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CCP drugs Flashcards

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1
Q

Adenosine MOA

A

Nucleoside that depresses conduction through AV node which interrupts re-entry circuits that may restore sinus rhythm in pts with SVT

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2
Q

Adenosine indications

A

pt > 12 years with SVT and a rate > 150 and; moderate compromise, mild compromise if known to be responsive to adenosine

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3
Q

Adenosine contraindications

A

Known severe allergy

Known sick sinus syndrome without internal pacemaker

2nd or 3rd degree block without internal pacemaker

Heart transplant without internal pacemaker

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4
Q

Adenosine cautions

A

Asthma/CORD: may precipitate bronchospasm and should be withheld if pt has had recurrent life-threatening bronchospasm or is currently experiencing exacerbation of Asthma/CORD.

WPW syndrome if rhythm possibly fast AF - in this setting risk of causing VF

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5
Q

Adenosine dose

A

6 mg, 2nd dose 12 mg if rhythm fails to revert

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6
Q

Adenosine administration

A

fast push IV with 20 ml flush

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7
Q

Adenosine common adverdse effects

A

Bradycardia

SOB

Light headed

Nausea and flushing

Chest tigthness

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8
Q

Adenosine preparation

A

ampoule 6 mg in 2 ml

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9
Q

Adenosine onset and duration

A

Onset: 5-10 secs

DOA: 10-20 secs

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10
Q

Amiodarone MOA

A

Class III antidysrhythmic that prolongs the action potential and refractory period od atrial, nodal and ventrcular tissues reducing abnormal conduction, reducing HR and stabilising SA and AV nodes

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11
Q

Amiodarone Indications

A

Cardiac arrect with VT or VF at any time

Adults - sustained VT

Adults with moderate compromise from fast AF or fast atrial flutter

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12
Q

Amiodarone contraindications

A

Known severe allergy

Known severe allergy iodine

VT secondary to tricyclic antidepressant OD

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13
Q

Amiodarone cautions

A

*None in cardiac arrest

Poor perfusion or signs of low CO

Hypotension

AF secondary to sepsis

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14
Q

Amiodarone dose

A

CA - 300 mg IV push, 2nd dose if persistant VF/VT 15 mins after 1st dose 150 mg

Tachydysrhythmia - 300 mg IV infusion over 30 mins, 2nd dose can be given over 30 mins 150 mg infusion

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15
Q

Amiodarone administration

A

CA - IV push

VT/AF/Aflutter 300 mg IV infusion over 30 mins, add to 100 ml 5% glucose. Further 150mg over 30 mins if rate remains above 120 BPM

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16
Q

Amiodarone adverse effects

A

Hypotension

light headed

Bradydysrhythmia

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17
Q

Amiodarone onset/duration

A

Onset 5-10 mins

DOA 1-4 hrs

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18
Q

Amiodarone preparation

A

ampoule 150 mg in 3 ml

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19
Q

Atropine MOA

A

Anticholinergic that blocks muscarinic AcH receptors causing vagal inhibition

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20
Q

Atropine indications

A

Adults with bradycardia, particularly if the rhythm is narrow complex

Organophosphate poisoning

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21
Q

Atropine contraindications

A

Known severe allergy

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22
Q

Atropine cautions

A

Myocardial Ischaemia. Atropine will increase myocardial oxygen consumption.

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23
Q

Atropine dose

A

0.6 mg IV, repeat as required without maximum dose if bradycardia is responsive to atropine

Repeated and escalating doses will likely be required for organophosphate poisoning

