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182 Cards in this Set
- Front
- Back
Adrenaline: Indications |
Cardiac Arrest Anaphylaxis Life threatening asthma with failing ventilations and continued deterioration despite nebuliser therapy . |
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Adrenaline: Actions |
Sympathomimetic that stimulates alpha and beta adrenergic receptors. Enhances myocardial and cerebral blood flow during CPR. CPR becomes more effective due to increased peripheral resistance which improves perfusion pressures. |
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Adrenaline: Actions cont.... |
Reverses allergic manifestations of acute anaphylaxis. Relieves bronchospasm in acute sever asthma. |
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Adrenaline: Contra-indications |
Do not give repeat doses in hypothermic patients. |
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Adrenaline: Cautions |
Severe hypertension may occur in patients on beta blockers- half doses unless profound hypotension. Half dose for patients on tricyclic antidepressants. |
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Adrenaline: Dose |
Cardiac arrest- 1mg every 3-5 mins no max Anaphylaxis/ asthma- 500mcgm every 5 mins no max |
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Amiodarone: Indications |
Shockable rhythms if unresponsive to defib. |
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Amiodarone: Actions |
Antiarrhythmic; lengthens cardiac action potential and therefore effective refractory period. Prolongs QT interval.
Acts to stabilise and reduce electrical irritability of cardiac muscle. |
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Amiodarone: Contra-indications |
None in context of cardiac arrest. |
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Amiodarone: Dose |
3rd Shock- 300mg 5th Shock- 150mg Max 450mg |
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Aspirin: Indications |
Adults with: Clinical or ECG evidence suggestive of MI or ischaemia. |
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Aspirin: Actions |
Anti-platelet reduces clot formation. Analgesic, anti-pyretic and anti-inflammatory. |
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Aspirin: Contra- indications |
Haemophilia or other blood clotting disorders. Active GI bleed.
Known hypersensitivity. Severe hepatic disease. |
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Aspirin: Cautions |
Pregnancy Asthma Current treatment with anticoagulants Kidney/ liver failure Gastric or duodenal ulcer |
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Aspirin: Dose |
300mg oral |
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Atropine: Indications |
Absolute bradycardia heart rate <40 bpm Systolic BP below for expected age Inadequate perfusion causing confusion Paroxysmal ventricular arrhythmias requiring suppression |
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Atropine: Contra-indications |
Do not administer to hypothermic patients |
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Atropine: Actions |
May reverse effects of vagal overdrive May increase HR by blocking vagal activity in sinus brady or in 3rd degree Enhances AV conduction |
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Atropine: Dose |
600mcgm 3-5 mins max 3 mg |
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Benzylpenicillin: Indications |
Suspected menigococcal disease with: Non- blanching rash (petechial or purpuric) & S+S of menigococcal septicaemia. |
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Benzylpenicillin: Action |
Broad spectrum antibiotic |
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Benzylpenicillin: Contra- indications |
Severe allergy to penicillin more than a simple rash |
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Benzylpenicillin: Dose |
IV: 1.2gm in 19.2ml WFI
IM: 1.2gm in 3.2ml WFI |
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Chlorphenamine: Indications |
Severe anaphylaxtic reactions Symptomatic allergic reactions falling short of anaphylaxis but causing pt distress. |
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Chlophenamine: Actions |
Antihistamine that blocks the effects of histamine release during a hypersensitivity reaction. Anticholinergic properties |
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Chlophenamine: Contra-indications |
Known hypersensitivity Children under 1 |
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Chlophenamine: Cautions |
Hypotension Epilepsy Prostatic disease Glaucoma Hepatic disease |
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Chlophenamine: Dose |
IV- 10mg Oral- 4mg |
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Clopidogrel: Indications |
Acute STEMI- In pts not already taking clopidogrel Receiving thrombolytic treatment Anticipated thrombolytic treatment Anticipated PPCI |
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Clopidogrel: Actions |
Inhibits platelet aggregation |
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Clopidogrel: Contra-indications |
Breast feeding Active pathological bleed eg peptic ulcer Known allergy Severe liver impairment |
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Clopidogrel: Cautions |
Pregnancy Renal impairment NSAIDs |
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Clopidogrel: Dose |
Thrombolysis: 300mg PPCI: 600mg |
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Dexamethasone: Indications |
Moderate- Severe croup |
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Dexamethasone: Actions |
Corticosteriod that reduces subglottic imflammation |
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Dexamethasone: Cautions |
