Term
|
Definition
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Term
|
Definition
An analgesic, anti inflammatory, anti pyretic and anti platelet agent.
Actions : reduce platelet aggregation and thrombin formation in acute coronary syndrome. |
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Term
| Aspirin primary emergency indications |
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Definition
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Term
| Aspirin contraindications (5) |
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Definition
hypersensitivity
Actively bleeding peptic ulcer
Bleeding disorders
Suspected dissecting aortic aneurysm |
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Term
|
Definition
Hx peptic ulcer
Asthma
Concurrent anticoagulant medication |
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Term
|
Definition
Children are contraindicated even for fever control (Reye's syndrome).
anti platelet effect last for life of affected platelets 8 - 10 days |
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Term
|
Definition
1 : 1000 (1mg in 1ml)
1 : 10000 (1mg in 10ml) |
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Term
|
Definition
A naturally occurring alpha and beta adrenergic stimulant.
Actions:1) ^ pulse by ^ SA node firing rate
2) ^AV node conduction velocity
3) ^force myocardial contractions
4) ^ ventricular irritability
5) peripheral vasoconsctriction
6) bronchodilatation |
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Term
|
Definition
| Converted to salicylic acid in gut mucosa and liver, excreted kidneys |
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Term
| ADRENALINE indications (10) |
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Definition
1) Unconscious Pulse less VT / VF
2) Asystole
3) PEA
4) inadequate perfusion cardiogenic
5) inadequate perfusion not cardiac or volume
6) bradycardia
7) anaphylaxis
8) severe asthma
9) unconscious asthma
10) croup |
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Term
|
Definition
| Metabolised by mono amine oxidase and other enzymes in blood at end of adrenergic cells |
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Term
|
Definition
Heartburn, nausea, GIT bleed
Increased bleeding time
Hypersensitivity reactions |
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Term
| ADRENALINE contraindications |
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Definition
| Hypovolaemic shock without adequate fluid replacement |
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Term
| ADRENALINE precautions (4) |
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Definition
1) Elderly patients
2) Cardiovascular disease
3) Patients on MAO inhibitors - lower doses needed
4) patients on beta blockers - higher doses needed |
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Term
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Definition
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Term
| ADRENALINE side effects (7) |
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Definition
Sinus tachycardia
ventricular arrhythmias
Supraventricular arrhythmias
Palpitations/ anxiety
Hypertension
Pupil dilatation
May increase infarction size |
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Term
| ADRENALINE intravenous times |
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Definition
Onset: 30 secs
Peak: 3 - 5 mins
Duration: 5 - 10 mins |
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Term
| ADRENALINE intramuscular times |
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Definition
Onset : 30 - 90 secs
Peak: 4 - 10 mins
Duration: 5 - 10 mins. |
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Term
| Adrenaline dose and repeat timing in cardiac arrest (adult & child) |
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Definition
1mg dose IV repeat every 3 mins
Child 10 mcg/ kg IV every 3 mins |
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Term
| Adrenaline dose and repeat times asthma (unable to obtain IV access for salbutamol) |
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Definition
0.3 mg IM repeat at 20 mins
Maximum 3 doses.
Child 10mcg/ kg IM, repeat at 20 mins, maximum 3 doses.
repeat 20 mins Maximum 3 doses |
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Term
| Adrenaline dose and repeat times for croup |
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Definition
| 5mg nebulised, repeat 5 minutely |
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Term
| Adrenaline dose - inadequate perfusion cardiogenic |
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Definition
| infusion 5mcg/ min - adjust each 2 minutes OR 10 mcg IV bolus, repeat up to 50 - 100 mcg each 2 minutes as needed |
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Term
| Adrenaline dose - inadequate perfusion not cardiac/ hypovolaemia |
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Definition
| infusion 5mcg/ min - adjust each 2 minutes OR 10 mcg IV bolus, repeat up to 50 - 100 mcg each 2 minutes as needed |
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Term
| Adrenaline dose anaphylaxis |
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Definition
Moderate 0.3mg IM repeat 5/60 as needed
Severe :50 mcg IV, repeat each 1 minute up to 100 mcg as needed |
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Term
| Adrenaline dose bradycardia |
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Definition
| infusion 5mcg/ min - adjust each 2 minutes to max 20mcg/ min OR 10 mcg IV bolus, repeat 10 mcg each 2 minutes as needed |
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Term
|
Definition
0.6 mg in 1ml
1.2mg in 1ml |
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Term
|
Definition
An anticholinergic agent
Actions: Inhibits the action of acetycholine on post ganglionic cholinergic nerves at the neuro effector site
e.g vagal blocker allows sympathetic effect to ^ pulse rate
ALSO antidote to reverse the effect of cholinesterase inhibitors (e.g. organophosphate poisoning) |
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Term
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Definition
| Liver and excreted by kidneys |
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Term
|
Definition
1) Bradycardia with poor perfusion
2) Organophosphate poisoning with excessive cholinergic effects |
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Term
| Atropine Contraindications |
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Definition
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Term
|
Definition
1) atrial flutter (risk ^tachycardia)
2) atrial fibrilation (risk ^tachycardia)
3) Do not increase HR to >100 unnless child <6yrs
4) Glaumcoma (^ intraoccular pressure) |
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Term
|
Definition
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Term
| Atropine side effects (8) |
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Definition
1) tachycardia
2) Palpitations
3) Dry mouth
4) Dilated pupils
5) Visual blurring
6) Urine retention
7) confusion/ restless (in large doses)
8) Hot dry skin (large doses) |
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Term
|
Definition
Onset < 2 mins
Peak < 5 mins
Duration 2 - 6 hrs |
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Term
| Atropine doses bradycardia |
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Definition
600mcg IV
in 3-5 mins if no response repeat 600mcg ONCE - total max 1.2mg |
