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DTPS Flashcards

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1
Q

Adrenaline Indications

A
  • Anaphylaxis OR severe allergic reaction
  • Severe life-t)hreatening bronchospasm OR silent chest (patient must be only able to speak in single words AND/OR have haemodynamic compromise AND/OR an ALOC
  • Bradycardia with poor perfusion (unresponsive to atropine AND/OR TCP
  • Cardiac arrest - Croup (with stridor at rest)
  • Shock unresponsive to adequate fluid resuscitation (excluding haemorrhagic cause)
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2
Q

Adrenaline Contraindications

A

Nil

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3
Q

Adrenaline Precautions

A
  • Hypertension
  • Hypovolaemic shock
  • Concurrent MAOI therapy
  • Multiple sclerosis
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4
Q

Adrenaline Side effects

A
  • Anxiety
  • Hypertension
  • Palpitations/tachyarrhythmias
  • Pupil Dilation
  • Tremor
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5
Q

Adrenaline Onset

A

IV - 30 seconds

IM - 60 seconds

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6
Q

Adrenaline Duration

A

5-10 minutes

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7
Q

Adrenaline Half-life

A

2 minutes

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8
Q

Adrenaline Adult Dosage

Anaphylaxis OR severe allergic reaction

A
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9
Q

Adrenaline

Adult Dosage

Severe Life Threatening Bronchospasm OR Silent Chest

A
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10
Q

Adrenaline

Adult Dosage

Bradycardia with poor perfusion (Unresponsive to Atropine AND/OT TCP)

A
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11
Q

Adrenaline

Adult Dosage

Cardiac Arrest

A
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12
Q

Adrenaline

Adult Dosage

Shock unresponsive to adequate fluid resuscitation (excluding haemorrhagic cause)

A
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13
Q

Amiodarone Indications

A

Cardiac Arrest (Refractory VF or pulseless VT)

Sustained conscious VT (haemodynamically stable)

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14
Q

Amiodarone Contraindications

A
  • Cardiac Arrest (Refractory VF or pulseless VT)
  • Nil
  • Sustained Conscious VT (haemodynamically stable)
  • KSAR or hypersensitivity
  • severe conduction disorders (unless pacemaker or AICD in situ)
  • Current amiodarone therapy
  • Current anti-arrhythmic therapy that prolonges QT interval
  • Pregnancy and/or lactation
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15
Q

Amiodarone Precautions

A

Cardiac arrest

  • concurrent anti-arrhythmic therapy that prolongs QT interval
  • thyroid disease

Sustained conscious VT

  • hypotension
  • thyroid disease
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16
Q

Amiodarone Side Effects

A

Hypotension

Bradycardia

Nausea and/or vomitting

Peripheral paresthesia

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17
Q

Amiodarone Onset

A

5 minutes

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18
Q

Amiodarone Duration

A

30 minutes

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19
Q

Amiodarone Half-Life

A

14-110 days (with chronic dosing)

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20
Q

Amiodarone Schedule

A

S4 (Restricted drugs)

