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Sem. B - Pharmacology > Indication/Diagnosis > Flashcards

Flashcards in Indication/Diagnosis Deck (27)
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1

Amiodarone Hydrochloride

  • Cardiac Arrest with shockable rhythms:
    • unresponsive VF
    • pulseless VT
  • If unresponsive to defibrillation administer after 3rd shock

2

Aspirin

  • Cardiac chest pain
  • Adults with clinical/ECG evidence suggestive of myocardial infarction or ischaemia

3

Atropine Sulfate

  • Symptomatic bradycardia in presence of ANY of these adverse signs:
    • absolute bradycardia (pulse <40 beats/min)
    • systolic BP below expected for age
    • paroxysmal ventricular arrhythmias requiring suppression
    • inadequate perfusion causing confusion, etc
    • bradycardia following ROSC

 

NB - hypoxia is most common cause of bradycardia in paediatrics, therefore support ABC and O2 should be first-line therapy

4

Benzylpenicillin Sodium

  • Suspected meningococcal disease in the presence of:
    • a non-blanching rash (classic, haemorrhagic, non-blanching rash(may be petechial or purpuric)
    • signs/symptoms suggestive of meningococcal septicaemia (stiff neck, photophobia, etc)

5

Adrenaline 1:1000

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

6

Adrenaline 1:10,000

  • Cardiac arrest

7

Chlorphenamine

  • Severe Anaphylactic reactions after initial resuscitation
  • Symptomatic allergic reactions falling short of anaphylaxis but causing pt distress (eg, sever itching)

8

Dexamethasone

  • Mild/moderate/severe croup
  • refer to modified Taussig Score

9

Diazepam

  • Pt who have prolonged (>5mins) OR repeated (>3/hour) convulsions who are currently convulsing - not secondary to hypoxic/hypoglycaemic episode
  • Eclamptic convulsions (initiate if seizure lasts over 2-3 mins or is recurrent)
  • Symptomatic cocaine toxicity (severe hypertension, chest pain or convulsions)

10

Glucose 40% (oral gel)

  • Known or suspected hypoglycaemia in a conscious pt with no risk of choking/aspiration

11

Glucagon

  • Clinically suspected hypoglycaemia
  • Unconscious pt where hypoglycaemia is considered likely cause (BM <4.0mmol/l)

 

NB - Glucagon only to be administered when oral glucose administration is not possible or is ineffective, AND/OR when IV access to administer 10% glucose is not possible

12

Glucose 10%

  • Hypoglycaemia (BM <4.0mmol/l) or suspected, when oral administration is not possible and a rapid improvement in clinical state and blood glucose level is required
  • Unconscious pt where hypoglycaemia is considered likely cause
  • Management of hypoglycaemia in pt who have not responded to administration of IM glucagon after 10 mins

13

Glyceryl Trinitrate (GTN)

  • Cardiac chest pain due to angina or MI, when systolic BP is >90mmHg
  • Breathlessness due to pulmonary oedema in acute heart failure when systolic BP >110mmHg
  • Pt with suspected cocaine toxicity presenting with chest pain

14

Hydrocortisone

  • Severe/Life-threatening Asthma - provided IV access is easy and administration does not delay transport to hospital
  • Anaphylaxis - only after adrenaline (if indicated) and chlorphenamine administration
  • Adrenal Crisis:
    • established adrenal crisis, administer ASAP (IV route preferable)
    • suspected adrenal insufficiency or unexplained collapse in steroid dependant pt (IM is sufficient, do not delay transport)

 

NB - if there is any doubt about previous steroid administration, better to administer further hydrocortisone

15

Ibuprofen

  • relief of mild to moderate pain
  • Pyrexia with discomfort (might relieve unpleasant aches/pains that often accompany febrile illness)
  • Soft tissue injury

16

Ipratromium Bromide

  • Acute, severe or life-threatening asthma
  • Acute asthma unresponsive to salbutamol
  • Exacerbation of COPD, unresponsive to salbutamol

17

Morphine Sulfate

  • Pain associated with suspected MI
  • Severe pain as part of a balanced analgesia regimen
  • Pain management for adults in EOLC if:
    • contact palliative care team
    • medication has not been prescribed
    • medication has been prescribed but is not yet available/has run out
    • medicines are in place without a pt specific document signed by an independant prescriber

18

Naloxone Hydrochloride (Narcan)

  • Reversal of acute opioid or opiate toxicity for respiratory arrest/depression
  • Unconsciousness associated with respiratory depression of unknown cause, where opioid overdose is a possibility
  • Cardiac arrest where opioid toxicity is considered the likely cause
  • Pt exposed to high-potency veterinary/anaesthetic preparations should be given Naloxone urgently if:
    • consciousness is impaired
    • exposure occurred within the last 10 mins, even if asymptomatic

 

NB - if an antidote is supplied with an opioid medication, such as diprenorphine (Revivon) or naloxone, administer immediately

19

Nitrous Oxide (Entonox)

  • Moderate to severe pain
  • Labour pain

20

Ondansetron

Adults:

  • Prevention & treatment of opiate-induced nausea & vomiting (eg. morphine)
  • Treatment of nausea & vomiting

 

Children:

  • Prevention & treatment of opiate-induced nausea & vomiting (eg. morphine)
  • For travel associated nausea & vomiting

21

Paracetamol

Oral:

  • Relief of mild to moderate pain or high temperature with discomfort (not for pyrexia alone)

 

IV:

  • As part of a balanced analgesic regimen for severe pain. Paracetamol is effective in reducing opioid requirements while improving analgesic efficacy
  • Alternative analgesic when morphine is contraindicated

22

Salbutamol

  • Acute asthma where normal inhaler therapy fails to relieve symptoms
  • Expiratory wheezing associated with allergy, anaphylaxis, smoke inhalation or other lower airway cause
  • Exacerbation of COPD

23

Sodium Chloride 0.9%

Adult fluid therapy:

  • medical conditions with/without haemorrhage
  • trauma related haemorrhage
  • burns
  • limb crush injury

 

Child fluid therapy:

  • medical conditions
  • trauma related haemorrhage
  • burns

 

Flush:

  • to confirm patency of IV/IO cannula
  • to follow drug administration

24

Syntometrine

  • Post-partum haemorrhage within 24hrs of delivery where bleeding from the uterus is uncontrollable by uterine massage
  • Miscarriage with life-threatening bleeding and a confirmed diagnosis (eg. where pt has gone home with medical management and bleeding begins)

25

Tranexamic Acid

  • Prevention and treatment of significant haemorrhage following trauma
  • Pt aged >12 with TIME CRITICAL injury where significant internal/external haemorrhage is suspected/known
  • Injured pt aged >12 fulfilling step 1 or 2 of the LAS Major Trauma Decision Tool & believed to be at risk of significant haemorrhage

26

Oxygen

Children:

  • Significant illness and/or injury

 

Adults:

  • Critical illness requiring high levels of supplemental O2
  • Serious illness requiring moderate levels of supplemental O2 if pt is hypoxaemic
  • COPD & other conditions requiring controlled or low dose Otherapy
  • Conditions for which pt should be monitored closely but O2 therapy is not required unless pt is hypoxaemic

27

Midazolam (pt own)

  • Convulsions lasting >5 mins & still fitting, or >3 convulsions in 1 hr
  • Convulsions continuing 10 mins after first dose of medication

 

NB - when midazolam is prescribed for a pt the clinician MUST follow the prescriber's instructions for its administration.