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Term
| Atropine doses organophosphate poisoning |
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Definition
1.2mg IV
Repeat each 5 mins as needed |
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Term
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Definition
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Term
|
Definition
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Term
|
Definition
| excreted unchanged in urine (33-67%) and bile |
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Term
|
Definition
1) suspected meningococcal septicaemia
2) Severe sepsis (consult) |
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Term
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Definition
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Term
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Definition
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Term
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Definition
Nausea & vomiting
Skin rash |
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Term
| Ceftriaxone special notes |
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Definition
IV dilute to 10ml with 9.5ml H20, administer ovwe 2 mins
IM dilute to 4ml with 3.5ml 1% lignocaine |
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Term
|
Definition
Adult 1 gram
Child 50mg/ kg |
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Term
| Dexamethasone presentation |
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Definition
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Term
| Dexamethasone pharmacology |
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Definition
| a corticosteroid. Action : to relieve inflammaatory process and provide immunosupression |
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Term
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Definition
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Term
|
Definition
1) bronchospasm not relieved by salbutamol
2) anaphylaxis
3) acute exacerbation COPD |
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Term
| Dexamethasone contraindications |
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Definition
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Term
| Dexamethasone precautions |
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Definition
| if contaminated/ not clear solution - discard |
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Term
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Definition
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Term
| Dexamethasone side effects |
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Definition
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Term
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Definition
onset 30-60 mins
peak 2 hrs
duration 36-72 hrs |
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Term
| Dexamethasone special note |
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Definition
| has no antimicrobial agent - use immediately and discard |
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Term
| Dexamethasone dose (adult & child) |
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Definition
8mg (all indications)
child 600mcg/ kg (MAX 12mg) |
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Term
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Definition
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Term
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Definition
isotonic crystalloid
compostion H20 and dextrose (5%)
ACTION small source of energy and body water |
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Term
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Definition
Dextrose broken down in most tissues - stored in liver and muscle as glycogen
Water excreted kidneys, distributed thru total body water - mostly extracellular |
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Term
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Definition
| dilution vehicle for IV drugs |
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Term
| Dextrose 5% contraindications |
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Definition
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Term
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Definition
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Term
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Definition
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Term
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Definition
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Term
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Definition
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Term
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Definition
| 50g in 500mls infusion soft pack (or 25g in 250mls) |
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Term
| Dextrose 10% pharmacology |
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Definition
slightly hypertonic solution composing H2O and dextrose 10%
ACTION source of energy and supplies body water |
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Term
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Definition
Dextrose broken down in most tissues, stored as glycogen in liver and muscles
H2O excreted by kidneys, distributed thru total body water, mostly extracellular |
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Term
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Definition
| Diabetic hypoglycaemia (BSL < 4mmol/l) with ALOC, unable to take oral |
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Term
| Dextrose 10% contraindication |
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Definition
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Term
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Definition
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Term
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Definition
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Term
| Dextrose 10% side effects |
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Definition
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Term
| Dextrose 10% effect times |
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Definition
onset 3 minutes
peak -
duration depends on severity of hypo |
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Term
| Dextrose 10% dose (adult & child) |
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Definition
adult 150 mls - reassess after 3 mins, repeat with 100ml if needed
child 3mls/ kg, reassess after 3 mins, repeat with 2ml/ kg if needed |
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Term
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Definition
100mcg in 2ml
600mcg in 2ml (IN only) |
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Term
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Definition
A synthetic narcotic analgesic.
ACTIONS CNS depression (analgesia) resp depression (apnoea) dependance, also decrease conduction velocity thru AV node |
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Term
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Definition
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Term
|
Definition
1) analgesia (IV/ IN)
2) sedation to facilitate intubation (RSI)
3) sedation to maintain ETT
4) drug facilitated intubation (IFS) |
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Term
