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From Flashcardlet > Paediatric DTP Doses > Flashcards

Paediatric DTP Doses Flashcards

0
Q

Paediatric doses of adrenaline for Severe life threatening bronchospasm

A

> 6 @ 300mcg
IMI @ 5 mins NMD
<6 @ 150mcg
IMI @ 5mins NMD

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1
Q

Paediatric doses of adrenaline for Anaphylaxis or severe allergic reaction

A

> 6 @ 300mcg
IMI @ 5 mins NMD
<6 @ 150mcg
IMI @ 5mins NMD

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2
Q

Paediatric doses of adrenaline for Cardiac arrest

A

> 10kg (>1y) - 10mcg/kg
IV @ 3-5min NMD
<10kg (<1y) - 100mcg
IV @ 3-5min NMD

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3
Q

Paediatric doses of adrenaline for Croup with stridor at rest

A

5 mg NEB

single dose only.

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4
Q

Paed dose of Adrenaline for Isolated facial swelling or angioedema with no stridor at rest

A

5 mg NEB, single dose only.

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5
Q

Fentanyl Paediatric dose for Significant Pain

A

> 1y = 1.5mcg/kg NAS
1mcg/kg @ 10mins
Total Max 100mcg

<1 = medical consult

NAS administration is ≤ 0.5 mL per nostril, although volumes up to 1 mL per nostril may be considered appropriate

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6
Q

Paediatric doses of midazolam

A

Initial dose 200 mcg/kg, max 5 mg

Subsequent doses at half the initial dose

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7
Q

Paediatric >1yr IV Doses of Morphine for Significant Pain and Autonomic Dysreflexia (SBP >160mmHg)

A

> 1yr old = 100 mcg / kg (single max dose 2.5mg) repeat every 5 mins at 50 mcg / kg. Max dose = 200mcg/kg

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8
Q

Paediatric 160mmHg)

A

<1yr = consult only

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9
Q

Paediatric 160mmHg)

A

<1yr = consult only

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10
Q

Paediatric >1yr IM Doses of Morphine for Significant Pain and Autonomic Dysreflexia (SBP >160mmHg)

A

> 1 yr old = 100-200mcg/kg (max single dose = 5mg) repeat every 10 mins. Max dose = 200mcg/kg

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11
Q

Hydrocortisone Schedule

A

S4 (Restricted drugs).

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12
Q

Hydrocortisone Precautions

A

Hypertension

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13
Q

Hydrocortisone Presentation

A

Vial, 100 mg hydrocortisone (Solu-Cortef ®)

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14
Q

Hydrocortisone Half-life (elimination)

A

6 – 8 hours

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15
Q

Hydrocortisone Metabolism

A

Hepatic

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16
Q

Hydrocortisone Drug class

A

Corticosteroid

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17
Q

Hydrocortisone Pharmacology

A
  • Produces an anti-inflammatory process.
    This inhibits the accumulation of inflammatory cells at inflammation sites, phagocytosis,
    lysosomal enzyme release and synthesis and/or release of mediators of inflammation.
  • Prevents and suppresses cell mediated immune reactions.
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18
Q

Hydrocortisone Contraindications

A

KSAR

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19
Q

Hydrocortisone preparation

A

• Each 100 mg hydrocortisone vial is to be reconstituted with 2 mL of water for injection

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20
Q

Hydrocortisone Onset (IV)

A

1 – 2 hours

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21
Q

Hydrocortisone Duration (IV)

A

6 – 12 hours

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22
Q

Hydrocortisone Indications

A

• Patients presenting with an approved
QAS Ambulance Management Plan (that meet the
requirements for hydrocortisone administration)
• (ICP) Moderate OR severe asthma
• (ICP) Acute exacerbation of COPD (with evidence
of respiratory distress)
• (ICP) Severe allergic reaction OR anaphylaxis
(requiring adrenaline administration)
• (ICP) Symptomatic adrenal insufficiency
(with a known history of Addison’s disease,
congenital adrenal hyperplasia, pan-hypopituitarism or long-term
steroid administration)

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23
Q

Oseltamivir Duration (PO)

A

< 12 hours

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24
Q

Oseltamivir Drug class

A

Antiviral

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25
Q

Oseltamivir Schedule

A

• S4 (Restricted drugs).