Do not cause distress to pt due to upper airway compromise |
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Dexamethasone: Dose |
1mnth- 12 mnths: 2mg 18mnths- 6 yrs: 4mg |
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Diazepam: Indications |
Fits longer than 5 mins + still fitting Repeated fits- not secondary to uncorrected hypoxia or hypoglycaemia Status epilepticus Eclamptic fits (>2-3 mins) Symptomatic cocaine toxicity (severe hypertension, chest pain or fitting). |
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Diazepam : Actions |
Central nervous system depressant, acts as an anticonvulsant and sedative. |
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Diazepam: Contra- indications |
None |
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Diazepam: Cautions |
Resp depression Alcohol, antidepressants or other CNS depressants- side effects more likely Recent does by cares ( max cumulative dose) |
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Diazepam: Dose |
Rectal- 10mg no repeat max 10mg 20mg no repeat max 10mg IV- 10mg, every 5 mins, repeat 10 mg, max 20mg |
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Entonox: Indications |
Moderate- sever pain Labour pains |
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Entonox: Actions |
Inhaled analgesic |
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Entonox: Contra- indications |
Severely disturbed psyc pts Head injury with LOC Diving in last 24hrs (bends) |
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Entonox: Cautions |
Suspects pneumothorax, pneumomediastinum or pneumoperitonem, eg polytrauma,penetrating torso inj. |
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Entonox: Dose |
PRN, 3-5 mins to be effective 5-10 max effect |
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Furosemide: Indications |
Pulmonary oedema 2nd to LVF |
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Furosemide: Actions |
Potentate diauretic with a rapid onset (within 30 mins) short lasting. |
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Furosemide: Contra-indications |
Pre-comatose state secondary to liver cirrhosis
Sever renal failure with anuria Under 18!! |
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Furosemide: Cautions |
Hypokalaemia (low potassium) could induce arrhythmias Pregnancy Hypotensive pt |
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Furosemide: Dose |
IV: 40-50mg |
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Glucagon: Indications |
Hypoglycaemia with BM <4 Clinically suspected hypo where oral glucose not available Unconscious pt where hypo likely cause |
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Glucagon: Actions |
Hormone that induces the conversion of glycogen to glucose in the liver, therefore increases blood sugar levels |
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Glucagon: Contra-indications |
Low glycogen store ( glucagon used recently) Hypoglycaemic seizures (use IV glucose 10%) |
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Glucagon: Cautions |
Avoid IM if thrombolysis required |
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Glucagon: Dose |
IM: 1mg no repeat |
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Glucose 10%: Indications |
Hypoglycaemia with BM <4 Clinically suspected hypo where oral glucose not possible Unconscious pt where hypo likely cause |
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Glucose 10%: Actions |
Reversal of hypo |
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Glucose 10%: Contra-indications |
None |
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Glucose 10%: Cautions |
Use a wide bore cannula into large vein- glucose 10% can irritate vein |
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Glucose 10%: Dose |
10gms, repeat every 5 mins, 10 gms, Max dose 30gms |
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Glucose 40%: Indications |
Hypo with BM <4, where there is no risk of chocking or aspiration |
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Glucose 40%: Actions |
Rapid increase of blood glucose by buccal absorption |
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Glucose 40%: Contra-indications |
None |
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Glucose 40%: Cautions |
Pts with LOC where aspiration or chocking a possibility. Soak a gauze, place it between the lip and the gum. |
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Glucose 40%: Dose |
10gms, repeat every 5 mins, 10gms, no max |
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GTN: Indiactions |
Cardiac chest pain due to angina or MI Acute pulmonary oedema |
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GTN: Actions |
Potent vasodilator.... Dilation of coronary arteries/ relief of coronary spasm Dilation of systemic veins resulting in lower pre-load Reduce BP |
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GTN: Contra-indications |
Viagra within last 24hrs Hypotension systolic <90 Hypovolaemia Head trauma Cerebral haemorrhage Unconscious |
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GTN: Cautions |
None |
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GTN: Dose |
SL: 400-800 mcgm, repeat 5-10 mins, no max |
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Heparin: Indications |
STEMI where heparin is required to as adjunctive therapy with reteplase or tenecteplase to reduce risk of re-infarction. |
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Heparin: Actions |
Anticoagulant |
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Heparin: Contra-indications |
