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ASNSW ICP STUDY > Pharmacology > Flashcards

Pharmacology Flashcards

(129 cards)

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1
Q

ADRENALINE - Adverse effects

A
  • Tachycardia
  • Dysrhythmias, including ventricular fibrillation
  • Hypertension
  • Pupillary dilation
  • Anxiety
  • Nausea and vomiting
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2
Q

ADRENALINE - Preparation

A

1mg in 1mL ampoule (1:1,000)

1mg in 10mL Min-I-Jet (1:10,000)

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3
Q

ADRENALINE – type

A

Sympathomimetic

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3
Q

ADRENALINE – action

A

Stimulates the ALPHA and BETA subdivisions 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
            **Onset**                    **Peak**              **Duration**

IM 30-90sec 4-10min 5-10min

IV 30sec 3-5min 5-10min

NEB 1-5min n/a up to 20min

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4
Q

ADRENALINE – USE

A
  • Cardiac arrest
  • Bradycardia
  • Cardiogenic shock
  • Severe/life threatening asthma
  • Anaphylaxis
  • Severe croup (nebulised)
  • Newborn Care
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5
Q

AMIODARONE – actions

A
  • Slows the sinus rate and increases the refractory period of the AV node.
  • Decreases peripheral vascular resistance

IV

onset- 2 mi

Peak- 20 min

Duration - 120 min

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6
Q

AMIODARONE – adverse effects

A
  • Hypotension
  • bradycardia
  • dysrhythmias
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7
Q

AMIODARONE – preparation

A

150mg in 3mL ampoule (50mg per mL)

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8
Q

AMIODARONE – type

A

Antiarrhythmic

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9
Q

AMIODARONE – use

A
  • Ventricular fibrillation/ pulseless tachycardia refractory to DC shocks and adrenaline
  • Dysrhythmias - tachycardia
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10
Q

ASPIRIN - Actions

A
  • Inhibits platelet aggregation thereby limiting thrombus enlargement in acute coronary syndrome
  • Reduces production of prostaglandins thereby relieving pain and fever
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11
Q

ASPIRIN - Adverse Effects

A
  • 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
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12
Q

ASPIRIN - Contraindications

A
  • Allergy or hypersensitivity to aspirin
  • Active, suspected or known bleeding tendency
  • Patients < 16 years of age
  • Patients meeting T1 Major Trauma criteria
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13
Q

ASPIRIN - Type

A

Non‐steroidal anti‐inflammatory drug

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14
Q

ASPIRIN - Use

A

Suspected acute coronary syndrome

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15
Q

ASPIRIN - Preparation

A

300mg tablet

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16
Q

ATROPINE - Adverse effects

A
  • Dry mouth
  • Blurred vision
  • Tachycardia
  • Nausea and vomiting
  • Hyperthermia
  • Dysrhythmias
  • Agitation, delirium, hallucinations, seizure and coma may occur in high doses
  • Urinary retention
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17
Q

ATROPINE - Use

A
  • Bradycardia
  • Excessive parasympathetic effects resulting from organophosphate poisoning or funnel-web spider envenomation
  • Nerve agent/organophosphate poisoning if authorised by HSFAC
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18
Q

ATROPINE - Action

A

Antagonises the parasympathetic effects of acetylcholine on muscarinic receptors resulting in:

  • Increased heart rate via increasing intrinsic rate of the sino-atrial node andconduction through the atrio-ventricular node
  • Reducing smooth muscle contraction resulting in pupillary dilation, reducedgastrointestinal motility and reduced bladder tone
  • Blocks exocrine gland activity causing decreased salivary, bronchial, gastric andsweat secretions
               **Onset**           **Peak**                 ** Duration**

IM Depends on perfusion

IV

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19
Q

ATROPINE - Preparation

A

600mcg in 1mL polyampoule

600mcg in 1mL polyampoule diluted to 6mL (100mcg in 1mL) with 5mL 0.9% normal saline

