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ICARDS Flashcards

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1
Q

Adrenaline is indicated for?

A

Cardiac arrest, Anaphylaxis, severe asthma. imminent respiratory arrest from COPD, stridor causing moderate or severe respiratory distress, epistaxis IN, clinically significant bleeding from a would TOPICAL. Out of scope, bradycardia with moderate or severe cardiovascular compromise, bp support if unresponsive to metraminol, septic/cardiogenic/neurogenic shock.

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2
Q

Mechanism of action of Adrenaline

A

Stimulates alpha and beta receptors with predominant effects occurring at alpha 1, beta 1 and beta 2 receptors.
Alpha 1 stimulation causes smooth muscle constriction.
Beta 1 stimulation causes an increase in cardiac contractility, increase in heart rate and increase of speed of electrical conduction within the heart.

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3
Q

Contraindications of Adrenaline

A

None

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4
Q

Cautions of Adrenaline

A

Myocardial ischaemia, adrenaline will increase myocardial o2 consumption.
Tachydysrhythmias, adrenaline will make them worse.

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5
Q

Dosage of Adrenaline

A

Topical: 1:10,000 dilute each mg into a total of 10 ml sodium chloride.
IN: as above.
Nebulised: undiluted
IM: undiluted 0.5mg
1mg in 1ml

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6
Q

Side effects of Adrenaline

A

Tachycardia, Tachydysrhythmia, myocardial ischaemia, ventricular ectopy, hypertension, nausea and vomiting, tremor, anxiety and sweating, hyperglycaemia.

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7
Q

Indications for Aspirin

A

Myocardial ischaemia, STEMI.

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8
Q

Mechanism of action for Aspirin

A

It has antiplatelet, antipyretic, anti-inflammatory and analgesic effects. It inhibits the enzyme cyclooxygenase which results in a reduction in the formation of prostaglandins and thromboxane.

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9
Q

Contraindications of Aspirin

A

Known severe allergy, 3rd trimester of pregnancy.

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10
Q

Cautions of Aspirin

A

Known bleeding disorder, clinically significant bleeding, known worsening of bronchospasm with NSAIDs.

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11
Q

Dosage of Aspirin

A

300mg per oral

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12
Q

Side effects of Aspirin

A

Increased bleeding, for long term administration: gastrointestinal ulcerations and gastrointestinal bleeding.

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13
Q

Indications for Glucagon

A

Hypoglycaemia when the patient cannot swallow food or oral glucose and IV access cannot be obtained.

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14
Q

Mechanism of action for Glucagon

A

It increases the blood glucose level. It releases the stored sugars in the liver into the circulation.

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15
Q

Contraindications of Glucagon

A

Known severe allergy

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16
Q

Cautions of Glucagon

A

None

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17
Q

Dosage of Glucagon

A

1mg IM once for an adult or child aged 5 or over. 0.5 mg under 5.

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18
Q

Side effects for Glucagon

A

None

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19
Q

Indications for Glucose Gel

A

Hypoglycaemia in adults and children provided they are conscious and can safely swallow, neonates also.

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20
Q

Mechanism of action of Glucose gel

A

It provides a source of glucose that can be easily swallowed and is rapidly absorbed.