| Fentanyl contraindications (2) |
|
Definition
known hypersensativity
IV amiodarone |
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Term
|
Definition
1) elderly
2) impaired renal/ hepatics
3) resp depression/ COPD
4) current asthma
5) MAO inhibitors (thought that fentanyl ^production of NA, leads to hyperdynamic CVS)
6) known narcotic addiction
7) oral amiodarone
8) rhinitits/ facial trauma (IN only) |
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Term
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Definition
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Term
| Fentanyl side effects (4) |
|
Definition
1) respiratory depression
2) apnoea
3) diaphragm/ intercostal rigidity
4) bradycardia |
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Term
|
Definition
schedule 8 under poison's act
respiratory depression can be reversed with naloxone
100mcg Fentanyl = 10mg morphine |
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Term
|
Definition
IN peak - 2 mins
IV onset immediate
IV peak <5 mins
IV duration 30-60 mins |
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Term
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Definition
100mcg (full dose) IV
50mcg (half dose) for |
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Term
| Fentanyl full dose for RSI |
|
Definition
| 100mcg for age <60 with BP >100 |
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Term
| Fentanyl half dose for RSI is 50mcg. Who is this for? |
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Definition
age <60yrs 80-100 OR BP >100 AND HR >100 with TBI
age >60yrs with BP >80 |
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Term
| Fentany 1/4 dose for RSI is 25mcg is a consideration - who for? |
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Definition
| BP <80 regardless of age (note all these pts should recieve only 1mg midazolam) |
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Term
| Fenatanyl dose for analgesia (adult) |
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Definition
| 25 - 50 mcg repeats 5/60 as needed |
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Term
| Fentanyl IN for analgesia (adult) |
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Definition
<60 yrs AND >60kg - 200mcg, repeat 100mcg/ kg twice at 5/60 as needed (400mcg max)
>60yrs OR <60kg - 100mcg repeat 50mcg twice at 5/60 as neeed (200mcg max) |
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Term
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Definition
2mcg/ kg, repeat 1mcg/kg twice at 5/60
>25kg use the 600mcg/ 2ml
25 kg or less = use 100mcg/2ml vial |
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Term
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Definition
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Term
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Definition
| A diuretic with actions to cause venous dilatation & reduce venous return AND promotes diuresis |
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Term
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Definition
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Term
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Definition
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Term
| Frusemide contraindications |
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Definition
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Term
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Definition
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Term
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Definition
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Term
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Definition
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Term
|
Definition
| effect of vasopressors may decrease after frusemide |
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Term
| Frusemide intravenous times |
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Definition
onset 5mins
peak 20 - 60mins
2 - 3 hours |
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Term
|
Definition
| 20-40mg OR pt's usual daily dose max 100mg |
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Term
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Definition
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Term
|
Definition
hormone normally secreted by pancreas
Actions: ^BSL by converting liver and muscle glycogen to glucose |
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Term
|
Definition
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Term
|
Definition
| BSL <4.0 unable to take oral glucose |
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Term
| Glucagon contraindications |
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Definition
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Term
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Definition
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Term
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Definition
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Term
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Definition
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Term
|
Definition
| not effective if no stored glycogen |
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Term
|
Definition
onset 3-5 mins
duration 12-25 mins |
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Term
| Glucagon dose (adult & child) |
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Definition
>25 kg = 1mg
<25 kg = 0.5mg |
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Term
|
Definition
| 0.6mg tablets OR 50mg patch (releases 0.4mg/hr) |
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Term
|
Definition
vascular smooth muscle relaxant
causes decrease pre and afterload.
Therefore reduce O2 demand, reduce BP, mild collateral dilatation, mild tachycardia
In pre-term labour goves uterine quiecense |
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Term
|
Definition
1) chest pain associated with ACS
2) Acute LVF
3) hypertension associated with ACS
4) autonomic dysreflexia
5) pre-term labour (consult) |
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Term
| GTN contraindications (9) |
|
Definition
1)Known hypersensativity
2) HR > 150
3) HR < 50 (except autonomic dysreflexia)
4) VT
5) BP < 110 (S/L)
6) BP < 90 (patch)
7) Inferior infarct with BP <160
8) RVI
9) viagra/ levitra in last 1/7, cialis in last 4/7 |
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Term
|
Definition
1) no prior administration
2) elderly
3) recent AMI
4) concurrent use of tocolytics |
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Term
|
Definition
S/L
patch
infusions for IHT's |
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Term
|
Definition
1) tachycardia
2) hypotension
3) headache
4) skin flushing
5) bradycardia |
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Term
|
Definition
tight storage conditions (light and heat sensative), replace after 1/12. Do use pt's own.
Men and women can be prescribed PED 5's, ask all patients |
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Term
|
Definition
S/L onset - 30 secs - 2mins
peak 5-10 mins
duration 15-30mins
Patch onset up to 30mins
peak - 2hrs
IV onset 30-60 secs
peak 3-5 mins
duration
15-30mins |
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Term
|
Definition
no previous admission = 300mcg repeat 5mins as needed
otherwise 600mcg repeated each 5/60 as needed |
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Term