2mg in Atropen® Auto-Injector

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20
Q

ATROPINE - Type

A

Anticholinergic

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21
Q

CALCIUM GLUCONATE - Type

A

Electrolyte

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22
Q

CALCIUM GLUCONATE – action

A

Antagonises the effect of hyperkalaemia on the heart

IV

Onset - 30 sec

Peak- N/A

Duration- 30min - 2hrs

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23
Q

CALCIUM GLUCONATE – adverse effects

A
  • May increase myocardial and cerebral damage by increasing intracellular calcium levels
  • Tissue necrosis if extra visitation from vain occurs
  • Dysrhythmias
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24
CALCIUM GLUCONATE – preparation
2.2mmol (10mL) ampoule (approximately 1g per 10mL)
25
CALCIUM GLUCONATE – use
Emergency treatment of hyperkalaemia as a cardio protectant
26
FENTANYL - Adverse Effects
* Respiratory depression * Hypotension * Nausea and vomiting
27
FENTANYL - Contraindications
* Active labour * Altered LOC (V,P or U) * Epistaxis or occluded nasal passages * Patients \< 1 year of age * Previous known allergy or adverse reaction **Note: Allergy to morphine is not a contraindication to fentanyl administration** **P A L L E**
28
FENTANYL - Preparation
600mcg in 2mL in a sealed vial **Route of administration** Intranasal (IN) via mucosal atomising device
29
FENTANYL - Type
Opioid analgesic
30
FENTANYL - Use
* First line moderate to severe pain management patients * Patients \>16 years of age where morphine is ineffective or contraindicated
31
FENTANYL - Action
* Potent analgesic * Effective drug for intranasal use because it is rapidly absorbed across mucous membranes
32
FEXOFENADINE - Action
Non‐sedating anti‐histamine
33
FEXOFENADINE - Adverse Effects
* Headache * Drowsiness * Nausea * Dry mouth
34
FEXOFENADINE - Contraindications
* Allergy or hypersensitivity to fexofenadine * Patients \< 12 years of age
35
FEXOFENADINE - Preparation
180mg tablet
36
FEXOFENADINE - Type
Anti-histamine
37
FEXOFENADINE - Use
Allergic reactions (localised, minor in severity)
38
FRUSEMIDE - Type
Diuretic
39
FRUSEMIDE - Action
A potent loop diuretic which produces increased urine output **IV** Onset - 5 min Peak - 20 -60 min Duration - 2-3 hours **IM** Onset - 10 min Peak - 30 min Duration - 2-3 hrs
40
FRUSEMIDE - Adverse Effects
* Excessive diuresis can lead to hypovolaemic shock * Potassium loss can precipitate dysrhythmias
41
FRUSEMIDE - Contraindications
* BP \< 100mmHg systolic * Patients \< 16 years of age
43
FRUSEMIDE - Use
Cardiogenic pulmonary oedema provided BP ≥ 100 mmHg systolic, to increase urine output and decrease venous return
43
FRUSEMIDE - Preparation
40mg per 4mL ampoule
44
GLUCAGON - Action
Converts liver glycogen to glucose. Glucagon may not work if liver glycogen is depleted due to starvation or chronic liver disease
45
GLUCAGON - Adverse Effects
* Nausea and vomiting * Allergic reactions rarely occur
46
GLUCAGON - Preparation
1mg vial & syringe containing 1mL of sterile water Dissolve the glucagon powder by adding the entire contents of the syringe to thevial containing the glucagon. The solution must be prepared immediately prior to use
47
GLUCAGON - Type
Pancreatic hormone
48
GLUCAGON - Use
Hypoglycaemia if unable to cannulate for administration of Glucose 10%
49
GLUCOSE 10% - Action
Principle energy source for body cells, especially the brain. **IV** Onset - 30sec Peak - 30sec Duration - Dependant on severity of hypoglycaemic episode