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21
Q

Contraindications of Glucose gel

A

None

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22
Q

Cautions of Glucose gel

A

None

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23
Q

Dosage of Glucose gel

A

10-20g for all ages

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24
Q

Side effects of Glucose gel

A

None

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25
Indications for GTN
myocardial ischaemia, cardiogenic pulmonary oedema (CPO), STEMI. Out of scope control of hypertension.
26
Mechanism of action of GTN
It is a vasodilator acting on vascular smooth muscle causing venous and arterial vasodilation with the predominant effect being on the veins. It reduces preload (blood in) and therefore reduces afterload (blood out).
27
Contraindications for GTN
Known severe allergy, systolic bp less than 110, heart rate less than 40, heart rate more than 150, ventricular tachycardia.
28
Cautions for GTN
STEMI, patient is frail, signs of shock, dysrhythmia, has taken erection dysfunction medication, known aortic or mitral stenosis.
29
Dosage for GTN
Myocardial ischaemia: 0.4mg every 4 mins. STEMI: 0.4mg with caution. CPO: 0.8mg every 5 mins, increase to 10 mins if a cautions is present. out of scope control of hypertension 0.4mg every 5 mins. SL
30
Side effects of GTN
Hypotension, flushing, headache, tachycardia, light headed.
31
Mechanism of action for Ibuprofen
It is a non-steroidal anti-inflammatory drug (NSAID) that is predominantly used for treating pain. It inhibits the activity of the enzyme prostaglandin synthetase, reducing prostaglandin production and causing a reduction in inflammation, pain and fever.
32
Indications for Ibuprofen
Mild to moderate pain, usually in combination with paracetamol. Moderate to severe pain, usually in combination with other medicines.
33
Contraindications for Ibuprofen
Known severe allergy. Pregnancy. The presence of sepsis, dehydration, shock or clinically significant bleeding. Known worsening of brochospasm with NSAIDs
34
Cautions for Ibuprofen
Taken within the last 4 hours. Abdominal pain, particulaly if the pt is vomiting. Aged over 75 years.
35
Dosage of Ibuprofen
600mg for an adult over 80kgs. 400mg for an adult under 80kgs.
36
Side effects of Ibuprofen
Renal impairment. Increased bleeding. Indigestion, gastrointestinal ulceration and gastrointestinal bleeding only with chronic administration.
37
What is Loratadine indicated for
Minor allergic reactions confined to skin involvement. Itch or rash associated with anaphylaxis, provided all systemic signs are improving.
38
Mechanism of action for Loratadine
It is a non-sedating antihistamine. It antagonises (blocks) peripheral histamine receptors, blocking the action of histamine and reducing itching and redness.
39
Contraindications for Loratidine
Known severe allergy. Aged less than 1 year
40
Cautions for Loratidine
Pregnancy
41
Dosage for Loratadine
20mg for an adult or child 12 years and over. 10mg for a child 1-11 years.
42
Side effects of Lortadine
None
43
Indications for Methoxyflurane
Moderate to severe pain, when there will be a significant delay in an opiate being administered.
44
Mechanism of action of Methoxyflurane
It is an inhalational analgesic. the MOA is not clear.
45
Contraindication for Methoxyflurane
Known severe allergy. Personal or family history of malignant hyperthermia. Known renal impairment. Has had in the last 7 days.
46
Cautions for Methoxyflurane
Age over 75 years. Pre-eclampsia (renal impairment is likely). Administration in a confined space. Acute exacerbation of chronic pain.
47
Dosage of Methoxyflurane
Adult and child over 12 max of 6ml (2 doses). Child under 12 3ml.
48
Side effects of Methoxyflurane
Sedation. Feeling light-headed.
49
Indications for Ondansetron
Clinically significant nausea and or vomiting.
50
Mechanism of action of Ondansertron
It is an antiemetic. It antagonises (blocks) serotonin receptors centrally if the brain and peripherally in the gastrointestinal tract, resulting in a reductio in nausea and vomiting.
51
Contraindication for Ondansertron
Known severe allergy. Age less than 1 year. Suspected serotonin syndrome.
52
Cautions for Ondansetron
None
53
Dosage for Ondansetron
4mg. May be repeated once after 20 mins.
54
Side effects of Ondansetron
Headache. Flushing
55
Indications for Paracetamol
Mild or moderate pain. Moderate to severe pain, in additions to other medicines.
56
Mechanism of action for Paracetamol
It inhibits the production of prostaglandins resulting in a reduction in pain and fever.
57
Contraindications for Paracetamol
Known severe allergy
58
Cautions for Paracetamol
Taken within the last 4 hours. Abdominal pain, particularly of pt is vomiting. Known severe liver disease.
59
Dosage for Paracetamol
1.5g for an adult over 80kgs. 1g for an adult under 80kgs
60
Side effects of Paracetamol
None
61
Indications for Prednisone and Prednisolone
Bronchospasm associated with asthma or COPD. Croup. Minor allergy associated with rash.
62
Mechanism of action of Prednisone
It is a prodrug that is metabolised to prednisolone in the liver. It is a corticosteroid with anti-inflammatory and immunosuppressant actions. It inhibits the production of inflammatory mediators, including prostaglandins and leukotrienes, resulting in a reduction in the inflammatory and immune response.
63
Contraindications of Prednisone
Known severe allergy
64
Cautions for Prednisone
Age less than 5 years with asthma
65
Dosage for Prednisone
40mg for an adult. See paediatric drug dose for child.
66
Side effects for Prednisone
Fatigue. Sodium and water retention. Gastrointestinal reflux
67
Indication of Ipratropium
Bronchospasam secondary to asthma or COPD. Prominent bronchospasm secondary to airway burns, smoke inhalation or chest infection.
68
Mechanism of action for Ipratropium
It is a bronchodilator. It is an anticholinergic agent, it antagonises (blocks) acetylcholine receptors, causing vagal inhibition resulting in bronchodilation.
69
Contraindications for Ipratropium
Known severe allergy
70
Cautions for Ipratropium
None
71
Dosage for Ipratropium
0.5mg once only for adults and children
72
Side effects of Ipratropium
Tachycardia. Dry mouth. Blurred vision (repeated doses)
73
Indications for Salbutamol
Bronchospasm secondary to asthma or COPD. Prominent bronchospasm secondary to airway burns, smoke inhalation or chest infection. Release syndrome following crush injury. Known or suspected hyperkalaemia with ECG changes.
74
Mechanism of action for Salbutamol
It is a bronchodilator. It is an agonist (stimulator) of beta-2 receptors.
75
Contraindications for Salbutamol
Known severe allergy
76
Cautions for Salbutamol
None
77
Dosage for Salbutamol
MDI-1 puff into the spacer for 6 breaths repeat 6 times. Nebulised 5mg for adults and children, repeated as required.
78
Side effects of Salbutamol
Tremor. Tachycardia

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