|
Definition
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Term
|
Definition
| anticholinergic bronchodilator |
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Term
|
Definition
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Term
|
Definition
| severe respiratory distress associated with bronchospasm |
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Term
| atrovent contraindication |
|
Definition
| allergy to atropine or derivatives |
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Term
|
Definition
glaucoma
avoid contact with eyes |
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Term
| atrovent side effects (7) |
|
Definition
1) headache
2) nausea
3) dry mouth
4) skin rash
6) tachycardia
7) palpitations
8) acute angle glaucoma |
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Term
|
Definition
adverse effects due to eye contact have been reported - ensure well fitted mask
nebulise with salbutamol |
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Term
|
Definition
adult - 500mcg ONCE
child - 250mcg ONCE |
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Term
|
Definition
onset 3-5 mins
peak 1.5-2hrs
duration 6hrs |
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Term
| lignocaine 1% presentation |
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Definition
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|
Term
| lignocaine 1% pharmacology |
|
Definition
| local anaesthetic (sodium channel blockade) |
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Term
|
Definition
| liver (90%), excreted by kidneys |
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Term
| lignocaine 1% indications (2) |
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Definition
1) ceftiaxone dilutent for IM injection
2) IO insertion in responsive pt |
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Term
| lignocaine 1% precautions |
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Definition
beware not to be given IV
hypotension
chronic LVF |
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Term
|
Definition
|
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Term
| lignocaine 1% side effects - CNS (7) |
|
Definition
drowsiness
disorientation
decreased hearing
blurred vision
speech changes
twitching and agitation
convulsions |
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Term
| lignocaine 1% side effects - CVS (4) |
|
Definition
hypotension
bradycardia
sinus arrest
AV block |
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Term
| lignocaine 1% side effects respiratory (2) |
|
Definition
difficuly breathing
respiratory arrest |
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Term
|
Definition
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Term
|
Definition
| A synthetic adrenergic stimulant with primary alpha effects |
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Term
|
Definition
| by monoamine oxidase and other enzymes in blood, liver and around nerve endings, excreted by kidneys |
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Term
| Metaraminol indication (2) |
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Definition
1) SVT associated ith inadequate perfusion but systolic BP >100
2) inadequate to extreme poor perfusion due to combined GTN and viagra/ cialis |
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Term
| Metaraminol contraindication |
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Definition
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|
Term
| Metaraminol precautions (2) |
|
Definition
1) can cause tissue necrosis, avoid extravasation
2) Do not raise BP above 90-100 systolic |
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Term
|
Definition
|
|
Term
| Metaraminol side effects (3) |
|
Definition
sinus tachycardia
ventricular arrhythmias
hyertension |
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|
Term
|
Definition
onset 1-2 mins
peak 10 mins
duration 20 mins |
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|
Term
| Metaraminol dose and repeats |
|
Definition
0.5mg over 1 minute
repeat each 2 mins until BP <100
total max = 5mg |
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|
Term
| Methoxyflurane presentation |
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Definition
|
|
Term
| Methoxyflurane pharmacology |
|
Definition
| Inhalational analgesic at low concentrations |
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|
Term
| Methoxyflurane metabolism |
|
Definition
| by liver, excreted mainly by lungs |
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|
Term
| Methoxyflurane inidcations |
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Definition
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|
Term
| Methoxyflurane contraindication (3) |
|
Definition
1) pre-existing renal disease/ impairment
2) concurrent tetracycline AB's
3) exceedinf 6mls in 24hrs |
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Term
| Methoxyflurane precautions (2) |
|
Definition
1) must be hand held and self admnistered by patient so inhaler will fall from face if unconsciouness occurs
2) pre-eclampsia |
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|
Term
|
Definition
| self administered inhalation via the penthrox inhaler with/ without O2 supplementation |
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|
Term
| Methoxyflurane side effects (3) |
|
Definition
drowsiness
hypotension/ bradycardia (rare)
exceeding 6ml in 24 hrs =potential for renal toxicity |
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|
Term
| Methoxyflurane special notes |
|
Definition
priming volume = 3ml whih should last approx 25mins, further 3 mls may be given if needed.
Analgesia occures after 8-10 breaths and will last 3-5 mins after ceasing |
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Term
| Metoclopromide presentation |
|
Definition
|
|
Term
| Metoclopromide pharmacology |
|
Definition
Antiemetic which accelarates gastric emptying and peristalsis
Mild SHT3-receptor antagonist |
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|
Term
| Metoclopromide metabolism |
|
Definition
| By liver, excreted kidneys |
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|
Term
| Metoclopromide indications (7) |
|
Definition
Nausea/ vomiting associated with
1) ACS
2) opioids
3) cytotoxic meds/ radiotherapy
4) previously Dx migrane
5) severe gastroenteritis
Treatment or prophylaxis in awake spinal trauma
Eye trauma |
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|
Term
| Metoclopromide contraindications (3) |
|
Definition
1) Children
2) susptect bowel obstruction or perforation
3) GI bleed |
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|
Term
| Metoclopromide precautions (3) |
|
Definition
1) adolescents (<20yrs age)
2) undiagnosed abdo pain
3) give over 1/60 to avoid extrapyramidal reactions |
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|
Term
|
Definition
|
|
Term
| Metoclopromide side effects(5) |
|
Definition
drowsiness
lethargy
dry mouth
muscle tremor
exttrapyramidal reactions - esp. distonic types |
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|
Term
| Metoclopromide special notes |
|
Definition
not effective in estanlished motion sickness
not effective as prophylaxis in setting of opioid administration |
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|
Term
|
Definition
IV onset 1-3 mins
IV duration 10-30 mins
IM onset 10-15mins
IM duration 1-2 hours |
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|