50
GLUCOSE 10% - Adverse Effects
* 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
52
GLUCOSE 10% - Type
Hypertonic sugar solution for intravenous use
52
GLUCOSE 10% - Preparation
10% ‐ 50g per 500mL bag
54
GLUCOSE 10% - Use
Hypoglyceamia
55
GLUCOSE GEL - Action
Principle energy source for body cells, especially the brain PO: Onset within 15 minutes
55
GLUCOSE GEL - Adverse Effects
May precipitate Wernicke’s encephalopathy in alcoholics with thiamine deficiency
56
GLUCOSE GEL - Contraindications
* ↓LOC or altered gag reflex * Patients \< 2 years of age
57
GLUCOSE GEL - Preparation
37.5g tube containing glucose gel 40% (15g glucose)
58
GLUCOSE GEL - Type
Hypertonic sugar solution for oral use
59
GLUCOSE GEL - Use
Correction of hypoglycaemia
61
GLYCERYLTRINITRATE - Type
Vasodilator
61
GLYCERYLTRINITRATE - Action
* Dilates coronary arteries * Dilates systemic veins and arteries * Decreases preload, afterload and blood pressure Onset is within 2 minutes and lasts up to 30 minutes
63
GLYCERYLTRINITRATE - Contraindications
* BP * Heart rate 150/min * Patients * Use of drugs to treat erectile dysfunction e.g. * Sildenafil ‐ Viagra® ‐ within 24 hours * Vardenafil ‐ Levitra® ‐ within 24 hours * Tadalafil ‐ Cialis® ‐ within 96 hours
64
GLYCERYLTRINITRATE - Use
* Suspected acute coronary syndrome * Cardiogenic pulmonary oedema * Autonomic dysreflexia
65
GLYCERYLTRINITRATE - Preparation
600mcg tablet
65
HARTMANN’S - Action
Following intravenous infusion it is distributed throughout the extracellular fluid space. Approximately 25% of the volume infused stays in the intravascular space
67
HARTMANN’S - Administration
* Patients \> 16 years of age via pump set * Patients \< 16 years of age via autostart burette and pump set
68
HARTMANN’S - Adverse Effects
* Cardiogenic pulmonary oedema * Coagulopathy, hypothermia and acidosis in the trauma patient
69
HARTMANN’S - Preparation
500mL bag
70
HARTMANN’S - Type
Crystalloid solution
71
HARTMANN’S - Use
* Traumatic hypovolaemia with head injury * Traumatic hypovolaemia with no head injury * Non-traumatic hypovolaemia * Anaphylaxis * Suspected sepsis with hypotension * Meningococcal septicaemia * Burns * Cardiogenic shock * Rehydration/fluid replacement * Dehydration * Diving emergencies * Hyperglycaemia * Newborn care * To keep IV patent and flush drugs * Limb realignment * Dysrhythmias * Cardiac arrest
72
IPRATROPIUM BROMIDE - Action
* Bronchodilation * Blocks vagal reflexes which mediate bronchoconstriction Onset 3-5min Duration 2-4hrs
73
IPRATROPIUM BROMIDE - Adverse Effects
Mild anticholinergic effects, e.g. urine retention
73
IPRATROPIUM BROMIDE - Contraindications
* Allergy or hypersensitivity to ipratropium bromide * Glaucoma
75
IPRATROPIUM BROMIDE - Preparation
500mcg in 1mL nebule for patients ≥ 6 years of age 250mcg in 1mL nebule for patients \< 6 years of age
76
IPRATROPIUM BROMIDE - Type
Anticholinergic bronchodilator
77
IPRATROPIUM BROMIDE - Use
* Moderate to severe asthma * COPD
78
LIGNOCAINE - ACTION
Blocks sodium channels reducing ventricular excitability and pain transmission **IV** Onset 1-4min Peak 5-10 min Duration 20 min
79
LIGNOCAINE - TYPE
Antiarrhythmic and local anaesthetic agent.
80
Lignocaine – adverse effects
* Lignocaine may cause or exacerbate ventricular dysrhythmias * In high doses, may cause: 1. Neurological side effects - (drowsiness, disorientation, agitation, muscle twitching, fits and coma) 2. Cardiac effects - (hypotension, bradycardia, heart block(s) and asystole)
