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Paramedic Drugs > Pharmacology > Flashcards

Pharmacology Flashcards

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1
Q

Adrenaline Preparation

A

1mg 1ml

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2
Q

Adrenaline Indications

A 
Cardiac Arrest
Anaphylaxis
Severe Asthma
Moderate-Severe Stridor
Epistaxis
Significant Wound Bleeding
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3
Q

Adrenaline Doses

A 
1mg IV @4/60
0.5mg IM @10/60 or @5/60 if anaphylactic and not improving/deteriorating
2ml per IN
5mg Neb
0.1mg/ml topical
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4
Q

Adrenaline MOA

A

Adrenergic receptor agonist with alpha and beta effects.
a1- smooth muscle contraction, vasoconstriction (epistaxis, bleeding, & stridor), stimulates glycogenolysis in the liver
a2- sedation & vasoconstriction
b1- increases inotropic, chronotropic, & dronotropic effects of the heart (increased force of contractility, increased HR, increased conduction) (cardiac arrest)
b2- smooth muscle relaxation, vasodilation, bronchodilation, Gi smooth muscle relaxation, stabilizes mast cell membranes decreasing histamine release (asthma & anaphylaxis)

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5
Q

Adrenaline Contraindications

A

Nil

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6
Q

Adrenaline Precautions

A

MI

Tachydysrhythmias

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7
Q

Adrenaline Onset

A

IV 5-10sec
IM 2-5min
Neb, topical, & IN on contact with target site

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8
Q

Adrenaline Duration

A

Cardiovascular effects last 2-15min

Mast cell membrane effects last several hours

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9
Q

Adrenaline Adverse Effects

A 
Tachycardia
Tachydysrhythmias
HTN
N&V
Tremor
Headache
Andiety
Dyspnoea
MI
Ventricular Ectopy
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10
Q

Amiodarone MOA

A 
Broadspectrum antidysrhythmic with class III activity, blocks K+ channels.
Prolongs action potential, reduces automaticity, & prolongs the refractory period of atrial, nodal, & ventricular tissues. 
Causes a reduction in abnormal electrical activity (ectopy) and stabilizes nodes
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11
Q

Amiodarone Preparation

A

150mg 3ml

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12
Q

Amiodarone Indication

A

VF or VT arrest post 1st dose of Adrenaline

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13
Q

Amiodarone Contraindication

A

Severe allergy to Iodine

VT secondary to cyclic antidepressant OD

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14
Q

Amiodarone Precautions

A

Nil if in arrest

Poor perfusion
Hypotension
AF associated with severe sepsis
Sick sinus syndrome w/o pacemaker
Pregnancy
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15
Q

Amiodarone Doses

A

300mg IV bolus (x2 ampuoles)

If VF/VT persists after 20/60- 150mg

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16
Q

Amiodarone Onset

A

5-10/60

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17
Q

Amiodarone Duration

A

1-4hrs post single dose, but longer in tissues

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18
Q

Amiodarone Adverse Effects

A 
Hypotension
N&V
Diaphoresis
Lightheadedness
Brady-dysrhythmias
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19
Q

Amoxicillin/clavulanic acid MOA

A

Broadspectrum beta-lactam antibiotic that inhibits production of bacterial cell walls causing cell death.
Clavulanic acid inhibits beta-lactamase enzyme from bacteria, reducing/ eliminating beta-lactam antibiotic resistant bacteria.

