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Pharmacology > Medication Formulary > Flashcards

Medication Formulary Flashcards

1
Q

Amiodarone Class

A

Antiarrhythmic Agent

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2
Q

Amiodarone Description

A

Class III Antiarrhythmic agent used to treat ventricular arrhythmias

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3
Q

Amiodarone Presentation

A

150mg in 3ml solutionPre-filled Syringes 10ml (30 mg/ml)

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4
Q

Amiodarone Administration

A

Inreavenously (IV)Intraosseous (IO)

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5
Q

Amiodarone Indications

A

Ventricular Fibrillation andPulseless Ventricular Tachycardia

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6
Q

Amiodarone Contraindications

A

KSARKnown Hypersensitivity To Iodine

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7
Q

Amiodarone Dosages

A

Adult: 5mg/Kg IV/IO (Loading dose in Cardiac Arrest 300mg and supplemental dose of 50mgPaed: 5mg/Kg

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8
Q

Amiodarone Pharmacology

A

AntiarrhythmicProlongs the action potentialProlongs the refractory periodProlongs atrioventricular conductionProlongs QT Interval

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9
Q

Amiodarone Side Effects

A

Inflammation of peripheral veinsBradycardiaAV conducting abnormalities

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10
Q

Amiodarone Additional Info

A

If diluted mix with Dextrose 5%May be flushed with NaCl

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11
Q

Aspirin Class

A

Platelet Aggregator Inhibitor

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12
Q

Aspirin Description

A

Anti-inflammatory agent and an inhibitor of platelet function.Useful agent in the treatment of various thromboembolic diseases such as acute myocardial infarction

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13
Q

Aspirin Presentation

A

3000mg soluble tablet

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14
Q

Aspirin Administration

A

Orally (PO) - if soluble, disperse in water. if non soluble, to be chewed.

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15
Q

Aspirin Indications

A

Cardiac chest pain or suspected myocardial infarction

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16
Q

Aspirin Contraindications

A

Active symptomatic gastro-intestinal ulcerBleeding disorder (e.g. Haemophilia)KSARPatients < 16 yrs old

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17
Q

Aspirin Dosages

A

Adult: 300mgPaed: not indicated

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18
Q

Aspirin Pharmacology

A

AntithromboticInhibits the formation of thromboxane A2, which stimulates platelet aggregation and artery constriction.This reduces clot/thrombus formation in an MI

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19
Q

Aspirin Side Effects

A

Epigastric pain and discomfortBronchospasmGastrointestinal Haemorrhage

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20
Q

Aspirin Additional Info

A

Aspirin 300mg is indicated for cardiac chest pain regardlessif patient is on anti-coagulants or is already on aspirin.If the patient has swallowed an aspirin (enteric coated) preparation without chewing it, the patient should be regarded as not having taken any aspirin; Administer Aspirin 300mg PO.

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21
Q

Atropine Class

A

Anticholinergic

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22
Q

Atropine Description

A

Parasympatholytic that is derived from the Atropa Belladonna plant

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23
Q

Atropine Presentation

A

Pre-filled syringe 1mg/10mlAmpoule 0.6mg in 1ml

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24
Q

Atropine Administration

A

Intravenous (IV)Intraosseous (IO)

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25
Q

Atropine Indications

A

Symptomatic BradycardiaOrganophosphate Poisoning

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26
Q

Atropine Contraindications

A

KSAR

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27
Q

Atropine Dosage

A

Organophosphate Poisoning - 1mg IV, Repeat at 3-5min intervals to ensure minimal salivary secretions.Symptomatic Bradycardia - 0.5mg IV. Repeat at 3-5min intervals to max 3mg.

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28
Q

Atropine Pharmacology

A

Anticholinergic agentBlocks acetylcholine receptors-enhances SA node automaticity-enhances AV node conduction-increases heart rate

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29
Q

Atropine Side Effects

A

TachycardiaDry MouthDilated Pupils

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30
Q

Atropine Additional Info

A

Accidental exposure to the eye causes blurred vision

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31
Q

Benzylpenicillin Class

A

Antibiotic, antibacterial

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32
Q

Benzylpenicillin Descriptions

A

Benzylpenicillin is an antibiotic agent

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33
Q

Benzylpenicillin Presentation

A

Intravenous (IV) or Intraosseous (IO).May give by IM injection if no IV access.IV/IO - Reconstitute each 600mg vial with 4ml of water for injection and give by slow IV injection over 3-5mins.IM - Reconstitute each 600mg vial with 2ml of water for injection

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34
Q

Benzylpenicillin Administration

A

Intravenous (IV)Intrados serous (IO)

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35
Q

Benzylpenicillin Indications

A

Suspected or confirmed Meningococcal Sepsis

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36
Q

Benzylpenicillin Contraindications

A

KSAR

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37
Q

Benzylpenicillin Dosage

A

Adult - 1200mg IV, IO or IMPaed - > 8 yrs - 1200mg1-8 yrs - 600mg< 1 yr - 300mg

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38
Q

Benzylpenicillin Pharmacology

A

AntibacterialGram positive cocci antibiotic

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39
Q

Benzylpenicillin Side Effects

A

Gastro-intestinal disturbancesHypersensitivity rections

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40
Q

Benzylpenicillin Additional Info

A

Also called Penicillin G

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41
Q

Clopidogrel Class

A

Platelet aggregator inhibitor

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42
Q

Clopidogrel Description

A

An inhibitor of platelet function

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43
Q

Clopidogrel Administration

A

Orally (PO)

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44
Q

Clopidogrel Indications

A

Identification of ST Elevation Myocardial Infarction (STEMI)

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45
Q

Clopidogrel Contraindications

A

KSARActive Pathological BleedingSevere Liver Impairment

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46
Q

Clopidogrel Doseage

A

600mg PO> 75yrs 75mg PO

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47
Q

Clopidogrel Pharmacology

A

Clopidogrel selectivelyinhibits the binding of adenosine diphosphate (ADP) to its platelet receptor, and the subsequent ADP - mediated activation of the GPIIb/IIIa complex, thereby inhibiting platelet aggregation.Biotransformation of clopidogrel is necessary to produce inhibition of platelet aggregation. Clopidogrel acts by irreversibly modifying the platelet ADP receptor