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26
Q

Oseltamivir packaging and labelling

A

The oseltamivir packaging must be labelled (hand printed by dispensing officer) with the following information:
- the name of the person for whom it’s intended
- the date the medication is supplied
- the name, initials, medal number and workplace
address of the person supplying the medicine
- the patient must be supplied with the
‘Oseltamivir QAS Dosage and Patient Information Form’.

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27
Q

Oseltamivir Onset (PO)

A

1 hour

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28
Q

Oseltamivir Characteristics of ILI

A

Fever (> 38°C or have a good history of fever)
AND
Cough, sore throat, runny nose, congestion or GI upset.

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29
Q

Oseltamivir Metabolism

A

Absorbed in the GI tract and not affected by food, converted to active metabolite by esterase in the liver and excreted by kidneys

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30
Q

Oseltamivir course and time frame

A

The patient is to be supplied with the full course of
oseltamivir.
Treatment should commence as soon as possible, but no later than 48 hours after the onset of fever.

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31
Q

Oseltamivir Adult dosages of ILI

A

75 mg capsule twice a day for 5 days

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32
Q

Oseltamivir Presentation

A

Capsule, 75 mg (box of 10) oseltamivir (Tamiflu®)

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33
Q

Oseltamivir Pharmacology

A

a neuraminidase inhibitor that selectively inhibits

the influenza A and B viruses

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34
Q

Oseltamivir Half-life (elimination)

A

1 – 3 hours

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35
Q

Oseltamivir Side effects

A

Nausea and/or vomiting

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36
Q

Oseltamivir Contraindications

A

As per the QAS oseltamivir checklist

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37
Q

Oseltamivir Complications

A

Nil

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38
Q

Oseltamivir Indications

A

Treatment of QAS operational staff with influenza like illnesses (ILI)

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39
Q

Oseltamivir Administration authority and checklist

A

Oseltamivir is only to be administered
on direct authority of the QAS Medical Director
(e.g. medical circular announcement).
All staff members must meet the administration
criteria according to the ‘QAS oseltamivir
administration checklist’ prior to being
administered oseltamivir.

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40
Q

Side effects for metochlopramide

A
  1. Drowsiness / lethargy
  2. Dry mouth
  3. Dystonic reaction
  4. Occulogyric crisis
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41
Q

Precautions for metochlopramide

A
  1. GI haemorrhage

2. Pts with bowel obstruction / perforation

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42
Q

Indications for metochlopramide

A
  1. Significant nausea / vomiting

2. Prophylactic use with pts who have Hx of nausea / vomiting with narcotic administration.

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43
Q

Pharmacology of Metoclopramide

A
  • a dopamine receptor antagonist
  • inhibits gastric smooth muscle relaxation
  • accelerates GI transit and gastric emptying
  • raises the chemoreceptors threshold in the floor of the fourth ventricle.
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44
Q

Half life of metoclopramide

A

2.5 - 5 hrs

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45
Q

Presentation of metochlopramide

A

10 mg in 2 mls

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46
Q

Drug class: Metoclopramide

A

Antiemetic

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47
Q

Onset of metoclopramide

A

1-3 mins IVI

10-15min IMI

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48
Q

Duration of metochlopramide

A

1-2 hrs

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49
Q

Schedule for metochlopramide

A

S4 restricted drugs

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50
Q

Contraindications for metochlopramide

A
  1. KSAR
    2, patients < 16 years
  2. Hx of dystonic reaction
  3. Pts whom have had phenothiazines in the last 6 hrs
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51
Q

Doses for metochlopramide

A

10-20 mg IMI and IVI ( slow push for 1-2 mins )

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52
Q

Hydroxocobalamin Contraindications

A

KSAR

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53
Q

Hydroxocobalamin administration STEP 4 – REPEAT

A

REPEAT steps 1–3 for 2nd vial

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54
Q

Hydroxocobalamin Special notes

A

All hydroxocobalamin infusions are to be initiated using industry supplied stock. Hydroxocobalamin will not be procured by QAS

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55
Q

Hydroxocobalamin Precautions

A

Hypertension

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56
Q

Hydroxocobalamin Half-life (elimination)

A

26 – 31 hours

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57
Q

Hydroxocobalamin administration STEP 2 – MIX

A

Rock or rotate the vial for 30 seconds to mix solution – DO NOT SHAKE.

