Drugs

Question 1

GTN Contraindications

Answer 1

1. known hypersensitivity
2. SBP<90
3. HR<50 (*does not apply in autonomic dysreflexia)
4. Viagra/Levitra/Spedra (sildenafil/vardenafil/avanafil) in last 24hrs
5. Tadalafil (Cialis) in last 3-4/7 normal population OR 4-5/7 elderly/renal impaired pts

Question 2

Morphine Contraindications

Answer 2

1. elderly
2. child<1yr
3. Active labour
4. Pts with CAL
5. GCS<13
6. SBP 70-90 (1/2 dose)
7. Hypovolaemia (correct with fluids before administering)
8. known hypersensitivity
9. previous opiates

Question 3

Methoxyflurane Contraindications

Answer 3

1. DLOC
2. known hypersensitivity
3. Malignant hyperthermia
4. concurrent doxycycline use

Question 4

Methoxyflurane precautions

Answer 4

1. Renal disease
2. Diabetes
3. pt unable to self-administer
4. Pain Mx in post-delivery phase labour/PPH (risk of uterine atonia)

Question 5

Methoxyflurane A/E

Answer 5

1. Jaundice
2. ALOC
3. Renal dysfunction
4. Uterine atonia

Question 6

Fentanyl contraindications + precautions

Answer 6

1. bilateral occlusion/bleeding nostrils
2. ALOC
3. Child<1yr
4. Known hypersensitivity
   prec: active labour

Question 7

Stemetil contraindications

Answer 7

1. Previous dose in last 8/24
2. paed<18yrs
3. known sensitivity to phenothiazines
4. CNS depression
5. shock/other circulatory compromise
6. not for use in pregnancy
7. not to be used in conjunction with IV amiodarone

Question 8

Stemetil precautions

Answer 8

1. Parkinson’s disease
2. Renal dysfunction
3. Myasthenia Gravis
4. Epilepsy
5. Caution in elderly - increased risk of dystonic reactions

Question 9

aspirin contras

Answer 9

1. known/suspected allergy
2. known bleeding tendency
3. known/suspected GI bleed
4. chest pain associated with psychostimulant overdose (increased risk of intracranial haemorrhage)

Question 10

aspirin dose

Answer 10

300mg oral chewed or dissolved
150mg if on warfarin

Question 11

aspirin action

Answer 11

• decrease platelet aggregation for up to 7 days
• decreases inflammation, pain, fever

Question 12

aspirin A/E

Answer 12

• allergic reaction
• GI irritation
• aggravation of bleeding tendencies

Question 13

adrenaline drug type

Answer 13

naturally occurring catecholamine

Question 14

adrenaline A/E

Answer 14

tachycardia
tachyarrhythima
hypertension

Question 15

adrenaline contra

Answer 15

known hypersensitivity

Question 16

adrenaline prec

Answer 16

only in Pts with CO
- Hx IHD, HTN
- Pts on MAO inhibitors - adrenaline has exaggerated response, only need approx 1/4 of full dose

Question 17

adrenaline actions

Answer 17

alpha - peripheral vasoconstriction
beta 1 - increase myocardial contractility, increase SA node rate, increase AV conduction speed, increase myocardial irritability
beta 2 - bronchodilation, skeletal muscle vasodilation

Question 18

atropine drug class

Answer 18

anticholinergic/parasympathetic blocking agent

Question 19

atropine presentation

Answer 19

600mcg/1mL

Question 20

atropine action

Answer 20

blocks vagal action on heart
increase SA rate
increase AV conduction
reduces salivary and tear duct secretions

Question 21

atropine A/E

Answer 21

dry mouth
tachycardia
constipation
blurred vision
palpitations
confusion
urinary retention
increased body temp (decreased sweating)

Question 22

atropine contras

Answer 22

known hypersensitivity

Question 23

atropine precautions

Answer 23

pts with glaucoma
aim to not increase HR > 100

Question 24

atropine use

Answer 24

organophosphate/spider bite with cholinergic symptoms to increase HR and/or assist airway Mx by reducing secretions

Question 25

atropine dose and repeats

Answer 25

0.01mg/kg IM, repeat every 5/60 while cholinergic symptoms present double each dose, max dose dependant on volume that can be delivered IM

Question 26

ceftriaxone drug type

Answer 26

3rd gen cephalosporin antibiotic

Question 27

ceft action

Answer 27

broad spectrum antibiotic effective against gram-negative bacteria (i.e. meningococcus) effective at crossing blood brain barrier

Question 28

ceft dose

Answer 28

50mg/kg up to 2g IV preferred; reconsitute into 10mL with N/S, give slow over 2-4 minutes can be given IM, give in 2 injections if over 1g/3ml

Question 29

ceft A/E

Answer 29

skin rash hypersensitive reactions diarrhoea

Question 30

ceft contras

Answer 30

known sensitivity to cepholasporins

Question 31

ceft precs

Answer 31

20% Pts with penicillin allergies may be sensitive

Question 32

droperidol drug class

Answer 32

antiphychotic

Question 33

droperidol A/E

Answer 33

- extrapyramidal effects - may lower seizure threshold - neuroleptic malignant syndrome - arrhythmias - prolonged QT, torsades --> ** must have ECG monitoring

Question 34

droperidol contras

Answer 34

known hypersensitivity parkinson's disease post ictal

Question 35

droperidol precs

Answer 35

Pts in pain must also be given analgesia

Question 36

droperidol dose

Answer 36

>14yrs: 10mg IM, 1x repeat in 10-15minutes if required if elderly/frail/>65yrs - 5mg IM, same repeat 10-15/60 not used in paeds <14yrs

Question 37

glucagon contras

Answer 37

known hypersensitivity

Question 38

glucagon dose

Answer 38

1 IU IM, no repeat 0.5 IU IM in paeds <20kgs

Question 39

glucagon A/E

Answer 39

(very rare) N+V hypersensitivity very occasionally

Question 40

glucose 10% A/E

Answer 40

tissue necrosis if allowed to escape vein hyperglycaemia

Question 41

glucose 10% dose

Answer 41

2.5ml/kg IV, slow over 5 minutes, continuous ensuring cannula patency 1 repeat if nil improvement