81
Lignocaine – contraindications
Allergy or hypersensitivity to lignocaine.
81
LIGNOCAINE – preparation
* Lignocaine 2% ‐ 100mg in 5mL polyampoule for IV bolus doses * Lignocaine 1% ‐ 20mg in 2mL ampoule for local anaesthesia **As two concentrations are available: Read the label carefully and check with your partner**
83
Lignocaine – use
* If ventricular fibrillation/pulseless VT persists after the maximum dose of amiodarone * Local anaesthesia of the skin prior to cannulation (1% preparation only)
84
METHOXYFLURANE - Action
Central nervous system depressant * Onset 2-3min * Duration 30min
85
METHOXYFLURANE - Contraindications
* Malignant hyperthermia * ↓LOC – V,P or U * Pre-eclampsia or eclampsia * Concurrent tetracycline use (e.g. doxycycline) * Untreated renal failure * Patients \< 1 year of age * Acute behaviourally disturbed patients
86
METHOXYFLURANE - Preparation
3mL amber bottle sealed, with external inhaler
87
METHOXYFLURANE - Type
Inhaled analgesic
88
METHOXYFLURANE - Use
* Moderate to severe pain in patients where a paramedic is not authorised to administer an opioid or an opioid is contraindicated *  Mild pain in patients \> 1year of age and \< 12 years of age * Multiple victim situations
89
METHOXYFLURANE - Adverse effects
* ↓LOC * Renal damage in high doses
90
METOCLOPRAMIDE - Action
Blocks central dopamine receptors IM ONSET – 10 to 15 minutes DURATION – 1 to 2 hours IV ONSET – 3 to 5 minutes DURATION – 1 to 2 hours
91
METOCLOPRAMIDE - Type
Anti-nauseant and anti-emetic
92
METOCLOPRAMIDE – Contraindications
* suspected bowel obstruction * suspected or known haematemesis or melaena * previous history of extrapyramidal/dystonic reaction * Allergy or hypersensitivity to metoclopramide * patients less than 16 years of age
93
METOCLOPRAMIDE – use
Severe nausea and/or active vomiting in patients \> 16 years of age where ondansetron has been ineffective after 10 minutes or is contraindicated
94
METOCLOPRAMIDE – preparation
10mg (2mL) ampoule
95
MIDAZOLAM - Action
Reduces seizure activity and has a tranquillising and amnesic effect ** Onset, Peak, Duration** **IM** 5‐10 min, 15 min, 30 min **IV** 1‐3 min, 10 min, 20 min I**N ** 1‐3 min, 12 min, 20 min
96
MIDAZOLAM - Adverse Effects
* ↓LOC resulting in upper airway obstruction * Respiratory and cardiovascular depression **Vital signs must be carefully monitored and equipment to support respiration must be available. Apnoea can often occur following parenteral use especially in the elderly and those with respiratory disease. Adverse effects are increased in the presence of other sedating drugs such as opiates and alcohol **
97
MIDAZOLAM - Preparation
5mg in 1mL ampoule 5mg in 1mL ampoule diluted to 5mL with 4mL 0.9% NaCl2 (1mg:1mL) **Paediatric bolus must not exceed the adult dose** **Oxygen must be administered to all patients receiving midazolam**
98
MIDAZOLAM - Type
Benzodiazepine
99
MIDAZOLAM - Use
* Control seizures * Post intubation sedation * Limb realignment and/or difficult extrication * Patient management **Midazolam MUST NOT be used to assist intubation **
100
MORPHINE - Action
* Decreases pain perception and anxiety * Causes peripheral vasodilation IM Onset 5-10 min Peak 25-40 min Duration 1-2 hrs IV Onset 2-5 min Peak 10 min Duration 1-2 hrs
101
MORPHINE - Adverse Effects
* ↓LOC * Respiratory depression * Hypotension * Nausea and vomiting
102
