Drugs

Question 1

What are 5 indications for sodium chloride 0.9%?

Answer 1

1. Inadequate tissue perfusion/shock
2. Hypovolaemia
3. Significant burns
4. Dissolve/dilute drugs
5. Flush an IV

Question 2

What are the contraindications for sodium chloride 0.9%?

Answer 2

Nil

Question 3

What is the dose of sodium chloride for a hypovolaemic adult?
How frequently should you reassess the patients condition?

Answer 3

PRN (as needed)
Every 250ml

Question 4

What is the dose of sodium chloride 0.9% for a paediatric patient with hypovolaemia?
When should you reassess?
What’s the total max dose?

Answer 4

10/20ml/kg
Every 10ml/kg
60ml/kg

Question 5

Name 3 precautions for sodium chloride 0.9%.

Answer 5

1. Patients with heart failure
2. Patients with renal failure
3. Uncontrolled haemorrhage

Question 6

Name 1 indication for glucose gel.

Answer 6

1. Hypoglycaemia

Question 7

Name 3 contraindications for glucose gel.

Answer 7

1. Unconscious patient
2. Patient can’t swallow
3. Patient under 2

Question 8

What is the dose of glucose gel administered to a hypoglycaemic adult?
What is the total max dose?
What is the paediatric dose?

Answer 8

15g (1 tube) repeated once at 15 mins if BGL is still under 4.
TMD 30g.
Paediatric dose 2yrs+ same as adult.

Question 9

Name 2 indications for glucose 10%.

Answer 9

1. Symptomatic hypoglycaemia but can’t self administer glucose gel
2. Unconscious hypoglycaemia

Question 10

Name the contraindications for glucose 10%.

Answer 10

Nil

Question 11

What is the adult dose for glucose 10%?
What’s the repeat dose?

Answer 11

15g (150ml).
Repeat 10g (100ml) every 5 mins until BGL of 4 is reached.

Question 12

What is the paediatric dose for glucose 10%?
What’s the repeat dose?

Answer 12

0.25g/kg (2.5ml/kg).
Repeat 0.1g/kg (1ml/kg) every 5 mins until BGL of 4.

Question 13

What is the main indication for glucagon?

Answer 13

Symptomatic hypoglycaemia
(There is one other)

Question 14

Name 1 contraindication of glucagon.

Answer 14

Allergy/ADR

Question 15

What is the glucagon dose for an adult with symptomatic hypoglycaemia?

Answer 15

Single dose 1mg.

Question 16

What is the glucagon dose for a paediatric patient;
1. Over 25kg
2. Under 25kg

Answer 16

1. 1mg single dose
2. 0.5mg single dose

Question 17

Name 4 indications for hydrocortisone.

Answer 17

1. Moderate to severe asthma
2. Acute exacerbation of COPD
3. Refractory anaphylaxis with persistent wheeze
4. Suspected or at risk of acute adrenal insufficiency (adrenal crisis)

Question 18

Name 1 contraindication for hydrocortisone.

Answer 18

Allergies/ADR

Question 19

What is the adult dose of hydrocortisone for acute adrenal insufficiency?

Answer 19

100mg single dose IV/IM

Question 20

What is the dose of hydrocortisone for a paediatric patient;
1. 0-4 years
2. 5-10 years
3. 10 years +

Answer 20

1. 25mg
2. 50mg
3. 100mg

Single dose IV/IM

Question 21

What is hydrocortisone?

Answer 21

A corticosteroid that replaces cortisol.

Question 22

When would you use glucagon instead of glucose 10%

Answer 22

If IV access isn’t possible.

Question 23

When would you use glucose 10% instead of glucose gel?

Answer 23

If the patient is unconscious or can’t swallow the gel.

Question 24

How does midazolam work?

Answer 24

Stimulates GABA receptors to inhibit CNS activity.

Question 25

Name 3 indications for midazolam.

Answer 25

1. Generalised/focal seizures 2. Sedation 3. Acute behavioural disturbance

Question 26

Name 1 contraindication for midazolam.

Answer 26

Allergies/ADR

Question 27

What is the presentation of midazolam?

Answer 27

5mg/1ml ampoule

Question 28

What is the correct IM dose and repeat dose for midazolam in an adult with tonic/clonic seizure?

Answer 28

5mg initial with a 5mg repeat every 10 mins (TMD 20mg)

Question 29

What is the correct IM dose of midazolam for a paediatric patient with seizures?

Answer 29

200microg/kg initial dose (SMD 5mg) Repeat every 10 mins Half initial dose (SMD 2.5mg) TMD 10mg

Question 30

What is the correct dose for IV midazolam in a paediatric patient?

Answer 30

Initial dose 100microg/kg (SMD 2.5mg) Repeat every 5 mins TMD 10mg

Question 31

What is ceftriaxone and what are its 2 indications?

Answer 31

An antibiotic. (Bactericidal cephalosporin) 1. Meningococcal septicaemia (with non-blanching rash) 2. Acute upper GI bleed

Question 32

Name 2 absolute and 1 relative contraindications for ceftriaxone.

Answer 32

1. Allergy/ADR to cephalosporin antibiotics 2. Immediate or severe reaction to penicillin or carbapenems 3. Patients under 1 month

Question 33

What is the adult dose of ceftriaxone (IM) for an adult with meningococcal septicaemia? How would you prepare it?

Answer 33

2g. 2 x 3ml syringes (1g in 2.4ml lidocaine = 1g/3ml) Single dose only

Question 34

What is the IV dose of ceftriaxone for an adult with meningococcal septicaemia? How would you prepare it?

Answer 34

2g 2 x 10ml syringe (1g in 9.4ml =1g/10ml) total of 2g/20ml Slow push over 5 mins

Question 35

What is the IM dose of ceftriaxone for a paediatric patient? How would you prepare it? Name 2 crucial rules when administering the drug.

Answer 35

50mg/kg 1g in 2.4ml = 1g/3ml 1. Doses over 2ml must be separated into 2 syringes and administered in 2 different sites 2. Only draw up the correct dose for administration and discard the rest

Question 36

What is the IV dose for paediatric ceftriaxone? How would you prepare it? Name 1 crucial rule when administering the drug.

Answer 36

50mg/kg 1g in 9.4ml = 1g/10ml 1. Discard drug so that only the required amount is in the syringe before administration