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Clinical Practise 2016 > Drugs > Flashcards

Drugs Flashcards

(95 cards)

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1
Q

Adrenaline presentation

A

1mg in 1ml

1mg in 10ml

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2
Q

Adrenaline contras

A

hypovolaemic shock without adequate fluid replacement

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3
Q

Adrenaline precautions

A

consider reduced doses for: elderly, pts with CVD, pts on monoamine oxidase inhibitors
beta blockers

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4
Q

Side effects of Adrenaline

A

Sinus tachy, supraventricular arrhythmias, ventricular arrhythmias, hypertension, pupillary dilation, may increase size of MI, feeling of anxiety/palpitations in the conscious pt

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5
Q

Presentation of Aspirin

A

300mg tablet

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6
Q

PEI Aspirin

A

ACS

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7
Q

Contras of Aspirin

A

hypersensitivity, actively bleeding peptic ulcers, bleeding disorders, suspected dissecting aortic aneurysm, chest pain assoc with psychostim OD if SBP greater than 160

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8
Q

Precautions of Aspirin

A

peptic ulcer
asthma
pts on anticoagulants

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9
Q

Side effects of Aspirin

A

heartburn, nausea, GI bleeding, increased bleeding time, hypersensitivity reactions

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10
Q

Dextrose 10% presentation

A

25g in 250ml soft pack

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11
Q

contras of Dextrose 10%

A

nil

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12
Q

Precautions of Dxtrose 10%

A

nil

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13
Q

Side effects of Dextrose 10%

A

nil

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14
Q

Presentation of Fentanyl

A

100mcg in 2ml
200mcg in 1ml
600mcg in 2ml

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15
Q

PEI of Fentanyl

A

sedation to facilitate intubation
sedation to maintain intubation
drug facilitated intubation
analgesia

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16
Q

contras of Fentanyl

A

known hypersensitivity

IV amiodarone

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17
Q

precautions of Fentanyl

A 
elderly
impaired renal function
resp depression
current asthma
pts on MOA inhibitors
known addition to opioids
rhinitis, rhinorrhea or facial trauma
oral amiodarone
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18
Q

Side effects of Fentanyl

A

resp depression
apnoea
rigid diaphragm
bradycardia

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19
Q

Fentanyl presentation used for Adult IN

A

600mcg in 2ml

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20
Q

Fentanyl Presentation used for Paed IN

A

100mcg in 2ml

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21
Q

GTN presentation

A

0.6mg tablets

50mg patch

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22
Q

PEI for GTN

A 
chest pain with ACS
acute LVF
hypertension assoc with ACS
autonomic dysreflexia
preterm labour
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23
Q

contras for GTN

A 
hypersensitivity 
SBP less than 110 tablet
SBP less than 90 patch 
viagra or levitra in 24 hours or cialis in 4 days 
HR greater than 150
HR less than 50
VT
inferior STEMI with SBP less than 160 
right ventricular MI
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24
Q