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58
Q

Hydroxocobalamin Side effects

A
  • Anaphylaxis
  • Chromaturia
  • Erythema
  • Rash (acne like)
  • Hypertension
  • Nausea and/or vomiting
  • Pain at infusion site
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59
Q

Hydroxocobalamin Drug Class

A

Antidote

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60
Q

Hydroxocobalamin Adult dosages for cyanide toxicity

A

IV INF - 5 g over 15 minutes

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61
Q

Hydroxocobalamin Pharmacology

A

Form of vitamin B12 is an antidote for cyanide toxicity.

It binds with circulating and cellular cyanide to form cyanocobalamin, which is then excreted in the urine.

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62
Q

Hydroxocobalamin Metabolism

A

Excreted by kidneys

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63
Q

Hydroxocobalamin administration STEP 3 – INFUSE VIAL

A

Use the vented IV infusion tubing (suppied) to hang and administer over 7.5 minutes.

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64
Q

Hydroxocobalamin administration STEP 1 – RECONSTITUTE

A

Add 100 mL of sodium chloride 0.9%
to the 2.5 g hydroxocobalamin vial using the transfer spike (supplied)
Fill to the line with the vial in upright position.

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65
Q

Hydroxocobalamin Presentation

A

Vial (red powder), 2 x 2.5 g Hydroxocobalamin (Cyanokit®)

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66
Q

Hydroxocobalamin Duration (IV)

A

Several days

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67
Q

Hydroxocobalamin Schedule

A

N/A – TGA Special Access Scheme

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68
Q

Hydroxocobalamin Indications

A

Suspected cyanide toxicity

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69
Q

Hydroxocobalamin Onset (IV)

A

Immediate

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70
Q

Side effects of naloxone

A
  1. Narcotic reversal can cause combativeness, vomiting, sweating, tachycardia and hypertension
  2. May produce acute withdrawal convulsions in the chronic narcotic user
  3. Pulmonary oedema
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71
Q

Nalaxone Administration Notes

A
  1. Administered following adequate ventilation and oxygenation
  2. Administered cautiously to pts that are known to have physical dependence to narcotics, this includes newborn infants.
  3. Administration of naloxone in the prehospital setting will unmask potentially unwanted side effects in the poly pharmacy setting.
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72
Q

Naloxone drug class

A

Opioid antagonist

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73
Q

Naloxone special notes

A
  1. Vast majority of pts will ONLY need supportive therapy followed by Tx to hospital.
  2. The duration of the narcotic may outlast the duration of naloxone and renarcotisation is possible
  3. No necessity for IV access unless they have sustained an injury or have another medical condition
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74
Q

Naloxone Duration

A

60 mins,

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75
Q

Schedule for naloxone

A

S4 restricted drugs

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76
Q

Presentation of naloxone

A

400mcg in 1 ml

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77
Q

Onset of naloxone

A

IV 1-3 mins

IMI 3-5 mins

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78
Q

Pharmacology of naloxone

A

Prevents or reverses the effects of opioids including respiratory depression, sedation and hypotension.

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79
Q

Precautions of naloxone

A

Use with caution on pts with pre-existing cardiac disease

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80
Q

Naloxone Half-life

A

60 mins

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81
Q

Indications of naloxone

A

Respiratory depression secondary to narcotic administration.