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20
Q

Amoxicillin/clavulanic acid Preparation

A

1g of amoxicillin + 200mg of clavulanic acid powder

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21
Q

Amoxicillin/clavulanic acid Indications

A

Sepsis >12yo + 1 high risk factor + greater than 30min to hospital
Cellulitis

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22
Q

Amoxicillin/clavulanic acid Contraindications

A

Severe allergy to Penicillins

Anaphylactic to beta-lactam antibiotics

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23
Q

Amoxicillin/clavulanic acid Precautions

A

Nil

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24
Q

Amoxicillin/clavulanic acid Doses

A

1.2g IV into a running line over 1-2min

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25
Amoxicillin/clavulanic acid Onset
30-60min
26
Amoxicillin/clavulanic acid Duration
6-8hr
27
Amoxicillin/clavulanic acid Adverse Effects
Nil
28
Aspirin MOA
NSAID that inhibits the production of COX, decreasing prostaglandin production, creating analgesic, anti-inflammatory, anti-pyretic, & anti-platelet effects
29
Aspirin Preparation
300mg tablets
30
Aspirin Indication
MI
31
Aspirin Contraindication
3rd trimester of pregnancy
32
Aspirin Precautions
Known worsening of bronchospasm with NSAIDs Known bleeding disorder Clinically significant bleeding
33
Aspirin Dose
300mg
34
Aspirin Onset
30-60min
35
Aspirin Duration
The life of the platelet, 3-5 days
36
Aspirin Adverse Effects
Bronchospasm in pts with COPD/Asthma Chronic use- indigestion, GI ulceration, & bleeding Increases activity of Warfarin
37
Ceftriaxone MOA
Broadspectrum cephalosporin antibiotic that inhibits bacterial cell wall synthesis, leading to cell death
38
Ceftriaxone Preparation
1g/2g powder
39
Ceftriaxone Indication
Suspected meningococcal septicaemia
40
Ceftriaxone Dose
2g IV/IM
41
Ceftriaxone Contraindication
Anaphylaxis to cephalosporins
42
Ceftriaxone Precaution
Nil
43
Ceftriaxone Onset
30-60min
44
Ceftriaxone Duration
24hrs
45
Ceftriaxone Adverse Effects
Nil
46
Droperidol MOA
Central dopamine & alpha receptor antagonist, resulting in sedation, reduced agitation, and a state of mental detachment
47
Droperidol Preparation
2.5mg 1ml
48
Droperidol Indication
>12yo with agitated delirium causing mild-moderate risk to safety when Olanzapine has not been administered/ has been ineffective.
49
Droperidol Contraindication
Nil
50
Droperidol Precautions
Parkinsons Concurrent administration of other sedatives Intoxication Elderly/frail
51
Droperidol Dose
10mg IM/IV Reduce to 5mg if frail Repeat once after 20/60
52
Droperidol Duration
4-6hrs
53
Droperidol Onset
5-10min
54
Droperidol Adverse Effects
Hypotension- especially if IV dose administered rapidly
55
Fentanyl MOA
Opiate receptor agonist in the brain & spinal cord causing analgesia
56
Fentanyl Preparation
100mcg 2mls
57
Fentanyl Indication
Moderate-severe pain CPO with severe anxiety Symptom control during end of life care
58
Fentanyl Contraindications
Unable to obey commands | Current respiratory depression
59
Fentanyl Precautions
<1yo High risk of respiratory depression Labor
60
Fentanyl Doses
10-50mcg IV @3-5/60 100mcg IN <80kg repeat 50mcg @10/60 200mcg IN >80kg repeat 100mcg @10/60
61
Fentanyl Onset
2-5min IV -max analgesic & resp effects may take 10-15min | 5-10min IN
62
Fentanyl Duration
30-60min
63
Fentanyl Adverse Effects
``` Respiratory depression Bradycardia Hypotension Sedation N&V Itch Euphoria ```
64
Gentamicin MOA
Aminoglycoside antibiotic with broad activity against gram-negative bacteria. Inhibits bacterial cell protein synthesis causing cell death.
65
Gentamicin Preparation
80mg 2ml
66
Gentamicin Indication
Sepsis where infection is urinary, abdo, or unknown, >12yo + 1 high risk factor + greater than 30min to hospital
67
Gentamicin Contraindication
Pregnancy
68
Gentamicin Precautions
Nil
69
Gentamicin Doses
<60kg 240mg (x3 amps) 60-80kg 320mg (x4 amps) >80kg 400mg (x5 amps) Diluted to 10-20mls and given into running IV line over 1-2min