Term
| Metoclopromide dose and repeat |
|
Definition
| 10mg, repeat 10mg after 10/60 if needed. Max total = 20mg |
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|
Term
|
Definition
5mg in 1ml amp
15mg in 3ml amp |
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|
Term
| Midazolam pharmacology (and 3 effects) |
|
Definition
A short acting CNS depressant with actions of
1) reducing anxiety
2) sedative
3) anti-convulsant |
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Term
|
Definition
|
|
Term
| Midazolam indications (8) |
|
Definition
1) continuous/ recurrent seizures
2) sedation to maintain ETT
3) sedation to enable intubation (IFS)
4) RSI
5) sedation to enable synchronised cardioversion
6) sedate the agitated patient
7) sedate the psychostimulant OD
8) convulsions assiciated with lignocaine toxicity |
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|
Term
| Midazolam contraindications |
|
Definition
| known hypersensativity to bezodiazepines |
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|
Term
| Midazolam precautions (4) |
|
Definition
1) elderly, CRF, CCF, shock - lower dose needed
2) CNS effects enhanced by other tranquilisers including ETOH/ narcotics
3) can cause severe respiratory depression in COPD
4) myasthenia gravis |
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Term
|
Definition
|
|
Term
| Midazolam side effects (4) |
|
Definition
depressed level of consciousness
respiratory depression
loss of airway control
hypotension |
|
|
Term
|
Definition
| not permit to sedate pts already recommended for transport under MHA - must be given by Dr or RN |
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Term
|
Definition
IM onset 3-5mins
IM peak 15mins
IM duration 30mins
IV onset 1-3 mins
IV peak 10mins
IV duration 20mins |
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Term
|
Definition
| 0.1mg/ kg (max 10mg) repeat after 10/mins once only |
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|
Term
|
Definition
<60yrs age 0.1mg/ kg (max 10mg)>60 OR BP <100 0.05mg/kg
seizures - repeat once after 10mins
agitation - repeat @ 10 mins, max 4 doses |
|
|
Term
| Midazolam IV for seizures (child & adult) |
|
Definition
5mins after 1st IM dose (0.1mg/kg IM)
IV 0.05mg/kg. total max dose repeats each 2-5/60(combined IM & IV =0.25mg/kg) |
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Term
| Midazolam to maintain ETT for child dose |
|
Definition
15 into 15mls with
1) 15mg morphine OR (1ml = 1mg each drug)
2) 300mcg Fentanyl (1ml = 1mg midaz & 20mcg fent)
both run at 0.2-0.2 ml/hr (0.1-0.2 mg/kg/hr of midaz)
IF NO INFUSION AVAIL. 0.1mg/kg IV |
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|
Term
| Midazolam to maintain ETT in adult dose |
|
Definition
infusion in 30mls mixed with either
1) morphine 30mg OR
2)) fentanyl 300mcg
run at 1-10ml/hr
IF NO INFUSION AVAIL - 0.5-5mg IV |
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|
Term
| Midazolam sedate to IFS/ RSI adult and child |
|
Definition
child - 1st pre-hydrate 10ml/kg
0.2mg/kg IV (with fentanyl 2mcg/kg OR morph 0.2mg/kg)
adult prehydrate 10ml/kg except APO
IV midaz 0.1mg/kg (half dose for age >60 yrs BP 80-100) 1mg only if BP <80 |
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|
Term
| Midazolam sedate to cardiovert dose |
|
Definition
with fentanyl 25mcg ONCE
midaz 2.5mg repeats at 2/60 until no response to voice |
|
|
Term
|
Definition
|
|
Term
| Morphine pharmacology (with x5 CNS effects and x2 CVS affects) |
|
Definition
a narcotic analgesic with CNS and CVS actions
1) CNS depression leading to analgesia
2) respiratory depression
3) cough reflex depression
4) stimulation of mood/ euphoria
5) dependance/ addiction
6) vasodilatation
7) decrease AV node conduction velocity |
|
|
Term
|
Definition
|
|
Term
|
Definition
1) pain relief
2) acute LVF with SOB and full field crackles
3) sedate to intubate (IFS)
4) sedate to maintain ETT
5) RSI |
|
|
Term
| Morphine contraindications (2) |
|
Definition
1) known hypersensativity
2) late 2nd stage labour |
|
|
Term
|
Definition
1) elderly
2) hypotension
3) respiratory depression
4) current asthma
5) respiratory tract burns
6) known addiction to narcotics
7) alcohol intoxication
8) pt's on MAO inhibitors (risk CVS overdrive) |
|
|
Term
|
Definition
|
|
Term
| Morphine side effects (CNS x6 CVS x2) |
|
Definition
1) drowsiness
2) respiratory depression
3) euphoria
4) nausea/ vomiting
5) pin-point pupils
6) addiction
7) hypotension
8) bradycardia |
|
|
Term
|
Definition
is a schedule 8 under Poisons Act
effect can be reversed with Naloxone
occasional wheals in veins used for IV - Not an allergy, is mild histamine release |
|
|
Term
|
Definition
IV onset 2-5 mins
IV peak 10 mins
IV durattion 1-2 hours
IM onset 10-30 mins
IM peak 30-60 mins
IM duration 1-2 hrs |
|
|
Term
| Morphine dose pain relief child |
|
Definition
IM 0.1mg/kg
IV 0.05-0.1mg/kg
repeat 5-10/60 0.05mg/kg.
consult after total 0.2mg/kg IV |
|
|
Term
| Morphine dose pain relief adult |
|
Definition
Up to 5mg IV, repeat each 5/60 as needed
IM <60kg= 0.1mg/kg ONCE
IM >60kg= 10mg, repeat 5mg ONCE @ 15/60 |
|
|
Term
| Morphine infusion to maintain ETT adult |
|
Definition
30mg in 30mls with midaz 30mg
run @ 1-10 ml/hr |
|
|
Term
| Morphine dose in acute LVF |
|
Definition
| IV 1-2mg IF alert and conscious |
|
|
Term
|
Definition
0.4mg in 1ml
2mg in 5ml pre-prepared syringe |
|
|
Term
|
Definition
| a narcotic antagonist - action of reversing effects of narcotics |
|
|
Term
|
Definition
|
|
Term
|
Definition
| Altered conscious state + respiratory depression associated with narcotic use |
|
|
Term
| Naloxone contraindicataions |
|
Definition
|
|
Term
|
Definition
1) if pt known narcotic dependant prepare for combative pt
2) neonates |
|
|
Term
|
Definition
|
|
Term
| Naloxone side effects (5) |
|
Definition
Symptoms of narcotic withdrawl
1) sweating, gooseflesh, tremor
2) nausea/ vomiting
3) agitation
4) pupil dilatation, excessive lacrimation
5) convulsions |
|
|
Term
| Naloxone special notes (6) |
|
Definition
1) 1/2 life shorter tha many narcotics - readministration may be needed
2) has no narcot effect itself
3) post narcotic related cardiac arrest NO NALOXONE
4) post head injury NO NALOXONE
5) if mother had narcotics in 1hr prior to delivery and baby respiratory depressed, consult for Naloxone
6) in absence of narcotic drugs Naloxone has no effect |
|
|
Term
|
Definition
IM and IV same
onset 1-3 mins
duration 30-45 mins |
|
|
Term
| Normal Saline presentation |
|
Definition
10ml amp
500ml/ 1000ml infusion soft pack |
|
|
Term
| Normal Saline pharmacology |
|
Definition
| isotonic crystalloid containing water and sodium & chloride |
|
|
Term
|
Definition
water - distributed thru total body water, excreted kidneys
electrolytes - excreted kidneys |
|
|
Term
| Normal Saline indications (5) |
|
Definition
1) fluid replacement in volume depleted patients
2) volume expansion in NON CARD/ NON HYPOVOLAEMIC pts eg burns, sepsis, snaphylaxis
3) fluid challenge in unresposive NOT HYPOVOLAEMIC pts other than LVF eg. asthma/ PEA
4) drug dilutent for IV drugs
5) fluid TKVO |
|
|
Term
| Normal Saline contraindications |
|
Definition
|
|
Term
| Normal Saline precautions |
|
Definition
|
|
Term
|
Definition
|
|
Term
| Normal Saline side effects |
|
Definition
|
|
Term
| Normal Saline special notes |
|
Definition
|
|
Term
| Normal Saline to pre-hydrate for IFS/ RSI |
|
Definition
|
|
Term
| Normal Saline dose inadequate perfusion NOt CARD/ NOT HYPOVOLAEMIC (sepsis) |
|
Definition
20ml/ kg over 30 mins.
