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Drug Administration Flashcards

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1
Q

How is activated charcoal presented?

A

50 grams in 250ml in either granules or suspension in the water

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2
Q

What are some indications for use of activated charcoal?

A

Acute oral poisoning or oral drug overdose

Adults and children aged 1 and over who have ingested toxins less that 1 hour before ambulance attendance

Adults and children, irrespective of time of ingestion, who have ingested toxins and where Toxbase or The National Poisons Information Service (0344 8920111) have been contacted and advised the administration of activated charcoal

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3
Q

What is considered a paracetamol overdose?

A

Recommended dose is 4g in 24 hours for adults

Ingestion exceeding 4g is an overdose but toxicity is extremely unlikely if less than 75mg/kg paracetamol has been ingested within 24 hours

Single acute overdose is defined as an ingestion or less than 4g in a period of less than an hour

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4
Q

How is the toxic dose of activated charcoal for pregnant patients?

A

Use patients pre-pregnancy weight

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5
Q

What is the volume of activated charcoal an adult can orally consume?

A

50mg in 250ml

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6
Q

What is the max dose of activated charcoal for an adult?

A

50mg

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7
Q

How much activated charcoal should children aged 1 year to under 12 years consume?

A

Should drink 125ml, which is equivalent to 25 grand of activated charcoal or half of contents of one bottle unless large quantity of poison has been ingested

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8
Q

What cab activated charcoal be consumed with?

A

Soft drinks or fruit juice

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9
Q

How is adrenaline 1mg in 10ml (1:10,000) presented?

A

Pre-filled syringe containing 1mg of adrenaline (epinephrine) in 10ml (1:10,000)

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10
Q

When should adrenaline 1:10,000 be used?

A

Cardiac arrest

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11
Q

When should repeated doses of adrenaline 1:10,000 not be used?

A

Cannot be repeated on hypothermic patients

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12
Q

During cardiac arrest, when should adrenaline 1:10,000 be administered?

A

Shockable rhythms:
Administer adrenaline after 3rd shock and then after alternate shocks (ie. 5th, 7th etc)

Non-shockable:
Administer adrenaline immediately IV access is achieved then alternate loops

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13
Q

What is the recommended adrenaline dose IV/IO for an adult?

A

1mg in the 10ml

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14
Q

What is the dose interval for adrenaline 1:10,000 and what is the max dose?

A

3-5 minutes

No limit to dose. Repeat 1mg dose

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15
Q

How is adrenaline 1mg in 1ml (1:1000) presented?

A

Pre-filled syringe or ampoule containing 1mg of adrenaline (epinephrine) in 1ml (1:1000)

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16
Q

When should adrenaline 1:1000 be used?

A

Anaphylaxis

Life-threatening asthma with failing ventilation and continued deterioration despite nebuliser therapy

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17
Q

When should adrenaline 1:1000 not be administered?

A

Should not be administered IV in cases of anaphylaxis

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18
Q

What is the recommended dose of adrenaline 1:1000 adults and children over the age of 12?

A

IM 500mcg in 0.5ml

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19
Q

What is the dose interval for adrenaline 1:1000 and what is the max dose?

A

5 minutes

No max dose. Repeat dose is 500mcg

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20
Q

How is aspirin presented?

A

300mg aspirin in tablet form. Dispersible or chewable

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21
Q

When can aspirin be given?

A

Adults with clinical or ECG evidence suggestive of myocardial infarction or ischaemia

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22
Q

What does aspirin do?

A

Has an anti-platelet action which reduces clot formation

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23
Q

What are some contraindications of aspirin?

A 
Allergy or sensitivity
Children under 16 years
Active gastrointestinal bleed
Haemophilia or other known clotting disorders 
Severe hepatic disease
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24
Q

What type of patients can have aspirin who also have MI or ischaemia?