Haemophilia or other haemorrhagic disorders Thrombocytopenia Recent cerebral haemorrhage Severe hypertension Severe liver disease Oesophageal varices Peptic ulcer Major trauma Recent eye surgery or to NS Acute bacterial endocarditis Spinal or epidural anaesthesia |
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Heparin: Cautions |
None |
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Heparin: Dose |
IV: with reteplase- 5,000 IV: with tenecteplase- <67 kg, 4,000 > 67 kg, 5,000 Further 1,000 bolus maybe required if heparin infusion has not started within 45 mins of original bolus. |
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Hydrocortisone: Indications |
Severe or life threatening asthma (hosp time >30) Anaphylaxis Adrenal crisis |
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Hydrocortisone: Actions |
Glucocorticoid drugs that reduces inflammation and suppressed the immune response |
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Hydrocortisone: Contra-indications |
Known allergy |
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Hydrocortisone: Cautions |
None relevant to single dose Avoid IM if thrombolysis needed |
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Hydrocortisone: Dose |
Asthma + Adrenal crisis: IV: 100mg Anaphylaxis: IV:200mg |
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Ibuprofen: Indications |
Mild- moderate pain/ high temp Soft tissue injuries |
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Ibuprofen: Actions |
Analgesic Anti-inflammatory Anti-pyretic |
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Ibuprofen: Contra-indications |
Dehydration Renal insufficiency Hypovolaemia GI disturbance Pregnant |
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Ibuprofen: Cautions |
Asthma- can cause bronchoconstriction Elderly- if not used NSAIDs recently |
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Ibuprofen: Dose |
400mg, repeat 8hrs, max 1.2gms |
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Ipratropium: Indications |
Acute severe- life threatening asthma Acute asthma unresponsive to salbutamol Exacerbation of COPD, unresponsive to salbutamol |
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Ipratropium: Actions |
Antimuscarinic bronchodilator. |
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Ipratropium: Contra-indications |
None |
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Ipratropium: Cautions |
Glaucoma Pregnancy/ breast feeding Prostatic hyperplasia COPD neb 6 mins |
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Ipratropium: Dose |
500mcgm no repeat |
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Metoclopramide: Indications |
Treatment/ prevention of nausea or vomiting in adults over 20yrs old Treatment/ prevention of nausea or vomiting following morphine |
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Metoclopramide: Actions |
Anti-emetic that acts centrally and in the GI tract |
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Metoclopramide: Contra-indications |
Renal failure Adrenal cancer GI obstruction, recent GI surgery Under 20 yrs old |
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Metoclopramide: Cautions |
Avoid IM if thrombolysis needed. Avoid in drug over dose. |
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Metoclopramide: Dose |
10mg, no repeat |
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Misoprostol: Indications |
Postpartum haemorrhage within 24hrs of delivery, bleeding from uterus uncontrolled by uterine massage. Miscarriage with life threatening bleeding and confirmed diagnosis. Both syntometrine and ergometrine are contra-indicated in hypertension |
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Misoprostol: Actions |
Stimulates contraction of the uterus Onset of action 7-10 mins |
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Misoprostol: Contra-indications |
Known hypersensitivity Active labour Possible multiple pregnancy/ suspected fetus in utero |
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Morphine: Indications |
Pain associated with MI Severe pain as a component of a balanced analgesic regimen |
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Morphine: Actions |
Strong opioid analgesic Produces sedations, euphoria and analgesia. May depress resp and induce hypotension Histamine release may contribute to vasodilating effects= urticaria and bronchoconstriction can occur. |
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Morphine: Contra-indications |
Under 1yrs old Actual systolic BP<90 Head injury with reduced GCS <9 Resp depression < 10 resp per min Known hypersensitivity |
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Morphine: Cautions |
Severe renal or hepatic impairment Extreme caution in pregnancy Chest injuries with resp difficulty, exp if resp inhibited by pain COPD, Asthma Head injury Acute alcohol intoxication Medications |
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Morphine: Dose |
IV: 10mg, repeat 5 mins, max 20mg IM: 10mg, repeat 60 mins, max 20mg Oral: 20mg, repeat 60 mins, max 40mg |
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Naloxone: Indications |
Opioid OD with resp, CVS and CNS depression OD of either opioid analgesic or compound analgesic Unconscious pt associated with resp depression of unknown cause, where opioid OD possible Reversal of resp and CNS depression in neonate following maternal opioid drug use during labour |
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Naloxone: Actions |
Antagonism of the effects of opioid drugs |
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Naloxone: Contra-indications |
Neonates born to opioid addicted mothers- BVM |
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Naloxone: Cautions |
None |
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Naloxone: Dose |