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48
Q

Clopidogrel Side Effects

A

Abdominal PainDyspepsiaDiarrhoea

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49
Q

Clopidogrel Additional Info

A

Paramedics are authorised to administer Clopidogrel PO following identification of STEMI and medical practitioner instruction

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50
Q

Cyclizine Class

A

Anti-emetic

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51
Q

Cyclizine Descriptions

A

Used in management of nausea and vomiting

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52
Q

CyclizinePresentation

A

Ampoule 50mg in 1ml

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53
Q

Cyclizine Administration

A

Intravenous (IV)Intraosseous (IO)

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54
Q

Cyclizine Indications

A

Management, prevention and treatment of nausea and vomiting

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55
Q

Cyclizine Contraindications

A

KSAR

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56
Q

Cyclizine Dosage

A

Adult - 50mg IV/IOPaed - not indicated

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57
Q

Cyclizine Pharmacology

A

Anti-emetic

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58
Q

Cyclizine Side Effects

A

TachycardiaDry MouthSedation

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59
Q

Cyclizine Additional Info

A

IM route should only be utilised where IV or IO access is not available

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60
Q

Dextrose 10% Solution Class

A

Carbohydrate

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61
Q

Dextrose 10% Solution Description

A

Dextrose is used to describe the six-carbon sugar d-glucose, which is the principal form of carbohydrate used by the body.D10W is a hypertonic solution

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62
Q

Dextrose 10% Solution Presentation

A

Soft pack for infusion 250ml and 500ml

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63
Q

Dextrose 10% Solution Administration

A

Intravenous (IV)Intraosseous (IO)

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64
Q

Dextrose 10% SolutionIndications

A

Hypoglycaemic emergencyBlood glucose level < 4 mmol/L

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65
Q

Dextrose 10% Solution Contraindications

A

KSAR

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66
Q

Dextrose 10% Solution Doseage

A

Adult - 250ml IV/IORepeat X 1 prnPaed - 5ml/KgRepeat X 1 prn

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67
Q

Dextrose 10% Solution Pharmacology

A

Hypertonic glucose solutionReadily utilisable energy sourse

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68
Q

Dextrose 10% Solution Side Effects

A

Necrosis of tissue around IV access

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69
Q

Dextrose 10% Solution Additional Info

A

Also called GlucoseCannula patency will reduce the effect of tissue necrosis

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70
Q

Epinephrine 1:10,000Class

A

Sympathetic Agonist

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71
Q

Epinephrine 1:10,000Description

A

Naturally occurring catecholamine. It is a potent alpha and beta adrenergic stimulant; however, its effect on beta-receptors is more profound

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72
Q

Epinephrine 1:10,000Presentation

A

Pre-filled syringe 1mg/10ml (1:10,000) as 0.1mg/ml

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73
Q

Epinephrine 1:10,000Administration

A

Intravenous (IV)Intraosseous (IO)

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74
Q

Epinephrine 1:10,000Indications

A

Cardiac ArrestPaediatric Symptomatic Bradycardia unresponsive to other measures

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75
Q

Epinephrine 1:10,000Contraindications

A

KASR

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76
Q

Epinephrine 1:10,000Dosage

A

Adult: Cardiac Arrest 1mg (1:10,000)Repeat every 3-5 minsPaed:Cardiac Arrest 0.01mg/kg (0.1ml/mg) (1:10,000)Repeat every 3-5 minsBradycardia 0.01mg/kg (0.1ml/mg) (1:10,000)Repeat every 3-5 mins

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77
Q

Epinephrine 1:10,000Pharmacology

A

Alpha and beta adrenergic stimulantIncreases heart rate - Chronotropic effectIncreases Myocardial contractions - inotropic effectIncreases Blood PressureIncreases electrical activity in the myocardiumincreases cerebral and coronary blood flowDilation of the bronchioles

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78
Q

Epinephrine 1:10,000Side Effects

A

In non cardiac arrest patients-Palpatationa-Tachyarrhythmias-Hypertension

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79
Q

Epinephrine 1:10,000Additional Info

A

N.B. Double check concentrations before use

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80
Q

Epinephrine 1:1,000Class

A

Sympathetic Agonist

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81
Q

Epinephrine 1:1,000Description

A

Naturally occurring catecholamine. It is a potent alpha and beta adrenergic stimulant; however, its effect on beta-receptors is more profound

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82
Q

Epinephrine 1:1,000Presentation

A

Pre-filled syringe, ampoule or auto injector1mg/ml (1:1,000)

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83
Q

Epinephrine 1:1,000Administration

A

Intramuscular (IM)

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84
Q

Epinephrine 1:1,000Indications

A

Severe Anaphylaxis

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85
Q

Epinephrine 1:1,000Contraindications

A

None known

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86
Q

Epinephrine 1:1,000Dosages

A

Adult:0.5mg (500mcg) (1:1,000) IMRepeat every 3-5 mins if indicatedPaed:8yrs - 0.5mg (500mcg) (.05ml)repeat every 3-5 mins if indicated

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87
Q

Epinephrine 1:1,000Pharmacology

A

Alpha and beta adrenergic stimulant.Reversal of laryngeal oedema and bronchospasm in anaphylaxis.Antagonises effects of histamine

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88
Q

Epinephrine 1:1,000Side Effects

A

PalpitationsAngina like symptomsTachyarrhythmiasHypertension

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89
Q

Epinephrine 1:1,000Additional Info

A

N.B. Double check the concentration on pack before use

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90
Q

FurosemideClass

A

Diuretic

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91
Q

FurosemideDescription

A

A loop diuretic

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92
Q

FurosemidePresentation

A

10mg per mL2ml, 5ml, 25ml Ampoule

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93
Q

FurosemideAdministration

A

Intravenous (IV)

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94
Q

FurosemideIndication

A

Pulmonary Oedema

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95
Q

FurosemideContraindications

A

PregnancyHypokalaemiaKSAR

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96
Q

FurosemideDosage

A

Adult: 40mg IVPaed: not indicated

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97
Q

FurosemidePharmacology

A

Acts on the ascending loop of Henle by inhibiting the reabsorption of Chloride and Sodium ions into the interstitial fluid. This results in a relative hypertonic state. Water is retained in the loop and eliminated via the bladder.It also causes venodilation which reduces venous return to the heart