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82
Q

Metabolism of naloxone

A

Liver

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83
Q

Contraindications of naloxone

A

KSAR

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84
Q

Duration of Salbutamol

A

16-60min neb

10-20min IV

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85
Q

Paediatric dose of Salbutamol for Bronchospasm

A

> 2 yo
5mg NEB
repeated PRN
NMD

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86
Q

Schedule of salbutamol

A

S4 restricted drugs

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87
Q

Precautions of salbutamol

A
  1. Acute pulmonary oedema

2. Ischaemic heart disease

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88
Q

Salbutamol drug class

A

Beta adrenergic agonist

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89
Q

Indications for salbutamol

A
  1. Bronchospasm

2. Suspected hyperkalaemia with QRS widening and / or av disassociation

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90
Q

Presentation of salbutamol

A

5 mg in 2.5 ml nebule

500 mcg in 1 ml ampoule

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91
Q

Pharmacology of salbutamol

A
  • a direct acting sympathomimetic
  • mainly affects the b2 adrenoreceptors
  • primarily acts as a bronchodilator
  • also has inotropic and chrontropic actions
  • also lowers serum potassium levels by it’s direct stimulation of the sodium / potassium pumps drawing potassium into the cells.
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92
Q

Onset of salbutamol

A

2-5 mins neb,

1-3 mins IV

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93
Q

Side effects of salbutamol

A
  1. Anxiety
  2. Tacharrythmias
  3. Muscle tremors
  4. Hypokalaemia
  5. Metabolic acidosis
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94
Q

Contraindications of salbutamol

A
  1. KSAR

2. Pts <2 yrs

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95
Q

Metabolism of salbutamol

A

By the liver excreted by the kidneys

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96
Q

Special notes for salbutamol

A
  1. Indifferent preparations of salbutamol are used for the IV and nebulised routes, do not mix
  2. NEB w/ 6-8L/min
  3. COPD pts = 6L/min
  4. Discard foil contents three months from opening
97
Q

Half-life of Salbutamol

A

1.6 hrs

98
Q

Adult dose of salbutamol for Bronchospasm

A

5mg NEB
repeated prn
NMD

99
Q

Indications for paracetamol

A

Mild pain and fever

100
Q

Doses of Paracetamol for Paediatrics

A

Paed (15mg) 0.625ml/ kg every four hours

101
Q

Precautions of paracetamol

A
  1. Hepatic or renal dysfunction

2. Pts on con commitment anticoagulant therapy excluding clopidogrel.

102
Q

Onset, duration and half life of paracetamol.

A

Onset 10-60 mins dependent on stomach contents, duration 4 hrs, half life 2 hrs

103
Q

Side effects of paracetamol

A

Nausea

104
Q

Schedule for paracetamol

A

S2 therapeutic poisons

105
Q

Metabolism of paracetamol

A

By the liver, excreted by the kidneys

106
Q

Contraindications of paracetamol

A
  1. KSAR

2. Pt <1 month old

107
Q

Presentation of paracetamol

A

500 mg tablet

120 mg in 5 ml acohol and sugar free elixir

108
Q

Special notes for paracetamol

A

Consider previous doses of paracetamol by pt, carer or guardian

109
Q

Doses of Paracetamol for Adults

A

Adult 500 mg to 1 g every four hours

110
Q

Paracetamol drug class

A

Analgesic

111
Q

Pharmacology of paracetamol

A

Paracetamol is a p-amino phenol derivative that exhibits mild analgesic and antipyretic effects. It does not possess significant anti-inflammatory properties.

112
Q

Pharmacology

A
  • Causes vasodilation and bronchodilation through inhibition of smooth muscle contraction
  • Possess anticonvulsant and anti-dysrrhythmic properties
113
Q

Duration (IV)

A

30 minutes

114
Q

Drug Class

A

Electrolyte

115
Q

Precautions

A

Renal impairment

116
Q

Special Notes

A

Irukandji syndrome is decribed as a tropical sting
(usually minimal discomfort) followed in 15 – 40 minutes of significant systemic symptoms of pain, agitation, restlessness, and clinically associated with signs of catecholamine excess

117
Q

Side effects

A

• Pain at the cannulation site
• Magnesium toxicity
– hypotension/respiratory depression
– loss of deep tendon reflexes