Precautions of GTN

A

no previous admin
elderly pts
recent MI
concurrent use with other tocolytics

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25
Side effects of GTN
tachycardia, hypotension, eadache, skin flushing, bradycardia
26
Presentation of Ipratropium Bromide
250mcg in 1ml
27
PEI for Ipratropium Bromide
severe resp distress associated with bronchospasm
28
contras of Atrovent
known hypersensitivity to Atropine or its derivatives
29
Precautions of Atrovent
glaucoma | avoid contact with eyes
30
Side effects of Atrovent
headache, nausea, dry mouth, skin rash, tahcycardia, palpitations, acute angle closure glaucoma
31
Methoxy presentation
3ml
32
PEI of Methoxyflurane
pain relief
33
contras of Methoxy
preexisting renal disease concurrent use with tetracycline antibiotics exceeding total dose in 24 hours
34
Precautions of Methoxy
penthrox held by pt pre-eclampsia concurrent use with oxytocin
35
Side effects of Methoxy
drowsiness, decrease in BP and bradycardia, renal toxicity
36
Presentaiton of Metoclopramide
10mg in 2ml
37
PEI for Metoclopramide
nausea and vomiting assoc with chest pain, opioid admin for pain, cytotoxic or radiotherapy, previously diagnosed migraine, severe gastro awake spinal immobilized pts, eye trauma
38
contras of Metoclopramide
children suspected bowel obstruction GI haemorrhage
39
precautions of Metoclopramide
undiagnosed abdo pain adolescents admin slowly over 1min
40
side effects of metoclopramide
``` drowsiness lethargy dry mouth muscle tremor extrapyrimidal reactions ```
41
Midazz presentations
5mg in 1ml | 15mg in 3ml
42
PEI of Midaz
``` status epilepticus sedation to enable intubation post intubation sedation sedation to enable synchronized cardioversion sedation in the agitated pt sedation in psychostim OD ```
43
Contras for Midaz
known hypersensitivity to benzos
44
Precautions for Midaz
reduced doses may be required for the elderly, renal failure, CCF or shock CNS depressant effects enhanced in the presence of narcotics can causes severe resp depression in COPD pts with myasthenia gravis
45
Side effects of Midaz
depressed level of consciousness resp depression loss of airway control hypotension
46
Presentation of Morphin
10mg in 1ml
47
PEi for Morphine
``` pain relief acute LVF with SOB and FF crackles sedation to maintain intubation sedation to enable intubation RSI ```
48
contras of Morphine
known hypersensitivity | late second stage labour
49
Precautions of Morphine
``` elderly hypotension resp depression asthma resp tract burns known addiction to opioids alcoholism MOA inhibitors ```
50
Side effects of Morphine
``` drowsiness resp depression euphoria n+v addication pin point pupils hypotension bradycardia ```
51
NAloxone presentation
0.4mg in 1ml
52
contras of Naloxone
nil
53
Precautions of NAloxone
physical dependence | neonates
54
side effects of naloxone
sweating, goosebumps, tremor | n+v, agitation, dilation of pupils, convulsions
55
Presentation of stemitil
12.5mg in 1ml
56
Contras of Stemitil
circulatory collapse CNS depression previous hypersensitivity children
57
precautions of Stemitil
hypotension epilepsy pts affected by alcohol or antidepressants
58
side effects of Stemitil
drowsiness, blurred vision, hypotension, sinus tachy, skin rash, extrapyrimidal reactions
59
Presentation of salbutamol
5mg in 2.5ml 500mcg in 1ml 5mg in 5ml
60
Contras of Salbutamol
IV
61
Precautions of Salbutamol
large doses of IV cause intracellular metabolic acidosis
62
PEI of Salbutamol
resp distress with suspected bronchospasm, asthma, severe allergic reactions, COPD, smoke inhalation, capsicum spray exposure
63
Side effects of Salbutamol
sinus tachy | muscle tremor
64
Actual Time Critical
Moderate or severe resp distress Oxygen sats less than 90% room air Less than adequate perfusion GCS less than 13
65
Emergent Time Critical