70
Gentamicin Onset
30-60min
71
Gentamicin Duration
24hrs
72
Gentamicin Adverse Effects
Nil
73
GTN MOA
Universal vasodilator that causes peripheral blood pooling, decreasing venous return & preload. Decreasing ventricular filling & cardiac output. Decreasing myocardial work & oxygen demand.
74
GTN Preparation
0.4mg doses | TTS 10 patch 0.5mg per hr
75
GTN Indications
MI CPO HTN associated with autonomic dysreflexia Patch if not responding to SL doses in CPO or AD
76
GTN Contraindications
SBP <100 HR <40 HR >150 VT
77
GTN Precautions
``` Frail Inferior STEMI or STEMI involving R ventricle Poor perfusion Dysrhythmia ED medication in last 24hrs Known aortic/mitral stenosis ```
78
GTN Doses
MI- 0.4mg CPO- 0.8mg AD- 0.4-0.8mg repeat @3-5min
79
GTN Onset
1-2min SL | 10-20min TTS
80
GTN Duration
15-30min SL in some pts BP effects last several hrs | 18hrs TTS but dissipate 10-20min once removed
81
GTN Adverse Effects
``` Hypotension Headache Tachycardia Light-headed Flushing ```
82
Glucagon MOA
Stimulates glycogenolysis & gluconeogenesis in the liver. Stored glycogen breaks down into glucose.
83
Glucagon Preparation
1mg powder
84
Glucagon Indication
Hypoglycaemia when pt can't swallow or no IV access
85
Glucagon Contraindication
Nil
86
Glucagon Precautions
Will be ineffective if pt has undergone strenuous exercise, not eaten food for >12hrs, has adrenal insufficiency, chronic hypoglycaemia, or alcohol-induced hypoglycaemia
87
Glucagon Dose
>5yo 1mg IM | <5yo 0.5mg IM
88
Glucagon Onset
5-10min
89
Glucagon Duration
15-60min
90
Glucagon Adverse Effects
Nil
91
Glucose MOA
Simple carbohydrate readily absorbed (10% & oral) -hypertonic solution Vehicle for drug delivery (5%) -isotonic solution
92
Glucose Preparation
10-20g sachet 500ml 10% bag 100ml 5% bag
93
Glucose Indication
Hypoglycaemia & Crush Injury (10%) | Gentamicin & Sodium Valproate (5%)
94
Glucose Contraindication
Nil
95
Glucose Precaution
Nil
96
Glucose Dose
``` 10-20g oral 100ml IV hypo 500ml 10% IV crush Gentamicin admin pts >20kgs 5% Valproate admin 5% ```
97
Glucose Onset
Immediate
98
Glucose Duration
Short
99
Glucose Adverse Effects
Necrosis if not flushed well
100
Ibuprofen MOA
Non-selective NSAID that inhibits prostaglandin production & release, causing analgesic & anti-pyretic effects
101
Ibuprofen Preparation
200mg tablets | 20mg/ml syrup
102
Ibuprofen Indication
Pain
103
Ibuprofen Contraindication
3rd trimester of pregnancy
104
Ibuprofen Precautions
``` Taken in the last 4hrs Abdo pain- especially if unwell or vomiting >75yo Dehydrated or shocked Known renal impairment Known bleeding disorder Clinically significant bleeding Known worsening of bronchospasm with NSAIDS Taking Warfarin Pregnancy ```
105
Ibuprofen Doses
>80kgs 600mg (x3 tablets) | <80kgs 400mg (x2 tablets)
106
Ibuprofen Onset
30-60min
107
Ibuprofen Duration
4hrs
108
Ibuprofen Adverse Effects
``` N&V Epigastric pain Indigestion Diarrhoea Bloating Ulcers- with chronic use ```
109
Ipratropium MOA
Anticholinergic agent with long lasting beta2 effects. It inhibits the parasympathetic response by antagonizing acetylcholine binding. This results in bronchodilation & decreased mucosal plugging
110
Ipratropium Preparation
0.5mg 2ml
111
Ipratropium Indication
Bronchospasm secondary to asthma/COPD/ | airway burns/smoke inhalation/chest infection in conjunction with Salbutamol
112
Ipratropium Contraindications
Nil
113
Ipratropium Precautions
Nil
114
Ipratropium Dose
0.5mg once
115
Ipratropium Onset
2-5min
116
Ipratropium Duration
6hrs
117
Ipratropium Adverse Effects
``` Nausea Dry mouth Blurred vision (existing glaucoma) Tachycardia Palpitations ```
118
Ketamine MOA
N-methyl-d-aspartate (NMDA) receptor antagonist, inhibits excitatory neurotransmitters in the brain
119
Ketamine Preparation
200mg 2ml
120
Ketamine Indication
Severe pain- especially musculoskeletal or burns if uncontrolled by an opiate
121
Ketamine Contraindication
<1yo
122
Ketamine Precautions
``` Unable to obey commands Active psychosis HTN Conditions that may be worsened by HTN MI Concurent sedatives Elderly/frail ```