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98
Q

FurosemideSide Effects

A

HeadacheDizzinessHypotensionArrhythmiasTransient deafnessDiarrhoeaNausea Vomiting

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99
Q

Furosemide Additional Info

A

Furosemide should be protected from light

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100
Q

GlucagonClass

A

Hormone and Anti-hypoglycaemic

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101
Q

GlucagonDescription

A

Glucagon is a protein secreted by the alpha cells of the Islets of Langerhans in the pancreas. It is used to increase the blood glucose level in cases of hypoglycaemia in which an IV cannot by immediately be placed

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102
Q

GlucagonPresentation

A

1mg vial powder for reconstitution (1ml)

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103
Q

GlucagonAdministration

A

Intramuscular (IM)

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104
Q

GlucagonIndications

A

Hypoglycaemia in patients unable to take oral glucose or unable to gain IV access with a blood glucose level <4mmol/L

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105
Q

GlucagonContraindications

A

KSARPhaeochromocytoma

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106
Q

GlucagonDosage

A

Adult: 1mg IMPaed: ≤ 8yrs 0.5mg IM> 8yrs 1mg IM

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107
Q

GlucagonPharmacology

A

Glycogenolysis.Increases plasma glucose by mobilising glycogen stored in the liver

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108
Q

GlucagonSide Effects

A

Rare: may cause Hypotension, dizziness, headache, nausea & Vomiting

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109
Q

GlucagonAdditional Info

A

May be ineffective in patients with low stored glycogen e.g. prior use in previous 24 hours, alcoholic patients with liver disease.Protect from light

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110
Q

Glucose GelClass

A

Anti-hypoglycaemic

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111
Q

Glucose GelDescription

A

Synthetic glucose paste

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112
Q

Glucose GelPresentation

A

Glucose gel in a tube or sachet

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113
Q

Glucose GelAdministration

A

Buccal Administration (BU)Administer gel to the inside of the patient’s cheek and gently massage the outside of the cheek

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114
Q

Glucose GelIndications

A

HypoglycaemiaBlood glucose <4 mmol/L

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115
Q

Glucose GelContraindications

A

KSAR

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116
Q

Glucose GelDosages

A

Adult: 10 - 20g buccalPaed: ≤ 8yrs: 5 - 10g buccal> 8yrs: 10 - 20g buccal

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117
Q

Glucose GelPharmacology

A

Increases blood glucose levels

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118
Q

Glucose GelSide Effects

A

May cause vomiting in patients under the age of five if administered too quickly

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119
Q

Glucose GelAdditional Info

A

Glucose gel will maintain glucose levels once raised but should be used secondary to Dextrose or Glucagon to reverse hypoglycaemia.Proceed with caution:- patients with airway compromise-altered level of consciousness

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120
Q

EnoxaparinClass

A

Anticoagulant

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121
Q

EnoxaparinDescription

A

Enoxaparin is a Low Molecular Weight Heparin used in conjunction with a thrombolytic agent for the treatment of STEMI

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122
Q

EnoxaparinPresentation

A

Prefilled syringes (100mg/mL)

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123
Q

EnoxaparinAdministration

A

Intravenous (IV)

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124
Q

EnoxaparinIndications

A

Acute STEMI immediately following the administration of a thrombolytic agent

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125
Q

EnoxaparinContraindications

A

Active major bleeding disorders and conditions with a high risk of uncontrolled haemorrhage, including recent haemorrhagic stroke or subdural haematoma; in jaundice; active gastric or duodenal ulceration; hiatal ulceration; threatened abortion, or retinopathy.Hypersensitivity to Enoxaparin or other LMWH.KSAR

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126
Q

EnoxaparinDosage

A

Adult: 30mg IV BolusPaed: not indicated

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127
Q

EnoxaparinPharmacology

A

It binds to the natural inhibitor of coagulation, anti-thrombin III and makes certain clotting factors inactive. This results in an increase in the clotting time

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128
Q

EnoxaparinSide Effects

A

Pain, Haematoma and mild local irritation may follow the subcutaneous injection

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129
Q

EnoxaparinAdditional Info

A

Do not store above 25°CDo not refrigerate or freeze.

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130
Q

GTNClass

A

Nitrate

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131
Q

GTNDescription

A

Special preparation of Glyceryl Trinitrate in an aerosol form that delivers precisely 0.4mg of GTN per spray

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132
Q

GTNPresentation

A

Aerosol spray: metered dose 0.4mg (400mcg)

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133
Q

GTNAdministration

A

Sublingual (SL)

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134
Q

GTNIndications

A

AnginaSuspected Myocardial Infarction (MI)Pulmonary Oedema

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135
Q

GTNContraindications

A

Sys BP <90 mmHgViagra or other Phosphodiesterase type 5 inhibitors (sildenafil,taladafil, vardenafil) used within previous 24 hoursKSAR

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136
Q

GTNDosage

A

Adult:Angina or MI: 0.4mg repeat at 3-5 mins to max 1.2mgPulmonary Oedema: 0.8mg Repeat X 1Paed: not indicated

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137
Q

GTNPharmacology

A

VasodilatorReleases nitric oxide which acts as a vasodilator. Dilates coronary arteries particularly if in spasm, increasing blood flow to the myocardium.Dilates systemic veins reducing venous return to the heart (preload) and thus reduces the heart workload.Reduces BP.

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138
Q

GTNSide Effects

A

HeadacheTransient HypotensionFlushingDizziness

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139
Q

GTNAdditional Info

A

If the pump is new or has not been used for a week or more the first spray should be released into the air

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140
Q

HydrocortisoneClass

A

Corticosteroid and anti-inflammatory

141
Q

HydrocortisoneDescription

A

Hydrocortisone is a potent corticosteroid with anti-inflammatory properties

142
Q

HydrocortisonePresentation

A

Powder and solvent for solution for injection or infusion.Vial containing off white powder and vial containing water for injections. Prepare the solution aseptically by adding not more than 2ml of sterile water for injections to the contents of one 100mg vial, shake and withdraw for use.