repeat to total 40-60ml/kg) |
|
|
Term
| Naloxone dose (adult & child)and repeat |
|
Definition
adult 1.6-2.0 mg IM
10/60 later if needed further 0.8mg IM OR IV
child 10mcg/ kg (max 2mg)IM. repeat same dose after 10/60 IM OR IV if needed |
|
|
Term
| Normal Saline dose hypovolaemia |
|
Definition
20ml/kg, repeat if
BP remains <100 & HR > 100
after 40ml/ kg consult for further 20ml/ kg
Child same |
|
|
Term
| Normal Saline burns (adult) |
|
Definition
for burns >15%
% burn area x pt weight kgs= volume needed in first 2hrs from burn time
eg. 80kg x 20% = 1600ml in first 2 hrs |
|
|
Term
Normal Saline hyperthermia
(>40.0 degrees) |
|
Definition
| as per hypovolaemia using COLD fluid until temp <38.0 |
|
|
Term
| Normal Saline burns (child) |
|
Definition
% BSA > 15%
3 x total BSA x pt weight = total vol in 1st 24 hours.
give 1/2 this in 1st 8hrs.
eg. 1yr old 10kg, 20% burns =
(3 x 20%) x 10
=600ml total fluid/ 24hrs
=300ml in fist 8hrs |
|
|
Term
|
Definition
|
|
Term
|
Definition
a non-depolarising neuromuscular blocker
Actions - blockes impule transmission at neuromuscular junction of striated muscles resulting in skeletal paralysis.
Weak vagolytic activity may cause slight ^HR and MAP |
|
|
Term
|
Definition
| kidneys, excreted mainly unchanged in urine |
|
|
Term
|
Definition
| to maintain paralysis and allow mechanical ventilation in intubated pt's who needed IFS or RSI. |
|
|
Term
| Pancuronium contraindications (2) |
|
Definition
1) only give if all monitoring is available
2) status epilepticus |
|
|
Term
| Pancuronium precautions (5) |
|
Definition
1) ensure IV patency
2) sedatives must be given 1st
3) ensure all monitoring working
4) myasthenia gravis pt's will need less dose, monitor for ^neuromuscular block
5) care with renal impairment |
|
|
Term
|
Definition
|
|
Term
| Pancuronium side effects (3) |
|
Definition
1) slight ^HR
2) slight ^MAP
3) local reaction at injection site (rare) |
|
|
Term
| Pancuronium special notes |
|
Definition
allergy including analphylaxis, urticaria, laryngeal oedema, bronchospasm all been reported.
May be needed for IHT |
|
|
Term
|
Definition
onset 2-3 mins
peak 8-10 mins
duration
35-45 mins |
|
|
Term
| Pancuronium dose (adult & child) |
|
Definition
adult 8mg - repeat as needed.
child 0.1mg/ kg repeat as needed |
|
|
Term
| Prochlorperazine presentation |
|
Definition
|
|
Term
| Prochlorperazine pharmacology |
|
Definition
| an antiemetic which acts on several central neurotransmitter systems |
|
|
Term
| Prochlorperazine metabolism |
|
Definition
|
|
Term
| Prochlorperazine indications (5) |
|
Definition
treatment or prophylaxis of nausea/ vomiting for
1) motion sickness
2) planned aero-medical evactuation
3) known allergy to metoclopromide
4) severe headache (irresoective of N/V)
5) vertigo |
|
|
Term
| Prochlorperazine contraindications (4) |
|
Definition
1) circulatory collapse
2) CNS depression
3) hypersensativity
4) children |
|
|
Term
| Prochlorperazine precautions (3) |
|
Definition
1) hypotensionn
2) epilsepsy
3) alcohol/ antidepressants |
|
|
Term
|
Definition
|
|
Term
| Prochlorperazine side effects (6) |
|
Definition
1) drowsiness
2) blurred vision
3) hypotension
4) sinus tachycardia
5) skin rash
6) extrapyramidal reactions (usually dystonic) |
|
|
Term
|
Definition
onset 20mins
peak 40mins
duration 6hrs |
|
|
Term
|
Definition
|
|
Term
|
Definition
5mcg in 2.5ml neb
500mcg in 1 mlamp
5mg in 5ml amp |
|
|
Term
|
Definition
| a synthetic beta-adrenergic stimulant (primary B2) causing bronchodilatation |
|
|
Term
|
Definition
|
|
Term
| Salbutamol indications (6) |
|
Definition
respiratory distress with suspected bronchospasm in
1) asthma
2) pulmonary oedema (non-card)
3) severe allergy
4) COPD
5) smoke inhallation
6) capsicum spray exposure |
|
|
Term
| Salbutamol contraindications |
|
Definition
|
|
Term
| Salbutamol precautions (2) |
|
Definition
1) between doses maintain 02