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21
Q

Amiodarone Adult Dosages

Cardiac Arrest

A
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22
Q

Amiodarone Adult Dosages

Sustainded conscious VT

A
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23
Q

Aspirin Indications

A

Suspected ACS

Acute cardiogenic Pulmonary Oedema

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24
Q

Aspiring Contraindications

A

KSAR or hypersensitivity to aspirin or other NSAIDs

Chest pain associated with psychostimulant overdose

Bleeding OR clotting disorder

Current GI bleed or peptic ulcers

Patients <18 years

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25
Aspirin Precautions
Possible aortic aneurysm, or other condition that may require surgery Pregnancy History of GI bleeds or peptic ulcers Current anticoagulant therapy (e.g. warfarin)
26
Aspirin Side Effects
Epigastric pain / discomfort Nausea and/or vomiting Gastritis GI bleed NSAID induced bronchospasm
27
Aspirin Onset
approx. 10 minutes
28
Aspirin Duration
approx. 1 week
29
Aspirin Schedule
S2 (therapeutic poisons)
30
Aspirin Adult Dosage
31
Atropine Indications
Bradycarda (with poor perfusion) Envenomation (with increased parasympathetic activity) Hypersalivation (secondary to ketamine administration) Organophosphate toxicity (with cardiac AND/OR respiratory compromise
32
Atropine Contraindications
KSAR or hypersensitivity to atropine
33
Atropine precautions
Atrial flutter Atrial fibrillation AMI Glaucoma
34
Atropine Side Effects
Agitation Hallucinations Dilated Pupils Dry mouth/ dry skin/ reduced bronchial and gastric secretion Tachycardia
35
Atropine Onset
1-2 minutes | (peak 15-50 minutes)
36
Atropine Duration
Up to 5 hours
37
Atropine Schedule
S4 (restricted drugs)
38
Atropine Adult Dosages Bradycardia
39
Atropine Adult Dosages Envenomation
40
Atropine Adult Dosages Hypersalivation
41
Atropine Adult Dosages Organophosphate toxicity
42
Ceftriaxone Indications
Suspected meningococcal septicaemia (with a non-blanching petchial AND/OR purpuric rash)
43
Ceftriaxone Contraindication
KSAR or Hypersensitivity to cephalosporin drugs Known anaphylaxis or severe allergice reaction fo penicillin based drugs - (isolated minor drug rash attributed to penicillin does not contraindicate the use of ceftriaxone)
44
Ceftriaxone Precuation
Nil
45
Ceftriaxone Side effects
Nausea AND/OR vomiting Pain at the IM administration site
46
Ceftriaxone Presentation
Vial (powder), 1g ceftriaxone
47
Ceftriaxone Onset Duration Half Life
Dose/route variable Duration: approx. 1 day Half Life: 5.8-8.7 hours
48
Ceftriaxone Schedule
S4 (restricted drugs)
49
Ceftriaxone Adult Dose
50
Fentalyn Indications
* Severe Pain * Sedation (for maintenance of an established ETT) * Autonomic dysreflexia (with significant BP 160 mmHg)
51
Fentanyl Contraindications
KSAR or hypersensitivity to fentanyl
52
Fentanyl Precautions
* Respiratory Tract burns * Respiratory depression and/or failure * Known addiction to narcotics * Current MAOI therapy * Elderly patients * Hypotension
53
Fentanyl Side Effects
* Bradycardia * Hypotension * Drowsiness * Nausea and/or vomiting * pin point pupils * Respiratory depression * Muscular rigidity (particularly muscles of respiration.
54
Fentanyl Onset/Duration/Half Life
Onset: \<3 minutes Duration: 30-60 minutes Half Life: 2-3 hours
55
Fentanyl Schedule
S8 (controlled drug)
56
Fentanyl Adult Dosage Severe Pain
57
Fentanyl Adult Dosage Severe Pain Autonomic dysreflexia (Severe Hypertension BP 160 Hgmm)
58
Fentanyl Adult Dosage Sedation (for maintenance of existing ETT)
59
Glucagon Indications
Symptomatic hypoglycaemia (with inability to self administer oral glucose)
60
Glucagon Contraindications
KSAR of hypersensitivity to glucagon
61
Glucagon Precautions
Nil
62
Glucagon side effects
Nil
63
Glucagon Onset/Duration/Half Life
Onset: 4-7 minutes Duration: Variable Half-Life: 3-6 minutes
64
Glucagon Schedule
S3 (therapeutic poison)
65
Glucagon Adult Dosage
66
Glyceryl trinitrate Indications
Suspected ACS with Pain Acute cardiogenic pulmonary oedema Irukandji syndrome (with systolic BP greater than or equal to 160 mmHg) Autonomic dysreflexia (with systolic BP greater than or equal to 160 mmHg)
67
GTN contraindications
KSAR or hypersensitivity to GTB HR \< 50 or \>150 SBP \<100 Acute CVA Head trauma Phosphodiesterase Inhibitor medication administration in previous 24 hours
68
GTN Precautions