143
Q

HydrocortisoneAdministration

A

Intravenous (IV)Intramuscular (IM)The preferred route for initial emergency use is intravenous

144
Q

HydrocortisoneIndications

A

Severe or recurrent anaphylactic reactionsPatients with asthma following an anaphylactic reactionExacerbation of COPD

145
Q

HydrocortisoneContraindications

A

No major contraindications in acute management of anaphylaxis

146
Q

HydrocortisoneDosage

A

Adult: 200mg IM or slow IV (over 1 - 10mins)Paed:< 1 year - 25mg IM or slow IV (over 1 - 10mins)1 to 5 years - 50mg IM or slow IV (over 1 - 10mins)6 to 12 years - 100mg IM or slow IV (over 1 - 10mins)> 12 years - 130mg IM or slow IV (over 1 - 10mins)

147
Q

HydrocortisonePharmacology

A

Potent anti-inflammatory properties and inhibit many substances that cause inflammation. the half life is 90 mins

148
Q

HydrocortisoneSide Effects

A

CCF, Hypertension, Abdominal distension, Vertigo, Headache, Nausea, Malaise and Hiccups

149
Q

HydrocortisoneAdditional Info

A

Intramuscular injection should avoid the deltoid area because of the possibility of tissue atrophy.Dosage should not be less than 25mg

150
Q

IbuprofenClass

A

Non-steroidal anti-inflammatory drugs (NSAIDs)

151
Q

IbuprofenDescription

A

It is used to reduce mild to moderate pain

152
Q

IbuprofenPresentation

A

Suspension 100mg in 5ml200mg tablet

153
Q

IbuprofenAdministration

A

Orally (PO)

154
Q

IbuprofenIndications

A

Mild to moderate pain

155
Q

IbuprofenContraindications

A

Not suitable for children under 3 monthsPatient with history of asthma exacerbated by aspirinPregnancyPeptic ulcer diseaseKSAR

156
Q

IbuprofenDosages

A

Adult: 400mg (PO)Paed: 10mg/Kg (PO)

157
Q

IbuprofenPharmacology

A

Suppresses prostaglandins, which cause pain via its inhibition of cyclooxygenase (COX).Prostaglandins are released by cell damage and inflammation

158
Q

IbuprofenSide Effects

A

Skin Rashes, GI Intolerance and bleeding.LTSE - Occasionally Gi Bleeding and ulceration occurs.May also cause acute renal failure, interstitial nephritis and nephritic syndrome

159
Q

IbuprofenAdditional Info

A

If ibuprofen administered in previous 6 hours, adjust the dose downward by the amount given by other sources resulting in a maximum of 10mg/Kg

160
Q

Ipratropium BromideClass

A

Anticholinergic

161
Q

Ipratropium BromideDescription

A

It is a parasympatholytic bronchodilator that is chemically related to atropine

162
Q

Ipratropium BromidePresentation

A

0.25mg (250mcg) in 1ml Nebuliser Solution

163
Q

Ipratropium BromideAdministration

A

Nebulised (NEB) mixed with age specific dose of Salbutamol dose

164
Q

Ipratropium BromideIndications

A

Acute severs asthma not responding to initial salbutamol dose

165
Q

Ipratropium BromideContraindications

A

KSAR

166
Q

Ipratropium BromideDosages

A

Adult: 0.5mg NEBPaed: 0.25mg NEB

167
Q

Ipratropium BromidePharmacology

A

It blocks muscarinic receptors associated with parasympathetic stimulation of the bronchial air passageways. This results in bronchial dilation and reduced bronchial secretions

168
Q

Ipratropium BromideSide Effects

A

Transient Dry MouthBlurred VisionTachycardiaHeadache

169
Q

LidocaineClass

A

Anti-arrhythmic

170
Q

LidocaineDescription

A

Ventricular anti-arrhythmic agent

171
Q

LidocainePresentation

A

Lidocaine Injection Minijet 1% w/v 100mg per ml

172
Q

LidocaineAdministration

A

Intravenous (IV)Intraosseous (IO)

173
Q

LidocaineIndications

A

When Amiodarone is unavailable it may be substituted with Lidocaine

174
Q

LidocaineContraindications

A

No contraindications for cardiac arrest

175
Q

LidocaineDosage

A

Adult: 1 - 1.5mg/Kg IV (Max 3mg/Kg)Paed: not indicated

176
Q

LidocainePharmacology

A

Reduces automaticity by decreasing the rate of diastolic depolarisation.Stabilises the neuronal membrane and prevents the initiation and transmission of nerve impulses, action is rapid and blockade may last up to 2 hours

177
Q

LidocaineSide Effects

A

Drowsiness, dizziness, twitching, paraesthesia, convulsionsBradycardiaRespiratory depression

178
Q

LidocaineAdditional Info

A

Lidocaine may not be administered if Amiodarone has been administrated

179
Q

LorazepamClass

A

Benzodiazepine

180
Q

LorazepamDescription

A

It is an anxiolytic used as a sedative

181
Q

LorazepamPresentation

A

1mg tablet

182
Q

LorazepamAdministration

A

Orally (PO)

183
Q

LorazepamIndications

A

Combative with hallucinations or paranoia & risk to self or others

184
Q

LorazepamContraindications

A

History of sensitivity to benzodiazepinesSevere hepatic or pulmonary insufficiencySuspected significant alcohol and or sedatives ingestedKSAR

185
Q

LorazepamDosage

A

Adult: 2mg POPaed: not indicated

186
Q

LorazepamPharmacology

A

Acts on CNS receptors to potentiate the inhibitory action of GABA

187
Q

LorazepamSide Effects

A

Drowsiness, Confusion, Headache, Dizziness, Blurred Vision and Nausea & VomitingOn rare occasions - hypotension, hypertension

188
Q

Magnesium Sulphate InjectionClass

A

Electrolyte and Tocolytic agent

189
Q

Magnesium Sulphate InjectionDescription

A

It is a salt that is an essential element in numerous biochemical reactions that occur within the body

190
Q

Magnesium Sulphate InjectionPresentation

A

5g in 10mL ampoule

191
Q

Magnesium Sulphate InjectionAdministration

A

Intravenous (IV)Intraosseous (IO)

