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If your not sure what answer should be entered, press the space bar and the next missing letter will be displayed. When you are all done, you should look back over all your answers and review the ones in red. These ones in red are the ones which you needed help on. Question: Adrenaline- Answer: Pre Filled syringe or ampule 1mg in 1ml (1:1000)
Pre Filled syringe or ampule containing 1mg in 10ml (1:10000) Question: - IndicationsAnswer: Cardiac Arrest, Anaphylaxis, Life threatening asthma with ventilation and continued deterioration, despite nebuliser therapy Question: Adrenaline- Answer: A sympathomimetic that stimulates both and beta adrenergic receptors. Therefore myocardial and cerebral blood flow is enhanced, due to increased peripheral resistance which improves perfusion pressures Question: - Contra-indicationsAnswer: Do not give doses to hypothermic patients Question: Adrenaline- Answer: Hypo tension may occur in pts on beta-blockers, therefore give half doses
For pts on tricyclic , half doses used for anaphylaxis
Question: Adrenaline- Cardiac Arrest Answer: Cardiac Arrest- 1:10000- IV- 1mg (10ml)- every 3-5 mins
Shockable rhythm - after 3rd shock then after every alternative (ie 5th, 7th etc)
Non rhythm- after IV access gained, then alternative loops
Question: Adrenaline- Anaphylaxis and Life Asthma DosageAnswer: 1:1000- IM - 0.5ml- 5 mins Question: - PresentationAnswer: Pre filled syringe 300mg in 10ml Question: - IndicationsAnswer: Cardiac - Shockable rhythm Question: Amiodarone- Answer: Anti-arrhythmic- lengthens action potential- prolongs QT interval on ECG
Blocks sodium and potassium channels in cardiac muscle
Acts to stabilise and reduce electrical irritability of cardiac muscle
Question: Amiodarone- -indicationsAnswer: None in arrest Question: Amiodarone- Side Answer: Bradycardia, , Bronchospasm, Arrhythmias- Torsades de pointes Question: Amiodarone- Answer: Administer into large vein as can cause burns Question: Amiodarone- Answer: IV/IO after 3rd shock- repeated 150mg after 5th shock Question: - PresentationAnswer: 300mg Question: Aspirin- Answer: with clinical or ECG evidence of MI or ischemia Question: Aspirin- Answer: Anti-platelet action to reduce clot , Analgesic, Anti-pyretic, Anti-inflammatory Question: - Contra-indicationsAnswer: Known , Children under 16, GI Bleeding, Haemophilia, Severe hepatic disease Question: - Side EffectsAnswer: Gastric , Wheezing in some asthmatics Question: - CautionsAnswer: As the benefits outweigh the risk, can be given to pts with Asthma, Pregnancy, or liver failure, Gastric or duodenal ulcers, Current treatment with anticoagulants Question: - DosageAnswer: 300mg chewed. Can be given regardless of how much taken that day Question: - PresentationAnswer: 1mg in Question: Atropine- Answer: Absolute bradycardia (less than 40bpm), Hypotension, ventricular arrhytmias, inadequate perfusion causing confusion (Note hypoxia is cause of bradycardia in children. Give O2 first) Question: Atropine- Answer: May reverse the effects of vagal overdrive, May increase heart rate by blocking vagal nerve activity in bradycardia or second or third degree heart , Enhances AV conduction Question: - Contra-indicationsAnswer: not be used in Hypothermic pts Question: - CautionsAnswer: Question: Atropine- Side Answer: Dry , blurred vision, dilated pupils, Confusion, hallucinations, Tachycardia, urine retention Question: - DosageAnswer: 0.6 mg IV/IO - 3-5 mins. Max dose 3mg Question: Benzylpenicillin (Pen G)- Answer: Ampoule containing 600mg Pen G as . To be dissolved in WFI Question: (Pen G)- IndicationsAnswer: Suspected meningococcal disease with non-blanching rash and S&S of meningococcal septicaemia Question: Benzylpenicillin (Pen G)- Answer: spectrum antibiotic Question: Benzylpenicillin (Pen G)- -indicationsAnswer: Known penicillin allergy (more than simple rash) Question: (Pen G)- CautionsAnswer: None Question: (Pen G)- DosageAnswer: IV- 1.2g dissolved with 20ml WFI- Given while on-route to hospital
IM- 1.2g with 4ml WFI- Slow injection- Given while on-route to hospital
Question: - PresentationAnswer: containing 10mg in 1ml Question: - IndicationsAnswer: Severe anaphylactic reactions, reactions distress ie severe itching Question: Chlorphenamine - Answer: Antihistamine, (relaxes smooth muscles) properties Question: - Contra-indicationsAnswer: Children less than 1 year, hypersensitivity Question: - CautionsAnswer: , Epilepsy, Glaucoma, Hepatic or Prostatic disease Question: Chlorphenamine - Side Answer: Sedation, Dry mouth, Headache, Blurred vision, Psychomotor impairment, GI disturbance, Hypotension, convulsions, Elderly more likely to suffer side effects, Warn driving Question: Chlorphenamine - Answer: IV 10mg (1ml) slowly over 1 minute Question: - PresentationAnswer: containing 75mg or 300mg Question: - IndicationsAnswer: STEMI Question: Clopidogrel - Answer: Inhibits aggregation Question: Clopidogrel - -indicationsAnswer: Active bleeding, Known allergy, Liver , Breastfeeding Question: Clopidogrel - Answer: As the benefits' outweigh the risk, can be to pts with Pregnancy, Renal impairment, NSAIDs Question: Clopidogrel - Side Answer: (indigestion), Abdo pain, Diarrhoea, Bleeding Question: - DosageAnswer: 300mg oral . Single dose Question: Diazepam - Answer: Ampoule containing 10mg in 2ml
