Pharm

Question 1

adrenaline type

Answer 1

Sympathomimetic.

Question 2

adrenaline action

Answer 2

 Stimulates the ALPHA and BETA receptors of the sympathetic nervous system to produce the “Fight” or “Flight” reaction
 ALPHA stimulation causes peripheral vasoconstriction. It raises the perfusion pressure of vital organs during cardiac arrest and it decreases capillary permeability and increases blood pressure in anaphylaxis
 Beta 1 stimulation causes increased myocardial excitability, tachycardia and increased myocardial contractility
 BETA 2 stimulation causes bronchodilation

Question 3

Adrenaline use

Answer 3

 C3 - Cardiac arrest
 C7 - Bradycardia
 C6 - Cardiogenic shock
 M4 - Asthma
 M16 - Anaphylaxis
 M7 - Croup
 O6 - Newborn resuscitation

Question 4

Adrenaline adverse effects

Answer 4

 Tachycardia
 Dysrhythmias, including ventricular fibrillation
 Hypertension
 Pupillary dilation
 Anxiety
 Nausea and vomiting

Question 5

BENZYL PENICILLIN type

Answer 5

Antibiotic active against a range of bacteria

Question 6

BENZYL PENICILLIN action

Answer 6

Inhibits bacterial cell wall synthesis and causes cytolysis when the bacterium tries to divide

Question 7

BENZYL PENICILLIN use

Answer 7

M13 - Meningococcal septicaemia

Question 8

BENZYL PENICILLIN adverse effects

Answer 8

Hypersensitivity reactions may occur (including urticaria, angio-oedema, convulsions and anaphylaxis)

Question 9

BENZYL PENICILLIN contraindications

Answer 9

 Life threatening allergic reaction to penicillin

Question 10

BENZYL PENICILLIN prep

Answer 10

600mg as a powder.
 IV/IO Administration: Dissolve 600mg in 10mL sodium chloride 0.9%
 IM Administration: Dissolve 600mg in 2mL sodium chloride 0.9%

Question 11

FENTANYL type

Answer 11

Opioid analgesic

Question 12

FENTANYL action

Answer 12

 Potent analgesic

 Effective drug for intranasal use because it is rapidly absorbed across mucous membranes

Question 13

FENTANYL use

Answer 13

 A6 - Pain management

Question 14

FENTANYL adverse effects

Answer 14

 Respiratory depression
 Hypotension
 Nausea and vomiting

Question 15

FENTANYL contraindication

Answer 15

 Altered LOC (V,P or U)
 Epistaxis or occluded nasal passages
 Patients under 1
? Previous know allergy or adverse reaction

Question 16

FENTANYL prep

Answer 16

600mcg in 2mL sealed vial

Question 17

FEXOFENADINE type

Answer 17

Anti-histamine

Question 18

FEXOFENADINE action

Answer 18

Non - sedating anti-histamine

Question 19

FEXOFENADINE use

Answer 19

M16 - Allergic reactions (localised, mild)

Question 20

FEXOFENADINE adverse effects

Answer 20

 Headache
 Drowsiness
 Nausea
 Dry mouth

Question 21

FEXOFENADINE contraindications

Answer 21

 Allergy or hypersensitivity to fexofenadine

 Patients under 12

Question 22

FEXOFENADINE prep

Answer 22

180mg tablet

Question 23

NALOXONE type

Answer 23

Opioid antagonist

Question 24

NALOXONE action

Answer 24

Reverses symptoms caused by opioid analgesics:
 Respiratory depression
 Sedation
 Hypotension

Question 25

NALOXONE use

Answer 25

D1 - Drug overdose and poisoning

Question 26

NALOXONE adverse effects

Answer 26

 Opioid withdrawal (nausea, vomiting, sweating, tachycadia, hypertension & combative behaviour)  Pulmonary oedema in patients with pre-existing cardiac disease.  Dysrhythmias (VF,VT)  Nausea and vomiting

Question 27

NALOXONE contraindications

Answer 27

Neonates born to opioid addicted mothers due to risk of inducing opioid withdrawal

Question 28

NALOXONE prep

Answer 28

 400mcg in 1mL ampoule. |  400mcg in 1mL ampoule diluted to 4mL with 3mL sodium chloride 0.9% (100mcg in 1mL)