118
Q

Contraindications

A
  • KSAR
  • Heart block
  • Renal failure
119
Q

Indications

A

• Box jellyfish envenomation (unresponsive to antivenom therapy)
• Eclampsia
• Irukandji syndrome (with intractable pain
unrelieved by narcotic analgesia AND/OR systolic
BP > 160 mmHg)
• Torsades de Pointes
• Severe life-threatening asthma (only in patients
who have required IV salbutamol AND/OR IM/IV
adrenaline)

120
Q

Presentation

A

Ampoule, 10 mmol (2.47 g)/5 mL

121
Q

Metabolism

A

filtered in the kidneys and excreted predominantly

in urine with small amounts in faeces and saliva

122
Q

Adult dose for Box Jellyfish envenomation (unresponsive to antivenom therapy)

A

IV 20 mmol
Slow push over 10 minutes.
SPRINGFUSOR ® use is highly recommended.
Single dose only.

123
Q

Adult dose for Irukandji syndrome (with intractable pain unrelieved by narcotic analgesia AND/OR systolic BP > 160 mmHg)

A

IV Loading dose – 20 mmol
Slow push over 10 minutes.

IV infusion maintenance dose (listed below) is to be administered immediately following IV loading dose.

IV INF
Maintenance infusion – 20 mmol over 60 minutes

124
Q

Onset (IV)

A

Immediate

125
Q

Paediatric dose for Irukandji and Box Jelly fish

A
  • IV 0.1 mmol/kg (rounded up to the nearest 0.5 mmol)
  • Slow push over 10 minutes.
  • SPRINGFUSOR ® use is highly recommended.
  • Single dose not to exceed 5 mmol.
  • Repeated once at 10 minutes.
  • Total maximum dose 10 mmol.
126
Q

Schedule

A

Unscheduled.

127
Q

Half-life (elimination

A

Variable

128
Q

Administration during cardiac arrest

A

• If a patient is in cardiac arrest due to box jellyfish
envenomation, box jellyfish antivenom is only to be
administered following the commencement of effective CPR, advanced life support measures and administration of cardioactive drugs.

129
Q

Adult dose for box jellyfish envenomation

A

IM 60,000 units
Single dose only.

IV 20,000 units
Slow push over 10 minutes.
Single dose only.

130
Q

Metabolism of Box jellyfish antivenom

A

In muscle tissue and the liver.

131
Q

Precautions for Box jellyfish antivenom

A

It is a foreign protein, which can cause sensitisation, allergic reaction or anaphylaxis

132
Q

Paediatric dose for Box jellyfish envenomation with patient in cardiac arrest

A

IV 20,000 units
Slow push over 2–5 minutes.
Repeated immediately up to 2 times.
Total maximum dose 60,000 units.

133
Q

Side effects for Box jellyfish antivenom

A

• Allergic reaction including anaphylaxis
and delayed serum sickness
• Intense stinging sensation on injection

134
Q

Onset (IV) Duration (IV) Half-life (elimination)

A

Not available

135
Q

Schedule

A

S4 (Restricted drugs).

136
Q

Anaphylaxis after administration

A

• At all times during antivenom therapy adrenaline must be available in case of an anaphylactic reaction.
- If reaction occurs, immediately cease the administration of box jellyfish antivenom and treat patient in accordance with the QAS Anaphylaxis and allergy CPG.

137
Q

Indications for Box jellyfish antivenom

A

Box jellyfish envenomation associated with any of the following:
– a patient currently in cardiac arrest
– ALOC
– cardiac AND/OR respiratory distress
or collapse
– total surface area affected greater than half
the surface area of one limb
– intractable pain unrelieved by icepacks,
methoxyflurane AND/OR narcotic analgesia.

138
Q

Paediatric dose for Box Jellyfish envenomation

A

IM 60,000 units
Single dose only.

IV 20,000 units
Slow push over 10 minutes.
Single dose only.

139
Q

What is the Syringe preparation

A

Mix 20,000 units of antivenom with sodium chloride 0.9% to achieve a final concentration of 20,000
units/20 mL.

140
Q

Adult dose for Box jellyfish envenomation with patient in cardiac arrest

A

20,000 units
Slow push over 2–5 minutes.
Repeated immediately up to 2 times.
Total maximum dose 60,000 units.