IV: 400mcgms, repeat every 3 mins, max 4400mcgm |
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Ondansetron: Indications |
Treatment/ prevention of opioid induced nausea or vomiting Treatment for nausea or vomiting |
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Ondansetron: Actions |
Anti-emetic that blocks 5HT receptors both centrally and in the GI tract |
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Ondansetron: Contra-indications |
Known hypersensitivity Under 1 month old |
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Ondansetron: Cautions |
Breast feeding Pregnancy Hepatic impairment QT interval prolongation |
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Ondansetron: Dose |
IV: 4mg, no repeat |
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Oxygen: Indications |
Critical illnesses requiring high levels of supplemental O2 Serious illnesses requiring moderate levels of O2 if pt is hypoxaemic COPD and other conditions requiring controlled or low dose O2 |
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Oxygen: Actions |
Essential for cell metabolism. Adequate tissue oxygenation is essential for normal physiological function O2 assists reversing hypoxia, raises concentration of inspired O2 |
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Oxygen: Contra-indications |
Explosive environments |
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Oxygen: Cautions |
O2 increased fire hazard De fibrillation- ensure pads are firmly applied to avoid spark hazard |
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Oxygen: Dose |
High levels of O2 with critical illness: 94-98% Cardiac arrest Major trauma Anaphylaxis Major pulmonary haemorrhage Sepsis Shock Active convulsion Hypothermia |
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Oxygen: Dose cont..... |
Moderate levels of O2: 94-98% <85%= 10- 15 Ltrs >85-93%=2-6 Ltrs (nasal) >85-93%= 5-10 Ltrs (mask) Acute hypoxaemia Deterioration of lung fibrosis or other interstitial disease Acute asthma Acute heart failure Pneumonia PE Severe anaemia |
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Oxygen: Dose cont...... |
Controlled or low dose O2= 88-92% at 4 ltrs COPD Chest wall disorders |
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Oxygen: Dose cont..... |
No O2, only if become hypoxaemic- 94-98% <85%= 10-15 ltrs >85-93%= 2-6 ltrs (nasal) >85-93%= 5-10 ltrs (mask) MI CVA Abdo pain Headache OD GI bleed Glycaemic emergencies |
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Paracetamol: Indications |
Mild to moderate pain relief/ high temp As part of a balanced analgesic regimen for severe pain (IV) |
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Paracetamol: Actions |
Anti-pyretic Analgesic |
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Paracetamol: Contra- indications |
Known allergy Exceeded max cumulative dose in 24hrs Taken within last 4hrs |
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Paracetamol: Cautions |
None |
|
Paracetamol: Dose |
Oral: 1mg, every 4-8 hrs, Max 4gms |
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Reteplase: Indications |
STEMI, 12 hr of symptom onset where PPCI not readily available |
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Reteplase: Actions |
Activates the fibrinolytic system, inducing the break up of intrvascular thrombi and emboli |
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Reteplase: Contra-indications |
See local trust checklist |
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Reteplase: Caution |
None |
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Reteplase: Dose |
>18 first dose 10 units, second dose 10 units 2nd does give after 30 mins |
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Salbutamol: Indications |
Acute asthma attack where inhalors have failed Expiratory wheeze associated with allergy, anaphylaxis, smoke inhalation or other low airway cause Excerbation of COPD SOB in pts with LVF |
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Salbutamol: Actions |
Selective beta2 adrenoreceptor stimulant. Relaxant effect on smooth muscle in medium and small airways which are in spasm during asthma attck |
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Salbutamol: Contra-indications |
None |
|
Salbutamol: Cautions |
Hypertension Angina Late pregnancy Overactive thyroid Severe hypertension may occur in pts on beta blockers= half doses COPD 6 mins |
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Salbutamol: Dose |
Neb: 5mg, every 5 mins, no max |
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Sodium Chloride 0.9%: Indications |
Medical conditions with/without haemorrhage Trauma related haemorrhage Burns Limb crush injuries Flush |
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Sodium Chloride 0.9%: Actions |
Increases vascular fluid volume which consequently raises cardiac output and improves perfusion |
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Sodium Chloride 0.9%: Contra-indications |
None |
|
Sodium Chloride 0.9%: Cautions |
None |
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Sodium Chloride 0.9%:Dose |
General medical conditions with/without haemorrhage & Penetrating torso = 250ml, repeat 250ml, PRN, max 2 ltrs Sepsis= 1ltr, repeat 1 ltr, 30mins, max 2 ltrs Burns= 1ltr Crush injury= 2 ltrs |
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Syntometrine: Indications |
Postpartum haemorrhage within 24hrs of delivery where bleeding from uterus is uncontrolled by uterine massage Miscarriage with life threatening bleeding and a confirmed diagnosis |
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Sodium lactate compound- Contra-indications |
Diabetic hyperglycaemic ketoacidotic coma, pre-coma.