Question 29

ASPIRIN type

Answer 29

Non-steroidal anti-inflammatory drug

Question 30

ASPIRIN action

Answer 30

 Inhibits platelet aggregation thereby limiting thrombus enlargement in acute coronary syndrome  Reduces production of prostaglandins thereby relieving pain and fever

Question 31

ASPIRIN use

Answer 31

 C1 - Acute coronary syndrome

Question 32

ASPIRIN adverse

Answer 32

 Allergic reactions, e.g. asthma, angioneurotic oedema, rhinitis, urticaria, laryngeal oedema and shock. Always check for history of previous reaction  Aggravation of any bleeding tendency  Gastric irritation (unlikely to be significant with one tablet)  Bleeding may take longer to stop

Question 33

ASPIRIN contraindications

Answer 33

 Allergy or hypersensitivity to aspirin  Active, suspected or known bleeding tendency  Patients

Question 34

COMPOUND SODIUM LACTATE type

Answer 34

Crystalloid solution containing sodium chloride, calcium, potassium and lactate

Question 35

COMPOUND SODIUM LACTATE action

Answer 35

Following intravenous infusion it is distributed throughout the extracellular fluid space, approximately 25% of the volume infused stays in the intravascular space for a variable period of time

Question 36

COMPOUND SODIUM LACTATE use

Answer 36

```  C6 - Cardiogenic shock  C9 - Hyperkalaemia  M8 - Dehydration  M21 - Hyperglycaemia  M25 - Medical hypoperfusion/hypovolaemia:  M13 - Meningococcal septicaemia  M16 - Anaphylaxis  M23 - Sepsis  E2 - Diving emergencies  O6 - Newborn resuscitation  T10 - Traumatic hypovolaemia  T23 - Trauma in pregnancy with any key sign of shock  T12 - Burns  T15 - Trapped patient ```

Question 37

COMPOUND SODIUM LACTATE adverse

Answer 37

 Pulmonary oedema  Hypothermia  When given in excess can contribute to coagulopathies (hypothermic & dilutional) and exacerbate acidosis

Question 38

CLOPIDOGREL type

Answer 38

Platelet receptor antagonist

Question 39

CLOPIDOGREL action

Answer 39

 Clopidogrel is a specific and potent inhibitor of platelet aggregation and limits propagation of thrombus by selectively inhibiting the binding of ADP to its platelet receptor  Clopidogrel is absorbed from the stomach and upper small bowel and begins to inhibit platelet function within 30 minutes

Question 40

CLOPIDOGREL use

Answer 40

 C13 - Cardiac reperfusion—Prehospital thrombolysis

Question 41

CLOPIDOGREL adverse

Answer 41

 Allergic reactions (e.g. asthma, angioneurotic oedema, rhinitis, urticaria, laryngeal oedema and shock). Always check for history of previous reaction  Aggravation of any bleeding tendency  Gastric irritation (unlikely to be significant with current doses)  Bleeding may take longer to stop

Question 42

CLOPIDOGREL contra

Answer 42

 Active, suspected or known bleeding tendency  Allergy or hypersensitivity to clopidogrel  Any exclusion via pre thrombolysis checklist  Patients

Question 43

DROPERIDOL type

Answer 43

Neuroleptic.

Question 44

DROPERIDOL action

Answer 44

 Droperidol produces marked tranquillisation and sedation  May  BP due to direct vasodilatory effect and alpha block  Droperidol potentiates other CNS depressants, e.g. narcotic analgesics such as fentanyl and benzodiazepines such as midazolam

Question 45

DROPERIDOL use

Answer 45

 A7 - Management of acute severe behavioural disturbance - Aetiology non head injured patients

Question 46

DROPERIDOL adverse

Answer 46

 Extrapyramidal reactions  Rarely, neuroleptic malignant syndrome (characterised by muscular rigidity, fever, hyperthermia, altered consciousness, and autonomic instability)

Question 47

DROPERIDOL contra

Answer 47

 Patients with known or suspected hypersensitivity to droperidol  Patients with known or suspected or potential head injury  Patients

Question 48

ENOXAPARIN SODIUM type

Answer 48

Low molecular weight antithrombotic

Question 49