141
Q

Pharmacology of Box jellyfish antivenom

A

concentrated immunoglobulin acts to neutralise the toxins in the venom

142
Q

IM administration

A

For the purpose of IM administration, officers may administer up to 2 mL in each Deltoid muscle and up to 5 mL in each Vastus Lateralis muscle.

143
Q

Presentation

A

Ampoule, 20,000 units/1.5 – 4 mL box jellyfish antivenom

144
Q

Contraindications for Box jellyfish antivenom

A

KSAR

145
Q

Speical notes

A
  • The dose of antivenom is related to the dose of venom, not based on the size of the patient.
  • IV injection is the preferred route of administration for all indications.
  • 60,000 units of antivenom may equate to a volume of up to 12 mL.
146
Q

Indications for Ipratropium Bromide

A
  • Severe life threatening bronchospasm

- Silent chest

147
Q

Side Effects of Ipratropium Bromide

A
  • Dilated Pupils
  • Dry mouth
  • Palpitations
148
Q

Adult dose of Ipratropium Bromide

A

NEB

  • 500mcg
  • single dose
149
Q

Presentation of Ipratropium Bromide

A

250mcg/1mL Ampoule

150
Q

Half-life of Ipratropium Bromide

A

3 hours

151
Q

Paediatric Dose of Ipratropium Bromide

A

NEB

  • > 2yo 250mcg
  • single dose
152
Q

Precautions for Ipratropium Bromide

A
  • Glaucoma

- Prostatic hypertrophy

153
Q

Contraindications for Ipratropium Bromide

A
  • KSAR to antocholinergics

- Pt <2yo

154
Q

Pharmacology of Ipratropium Bromide

A

Antimuscurinic agent which promotes bronchodilation by inhibiting cholinergic bronchomotor tone

155
Q

Duration of Ipratropium Bromide

A

4-6 hours

156
Q

Drug Class of Ipratropium Bromide

A

Anticholinergic agent

157
Q

Special notes of Ipratropium Bromide

A

Must be administered with salbutamol NEB mix

158
Q

Onset of Ipratropium Bromide

A

1.5 - 3mins

Peak 1.5-2hrs

159
Q

Special notes for methoxyflurane

A
  1. Deep sedation in pts < 5 yrs old
  2. At no time should unconsciousness be deliberately induced by administration
  3. At no time should a pt self administering be left unattended.
  4. The lowest dose should be used to achieve analgesia
  5. If the pt prefers simultaneous administration through nose and mouth a face mask can be connected prior to administration
  6. Total weekly dose should not exceed 15 mls
  7. Only 1 in the back of the vehicle, 2 per shift per officer
160
Q

Presentation of methoxyflurane

A

3ml glass bottle

161
Q

Precautions for methoxyflurane

A
  1. ALOC

2. Intoxicated or drug affected patients

162
Q

Contraindications for methoxyflurane

A
  1. KSAR
  2. Hx of malignant hyperthermia
  3. Hx of signicant liver or renal disease
  4. t monitor pain level and self administration
163
Q

Schedule of methoxyflurane

A

S4 restricted drug

164
Q

Indications for methoxyflurane

A

Pain

165
Q

Metabolism of methoxyflurane

A

By the liver and excreted mainly by the lungs

166
Q

Doses of methoxyflurane for adults

A

3ml repeatable after 20 mins, max dose 6ml

167
Q

Onset of methoxyflurane

A

1-3mins

168
Q

Duration of methoxyflurane

A

5-10mins

169
Q

Pharmacology of methoxyflurane

A

Inhalation agent that provides analgesia at low doses.
More susceptible to metabolism than other halogenated ethers
Greater propensity to diffuse into fatty tissue.