192
Q

Magnesium Sulphate InjectionIndications

A

Torsades de pointesPersistent Bronchospasm

193
Q

Magnesium Sulphate InjectionContraindications

A

None in cardiac arrestKSAR

194
Q

Magnesium Sulphate InjectionDosage

A

Adult:Torsades: 2g IV/IO infusion over 15 minutesBronchospasm: 1.5g IV/IO over 20 minutesPaed: not indicated

195
Q

Magnesium Sulphate InjectionPharmacology

A

It acts as a physiological calcium channel blocker and blocks neuromuscular transmission

196
Q

Magnesium Sulphate InjectionSide Effects

A

Decreased deep tendon reflexes, respiratory depression, bradycardia and hypothermia

197
Q

Magnesium Sulphate InjectionAdditional Info

A

Dilute in 100mL NaCl for infusion

198
Q

Midazolam SolutionClass

A

Benzodiazepine

199
Q

Midazolam SolutionDescription

A

It is a potent sedative agent. Clinical experience has shown Midazolam to be 3 to 4 times more potent per mg as Diazepam

200
Q

Midazolam SolutionPresentation

A

10mg in 2ml ampoule or 10mg in 5ml ampoule.Buccal liquid 50mg in 5ml or 10mg in 1ml pre-filled syringe

201
Q

Midazolam SolutionAdministration

A

Intravenous (IV)Intraosseous (IO)Intramuscular (IM)Buccal (BU)Intranasal (IN) (50% in each nostril)

202
Q

Midazolam SolutionIndications

A

SeizuresPsychostimulant overdoseHallucinations or paranoia

203
Q

Midazolam SolutionContraindications

A

ShockDepressed vital signs or alcohol related altered level of consciousnessKSARRespiratory depression

204
Q

Midazolam SolutionDosage

A

Adult:Seizure: 2.5mg IV or 5mg IM or 10mg BU or 5mg IN (repeat X 1 prn)Psych OD: 2.5mg IV or 5mg IM (repeat X 2 prn)Halllucinations or Paranoia: 5mg IV/IMPaed:Seizure: 0.5mg/Kg BU or 0.2mg/Kg IN or 0.1mg/Kg IV/IO (repeat X 1 prn)

205
Q

Midazolam SolutionPharmacology

A

It affects the activity of a chemical that transmits impulses across nerve synapses called Gamma-AminoButyric Acid (GABA). GABA is an inhibitory neurotransmitter. Midazolam works by increasing the effects of GABA at these receptors

206
Q

Midazolam SolutionSide Effects

A

Respiratory DepressionHeadacheHypotensionDrowsiness

207
Q

Midazolam SolutionAdditional Info

A

Midazolam IV should be titrated to effect. Ensure oxygen and resuscitation equipment are available prior to administration. The max dose of Midazolam includes that administered by caregiver prior to arrival of practitioner

208
Q

MorphineClass

A

Narcotic Analgesic

209
Q

MorphineDescription

A

CNS depressant and a potent analgesic with haemodynamic properties that make it extremely useful in emergency medicine

210
Q

MorphinePresentation

A

Ampoule 10mg in 1ml (dilute in 9ml of NaCl)Supension (10mg/5ml)

211
Q

MorphineAdministration

A

Intravenous (IV)Intraosseous (IO)Orally (PO)Intramuscular (IM)

212
Q

MorphineIndication

A

Adult: Severe Pain (≥ 5 on pain scale)Paed: Severe Pain (≥ 6 on pain scale)

213
Q

MorphineContraindication

A

PO < 1 Year oldKSARBrain InjuryLabour painsAcute alcoholismAcute respiratory drpressionSys BP < 90mmHgMigraine

214
Q

MorphineDosage

A

Adult: 2mg IV/IO Repeat at not < 2 minute intervals if indicated to Max 10mgFor musculoskeletal pain Max 16mgUp to 10mg IM ( if not cardiac chest pain and no IV access)Paed: 0.3mg/Kg (300mcg/Kg) PO (Max 10mg)0.05mg/Kg (50mcg/Kg) IV/IORepeat at not < 2 min prn to Max of 0.1mg/Kg IV/IO

215
Q

MorphinePharmacology

A

Opiate AnalgesicActs on CNS to educe pain & anxietyVasodilation resulting in reduced peload to myocardium

216
Q

MorphineSide Effects

A

Respiratory depressionDrowsinessNausea & vomitingConstipationLTSE - May lead to dependence

217
Q

MorphineAdditional Info

A

Use with extreme caution particularly with elderly/youngCaution with acute respiratory distressN.B. Controlled under the Misuse of Drugs Act (1977, 1984)

218
Q

NaloxoneClass

A

Narcotic antagonist

219
Q

NaloxoneDescription

A

Effective in management and reversal of overdoses caused by narcotics or synthetic narcotic agents

220
Q

NaloxonePresentation

A

Ampoules 0.4mg in 1mL (400mcg/1mL) Pre-filled syringe

221
Q

NaloxoneAdministration

A

Intravenous (IV)Intraosseous (IO)Intramuscular (IM)Subcutaneous (SC)

222
Q

NaloxoneIndications

A

Respiratory rate < 10 secondary to known or suspected narcotic overdose

223
Q

NaloxoneContraindications

A

KSAR

224
Q

NaloxoneDosage

A

Adult: 0.4mg IV/IO/IM/SC. Repeat after 3min if indicated to Max 2mg.Paed: 0.01mg/Kg (10mcg/Kg) IV/IO/IM/SC.Repeat dose prn to maintain opoid reversal to max 0.1mg/Kg or 2mg

225
Q

NaloxonePharmacology

A

Narcotic antagonistReverse the respiratory depression and analgesic effect of narcotics

226
Q

NaloxoneSide Effects

A

Acute reversal of narcotic effect ranging from nausea & vomiting to agitation & seizures

227
Q

NaloxoneAdditional Info

A

Use with caution in pregnancyAdminister with caution to patients who have taken large dose of narcotics ar are physically dependent.Rapid reversal will precipitate acute withdrawal syndrome.Prepare to deal with aggressive patients

228
Q

NifedipineClass

A

Tocolytic agent and calcium channel blocker

229
Q

NifedipineDescription

A

Dihydropyridine calcium channel blocker

230
Q

NifedipinePresentation

A

20mg tablet

231
Q

NifedipineAdministration

A

Orally (PO)