ENOXAPARIN SODIUM action

Answer 49

 Induces a sustained release of tissue factor pathway inhibitor  Inhibits thrombin generation  Inhibits coagulation factors Xa and thrombin (anticoagulant)  Reduces reinfarction & ischaemia complications after lysis of STEMI

Question 50

ENOXAPARIN SODIUM use

Answer 50

 C13 - Cardiac reperfusion—Prehospital thrombolysis

Question 51

ENOXAPARIN SODIUM adverse

Answer 51

 Aggravation of any bleeding tendency  Allergic reactions (e.g. asthma, angioneurotic oedema, rhinitis, urticaria, laryngeal oedema and shock)  Bleeding may take longer to stop

Question 52

ENOXAPARIN SODIUM contra

Answer 52

 Allergy or hypersensitivity to enoxaparin sodium |  Any exclusion per thrombolysis checklist

Question 53

GLUCAGON type

Answer 53

Pancreatic hormone

Question 54

GLUCAGON action

Answer 54

Converts liver glycogen to glucose. Glucagon may not be effective if glycogen is depleted due to starvation or chronic liver disease

Question 55

GLUCAGON use

Answer 55

M21 - Hypoglycaemia (BGL

Question 56

GLUCAGON adverse

Answer 56

 Nausea and vomiting. |  Allergic reactions rarely occur.

Question 57

GLUCOSE 10% type

Answer 57

Hypertonic sugar solution for intravenous use

Question 58

GLUCOSE 10% action

Answer 58

Principle energy source for body cells, especially the brain

Question 59

GLUCOSE 10% use

Answer 59

M21 - Hypoglycaemia

Question 60

GLUCOSE 10% adverse

Answer 60

 Tissue necrosis if extravasation from vein occurs  May aggravate brain damage in head injuries and strokes  May precipitate Wernicke’s encephalopathy in alcoholics with thiamine deficiency

Question 61

GLUCOSE GEL type

Answer 61

Hypertonic sugar solution for oral use.

Question 62

GLUCOSE GEL action

Answer 62

Principle energy source for body cells, especially the brain.

Question 63

GLUCOSE GEL use

Answer 63

M21 - Hypoglycaemia

Question 64

GLUCOSE GEL adverse

Answer 64

 May precipitate Wernicke’s encephalopathy in alcoholics with thiamine deficiency.

Question 65

GLUCOSE GEL contra

Answer 65

 reduced LOC or altered gag reflex |  Patients

Question 66

GLYCERYL TRINITRATE type

Answer 66

Vasodilator

Question 67

GLYCERYL TRINITRATE action

Answer 67

 Dilates coronary arteries  Dilates systemic veins and arteries  Decreases preload, afterload and blood pressure

Question 68

GLYCERYL TRINITRATE use

Answer 68

 C1 - Acute coronary syndrome  C5 - Cardiogenic pulmonary oedema  M15 - Autonomic dysreflexia

Question 69

GLYCERYL TRINITRATE adverse

Answer 69

 Hypotension  Flushing  Headache

Question 70

GLYCERYL TRINITRATE contra

Answer 70

 BP 150/min |  Patients

Question 71

HYDROCORTISONE type

Answer 71

Corticosteroid

Question 72

HYDROCORTISONE action

Answer 72

 Glucocorticoid drug that reduces inflammation and suppresses immune response

Question 73

HYDROCORTISONE use

Answer 73

 M4 - Asthma |  M24 - Adrenal crisis

Question 74

HYDROCORTISONE contra

Answer 74

 Known or suspected allergy to corticosteroids, sodium succinate or sodium phosphate  Uncontrolled infection  Active peptic ulcer disease

Question 75

IBUPROFEN type

Answer 75

Non-steroidal anti-inflammatory

Question 76

IBUPROFEN action

Answer 76

Provides anti-inflammatory and analgesic effects

Question 77

IBUPROFEN use

Answer 77

A6 - Pain management (Mild pain)

Question 78

IBUPROFEN adverse

Answer 78

 G.I. irritation (e.g. nausea, diarrhoea) |  Hypersensitivity reactions may occur (e.g. anaphylaxis, asthma, angio-oedema, urticaria)

Question 79

IBUPROFEN contra

Answer 79

 Active or suspected or known bleeding tendency  History of allergic reactions to NSAIDs  Patients with asthma who have a history of wheeze post NSAID administration or have not previously taken a NSAID  Active peptic ulcer disease or GI bleeding  Dehydration  Renal impairment  Pregnancy  Patients