170
Q

Methoxyflurane drug class

A

Analgesic ( at low doses )

171
Q

Side effects of methoxyflurane

A
  1. Cough
  2. ALOC
  3. Hepatic or renal failure following repeated high doses
172
Q

Dose for Paediatrics

A

3 ml non repeatable

173
Q

Special notes for GTN

A
  1. GTN first for ACS
  2. GTN first for autonomic dysreflexia
    morphine should be considered as Mx
174
Q

Metabolism of GTN

A

Readily absorbed and metabolised by the liver

175
Q

Side effects of GTN

A
  1. Dizziness
  2. Vascular headache
  3. Syncope
  4. Hypotension
  5. Reflex tachycardia
176
Q

Onset of GTN

A

< 2 mins

177
Q

Drug class of GTN

A

Vasodilator

178
Q

Half-life of GTN

A

5 mins

179
Q

Indications for GTN

A
  1. Suspected ACS
  2. cardiogenic APO
  3. Autonomic dysreflexia with a systolic >= 160 mmHg
  4. Irrukandji syndrome with a systolic >= 160 mmHg
180
Q

Duration of GTN

A

20-30 mins

181
Q

When should IV GTN be considered?

A

All pts unresponsive to sublingual GTN, narcotics and betablockers.

182
Q

Presentation of GTN

A

Sublingual spray 400 mcg

Ampoules 50 mg in 10 mls*

183
Q

Contraindications for GTN

A
  1. KSAR
  2. Head trauma
  3. Acute CVA
  4. Heart rate < 50 or >150 bpm
  5. Bp < 100 mmHg
  6. Erectile dysfunction medications in last 24 hrs
184
Q

Precautions of GTN

A
  1. Cerebral vascular disease
  2. Intoxicated pts
  3. Risk of hypotension / syncope
  4. Suspected inferior AMI
  5. Erectile dysfunction medications in last 4 days
  6. Pt w/normal or low left ventricular filling pressures may be hypersensitive to GTN.
185
Q

Pharmacology of GTN

A

Pools venous blood in the peripheral veins.
Increases venous capacity decreasing preload.
Reduce ventricular filling pressures.
Decreasing arterial blood pressure.
Vasodilates coronary arteries that are in spasm.
May assist the redistribution of blood flow through collateral channels of the heart.

186
Q

Pharmacology of glucose gel

A

Glucose gel is a form of pure glucose that is rapidly absorbed into the GI mucousa
Used as glucose in the blood
In the liver it is converted to glycogen the storage form of glucose.
It is the principle source of energy especially for the brain.

187
Q

Special notes for glucose gel

A

Pts are to swallow the entire contents of the tube where possible to maximise the rise in blood glucose levels.

188
Q

Drug class of glucose gel

A

Hyperglycaemic

189
Q

Side effects of glucose gel

A

Diarrhoea

Nausea / vomiting

190
Q

Doses of glucose gel, adult and paediatric

A

15g repeatable at 10mins, total max dose 30 g

191
Q

Schedule for glucose gel

A

Unscheduled

192
Q

Onset, duration and half life of glucose gel

A

Onset 10 mins variable, duration variable, half life n/a

193
Q

Presentation of glucose gel

A

15g in a tube

194
Q

Indications for glucose gel

A

Symptomatic hypoglycaemia in a pt able to ingest oral glucose

195
Q

Contraindications of glucose gel

A
  1. KSAR
  2. Unconscious pts
  3. Pts with difficulty swallowing
  4. Pts < 2 yrs old
196
Q

Precautions for glucose gel

A

Nil

197
Q

Drug class of glucose 10%

A

Hyperglycaemic

198
Q

Adult doses of glucose 10%

A

150ml repeat 100 ml every 5 mins until BSL > 4 mol/L NMD

199
Q

Onset, duration and half life of glucose 10%

A

Onset = rapid, duration N/A, half life n/a.

200
Q

Presentation of glucose 10%

A

500ml Bag

201
Q

Contraindications for glucose 10%

A

Nil

202
Q

Paediatric doses of glucose 10%

A

2.5mls/ kg every 5 mins at 1 ml/kg until BSL greater than 4 mol/L

203
Q

Side effects to glucose 10%

A

Nil

204
Q

Pharmacology of glucose 10%

A

Glucose is a sugar that is the principle energy source for the body’s cells, especially the brain