232
Q

Nifedipineindications

A

Prolapsed cord

233
Q

NifedipineContraindications

A

HypotensionKSAR

234
Q

NifedipineDosage

A

Adults: 20mg POPaed: not indicated

235
Q

NifedipinePharmacology

A

Inhibits muscle contraction by interfering with the movement of calcium ions through the slow channels of active cell membrane

236
Q

NifedipineSide Effects

A

HypotensionHeadacheBradycardiaNausea & Vomiting

237
Q

NifedipineAdditional Info

A

Close monitoring of maternal pulse & BP is required and continuous foetal monitoring should be carried out if possible

238
Q

EntonoxClass

A

Analgesic

239
Q

EntonoxDescription

A

Potent analgesic gas contains a mixture of both nitrous oxide and oxygen

240
Q

EntonoxPresentation

A

Cylinder, coloured blue with white anf blue triangles on cylinder shoulders.Medical Gas: 50% Nitrous Oxide & 50% Oxygen

241
Q

EntonoxAdministration

A

Self administered.Inhalation by demand valve with face mask or mouthpiece

242
Q

EntonoxIndications

A

Pain Relief

243
Q

EntonoxContraindications

A

ShockChest Injury / PneumothoraxAltered Level of ConsciousnessRecent Scuba DiveInhalation InjuryDecompression SicknessIntestinal ObstructionCarbon Monoxide poisoningKSAR

244
Q

EntonoxDosage

A

Self Administered until pain relieved

245
Q

EntonoxPharmacology

A

Analgesic agent gas:- CNS Depressant- Pain relief

246
Q

EntonoxSide Effects

A

DisinhibitionDecreased level of consciousnessLight headedness

247
Q

EntonoxAdditional Info

A

Do not use if patient unable to understand instructions.In cold temperatures, warm cylinder and invert to ensure mix of gases.Advanced paramedics may use discretion with minor chest injuries.Brand name: Entonox.Has an addictive property

248
Q

OndansetronClass

A

Anti-emetic

249
Q

OndansetronDescription

A

Used in the management of nausea & vomiting.Potent, highly selective 5HT3 receptor-antagonists

250
Q

OndansetronPresentation

A

Ampoule 2ml (4mg in 2ml)

251
Q

OndansetronAdministration

A

Intravenous (IV)

252
Q

OndansetronIndications

A

Management, prevention and treatment of nausea & vomiting

253
Q

OndansetronContraindications

A

KSAR

254
Q

OndansetronDosage

A

Adult: 4mg slow IVPaed: 0.1mg/Kg IV slowly to Max 4mg

255
Q

OndansetronPharmacology

A

Precise mode of action in the control of nausea & vomiting is not known

256
Q

OndansetronSide Effects

A

HeadacheSensation of warmthFlushingHiccups

257
Q

OndansetronAdditional Info

A

None

258
Q

OxygenClass

A

Gas

259
Q

OxygenDescription

A

Odourless, tasteless, colourless gas necessary for life

260
Q

OxygenPresentation

A

D,E, or F cylinders, coloured black with white shouldersCD cylinder; white cylinderMedical Gas

261
Q

OxygenAdministration

A

Inhalation via:- high concentration reservoir (non-rebreather) mask- simple face mask- venturi mask- tracheostomy mask- nasal cannula- bag valve mask

262
Q

OxygenIndications

A

Absent/inadequate vebtilation following an cute medical or traumatic event.SpO2 < 94% adults and < 96% paedsSpO2 < 92% for patients with acute exacerbation of COPD

263
Q

OxygenContraindications

A

Paraquat poisoningBleomycin lung injury

264
Q

OxygenDosage

A

Adult:Cardiac / Respiratory arrest: 100%Life Threats identified in Primary survey: 100% until reliable SpO2 of 94% - 98%COPD: titrate to 92%Everything else: titrate to 94%- 98%Paed: cardiac/respiratory arrest: 100%Life Threats Prim Surv: 100% titrate to 96% -98%Everything else: titrate to 96% - 98%

265
Q

OxygenPharmacology

A

Oxygenation of tissue/organs

266
Q

OxygenSide Effects

A

Prolonged use of O2 with chronic COPD patients may lead to reduction in ventilation stimulus

267
Q

OxygenAdditional Info

A

A written record must be made of what oxygen therapy is given to every patient. Documentation recording oximetry measurements should state whether patient is breathing air or a specified dose of supplemental oxygen. consider humidifier if O2 therapy for paed patients is > 30 mins duration. Avoid naked flames, powerful oxidising agent.

268
Q

ParacetamolClass

A

Analgesic and anti-pyretic

269
Q

ParacetamolDescription

A

Paracetamol is used to reduce pain and body temperature

270
Q

ParacetamolPresentation

A

Rectal suppository 180mg and 60mg.Suspension 120mg in 5mL.500mg Tablet

271
Q

ParacetamolAdministration

A

Per rectum (PR)Orally (PO)

272
Q

ParacetamolIndications

A

Pyrexia following seizure for paed patients.AP’s may administer Paracetamol, in the absence of a seizure for the current episode, provided the paediatric patient is pyrexial and has a previous history of febrile convulsions.Minor or moderate pain for adult and paediatric patients

273
Q

ParacetamolContraindications

A

KSARChronic Liver disease

274
Q

ParacetamolDosage

A

Adult: 1g POPaed:20mg/Kg PO< 1 Year - 60mg PR1 - 3 Years - 180mg PR4 - 8 Years - 360mg PR

275
Q

ParacetamolPharmacology

A

Analgesic - central prostaglandin inhibitor.Anti-pyretic - Prevents the hypothalamus from synthesising Prostaglandin E, inhibiting the body temperature from rising further.