A 
Asthma
Pregnancy
Kidney or liver failure 
Gastric or duodenal ulcer
Current treatment with anticoagulants
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25
What are some side effects of activated charcoal?
Black stools Intestinal obstruction (blockage of digestive system) Bezoar formation (ball of material in the stomach that is not passed out) Intestinal perforation (rare, but can occur after several treatments)
26
What is the side effects of aspirin?
Increased risk of gastric bleeding Wheezing in some asthmatics
27
Who can have aspirin?
Children over the age of 16 and adults
28
What is the dose of aspirin for an adults?
Oral - 300mg in 1tablet
29
What is the max dose of aspirin?
300mg Cannot be repeated
30
How is glucagon presented?
Glucagon injection, 1mg of powder in vial for reconstitution with water for injection
31
When would glucagon be administered?
Hypoglycaemia or unconscious patients where hypoglycaemia is considered likely cause (less than 4 BM) Glucagon IM should only be administered when oral glucose administration is not possible or is ineffective, and/or when IV access to administer 10% glucose is not possible
32
Why should glucagon not be given by IV injection?
Increased vomiting associated with IV use
33
What are the side effect of glucagon?
``` Nausea and vomiting Abdominal pain in adults Diarrhoea in children Hypokalaemia Hypotension in adults Acute hypersensitivity reaction, although is rare ```
34
If patient is unconscious due to hypoglycaemia, how should glucagon be administered and how much?
Glucose 10% IV
35
What is the IM dose of glucagon in thigh or upper arm?
1mg in 1 vial
36
Can glucagon dose be repeated?
No and max dose is 1mg
37
If no response to IM glucagon, what is next point of treatment?
If no response within 10 minutes administer intravenous glucose 10%
38
How is glucose 40% oral gel presented?
Plastic tube containing 25g glucose 40% oral gel
39
What is the recommended dose of glucose 40% oral gel for an adult and children older than 12?
Route is buccal 10-20g in 1-2tubes
40
What is the max dose of glucose 40% oral gel?
2 tubes/20grams
41
How is glyceryl trinitrate (GTN) presented?
Sublingual spray containing 400mcg per metered dose
42
What are the indications of the use of GTN?
Cardiac chest pain due to angina or MI, when systolic BP is greater than 90mmHg Breathlessness due to pulmonary oedema in acute heart failure when systolic BP is greater than 110mmHg
43
What are the side effects of GTN?
Headache Dizziness Hypotension
44
What is the dose of GTN for angina, MI and Acute Heart Failure?
400-800mcg in 1-2 sprays
45
What is the dose interval for GTN?
5-10mins
46
How is ibuprofen presented?
Solution or suspension containing ibuprofen 100mg in 5ml (20mg in 1ml)
47
What are some indications of ibuprofen?
Relief of mild to moderate pain Pyrex is with discomfort Soft tissue injuries
48
What is the dose of ibuprofen for children aged 12 years and over, and adults?
400mg
49
What is the dose interval of ibuprofen and what is the repeat dose and max dose?
8 hours 4mg 1.2g per 24 hours
50
How is Ipratropium Bromide presented?
Nebuliser liquid Ipratropium 250mcg per 1ml liquid unit dose vial Nebuliser liquid Ipratropium 500mcg per 2ml liquid unit dose vial
51
What are the indications for the use of Ipratropium bromide?
Acute, severe or life threatening asthma Acute asthma unresponsive to salbutamol Exacerbation of COPD unresponsive to salbutamol
52
What are some side effects of Ipratropium?
``` Nausea Dry mouth Tachycardia/arrhythmia Tightness of chest Allergic reaction ```
53
If COPD, what is the time interval for Ipratropium?
6 minutes
54
What is the adult dose of Ipratropium?
6-8 litres per minute oxygen | 500mcg in 2ml Half for child
55
What is the dose of paracetamol for an infant? (3 months to 5 years)
120mg in 5ml
56
What is the dose of paracetamol for 6 and over?
250mg in 5ml
57
What is the paracetamol dose for a 16 year old - adult?
500mg-1g in 10-20ml
58
What is the dose interval for paracetamol for a 16 year old - adult?
4-6 hours
59
What is the max dose of paracetamol for 16 years - adult?
2-4 grams in 24 hours
60
For all ages of paracetamol administration, what should be checked?
JRCALC
61
How is salbutamol presented?
Nebules containing salbutamol 2.5mg in 2.5ml or 5mg in 2.5ml
62
When is salbutamol used?
Acute asthma attack where normal inhaler therapy has failed Expository wheezing associated with allergy, anaphylaxis, smoke inhalation or other lower airway causes Exacerbation of COPD
63
What are the side effects of using salbutamol?
``` Tremor (shaking) Tachycardia Palpitations Headache Feeling of tension Peripheral vasodilation Muscle cramps Rash ```
64
What is the adult dose of salbutamol?
6-8 litres of oxygen | 5mg in 5ml

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