MORPHINE - Contraindications
* Altered LOC (V,P or U with the exception of patients requiring post intubation sedation) * Active labour * Allergy or hypersensitivity to morphine * Patients \< 6 months of age **P A L L**
103
MORPHINE - Preparation
10mg in 1mL ampoule 10mg in 1mL ampoule diluted to 10mL with 9mL 0.9% normal saline – (1mg in 1mL)
104
MORPHINE - Type
Opioid analgesic
105
MORPHINE - Use
* Pain management * Post intubation sedation
106
NALOXONE - Action
Reverses symptoms caused by opioid analgesics: * Respiratory depression * Sedation * Hypotension
107
NALOXONE - Additional Information
**Opioid effects may exceed that of naloxone and renarcotisation is possible. Therefore repeat doses may be required** **Naloxone is contraindicated in neonatal patients of opioid addicted mothers as serious withdrawal effects may occur** **Hypoventilating newborns, due to maternal opiate use, will be hypercapnoeic and naloxone may provoke dysrhythmias, seizures and pulmonary oedema**
108
NALOXONE - Adverse Effects
* Opioid withdrawal (nausea, vomiting, sweating, tachycardia, hypertension, combative behaviour) * Pulmonary oedema in patients with pre existing cardiac disease * Dysrhythmias (VT, VF)
109
NALOXONE - Contraindications
Patients \< 30 days of age
110
NALOXONE - Preparation
* 400mcg in 1mL ampoule * 400mcg in 1mL ampoule diluted to 4mL (100mcg in 1mL ) with 3mL of 0.9% normal saline
111
NALOXONE - Type
Opioid antagonist
112
NALOXONE - Use
* Life threatening opioid overdose * Opioid overdose * Etorphine or Buprenorphine overdose
113
ONDANSETRON - Action
Blocks central and peripheral 5-HT3 receptors IM Onset 10-15 min Duration 1-2 hrs IV Onset 3-5min Duration 1-2 hrs
114
ONDANSETRON - Adverse Effects
* Headache and/or flushing * Seizures and movement disorders * Visual disturbance * Hypersensitivity reactions (including anaphylaxis)
115
ONDANSETRON - Contraindications
* Allergy or hypersensitivity to ondansetron * Patients
116
ONDANSETRON - Preparation
4mg in 2mL ampoule
117
ONDANSETRON - Type
Anti‐emetic and anti‐nauseant
118
ONDANSETRON - Use
* **For first line management of severe nausea and/or vomiting** * **Suspected penetrating eye injury **
119
SALBUTAMOL - Action
Stimulates beta 2 receptors in bronchial smooth muscle resulting in bronchodilation NEB Onset - 2-5 min Peak - 5 -10 min Duration - 1-2 hours
120
SALBUTAMOL - Adverse Effects
* Dysrhythmias in large doses * Shakes and tremors
121
SALBUTAMOL - Preparation
``` 5mg in (2.5mL) nebule 2.5mg in (2.5mL) nebule ```
122
SALBUTAMOL - Type
Sympathomimetic
123
SALBUTAMOL - Use
To relieve bronchospasm
124
SODIUM BICARBONATE – actions
* Reverses metabolic acidosis by buffering hydrogen ions * Reduces plasma potassium by altering pH and causing intracellular movements of potassium ions * Alters protein binding of tricyclics by acting on trans‐membrane sodium channels
125
SODIUM BICARBONATE – adverse effects
* Metabolic alkalosis (may cause dysrhythmias) * Hypokalaemia(maycausedysrhythmias) * Heartfailure
126
SODIUM BICARBONATE – type
Alkalising solution
127
SODIUM BICARBONATE – use
* Emergency treatment of hyperkalaemia * Tricyclic overdoses with conduction delay (wide QRS complex) presenting with IV Onset Immediate shock, fitting or coma
128
SODIUM BICARBONATE – preparation
8.4% 50mL (1mmol/mL) Min‐I‐Jet
129
GLYCERYLTRINITRATE - Adverse Effects
* Hypotension * Flushing * Headache

ASNSW ICP STUDY (10 decks)

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