276
Q

ParacetamolSide Effects

A

None.LTSE - Long term use at high dosage or over dosage can cause liver damage and less frequently renal damage

277
Q

ParacetamolAdditional Info

A

Note: Paracetamol is contained in Paracetamol Suspension and other over the counter drugs.Consult with parent/guardian in relation to medication prior to arrival on scene. For PR use be aware of modesty of patient, should be administered in the presednc of a 2nd person.If paracetamol is administered in previous 4 hours, adjust the dose downward by the amount given by other sources resulting in a maximum of 20mg/Kg

278
Q

SalbutamolClass

A

Sympathetic agonist

279
Q

SalbutamolDescription

A

Sympathomimetic that is selective for Beta-2 adrenergic receptors

280
Q

SalbutamolPresentation

A

Nebule 2.5mg in 2.5mLNebule 5mg in 2.5mLAerosol Inhaler: metered dose 0.1mg

281
Q

SalbutamolAdministration

A

Inhalation (INH) via nebuliser

282
Q

SalbutamolIndications

A

BronchospasmExacerbation of COPDRespiratory distress following submersion incident

283
Q

SalbutamolContraindications

A

KSAR

284
Q

SalbutamolDosage

A

Adult: 5mg Neb Repeat at 5 min prn (AP X 3, P X 1)Paed: <5 yrs - 2.5mg Neb≥ 5yrs - 5mg Neb Repeat at 5min prn (AP X 3, P X 1)

285
Q

SalbutamolPharmagology

A

Beta 2 agonistBronchodilationRelaxation of smooth muscle

286
Q

SalbutamolSide Effects

A

TachycardiaTremorsTachyarrhythmiasLTSE: High doses may cause hpokalaemia

287
Q

SalbutamolAdditional Info

A

It is more efficient to use a volumiser in conjunction with an aerosol inhaler when administering Salbutamol.If an Oxygen driven nebuliser is used to administer Salbutamol for a patient with acute exacerbation of COPD, it should be limited to 6 minutes maximum

288
Q

Sodium Bicarbonate InjectionClass

A

Alkalinizing Agent

289
Q

Sodium Bicarbonate InjectionDescription

A

A salt that is an alkalinizing agent and electrolyte supplement

290
Q

Sodium Bicarbonate InjectionPresentation

A

Glass vial 8.4% in 50ml

291
Q

Sodium Bicarbonate InjectionAdministration

A

Intravenous (IV)

292
Q

Sodium Bicarbonate InjectionIndications

A

Wide complex QRS arrhythmias and/or seizures following tricyclic (TCA) overdoseCardiac arrest following Tricyclic overdose

293
Q

Sodium Bicarbonate InjectionContraindications

A

KSAR

294
Q

Sodium Bicarbonate InjectionDosage

A

Adult: 1mEq/Kg (1ml/Kg 8.4% solution)Paed: not indicated

295
Q

Sodium Bicarbonate InjectionPharmacology

A

TCA excretion from the body is enhanced by making the urine more alkaline (raising the pH)

296
Q

Sodium Bicarbonate InjectionSide Effects

A

Nil when used for emergencies

297
Q

Sodium Bicarbonate InjectionAdditional Info

A

None

298
Q

Sodium Chloride 09%Class

A

Isotonic crystalloid solution

299
Q

Sodium Chloride 09%Description

A

Solution of sodium and chloride, also known as normal saline (NaCl)

300
Q

Sodium Chloride 09%Presentation

A

100ml, 500ml, 1000ml soft-pack for infusion10ml Ampoules

301
Q

Sodium Chloride 09%Administration

A

Intravenous (IV) InfusionIntravenous (IV) FlushIntraosseous (IO)

302
Q

Sodium Chloride 09%Indications

A

IV/IO fluid for pre-hospital emergency care

303
Q

Sodium Chloride 09%Contraindications

A

KSAR

304
Q

Sodium Chloride 09%Dosage ADULT

A

Anaphylaxis: 1000ml (Rpt X 1)Burns: >10% TBSA consider 500ml >25% TBSA & 1 hr from injury to ED, 1000mlCrush Injury: 20ml/KgDecompression Illness:500mlGlycaemic Emergency: 1000mlHypothermia: 250ml (warmed to ≈ 40°C) Max 1000mlKVO or medication flush in Cardiac arrestPost-resus care: 500ml (at ≈ 4°C) Maintain Sys BP >90mmHgShock: 500ml. rpt 250ml to maintain Sys BP of:- 100mmHg (hypovolaemia or septic)- 90 - 100mmHg (Head Inj GCS >8)- 120mmHg (Head Inj GCS ≤8)Cardiac Arrest: 20ml/Kg

305
Q

Sodium Chloride 09%Dosage PAEDIATRIC

A

Anaphylaxis: 20ml/Kg (Rpt X 1)Burns: >10% TBSA and/or 1 hr from injury to ED:5 ≤ 10 yrs 250ml, >10 yrs 500mlCrush Injury: 20ml/KgGlycaemic Emergency: 20ml/KgHypothermia: 20ml/Kg (warmed to ≈ 40°C) Haemorrhagic shock: 10ml/Kg, rpt if signs of inadequate perfusionKVO or medication flush in Cardiac arrestPost-resus care: 20ml/Kg (at ≈ 4°C) Neonatal Resus: 10ml/KgShock: 20ml/KgCardiac Arrest: 20ml/Kg

306
Q

Sodium Chloride 09%Pharmacology

A

Isotonic crystalloid solutionFluid replacement

307
Q

Sodium Chloride 09%Side Effects

A

Excessive volume replacement may lead to heart failure

308
Q

Sodium Chloride 09%Additional Info

A

NaCl is the IV/IO fluid of choice for pre-hospital emergency care.For KVO use 500ml pack only

309
Q

SyntometrineClass

A

Synthetic Hormone

310
Q

SyntometrineDescription

A

Ergometrine maleate 0.5mg and synthetic oxytocin 5 units per mL

311
Q

SyntometrinePresentation

A

1mL ampoule

312
Q

SyntometrineAdministration

A

Intramuscular (IM)

313
Q

SyntometrineIndications

A

Control of post-partum Haemorrhage

314
Q

SyntometrineContraindications

A

Severe kidney, live or cardiac dysfunction.Sepsis.KSAR

315
Q

SyntometrineDosage

A

Adult: 1mL IMPaed: not indicated

316
Q

SyntometrinePharmacology

A

Causes Rhythmic contraction of uterine smooth muscle, thereby constricting uterine blood vessels