123
Ketamine Doses
>80kgs 30mg IV 50-80kgs 20mg IV 0.5mg/kg IM/PO
124
Ketamine Onset
1-2min IV 5-10min IM 10-20min PO
125
Ketamine Duration
10-60min
126
Ketamine Adverse Effects
``` HTN Tachycardia Apnoea N&V Sedation Hallucinations ```
127
Lignocaine MOA
Local anaesthetic that blocks initiation & transmission of nerve impulses by blocking the movement of Na+ ions across cell membranes
128
Lignocaine Preparation
50mg 5ml
129
Lignocaine Indication
IV pain Ring blocks IO bone pain associated with NaCl infusion
130
Lignocaine Contraindications
Local infection at injection site
131
Lignocaine Precautions
Pts taking anticoagulants
132
Lignocaine Doses
1-2ml blebs either side of digit | 50mg IO
133
Lignocaine Onset
1-2min for IV pain | 5-10min for ring block
134
Lignocaine Duration
30-60min
135
Lignocaine Adverse Effects
Stinging
136
Loratadine MOA
Long acting selective peripheral H1 receptor antagonist that blocks the action of histamine, decreasing itching, redness, & hives
137
Loratadine Preparation
10mg tablets
138
Loratadine Indication
Minor allergic reactions confined to skin involvement | Prominent itch associated with anaphylaxis
139
Loratadine Contraindication
<1yo
140
Loratadine Precautions
Pregnancy
141
Loratadine Doses
>11yo 10mg | <11yo 5mg
142
Loratadine Onset
30-60min
143
Loratadine Duration
12-24hrs
144
Loratadine Adverse Effects
Nil
145
Methoxyflurane MOA
GABA receptor antagonist with analgesic effects on the CNS
146
Methoxyflurane Preparation
3ml
147
Methoxyflurane Indications
Pain
148
Methoxyflurane Contraindications
Unable to obey commands pHx or fHx of malignant hyperthermia Known renal impairment Had in the last week
149
Methoxyflurane Precautions
>75yo Pre-eclampsia Confined space
150
Methoxyflurane Doses
3ml | Adult max of 6ml, child max of 3ml
151
Methoxyflurane Onset
1-2min
152
Methoxyflurane Duration
2-5min after stopping administration
153
Methoxyflurane Adverse Effects
Drowsiness Lightheadedness Nausea Headache
154
Midazolam MOA
Benzodiazepine, GABA agonist at GABA receptors in CNS causing anticonvulsant activity, sedation, amnesia, anxiolysis, & muscle relaxation
155
Midazolam Preparation
15mg 3ml
156
Midazolam Indication
Prolonged seizures | Agitated delirium with risk to safety and Droperidol is ineffective or unavailable
157
Midazolam Contraindications
Nil
158
Midazolam Precautions
Concurrent use of opiates/sedatives Intoxication Elderly/frail
159
Midazolam Doses
``` Seizures: 5mg IV (3mg if frail) repeat once after 5/60 10mg IM (5mg if frail) repeat once after 10/60 ``` Agitated Delirium: 2-3mg IV (1-2mg if frail) repeat after 5/60 as required 10mg IM repeat once after 20/60
160
Midazolam Onset
2-3min IV | 3-5min IM
161
Midazolam Duration
30-60min
162
Midazolam Adverse Effects
Sedation Respiratory depression Hypotension Amnesia
163
Naloxone MOA
Opiate receptor antagonist that reverses the effects of opiates, especially respiratory depression and sedation
164
Naloxone Preparation
0.4mg 1ml
165
Naloxone Indication
Opiate overdose with altered level of consciousness or respiratory depression Excess adverse effects from opiate administration
166
Naloxone Contraindications
Nil
167
Naloxone Precautions
Chronic opiate use
168
Naloxone Doses
0. 1-0.4mg IV repeat after 5min | 0. 8mg IM repeat after 20min
169
Naloxone Onset
1-2min IV | 5-10min IM
170
Naloxone Duration
30-60min
171
Naloxone Adverse Effects
Sweating Tachycardia HTN
172
Olanzapine MOA
Atypical anti-psychotic, acts at multiple receptors in the brain causing a reduction in agitation, sedation, anxiolysis, and stabilization of mood
173
Olanzapine Preparation
5mg wafers
174
Olanzapine Indication
>12yo with agitated delirium and a risk to safety
175
Olanzapine Contraindication
Antipsychotic poisoning
176
Olanzapine Precaution
Pregnancy | Elderly
177
Olanzapine Dose
10mg (x2 wafers) (5mg if frail) repeat once after 20/60
178
Olanzapine Onset
10-20min
179
Olanzapine Duration
12-24hrs
180
Olanzapine Adverse Effects
Sedation
181
Ondansetron MOA