``` ACS Acute stroke Severe sepsis, including suspected meningococcal disease Possible AAA Undiagnosed severe pain Need for hyperbaric treatment Hypo or hyperthermia ```
66
Causes of PEA
``` Hypoxia Exsanguination Asthma TPT Anaphylaxis Airway obstruction ```
67
Contras for LMA
intact gag reflex or resistance to insertion strong jaw tone and/or trismus suspected epiglottitis or upper airway obstruction the use of sedation to assist placement
68
Precautions of LMA
inability to prepare pt in sniffing position pts who require high airway pressures Pts less than 14 significant volume of vomit
69
RSI preparation
``` Optimise position C-spine considerations Oxygen supply sufficient Nasal prongs IV/IO access x2 Normal saline at least 10ml/kg Suction tested O.P airway ```
70
Causes of APO
``` LVF nutritional deficiency liver disease renal disease fluid overload ```
71
Adult initial dose of Fentanyl IN for all adults (ml)
200mcg in 0.75ml
72
Adult Subsequent dose of Fentanyl IN for all adults (ml)
50mcg in 0.25ml
73
Adults initial dose of Fentanyl IN for frail adults (ml)
100mcg in 0.45ml
74
Adults subsequent dose of Fentanyl IN for frail adults (ml)
50mcg in 0.25ml
75
Morphine doses for adults
IV - up to 5mg repeat after 5 mins IM - over 60kg 10mg repeat 5mg after 15 mins under 60kg 0.1mg/kg once only
76
Severe headache doses
Methoxy 3ml and Stemitil 12.5mg IM Morphine 2.5mg IV every 5mins Fentanyl 25mcg IV every 5mins Elderly or frail: 50mcg IN Fentanyl repeat 25mcg after 5 mins Other adults: 100mcg IN Fentanyl repeat 25mcg after 5mins
77
Contras for CPAP
``` GCS less than 13 Facial trauma Pneumothorax Active vomiting Life threatening arrhythmias Pts requiring airways management Hypoventilation ```
78
Seizure treatment
Midaz 10mg IM (2 ampoules) | OXYGEN
79
Anaphylaxis symptoms
R-resp distress A-abdo symptoms S-skin/mucosal symptoms H-hypotension
80
Anaphylaxis treatment
500mcg Adrenaline IM repeat after 5 mins 300mcg for elderly or frail neb adrenaline 5mg in 5ml if required
81
Evidence of Opioid overdose
``` altered consious state resp depression substance involved exclude other causes pin point pupils track marks ```
82
Treatment of Opioid overdose
Naloxone 1.6-2mg (4-5 ampoules) | repeat 0.8mcg after 10mins (2ampoules)
83
Assessment of the agitated patient
``` Alcohol Epilepsy Insulin Overdose Underdose Trauma Infection/sepsis Pain/psycho Stroke/TIA ```
84
Sedation of the agitated pt
Midaz 5-10mg IM lower doses for elderly repeat after 10 mins
85
Autonomic Dysreflexia symptoms
previous CI at T6 or above severe headache SBP greater than 160
86
Stroke Mimics
``` H-hypo/hyperglycaemia I-intoxication B-brain tumour E-electrolyte imbalance S-sepsis S-subdural haematoma S-seizure S-syncope M-migraine M-middle ear disorder ```
87
Modifying Factors of hypovolaemia
``` SCI chest injury penetrating trunk injury AAA uncontrolled external heamorrhage GI haemorrhage ```
88
Paed weights
``` Newborn 3.5kg 2 months 5kg 5 months 7kg 1 year 10kg 1-9yrs age x2 + 8 10-14 age x 3.3 ```
89
Paed perfusion
``` HR: 120-160 100-160 80-120 80-100 BP N/a 70 80 90 RR: 40-60 20-50 20-35 15-25 ```
90
Paed GCS verbal
``` Appropriate words, social smiles, fixes cries but consolable Persistently irritable Restless and agitated None ```
91
Paed dose of Fentanyl IN initial
small child 25mcg in 0.6ml | large child 50mcg in 1.1ml
92
Unconsciouos asthma ventilation rates
infant 15-20 small child 10-15 large child 8-12
93
Unconscious asthma adrenaline dose
10mcg/kg IM repeat after 20mins (max 30mcg/kg)
94
Seizure of a paed
``` large child 5mg in 1ml Midaz small child 2.5mg in 0.5ml infant 1mg in 0.2ml newborn 0.5mg in 0.1ml repeat after '10 mins once only ```
95
Anaphylaxis treatment for paeds
Adrenaline 10mcg/kg IM repeat after 5 mins

Clinical Practise 2016 (12 decks)

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