2) large doses IV may cause intracellular acidosis |
|
|
Term
|
Definition
neb
IV (and infusion)
ETT
pMDI |
|
|
Term
| Salbutamol side effects (5) |
|
Definition
sinus tachycardia
muscle tremor |
|
|
Term
|
Definition
IV has no advantage to IV if ventilating OK
nebs have short life once packet opened
infusions may be needed for IHT of pre-term labour |
|
|
Term
|
Definition
neb onset 5-15mins
duration 15-50mins
IV onset 1-2 mins
duration 30-60 mins |
|
|
Term
|
Definition
MDI 4x puffs each4/60 as needed
neb: 10mg, repeat 5mg as needed each 5/60
IV 250mcg IV, repeat 125 mcg each 5/60 as needed (max 500mcg)
IV infusion 15mcg/ min (1mg in 50mls) = 45mls/ hr |
|
|
Term
|
Definition
MDI 4x puffs each 4/60
neb 10mg, repeat 5mg as needed each 5/60
IV 5mcg/ kg - repeat 2.5mcg/kg 2-3/60 as needed to max 10mcg/kg
IV infusion 2mcg/kg/min
(made of 100mcg/ kg to 50mls = 60ml/hr) |
|
|
Term
| Sodium Bicarbonate 8.4% presentation |
|
Definition
| 50ml in pre-prepared syringe |
|
|
Term
| Sodium Bicarbonate 8.4% pharmacology |
|
Definition
| hypertonic crystalloid containing bicarbonate ions in solution of high pH. Action to raise pH |
|
|
Term
| Sodium Bicarbonate 8.4% metabolism |
|
Definition
excreted by kidneys
Bicarbonate is part excreted kidneys, and lungs excrete CO2 |
|
|
Term
| Sodium Bicarbonate 8.4% indications (2) |
|
Definition
1) reduce acidosis after 15/60 ambulance CPR
2) symptomatic tricyclic antidepressant OD |
|
|
Term
| Sodium Bicarbonate 8.4% contraindications (1) |
|
Definition
| severe hypothermia (<30 degrees) |
|
|
Term
| Sodium Bicarbonate 8.4% precautions (3) |
|
Definition
1) must be accompanied with effective ventilation/ cardiac compressions in arrested patient
2) causes tissue necrosis
3) do not mix or flush with other drugs |
|
|
Term
| Sodium Bicarbonate 8.4% route |
|
Definition
|
|
Term
| Sodium Bicarbonate 8.4% side effects (2) |
|
Definition
sodium overload may provoke pulmonay oedema
excessive administration without ventialtion/ circulation may cause intracellular acidosis |
|
|
Term
| Sodium Bicarbonate 8.4% times |
|
Definition
onset 1-2mins
duration depends on pt condition and perfusion |
|
|
Term
| Sodium Bicarbonate 8.4% doses cardiac arrest (adult and child) |
|
Definition
adult = 50mls
child = 1ml/ kg |
|
|
Term
| Sodium Bicarbonate 8.4% doses TCA overdose (adult and child) |
|
Definition
adult 100ml over 3/ 60 - repeat after 10/60 if needed - consult thereafter.
Child 2ml/ kg over 3/60 - repeat after 10/60 if needed - consult thereafter. |
|
|
Term
| Suxamethonium presentation |
|
Definition
|
|
Term
| Suxamethonium pharmacology |
|
Definition
| A depolarising neuromuscular blocking agent with action of short acting muscle relaxant |
|
|
Term
|
Definition
| pseudo-cholinesterase in plasma |
|
|
Term
|
Definition
| complete muscle relaxation to allow ETT inubation (RSI) |
|
|
Term
| Suxamethonium contraindications (10) |
|
Definition
1) known hypersensativity
2) upper airway obstruction
3) severe respiratory distress
4) penetrating eye injury
5) ECG signs of high K+ (eg rhabdo, renal failure)
6) burns older than 24hrs
7) organophosphate poisoning
8) Ruptured AAA
9) known Hx suxamethonium apnoea
10) known Hx malignant hyperthermia |
|
|
Term
| Suxamethonium precautions (5) |
|
Definition
1) liver disease
2) elderly patients
3) crush injuroes
4) pt's not fasted
5) airway trauma |
|
|
Term
|
Definition
|
|
Term
| Suxamethonium side effects (4) |
|
Definition
muscle fasiculation
^ intraoccular pressure
^ intragastric pressure
^ serum K+ level |
|
|
Term
| Suxamethonium special notes |
|
Definition
1) sedation first
2) preceed with atropine 600mcg if BP <60
3) For children preceed with atropine 20mcg/ kg
4) a 2nd dose usually = profound bradycardia
5) needs refridgeration (or rotate weekly) |
|
|
Term
|
Definition
onset 20 - 40 secs
peak 60 secs
duration 4-6 mins |
|
|
Term
|
Definition
adult 1.5mg/ kg (rounded UP nearest 25). Max 150mg.