205
Q

Precautions for glucose 10%

A

Tissue / vascular necrosis secondary to extravasation

206
Q

Indications for glucose 10%

A

Symptomatic hypoglycaemia in a pt unable to self administer oral glucose

207
Q

Indications for glucagon

A

Symptomatic hypoglycaemia in a pt unable to self administer oral glucose

208
Q

Half life of glucagon

A

3-6 mins

209
Q

Glucagon drug class

A

Hyperglycaemic

210
Q

Metabolism of glucagon

A

Liver, kidneys and plasma

211
Q

Side effects of glucagon

A

Nil

212
Q

Doses for glucagon

A

< 25 kg = 0.5 mg

> 25 kg = 1 mg single dose only

213
Q

Pharmacology of glucagon

A

Mobilises hepatic stores of glycogen to be used as glucose in the blood.

214
Q

Presentation of glucagon

A

Glycogen hypokit

1 mg powder / 1 ml of diluting solution

215
Q

Contraindications of glucagon

A

KSAR

216
Q

Precautions of glucagon

A

Nil

217
Q

Onset of glucagon

A

4-7 mins

218
Q

Duration of glucagon

A

variable

219
Q

Glucagon special notes

A
  1. Glucagon may be ineffective in pts that have no hepatic stores of glycogen
    ( e.g. Alcoholic pts with impaired liver function and neonates )
220
Q

1 yo, 2 yo, 3 yo, 4 yo, 5 yo, 6 yo, 7 yo and 8 yo doses of paracetamol

A 
1 = 10 kg = 150 mg / 6.25 mls
2 = 13 kg = 195 mg / 8.125 mls
3 = 15 kg = 225 mg / 9.375 mls
4 = 17 kg = 255 mg / 10.625 mls
5 = 19 kg = 285 mg / 11.875 mls
6 = 21 kg = 315 mg / 13.125 mls
7 = 23 kg = 345 mg / 14.375 mls
8 = 25 kg = 375 mg / 15.625 mls

Please note to quick fix the millage, multiply kg x 0.625

221
Q

Schedule for water for injection

A

Unscheduled

222
Q

Pharmacology of water for injection

A

Water for injection is sterile water used to dilute or dissolve drugs

223
Q

Contraindications, precautions and side effects of water for injection

A

Nil

224
Q

Onset, duration and half life of water for injection

A

N/A

225
Q

Water for injection drug class

A

N/A

226
Q

Metabolism of water for injection

A

N/A

227
Q

Presentation of water for injection

A

Ampoule, 20 ml water for injection

228
Q

Schedule for ceftriaxone

A

S4 restricted drugs

229
Q

Paediatric doses for ceftriaxone

A

IMI all doses mixed with 3.6 mls of water for injection, 50 mg / kg = 0-5 kg 250mg, 5-10kg 500 mg, 10-15 kg 750 mg, >20 kg 1gm
IVI all doses mixed with 9.6 mls of water for injection, 50 mg / kg = 0-5 kg 250mg, 5-10kg 500 mg, 10-15 kg 750 mg, >20 kg 1gm

230
Q

Adult doses for ceftriaxone

A

IMI 1 g mixed with 3.6 mls of water for injection

IVI 1 g mixed with 9.6 mls of water for injection

231
Q

Precautions of ceftriaxone

A

Nil

232
Q

Indications for ceftriaxone

A

Suspected meningococcal septicaemia with non blanching petechial or purpuric rash

233
Q

Pharmacology of ceftriaxone

A

Ceftriaxone is a third generation cephalosporin antibiotic used in the treatment of meningococcal septicaemia

234
Q

Presentation of ceftriaxone

A

1 g vial of powder

235
Q

Side effects of ceftriaxone

A
  1. Nausea / vomiting

2. Intense pain at site of injection

236
Q

Ceftriaxone drug class

A

Antibiotic

237
Q

Onset, duration and half life of ceftriaxone

A

Onset = 30 secs IVI 60 secs IMI, duration = 5-10 mins, half life = 2 mins

238
Q

Contraindications for ceftriaxone

A

KSAR to cephalosporin drug

Known anaphylaxis or severe allergic reaction to penicillin based antibiotics

239
Q

Special notes for ceftriaxone

A

All cannulae should be flushed with saline following administration

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