Neonates |
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Sodium lactate compound- Cautions |
Limb crush injuries- if sodium chloride is available Renal and liver failure |
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Syntometrine: Actions |
Stimulates uterine contraction Onset 7-10 mins |
|
Syntometrine: Contra-indications |
Hypertension and severe pre-eclampsia Known hypersensitivity
Active labour Possible multiple pregnancy/ suspected fetus in utero |
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Syntometrine: Catuions |
None |
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Syntometrine: Dose |
IM: 500mcgm ergometrine and 5 units of oxytocin |
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Tenecteplase: Indiacations |
STEMI with 6hrs of symptom onset where PPCI not readily available |
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Tenecteplase: Actions |
Activates fibrinolytic system , inducing the breaking up of intrvascular thrombi and emboli |
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Tenecteplase: Contra-indications |
See trust checklist |
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Tenecteplase: Cautions |
None |
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Tenecteplase: Dose |
<60kg= 6,000 units 60-69 kg= 7,000 units 70-79 kg= 8,000 units 80-89 kg= 9,000 units >90 kg= 10,000 units |
|
Tranexamic Acid: Indications |
Pts with time critical injury where significant internal/external haemorrhage is suspected Injured pts fulfilling step 1 or 2 of trauma triage protocol |
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Tranexamic Acid: Actions |
Ainti-fibrinolytic which reduces the breakdown of blood clots. |
|
Tranexamic Acid: Contra-indications |
Bleeding has stopped If interventions delay transport to hospital
|
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Tranexamic Acid: Cautions |
None |
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Tranexamic Acid: Dose |
IV: 1gm |
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Anti-epileptics |
Carbamazepine Valporates Phenytoin |
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GI- Regulate stomach acid |
Cimetidine
Ranitidine Famotidine Nizatidine |
|
GI- Inhibit acid secretion |
Omeprazole Lansoprazole |
|
GI |
Magnesium + Aluminium hydroxide Calcium carbonate Sodium bicarbonate |
|
Calcium channel blockers- Hypertension |
Amlodipine Diltiazem Felodipine Nicardipine Nifedipine Verapamil |
|
Beta blockers (*lol's) |
Atenolol Bisprolol Propanolol Oxprenolol |
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SSRI's- antidepressant |
Fluoxetine Citalopram Trazodone Paroxetine Venlafaxine |
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Benzodiazepines- (*am) |
Diazepam Flurazepam Lorazepam Temazepam Triazolam |
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Tricyclic antidepressant |
Amitriptyline Trimipramine Lofepramine Dozepin |
|
Nitrates- angina |
Isosorbide dinitrate Mononitrate Ismo Ismo retard Angikat Isodur Nitrolingual Glutrin Nitromin |
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Anti-diabetic- Sulphonyureas |
Tolbutaminde
Gliclazide Chlorpropamide |
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Anti-diabetics- Biguanides |
Metformin |
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Anti-diabetics- a-glucosidase |
Acarbose |
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ACE inhibitors- Hypertension |
Ramipril Perindopril Lisinporil Enalapril Captopril |
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Statins- Cholesterol |
Simvastatin Atorvastatin Pravastatin Rosuvastatin |
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Antibotics- Sulphonamides |
Trimethoprim Co-trimoxazole |
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Antibotics- Penicillins |
Phenoxymethylpenicillin Benzylpenicillin Amoxycillin Flucloxacillin Ampicillin. |
|
Antibotics- Cephalosporins |
Cefaclor Cefalexin Cefradine |
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Antibotics- Tetracyclines |
Oxytetracycline Tetracycline Doxycycline Lymecycline |
|
Antibotics-Macrolides |
Erythromycin Clarithromycin Azithromycin |
|
Viagra |
Sildenafil Alprostadil Tadalafil Vardenafil |
|
Diuretics- Hypertension and Oedema |
Bendroflumethiazide Furosemide Bumetanide Amiloride |