for opioid receptor

Question 8

What are important adverse reactions to naloxone?

Answer 8

withdrawal reaction - restlessness, nausea, cold

Question 9

What are warnings for nalaxone?

Answer 9

opioid dependance

palliative care - avoid complete reversal

Question 10

What are interactions for nalaxone?

Answer 10

N/A

Question 11

What are the indications for oxygen?

Answer 11

hypoxia, CO poisoning, treating pneumothorax

Question 12

What is the mechanism of action of oxygen?

Answer 12

increases delivery of oxygen to tissue, shorten half life of CO

Question 13

What are adverse effects of oxygen?

Answer 13

uncomfortable device, lack of water vapour (dry)

Question 14

What are the warnings of oxygen?

Answer 14

COPD high O2 can cause high CO2

oxygen is flamable

Question 15

What are the interactions with oxygen?

Answer 15

N/A

Question 16

What are the indications of paracetamol?

Answer 16

first line analgesic

reduce fever

Question 17

What is the mechanism of action of paracetamol?

Answer 17

weak inhibitor of COX

Question 18

What are the adverse reactions of paracetamol?

Answer 18

overdose

liver toxicity/failure

Question 19

What are the interactions with paracetamol?

Answer 19

CYP inducers increase risk of liver toxicity

Question 20

What are the warnings with paracetamol?

Answer 20

chronic excessive alcohol misuse, malnutirition, <50kg, severe hepatic impairment

Question 21

What are common indicators of morphine?

Answer 21

acute severe pain
chronic pain
reduce breathlessness

Question 22

What is the mechanism of action of morphine?

Answer 22

activation of opioid receptors

reduce sympathetic nervous system

Question 23

What are the adverse reactions of morphine?

Answer 23

respiratory or neuro depression 
nausea and vomiting 
pupillary constriction 
constipation
itching 
tolerance, dependance, withdrawal

Question 24

What are the warnings of morphine?

Answer 24

hepatic, renal, respiratory failure
elderly
biliary colic

Question 25

What are the interactions of morphine?

Answer 25

Other sedating drugs

Question 26

What is acetylcystine and how does it work?

Answer 26

it is usec to treat paracetamol poisoning , to reduce viscosity of respiratory secretions glutathione combines so paracetamol is not toxic - it replenishes glutathione supplies, has antioxident effects

Question 27

What are adverse effects of acetylcysteine?

Answer 27

anaphylactoid reaction | bronchospasm

Question 28

What are warnings of acetylcysteine?

Answer 28

previous anaphlaxis - be cautious

Question 29

What are interactions with acetylcysteine?

Answer 29

N/A

Question 30

What are common indications of activated charcoal?

Answer 30

reduce absorption of poisons

Question 31

What is the mechanism of action of activated charcoal?

Answer 31

molecules adsorb to the surface of the charcoal so their absorption is reduced

Question 32

What are adverse reactions of activated charcoal?

Answer 32

can aspirate charcoal = pneumonitis, bronchospasm, airway obstruction intestinal obstruction black stools and vomiting

Question 33

What are warnings of activated charcoal?

Answer 33

Do not give to patients with decreased consciousness | persistent vomiting, reduced gut motility

Question 34

What are important interactions with activated charcoal?

Answer 34

reduces absorption of therapeutic drugs too

Question 35

What is the indications of ondansetron?

Answer 35

anti-emetic

Question 36

What are the adverse reactions of ondasetron?

Answer 36

constipation, diarrhoea, headaches

Question 37

What are the warnings of ondasetron?

Answer 37

it can prolong QT interval

Question 38

What are interactions of ondasetron?

Answer 38

drugs that prolong QT intervals

Question 39

What is propofol and its indication?

Answer 39

it is an anaesthesia used for induction or maintainence of sedation

Question 40

What are adverse reactions of propofol?

Answer 40

apnoea, arrhythmias, headache, hypotension, localised pain, nausea, vomiting

Question 41

What are cautions of propofol?

Answer 41

shock, cardiac problems, elderly, epilepsy, fixed CO, hypotension, hypovolaemia, raised ICP, respiratory impairment

Question 42

What are interactions with propofol?

Answer 42

other drugs that cause hypotension or CNS depression | Valporate can increase concentration of propofol

Question 43

What are indications of adrenaline?

Answer 43

anaphylaxis, cardiac arrest, induce local vasoconstriction

Question 44

What is mechanism of action of adrenaline?

Answer 44

potent agonist of adrenoreceptors = vasocontriction, bronchodilation, redistribution of blood flow to heart, suppression of inflammatory mediator release from mast cells

Question 45

What are some adverse reactions of adrenaline?

Answer 45

hypertension, anxiety, tremor, headache, palpitations | angina, myocardial infarction, arrhythmias

Question 46

What are some warnings of adrenaline?

Answer 46

no contraindications in cardiac arrest and anaphylaxis | heart disease - vasocontriction

Question 47

What are some interactions with adrenaline?

Answer 47

beta blockers - can cause widespread vasoconstriction

Question 48

What are some weak/moderate opioids?

Answer 48

tramadol, codeine, dihydrocodeine

Question 49

What are some adverse effects of weak/moderate opioids?

Answer 49

nausea, constipation, dizzy, drowsy | neurological and respiratory depression

Question 50

What are some warnings and interactions of weak/moderate opioids?

Answer 50

significant respiratory disease, renal or hepatic impairment, elderly, epilepsy don't prescribe with other sedating drugs, drugs that lower seizure thresholds, serotonergic drugs