Phosphodiesterase inhibitor medication administration in previous 48 hours Suspected inferior AMI Cerebral vascular disease Risk of hypotension or syncope Intoxication (GTN effects enhances)
69
GTN side effects
Dizziness Syncope Hypotension Reflex tachycardia Vascular headaches
70
GTN Onset/Duration/Half-Life
Onset: \<2 minutes Duration: 20-30 minutes Half-Life: 5.5 minutes
71
GTN Schedule
Sublingual: S3 (therapeutic poisons) Ampoule: S4 (restricted drugs)
72
GTN Dosages
73
Hydrocortisone Indications
* Moderate or Severe Asthma * Acute exacerbation of COPD (with evidence of respiratory distress) * Severe allergic reaction OR anaphylaxis (requiring adrenaline administration) * Symptomatic adrenal insuficiency (with a known history of Adison's disease, congenital adrenal hyperplasia, pan-hypopertuitarism or long-term steroid administration)
74
Hydrocortisone Contraindications
KSAR or hypersensitivity to hydrocortisone
75
Hydrocortisone Precautions
Hypertesion
76
Hydrocortisone Side effects
Nil
77
Hydrocortisone Onset/Duration/Side Effects
Onset: 1-2 hours Duration: 6-12 hours Half life: 6-8 hours
78
Hydrocortisone Schedule
S4 (restricted drugs)
79
Hydrocortisone Dosages
80
Ipratropium Bromide Indications
Moderate or Severe Bronchospasm
81
Ipratropium Bromide Contraindications
KSAR or hypersensitivity Patient \<2 yrs
82
Ipratropium bromide Precautions
Glaucoma
83
Ipratropium Bromide Side Effects
Dilated pupils Dry mouth Plpitations
84
Ipratropium Bromide Onset/Duration/Half-life
Onset: 1.5-3 minutes Duration: 4-6 hours Half-Life: 3 hours
85
Ipratropium bromide Schedule
S4
86
Ipratropium Bromide Adult Dosages
87
Ketamine Indications
* Severe traumatic Pain (following 0.1-0.2 mg/kg of morphine OR 1-2 mcg/kg fentanyl) associated iwth: * Fracture reduction and splinting * Multiple significant fractures requiring facilitated extrication * patients with splinted fractures requiring ongoing narcotic analgesia for transport requirements * Severe traumatic pain associated with burns (following 0.2-0.3 mg/kg morphine OR 2-3 mcg/kg fentanyl AND 1-2 mg (adult or 0.05mcg/kg (paediatric) midazolam) * Induction of anaeshtesia * Ongoing traumatic pain unresponsiv eto narcotics (following 0.2-0.3 mg/kg morphine OR 2-3 mcg/kg Fentanyl)
88
Ketamine Contraindications Analgesia
* KSAR or hypersensitivity * Age \<1 yr * GCS 12 or less * Uncontrolled hypertension (SBP 180mmHg or less AND/OR DBP 110 mmHg or less) * Suspected acute ACS or acute heart failure * Known Hydrocephalus or raised intraocular pressure
89
Ketamine Contraindications Induction of anaethsesia
KSAR or Hypersensitivity
90
Ketamine Precautions
* Age \>65 * Patients hwo have been administered midaolam or other CNS depressant medications * Patients with significant hypovolaemia (exaggerated effects and a delayed onset of action) * Globe injuries * Complex facial injuries and fractures * Patients who have imparied respiratory function * Patients exhibiting psychotic symptoms
91
Ketamine Side Effects
* Dissociation and trance-like state * transient hypertonicity and nystagmus * disinhibition * emergence * hypertension * tachycardia * depression of consciousness * hypersalivation * nausea and/or vomiting * laryngospam * respiratory depression (rare)
92
Ketamine Onset/Duration/Half Life Schedule
Onset: 30 seconds Duration 5-20 minutes Half Life: 10-15 minutes Schedule: S8 (controleld drugs)
93
Ketamine Adult Dosages Severe Traumatic Pain
94
Ketamine Adult Dosage Severe traumatic pain associated with burns
95
Ketamine Adult Dosages Induction for Anaesthesia
96
Lignocaine Indications
* Pain associated with IO drug and fluid administration following EZ-IO needle insertion * Local anaesthesia * radial artery line placeent * fish hook removal
97
Lignocaine Contraindications
KSAR or hypersensitivity to Lignocaine
98
Lignocaine Precautions
Inadvertent intravascular injection
99
Lignocaine Side effects
Convulsions Hypotension Nausea Tinnitus
100
Lignocaine Onset/Duration/Half Life Schedule
Onset: 1-3 minutes Duration: 20-30 minutes Half life: 1-2 hours Schedule: S4 (Restricted drugs)
101
Lignocaine Dosages
102
Magnesium Sulphate Indications
* Box jellyfish (Chironex fleckeri) evenomation (unresponsive to antivenom threapy) * Eclampsia * Irukandji sydrome (with intractable pain unreleived 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)
103
Magnesium Sulphate conraindications