317
Q

SyntometrineSide Effects

A

Nausea & vomitingAbdominal painHeadacheDizzinessCardiac arrhythmias

318
Q

SyntometrineAdditional Info

A

Ensure that a second foetus is not in the uterus prior to administration

319
Q

TenecteplaseClass

A

Thrombolytic agent

320
Q

TenecteplaseDescription

A

A recombinant fibrin-specific plasminogen activator

321
Q

TenecteplasePresentation

A

Powder and solvent for solution.1 vial contains 10,000 units (50mg) Tenecteplase.1 prefilled syringe contains 10mL water for injections.The reconstituted solution contains 1,000 units (5mg) tenecteplase per mL

322
Q

TenecteplaseAdministration

A

Intravenous (IV)

323
Q

TenecteplaseIndications

A

Patient conscious, coherent and understands therapy.Patient consent obtained. 20 mins & ≤ 6 hours.Time to PPCI centre > 90 mins of STEMI confirmation on 12 lead ECG

324
Q

TenecteplaseContraindications

A

Haemorrhagic stroke or stroke of unknown origin at any time.Ischaemic stroke in previous 6 months.CNS damage or neoplasms.Recent major trauma/ surgery/ head injury (within 3 weeks).GI bleeding within last month.Active peptic ulcer.Known bleeding disorder.Oral anticoagulant therapy.Aortic Dissection.TIA in preceding 6 mths.Pregnancy and within 1 week post partum.Non-compressible punctures.Traumatic resuscitation.Refractory HTN (Sys BP >180mmHg).Advanced liver diseaseInfective endocarditis

325
Q

TenecteplaseDosage

A

Adult: < 70Kg - 7,000units, 35mg, 7mL70 < 80Kg - 8,000units, 40mg, 8mL80 < 90Kg - 9,000units, 45mg, 9ml≥90Kg - 10,000units, 50mg, 10mLPaed; not indicated

326
Q

TenecteplasePharmacology

A

Tenecteplase is a recombinant fibrin-specific plasminogen activator that is derived from native t-PA by modifications at three sites of the protein structure. It binds to the fibrin component of the thrombus (Blood clot) and selectively converts thrombus-bound plasminogen to plasmin, which degrades the fibrin matrix of the thrombus.

327
Q

TenecteplaseSide Effects

A

Haemorrhage predominantly superficial at the injection site. Ecchymoses are observed commonly but usually do not require any specific action.Stroke (including intracranial bleeding) and other serious bleeding episodes.

328
Q

TenecteplaseAdditional Info

A

Enoxaparin should be used as antithrombotic adjunctive therapy.

329
Q

Fentanyl

Class

A

Narcotic analgesic

330
Q

Fentanyl

Description

A

Synthetic narcotic analgesic with a rapid onset and short durationof action. It has a half-life of 6.5 minutes when IN route is used.

331
Q

Fentanyl

Presentation

A

100 micrograms in 2 mL ampoule. (0.1 mg in 2 mL)

332
Q

Fentanyl

Administration

A

Intranasal (IN)

333
Q

Fentanyl

Indications

A

Acute severe pain in patients between 1 and 16 years old (≥ 1 yearand < 16 years).

334
Q

Fentanyl

Contraindications

A 
Known fentanyl hypersensitivity
ALoC
Bilateral occluded nasal passage
Nasal trauma
Epistaxis
Hypovolaemia.
335
Q

Fentanyl

Dosage

A

Adult: Not applicableAdolescent: (14 to < 16 years)0.0015 mg/Kg (1.5 mcg/Kg) IN. Repeat by one after 10 minutes ifsevere pain persists.
Paediatric:0.0015 mg/Kg (1.5 mcg/Kg) IN. Repeat by one after 10 minutes ifsevere pain persists.

336
Q

Fentanyl

Pharmagology

A

Fentanyl provides some of the effects typical of other opioidsthrough its agonism of the opioid receptors. Its strong potency inrelation to that of morphine is largely due to its high lipophilicity.Because of this, it can more easily penetrate the CNS.Fentanyl binds to μ-opioid G-protein-coupled receptors, whichinhibit pain neurotransmitter release by decreasing intracellularCa2+ levels.

337
Q

Fentanyl

Side Effects

A

Sedation
Nausea & vomiting
Respiratory Depression

338
Q

Fentanyl

Additional Info

A

Caution if patient has transdermal Fentanyl patch.
Include an additional 0.1 mL, to allow for dead space in MAD, in the calculated volume required.
Administer 50% volume in each nostril if more than 1 mL.

339
Q

Adenosine Class

A

AntiArrhythmic Agent

340
Q

Adenosine Description

A

Antiarrhythmic agent used to treat Supraventricular Tachycardia

341
Q

Adenosine Presentation

A

6mg in 2ml

3mg/ml solution for infusion vials

342
Q

Adenosine Administration

A

Intravenous IV

343
Q

Adenosine Indications

A

Paroxysmal Supraventricular Tachycardia (>150) with signs of poor perfusion

344
Q

Adenosine Contra-indications

A 
Asthma
Wolff-Parkinson-White Syndrome
Chronic Obstructive Pulmonary Disease (COPD)
Decompensated Heart Failure
Long QT Syndrome
2º &amp; 3º AV Block
Severe Hypotension
Sick Sinus (unless pacemaker fitted)
KSAR
345
Q

Adenosine Dose

A

6mg IV

Repeat @ 12mg x 2 Max

346
Q

Adenosine Pharmacology / Action

A

Rapid reversion to sinus rhythm of paroxysmal Supraventricular tachycardia

347
Q

Adenosine Side Effects

A 
Angina (discontinue)
Apprehension - arrhythmia (discontinue if asystole or severe bradycardia occur)
AV Block
Dizziness
Dyspnoea
Flushing
Headache
Nausea
Sinus Pause

Uncommon:
Blurred Vision / Hyperventilation / Metallic Taste / Palpitation / Sweating / Weakness

348
Q

Adenosine Cautions

A 
Atrial Fibrillation with accessory pathway
Atrial Flutter with accessory pathway
AV Block
Bundle Branch Block
1º AV Block
Heart Transplant
Recent MI
Severe Heart Failure
Stenotic Valvular Heart Disease
Uncorrected Hypovolaemia

Pharmacology (13 decks)

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