Child 1-2mg/kg (FLIGHT ONLY) |
|
|
Term
|
Definition
|
|
Term
|
Definition
Calcium antagonist/ antiarrythmic
with actions (Ca2+ channel blocker)
1) increase refractory period of AV node
2) dilates coronary arteries
3) decrease myocardial contractility
4) reduces peripheral resistance
5) effect of 3) and 4) = drop in BP |
|
|
Term
|
Definition
|
|
Term
|
Definition
| SVT with adequate/ borderline perfusion, but symptomatic but not responded to abdominal valsalva manouvre |
|
|
Term
| Verapamil contraindications (2) |
|
Definition
1) hhypotension
2) pt on beta blockers |
|
|
Term
| Verapamil precautions (3) |
|
Definition
1) partial AV block
2) LVF
3) concurrent chest pain cardiac nature |
|
|
Term
|
Definition
|
|
Term
| Verapamil side effects (5) |
|
Definition
hypotension
LVF
bradycardia
VF
asystole |
|
|
Term
|
Definition
onset 1-2 mins
peak 5-10 minis
duration 20-30 mins |
|
|
Term
|
Definition
SVT adequate perfusion
(> 30min transport, SOB with pain/ crackles)
5mg IV, then each minute 1mg further as needed, maximum 10mg. |
|
|
Term
|
Definition
|
|
Term
|
Definition
| a synthetic prostaglandin |
|
|
Term
|
Definition
| converted to Misoprotol Acid in blood, metabolised by tissues, excreted by kidneys |
|
|
Term
|
Definition
| Primary Post Partum Haemorrhage |
|
|
Term
| Misoprostol contraindications (2) |
|
Definition
1) allergy to prostaglandins
2) ensure multiple pregnancy excluded |
|
|
Term
| Misoprostol precaution (1) |
|
Definition
|
|
Term
|
Definition
|
|
Term
| Misoprostol side effects (3) |
|
Definition
fever
shivering
abdo pain & diarrhoea |
|
|
Term
| Misoprostol special notes |
|
Definition
| side effects more likely @ doses >600mcg |
|
|
Term
|
Definition
onset 8-10 mins
duration 2-3hrs |
|
|
Term
|
Definition
|
|
Term
| Oxytocin (syntocinon) presentation |
|
Definition
|
|
Term
| Oxytocin (syntocinon) pharmacology |
|
Definition
| a synthetic oxytocic with action of stimulating smooth muscles of uterus to contract |
|
|
Term
| Oxytocin (syntocinon) metabolism |
|
Definition
|
|
Term
| Oxytocin (syntocinon)indications |
|
Definition
| Primary Post Partum Haemorrhage |
|
|
Term
| Oxytocin (syntocinon) contraindications (4) |
|
Definition
1) previous hypersensativity
2) severe toxaemia (pre-clampsia)
3) ensure NOT multiple pregnancy
4) cord prolapse |
|
|
Term
| Oxytocin (syntocinon) precautions (2) |
|
Definition
1) If given IV may cause transient hypotension
2) concurrent with methoxyflurane may cause hypotension |
|
|
Term
| Oxytocin (syntocinon) route |
|
Definition
|
|
Term
| Oxytocin (syntocinon) side effects (2) |
|
Definition
uncommon in IM
tachy/ brady cardia
nausea |
|
|
Term
| Oxytocin (syntocinon) special notes |
|
Definition
concomitant use with misoprostol may potentialte uterotonic effect
Store 2-8 degrees |
|
|
Term
| Oxytocin (syntocinon) times |
|
Definition
onset 2-4 mins
duration 30-60 mins |
|
|
Term
|
Definition
|
|
Term
|
Definition
| A class III anti-arrhythmic agent |
|
|
Term
|
Definition
|
|
Term
| Amiodarone emergency indications (2) |
|
Definition
1) VF/ pulseless VT refractory to cardioversion
2) Sustained/ recurrent VT |
|
|
Term
| Amiodarone Contraindications (arrest & conscious x3) |
|
Definition
In cardiac arrest - NIL
in awake pt
1) inadequate perfusion/ deteriorating rapidly
2) pregnant
3) TCA overdose |
|
|
Term
|
Definition
|
|
Term
| Amiodarone side effects (2) |
|
Definition
|
|
Term
|
Definition
onset 2 mins
peak 20 mins
duration 2 hours |
|
|
Term
|
Definition
Amiodarone is incompatable with saline - dilute with 5% dextrose only
May be needed for IHT |
|
|
Term
|
Definition
|
|
Term
|
Definition
| by adenosine deaminase in red blood cells and vascular epithelium |
|
|
Term
|
Definition
| a naturally occurring purine nucleoside found in all body cells. Actions: slows conduction thru AV node = termination of re-entry circuit activity involving the AV node (AVRT/ AVNRT) |
|
|
Term
|
Definition
| AVRT/ AVNRT with adequate or inadequate perfusion BUT NOT deteriorating rapidly |
|
|
Term
| Adenosine Contraindications (5) |
|
Definition
1) 2nd/ 3rd degree AV block
2) Atrial fibrillation
3) Atrial flutter
4) ventricular arrhythmias
5) known hypersensitivity |
|
|
Term
| Adenosine Precautions (2) |
|
Definition
1) may provoke bronchospasm in asthmatic pt.
2) adenosine is antagonised by methylxanthines (e.g. caffeine & theophylinne) and may not be effective in patients effect by these. |
|
|
Term
|
Definition
|
|
Term
| Adenosine side effects (6) |
|
Definition
All are usually brief and transient
1) dysrhythmia (incl asystole, bradycardia, ectopy)
2) chest pain
3) dyspnoea
4) headache/ dizziness
5) nausea
6) skin flushing |
|
|
Term
|
Definition
Adenosine has very short half life and should be administered thru a proximal vein
Duration < 10seconds. |
|
|
Term
|
Definition
| 6mg, repeat with 12mg twice each 2/60 if needed (total max dose = 3 doses) |
|
|
