medical emergency drug kit

Question 1

What is GTN used for?

Answer 1

angina

Question 2

What dosage of GTN spray is kept in the medical emergency kit?

Answer 2

400 micrograms

Question 3

What route is GTN spray administered?

Answer 3

Sublingually (under the tongue)

Question 4

What type of inhaler is kept in the medical emergency drugs kit?

Answer 4

Salbutamol

Question 5

What dosage per usage is administered with a salbutamol inhaler?

Answer 5

100 micrograms

Question 6

What medical emergency drug is administered for myocardial infarction?

Answer 6

Dispensable aspirin.

Question 7

What dosage of dispensable aspirin is administered in the event of an MI?

Answer 7

300 mg

Question 8

What is administered in the event of a hypoglycaemic attack?

Answer 8

1mg Glucagon

Question 9

How is glucagon administered during a hypoglycaemic attack?

Answer 9

Intramuscularly

Question 10

Which drug is administered in the event of status epilepticus?

Answer 10

Midazolam

Question 11

How much midazolam is administered in the event of status epilepticus?

Answer 11

5 mg/ml or 10 mg/ml

Question 12

How is midazolam administered?

Answer 12

Buccally

Question 13

How much adrenaline is administered to adults and children over 12?

Answer 13

500 micrograms

Question 14

How much adrenaline is administered to children from 6-12?

Answer 14

300 micrograms

Question 15

How much adrenaline is administered to children under 6?

Answer 15

150 micrograms

Question 16

When would oxygen be administered?

Answer 16

For anaphylaxis, asthma attack, angina and myocardial infarction.

Question 17

In the event of anaphylaxis, how much oxygen would be administered?

Answer 17

15 litres/min through a non-rebreathe mask.

Question 18

8 drugs found in the ME kit:

Answer 18

1. Adrenaline (1:1000)
2. Dispensable Aspirin 300mg
3. Glucagon injection (1 unit vial)
4. Glucose (oral administration)
5. GTN spray
6. Midazolam oral mucosal solution
7. Oxygen
8. Salbutamol aerosol inhaler (100 micrograms)

Question 19

What is the mode of action for adrenaline?

Answer 19

ALPHA AGONIST:
reverses peripheral vasodilation and reduces oedema.

BETA AGONIST
- dilates the bronchial airways.
- inhibit mast cell activation so early administration helps anaphylaxis.

Question 20

Presentation of Adrenaline

Answer 20

1. Ampoules (administered either 23-21 needle).
2. Pre-filled syringes.
3. Auto-injector devices.

autoinjectors not used due to expense

Question 21

What are the side effects of adrenaline administration?

Answer 21

• palpitations
• dry mouth
• only adverse effect was an MI in a patient with severe ischemic heart disease *

Question 22

What is the mechanism of action for adrenaline?

Answer 22

COX-1 and COX-2 inhibitors.

Inhibits thrombus formation to create an antiplatelet effect.

Question 23

Presentation of soluble aspirin.

Answer 23

Soluble aspirin 300mg either in a child proof container or blister pack.

Question 24

Dose and route of administration of Aspirin.

Answer 24

300mg crushed or chewed

(reduces the incidence of re-occlusion following thrombolytic therapy)

Question 25

Contraindications of Aspirin

Answer 25

A known allergy

Question 26

When should glucagon be administered?

Answer 26

When the patient is in an unconscious state of hypoglycaemia (blood sugar levels of less than 3)

Question 27

What is the mode of action for glucagon?

Answer 27

Increases the patient’s blood sugar levels by metabolising glycogen in the liver.

Question 28

Presentation of glucagon in the medical emergency drugs kit?

Answer 28

Glucagon injection As GlucaGen Hypokit. *stored in the fridge or out below 25C for up to 18 months*

Question 29

Glucagon dose and route of administration.

Answer 29

Adults and children greater than 8 or 25 kg, inject all of the medicine. Children under 8, inject half the medicine (0.5 ml).

Question 30

Side effects of Glucagon.

Answer 30

Nausea, vomiting and temporary tachycardia.

Question 31

Contraindications for use of Glucagon

Answer 31

1. Allergy to glucagon or lactose. 2. Tumour of the adrenal gland. 3. Tumour of the pancreas.

Question 32

When would glucose be administered?

Answer 32

Hypoglycaemia *when conscious, co-operative and IN-TACT GAG REFLEX*

Question 33

Dose of Glucose

Answer 33

10-20g of 40% fast acting glucose gently rubbed to aid absorption.

Question 34

When does GTN reach its peak concentration?

Answer 34

4 minutes

Question 35

How does GTN work?

Answer 35

Increases the production of Nitric Oxide which initiates the relaxation of smooth muscle to produce arterial and venous vasodilation.

Question 36

What does GTN present as in the drugs kit?

Answer 36

Pressured container (red) which delivers 400 micrograms.

Question 37

Dose and route of administration of GTN.

Answer 37

1 or 2 metered doses (400-800 micrograms) given under the tongue whilst the patient holds their breath. *no more than 3 doses at one time*

Question 38

Mode of action of midazolam?

Answer 38

Binds to the GABA receptor but doesn’t displace GABA, it increases the affinity for its receptor site on the same receptor complex. Reduces seizure activity.

Question 39

Midazolam dose.

Answer 39

Child 1-5: 5 mg Child 5-10: 7.5 mg Child above 10: 10mg