Antiemetic with selective 5HT receptor antagonism centrally in the brain and peripherally in the GI.
182
Ondansetron Preparation
4mg 2ml
183
Ondansetron Indication
Significant N&V
184
Ondansetron Contraindication
<1yo
185
Ondansetron Precautions
Nil
186
Ondansetron Doses
8mg IV 4mg IM One IV dose may be administered in addition to one IM dose if N&V persists, max 12mg
187
Ondansetron Onset
2-5min IV | 5-10min IM
188
Ondansetron Duration
4-8hrs
189
Ondansetron Adverse Effects
Headache Flushing Metallic taste
190
Oxytocin MOA
Stimulates oxytocin receptors on the uterus causing increased uterine contraction and reducing blood loss from the uterus
191
Oxytocin Preparation
10units 1ml
192
Oxytocin Indication
Following normal birth | PPH
193
Oxytocin Contraindications
Nil
194
Oxytocin Precautions
Nil
195
Oxytocin Doses
10units IM
196
Oxytocin Onset
5-10min
197
Oxytocin Duration
30-60min
198
Oxytocin Adverse Effects
Abdominal cramping Tachycardia Flushing
199
Paracetamol MOA
Inhibits the production of prostaglandins resulting in a reduction in pain and fever
200
Paracetamol Preparation
500mg tablet | 50mg/ml syrup
201
Paracetamol Indication
Pain
202
Paracetamol Contraindications
Nil
203
Paracetamol Precautions
Taken in the last 4hrs Abdo pain, especially if unwell with vomiting Known severe liver disease
204
Paracetamol Doses
>80kg 1.5g (x3 tablets) | 50-80kg 1g (x2 tablets)
205
Paracetamol Onset
10-20min
206
Paracetamol Duration
4-6hrs
207
Paracetamol Adverse Effects
Nil
208
Prednisone MOA
Prednisone is a prodrug that is metabolised to prednisolone in the liver. Prednisolone is a corticosteroid with anti-inflammatory and immunosuppressant actions. It inhibits the production of inflammatory mediators, including prostaglandins and leukotrienes, resulting in a reduction in the inflammatory and immune response.
209
Prednisone Preparation
20mg tablets | 5mg/ml syrup
210
Prednisone Indications
Bronchospasm associated with Asthma/COPD Croup Prominent rash associated with anaphyalxis Minor allergy associated with rash
211
Prednisone Contraindications
Nil
212
Prednisone Precautions
<5yo with asthma
213
Prednisone Dose
40mg (x2 tablets)
214
Prednisone Onset
30-60min
215
Prednisone Duration
24hrs
216
Prednisone Adverse Effects
``` Reflux N&V Dizziness Headache HTN ```
217
Salbutamol MOA
Short acting beta2 adrenergic receptor agonist causing smooth muscle bronchodilation & sympathomemetic effects
218
Salbutamol Preparation
5mg 2.5ml
219
Salbutamol Indication
Bronchospasm associated with asthma/COPD/airway burns/smoke inhalation/chest infection Release syndrome following crush injury
220
Salbutamol Contraindications
Nil
221
Salbutamol Precautions
Nil
222
Salbutamol Doses
5mg
223
Salbutamol Onset
2-5min
224
Salbutamol Duration
1-2hrs
225
Salbutamol Adverse Effects
Tremor Tachycardia Tachydysrhythmias Headache
226
Tranexamic acid MOA
Anti-fibrinolytic that blocks the conversion of plasminogen to plasmin, reducing fibrinolysis & bleeding
227
Tranexamic acid Preparation
1g 10ml
228
Tranexamic acid Indications
Postpartum Haemorrhage Hypovolaemia from uncontrolled bleeding Other form of bleeding severe enough to cause hypovolaemia requiring IV NaCl
229
Tranexamic acid Contraindications
Trauma when TXA will be administered 3hrs after time of injury
230
Tranexamic acid Precautions
Nil
231
Tranexamic acid Dose
1g IV
232
Tranexamic acid Onset
30-60min
233
Tranexamic acid Duration
8hrs
234
Tranexamic acid Adverse Effects
Nil
235
Sodium Valporate MOA
Anticonvulsant that blocks Na+ channels & enhances activity of GABA at GABA receptors in the CNS
236
Sodium Valporate Preparation
400mg powder
237
Sodium Valporate Indication
Status epilepticus that has not responded to x2 doses of midazolam
238
Sodium Valporate Contraindication
Nil
239
Sodium Valporate Precaution
Nil
240
Sodium Valporate Doses
1.2g IV (x3 amps)
241
Sodium Valporate Onset
10-20min
242
Sodium Valporate Duration
6-12hrs
243
Sodium Valporate Adverse Effects
Nil

Paramedic Drugs (2 decks)

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