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24
Q

Atropine administration

A

Undilute as rapid IV bolus

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25
Atropine onset and duration
onset - 5-10 secs DOA 15-60 mins
26
Atropine preparation
Ampoule 0.6 mg in 1 ml
27
Magnesium sulphate MOA
Reduces bronchial smooth muscle contraction causing bronchodilation
28
Magnesium sulphate indications
Bronchospasm secondary to severe or immediately life threatening asthma Bronchospasm secondary to severe COPD or imminent respiratory arrest from COPD
29
Magnesium sulphate contraindication
known severe allergy
30
Magnesium sulphate cautions
Hypotension - vasodilator which may make hypotension worse
31
Magnesium sulphate dose
10 mmol, second dose if transport time is longer than 30 mins and not improving
32
Magnesium sulphate administration
Add to 100 ml 5% glucose and give as infusion over 15 mins Dilute to 10 ml with NaCl and give 1 ml every 1-2 mins through running IV
33
Magnesium sulphate onset/duration
Onset 5-10 mins DOA 30-60 mins
34
Magnesium sulphate preparation
ampoule 10 mmol in 5 ml
35
Metaraminol MOA
Alpha receptor agonist causing peripheral vasoconstriction
36
Metaraminol indications
Hypotension in the setting of septic shock, post CA, cardiogenic shock, severe TBI, neurogenic shock, RSI and post intubation
37
Metaraminol contraindications
known severe allergy
38
Metaraminol dose
Titrate to effect - 0.5 mg-1 mg every 5-10 mins
39
Metaraminol administration
Draw up into 10 mg in 10 ml
40
Metaraminol preparation
ampoule 10 mg in 1 ml
41
Metaraminol onset/duration
onset 1-2 mins DOA 10-15 mins
42
Rocuronium MOA
Neuromuscular blocker which antagonises nicotinic acetylcholine receptors at the neuromuscular junction
43
Rocuronium indications
RSI, post intubation provided ETT position confirmed with capnography
44
Rocuronium contraindications
Known severe allergy, ETT not confirmed by capnography
45
Rocuronium cautions
Predicted difficult intubation, chronic muscle weakness (HALVE DOSE), adult with poor prognosis post cardiac arrest
46
Rocuronium dose
RSI <70 kg 150 mg, 70-90 kg 150 mg, >90 kg 200 mg Post intubation - ≤80 kg 50 mg, >80 kg 100 mg
47
Rocuronium onset and duration
onset 30-60 secs, duration 30-60 mins
48
Rocuronium preparation
Ampoule 50mg in 5 ml
49
Rocuronium administration
IV undiluted as a bolus
50
Rocuronium storage
If not refrigerated it loses 5-10% activity per month, once in kits it must be dated 8 weeks post removal from fridge
51
Rocuronium vs suxamethonium
Rocuronium antagonist which blocks acetylcholine at neuromuscular junction - no stimulation prior to blockade = no fasciculations Suxamethonium is an acetylcholine agonist which binds to receptors and keeps the channels open - stimulates receptor so will see fasciculations
52
Ripovacaine 0.75% MOA
local anaesthetic which blocks the initiation and transmission of nerve impulses by blocking the movement of sodium ions across the nerve cell membrane
53
Ripovacaine 0.75% indications
- FI blocks - severe pain with obvious NOF or proximal femur fracture where pain is not adequately controlled with opiates and transport time is > 30mins (including extrication time) - Ring blocks - isolated injuries to digits with moderate to severe pain and transport time is > 60 mins
54
Ripovacaine 0.75% contraindications
Known severe allergy, infection at site of injection, *for FI block - previous surgery in the groin, age < 12 years
55
Ripovacaine 0.75% dose
FI blocks: ADMINISTER BLOCK ONCE ONLY >60 kg 40 ml of 0.375% (20ml of 0.75% diluted to 40ml) <60 kg 30 ml of 0.375% (15 ml of 0.75% diluted to 30 ml) Ring blocks: 1-2 ml of 0.75% into tissue either side of digit. If more than 20 ml is required dilute to 0.375%
56
Ripovacaine 0.75% preparation
ampoule 150 mg in 20 ml
57
Ripovacaine 0.75% onset and duration
Onset 5-10 mins, duration 1-2 hrs
58
Metaraminol cautions
Bradycardia, may make bradycardia worse from decreased release of endogenous adrenaline. Consider adrenaline if hypotensive and bradycardic
59
Ketamine for dissociation dose
1 mg/kg up to 100 mg IV, repeat once after 5 mins
60
Ketamine for agitated delirium
IV 1 mg/kg (up to 100 mg), repeat every 5 mins IM 5mg/kg rounded up to the nearest 100 mg, (up to 400mg), repeat once only after 20 mins
61
Midazolam for agitated delirium
2-3 mg IV every 5 mins as required
62
Midazolam for pain/adjunct
Indicated when pain is spasmodic, or anxiety related and opiate/ketamine is not appropriate 0.5-1 mg IV every 10 mins as required

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