medications Flashcards by jacob mcmahon

Adrenaline

Presentation

1mg: 1ml
1mg: 10ml

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Adrenaline

Pharmacology

Naturally occurring alpha & beta adrengic stimulant

Increasing HR increasing firing through SA node (beta 1)
Increasing conduction velocity through the AV node (beta 1)
Increased Myocardial contractility (beta 1)
Increased Ventricular irritability (beta 1)
Vasoconstriction (alpha)
bronchodilation (beta 2)

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Adrenaline

Primary emergency indication

Cardiac arrest (PEA, asystole, Pulseless VT or VF)
Inadequate perfusion (cardiogenic/non-cardiogenic)
Bradycardia with poor perfusion
Anaphylaxis
Croup - severe
Asthma- Unconscious with no BP, imminent life threat, not responding to nebulised treatment

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Adrenaline

Contraindications

Hypovolaemic shock without adequate fluid replacement

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Adrenaline

Precautions

Consider reduced doses for

Pts with cardiovascular disease
Pts on monoamine oxidase inhibitors
Elderly/frail pts

Consider higher doses for
- Pts on beta blockers

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Adrenaline

Side effects

Sinus tachycardia 
Hypertension 
Ventricular arrhythmias
Feeling of anxiety/palpations 
May increase size of Myocardial infarctions 
Pupil dilation
Supraventricular arrhythmias

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Adrenaline

Times

IV
Onset 30seconds
Peak 3-5minutes
duration 5-10minutes

IM
Onset 30-90seconds
Peak 4-10minutes
duration 5-10minutes

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Adrenaline

Metabolism

Metabolised by 
- monoamine oxidase and other enzymes in blood 
- liver 
- nerve endings 
excreted by kidneys

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Aspirin

Presentation

300mg

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Aspirin

Pharmacology

an analgesic, antiplatelet, anti-inflammatory, anti-pyretic

Works to minimise platelet aggregation & thrombus formation to retard the progression of coronary artery thrombus in ACS

Inhibit prostaglandin synthesis - anti-inflammatory actions

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Aspirin

Metabolism

convert to salicylate in gut mucosa & liver

excreted by kidneys

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Aspirin

Primary emergency indications

Acute coronary syndrome (ACS)

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Aspirin

Contraindications

Hypersensitivity
Actively bleeding peptic ulcer 
Bleeding disorders 
Chest pain associated with psychostimulant overdose with SBP >160mmHg 
Suspected dissecting aortic aneurysm

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Aspirin

Precautions

Peptic ulcer
Asthma
Pts on other anti-coagulates

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Aspirin

Side effects

Heartburn, nausea, gastrointestinal bleeding
Increased bleeding time
Hypersensitivity

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Aspirin

Times

Onset n/a
Peak n/a
Duration 8-10days

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Ceftriaxone

Presentation

1 g sterile powder in a glass vial

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Ceftriaxone

Pharmacology

cephalosporin antibiotic

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Ceftriaxone

Metabolism

excreted in urine & bile

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Ceftriaxone

Primary emergency indications

Meningococcal septicaemia 
Severe sepsis (consult only)

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Ceftriaxone

Contraindications

Allergy to cephalosporin antibiotics

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Ceftriaxone

Precautions

Allergy to Penicillin antibiotics

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Ceftriaxone

Side effects

Nausea
Vomiting
Skin rash

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Ceftriaxone

times

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Onset n/a
peak n/a
duration n/a

Dexamethasone Presentation

8mg: 2ml

Dexamethasone Pharmacology

Corticosteroid secreted by the adrenal cortex - relieves inflammatory reactions - immunosuppression

Dexamethasone Metabolism

metabolism - liver & other tissues excreted by the kidneys

Dexamethasone Primary emergency indications

Moderate - severe croup Adult stridor (non-foreign body) exacerbation of COPD Bronchospasm with acute respiratory distress not responding to nebulised salbutamol

Dexamethasone Contraindications

Known hypersensitivity

dexamethasone Precautions

Solutions that are - contaminated - discoloured

dexamethasone Side effects

nil of significance

Dexamethasone times

onset 30-60minutes peak 2hrs duration 36-72hrs

Dextrose Presentation

25g:250ml

Dextrose Pharmacology

``` Slightly hypertonic crystalliod solution contains - Sugar 10% - water provides body with source of energy supplies body water ```

Dextrose Metabolism

Dextrose - broken down in most tissues - stored in liver & muscle as glycogen water - excreted by kidneys - distributed throughout total body water, mainly in extracellular compartment

Dextrose Primary emergency indications

Hypoglycaemia with BGL below 4mmol, altered conscious state and unable to self administer oral glucose.

Dextrose Contraindications

Nil of significance

Dextrose Precautions

Nil of significance

Dextrose Side effects

Nil of significance

Dextrose Times

IV Onset 3minutes Peak n/a duration depends on severity

Fentanyl Presentation

100mcg: 2ml (IV) 250mcg: 1ml (IN)

Fentanyl Metabolism

metabolised by liver excrete by kidneys

Fentanyl Pharmacology

Synthetic opioid analgesic depression (analgesic) respiratory depression (apnoea) dependence (addiction) slows conduction through AV node (beta 1)

Fentanyl Primary emergency indications

``` Enable intubation (RSI) maintain intubation transcutaneous pacing synchronised cardioversion CPR interfering Pt ``` Analgesic - Contraindication for morphine - Hypersensitivity to morphine - Headache - Hypotension - Nausea & vomiting - Renal impairment/disease - short duration of action desirable

Fentanyl Contraindications

Late second stage labour | Hypersensitivity

Fentanyl Precautions

``` Elderly/ frail impaired hepatic function respiratory depression current asthma Pts on monoamine oxidase inhibitors Known addiction Pt with rhinitis, rhinorrhoea, facial trauma ```

Fentanyl Side effects

Respiratory depression Apnoea rigidity of diaphragm/intercostal muscles bradycardia

Fentanyl times

IV Peak immediate onset <5mins duration 30-60mins In Peak 2 minutes

Glucagon Presentation

1mg:1ml

Glucagon Pharmacology

A naturally occurring hormone secreted by the pancreas Works by converting stored glycogen in liver into glucose causing rise in BGL

Glucagon Metabolism

Metabolised by liver, kidneys, plasma

Glucagon Primary emergency indications

Hypoglycaemia with BGL below 4mmol, altered conscious state, unable to self administer oral glucose adult anaphylaxis in which pt remains hypotensive following adrenaline administration, with past history of heart failure or taking beta blocker medication

Glucagon Contraindications

Nil of significance

Glucagon Precautions

Nil of significance

Glucagon Side effects

Nausea | vomiting

Glucagon times

Peak 5 mins onset n/a duration 25mins

GTN Presentation

300mcg 600mch Patch 50mg (0.4mg per hr)

GTN Pharmacology

A vascular smooth muscles relaxant Venous dilation -

medications Flashcards

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