* KSAR or hypersensitivity to magnesium sulphate * AV block * Renal failure
104
Magnesium Sulphate Precautions
Renal impairment
105
Magnesium Sulphate Side Effects
* Pain at cannulation site * Magnesium toxicity * hypotension/respiratory depression * loss of deep tendon reflexes
106
Magnesium Sulphate Onset/Duration/Half Life Schedule
Onset: immediate Duration: 30 minutes Half-life: variable Schedule: unscheduled
107
Magnesium Sulphate Adult Dosages Torsades do pointes
108
Magnesium Sulphate Adult Dosage Box Jellyfish
109
Magnesium Sulphate Adult Dosage Irukandji Syndrome
110
Magnesium Sulphate Adult Dosage Eclampsia
111
Methoxyfleurane Indications
Pain
112
Methoxyfleurane Contraindications
* KSAR or hypersensitivity * Patient \<1 yr * History of significat liver or renal disease * History of malignant hyperthermia
113
Methoxyfleurane Precautions
ALOC Intoxicated or drug affected patients
114
Methoxyfleurane side effects
ALOC Cough Renal/hepatic failure (following repeated high dose exposure)
115
Methoxyfleurane Onset/Duration/Half-Lfe Schedule
Onset: 1-3 minutes Duration: 5-10 minutes Half-life: not available Schedule: S4 restricted drugs
116
Methoxyfleurane Adult Dosage
117
Morphine Indications
* Significiant pain * Autonomic dysreflexia (with systolic BP \>160mmHg) * Sedation for the maintenance of an established ETT
118
Morphine Contraindications
KSAR or hypersensitivity to morphine Renal failure
119
Morphine Precautions
* Elderpy patient * hypotension * respiratory tract burns * respiratory depression and/or failure * known addiction to narcotics * concurrent MAOI therapy * Cardiac chest pain
120
Morphine Side effects
* Hypotension * Drowsiness * Nausea/vomiting * Bradycardia * Pin point pupils * Respiratory depression
121
Morphine Onset/Duration/Half-life Schedule
Onset: (IM) 5-10 minutes (peak 20-30 minutes) (IV) 2-5 minutes (peak 20 minutes) Duration: 1-2 hours Half-life: 2 hours Schedule: S8 controlled drugs
122
Morphine Adult Dosages Significant Pain (ACP1)
123
Morphine Adult Dosage Significant Pain Autonomic Dysreflexia
124
Morphine Adult Dosages Sedation
125
Naloxone Indications
Respiratory depression (secondary to administration of narcotic drugs)
126
Naloxone Contraindications
KSAR or hypersensitivity to naloxone
127
Naloxone Precautions
Use with caution on patients with preexisting cardiac disease
128
Naloxone side effects
* Narcotic reversal can cause combativeness, vomiting, sweating, tachycardia and hypertension * May produce acute withdrawal convulsions in the chronic narcotic user * Pulmonary oedema
129
Naloxone Onset/Duration/Half-life Schedule
Onset: 3-5 min (IM)/1-3 min (IV) Duration; approx. 60 min Half-life: 60 min Schedule: 24 (restricted drugs
130
Naloxone Adult Dosage
131
Ondansetron Indications
Nausea and/or vomiting Prophylactic administration for patients presenting with ACS
132
Ondansetron contraindications
* KSAR to ondansetron or other 50HY3 receptor antagonists * Congenital long QT syndrome * Patient \<3 years
133
Ondansetron precautions
Hepatic impairment Intestinal obstruction Patients with risk factors for QT interval prologation or cardiac arrythmias
134
Ondansetron Side Effects
Headache Constipation Sensation of warmth or flushing Dysrhythmias
135
Ondansetron Onset/Duration/Half-life
Onset: 5 minutes Duration: several hours Half-life: 3-4 hours Schedule: S4 (restricted drugs)
136
Ondansetron Adult Dosages
137
Paracetamol Indications
Minor pain Fever (causing distress)
138
Paracetamol Contraindications
KSAR of hypersensiticity to paracetamol Patient \< 1 month old
139
Paracetamol side effects
Nausea
140
Paracetamol Onset/Duration/Half Life Schedule
Onset: 10-60 minutes Duration: 4 hours Half-life: approx. 2 hours Schedule S2 (therapeutic poison)
141
Paracetamol Adullt Dosage
142
Salbutamol Indications
Bronchospasm Suspected hyperkalaemia (with QRS widening AND/OR AV dissociation
143
Paracetamol Contraindications
KSAR or hypersensitivity to salbutamol Patient \< 2 years
144
Salbutamol Precautions
Acute Pulmonary oedema Ischaemic heart disease
145
Salbutamol Side effects
Anxiety Tachyarrythmia Tremors Hypokalaemia and metabolic acidosis
146
Salbutamol Onset/Duration/Half Life
Onset: 2-5 minutes (NEB)/1-3 minutes (IV) Duration: 16-60 minutes (NEB)/10-20 minutes (IV Half Life: 1.6 hours
147
Salbutamol adult dosages Bronchospasm
148
Salbutamol adult dosages Suspected hyperkalaemia
149
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