Rectal tube 2.5mg, 5mg or 10mg Question: Diazepam - Answer: Fits than 5 mins and still fitting, Repeated fits, Status epilepticus, Eclamptic fits (if fits last more than 2-3 mins) Question: Diazepam - Answer: Central Nervous System depressant (anticonvulsant and ) Question: Diazepam - -indicationsAnswer: Question: Diazepam - Answer: Respiratory depression, Doses given by carers, If pt has used or other medications Question: Diazepam - Side Answer: Respiratory depression, , Drowsiness, Confusion Question: - DosageAnswer: IV- 10mg given slowly, titrated to response, further 10mg given after 5 mins. Max - Single tube. If dose given PR and then IV access gained, single dose can be given IV Question: - PresentationAnswer: oxide 50% and Oxygen 50%. Blue cylinder with white shoulders Question: - IndicationsAnswer: Moderate to severe pain, Labour Question: Entonox - Answer: analgesic agent Question: Entonox - -indicationsAnswer: Severe head injuries, Decompression sickness (The bends), Violently psychiatric pts Question: Entonox - Answer: Pneumothorax, Poly chest injuries Question: - DosageAnswer: Self administered 3-10 mins till effect is . Question: - PresentationAnswer: Ampoules containing 50mg/5ml or 40mg/2ml
Prefilled containing 80mg
Question: - IndicationsAnswer: Pulmonary secondary to LVF Question: - ActionsAnswer: Diuretic, rapid (within 30mins) and short duration Question: Furosemide - -indicationsAnswer: Pre comatose secondary to liver cirrhosis, Severe renal failure with anuria Question: - CautionsAnswer: (low potassium)can induce arrhythmias, Pregnancy, Hypotension Question: Furosemide - Side Answer: Hypotension, GI Question: Furosemide - Answer: IV- 50mg slowly over 5 mins. dose. Give GTN first. Question: Glucagon - Answer: 1mg powder in vial made up with Question: - IndicationsAnswer: Hypoglycaemia where oral administration is not possible due to reduced LOC Question: - ActionsAnswer: A hormone that converts glycogen to glucose in the liver raising blood sugar levels Question: Glucagon - -indicationsAnswer: Low glycogen stores (recent use of ), Hypoglycaemic seizures- IV Glucose 10% is preferred Question: Glucagon - Answer: IM administration of a drug if thrombolysis is required Question: Glucagon - Side Answer: , vomiting, diarrhoea, Hypersensitivity, Hypokalaemia, Hypotension Question: Glucagon - Answer: IM- 1mg (1 vial). dose. Question: 10% - PresentationAnswer: 500ml bag of 10% (50 grams) Question: Glucose 10% - Answer: Hypoglycaemia where oral glucose administration is not due to reduced LOC Question: Glucose 10% - Answer: of hypoglycaemia Question: 10% - Contra-indicationsAnswer: None Question: Glucose 10% - Answer: Use bore cannula into a large vein as glucose is an irritant Question: Glucose 10% - Side Answer: Question: Glucose 10% - Answer: Large bore IV - 10 grams (100ml) Repeated after 5 mins. Max dose 30 grams Question: Glucose Oral Gel - Answer: Plastic tube containing 25 40% oral gel. Question: Glucose Oral Gel - Answer: Hypoglycaemia where there is no risk of patient Question: Oral Gel - ActionsAnswer: Rapid increase of sugars due to buccal absorption Question: Oral Gel - Contra-indicationsAnswer: None Question: Glucose Oral Gel - Answer: Reduced LOC, Soaking gauze swab and placing in between lip and gum may help Question: Oral Gel - Side effectsAnswer: Question: Glucose Oral Gel - Answer: Buccal route- repeated every 5 mins. No Limit. Question: GTN - Answer: Metered dose spray containing 0.4 mg per dose
Tablets 2,3 or 5 mg Question: GTN - Answer: Cardiac chest pain due to angina or MI
Acute cardiogenic oedema Question: GTN - Answer: Potent vasodilator. Dilatation of coronary arteries/relief of coronary spasm. Dilations of systemic veins causing lower pre load. blood pressure Question: GTN - -indicationsAnswer: Hypo tension (Systolic less than 90mmHg), Hypovolaemia, Head , Cerebral haemorrhage, Viagra type medications, Unconscious pt. Question: GTN - Answer: Question: GTN - Answer: 1-2 spray (0.4-0.8 mg). No limit on as long as BP above 90mmHg Question: Hydrocortisone - Answer: Ampoule containing 100mg in 1ml vial
Ampoule containing 100mg for with up to 2ml WFI
Question: Hydrocortisone - Answer: or Life-threatening asthma, where call to hospital time is greater than 30 mins
Anaphylaxis
Adrenal crisis
Question: Hydrocortisone - Answer: Glucocorticoid drug that reduces and the immune response Question: Hydrocortisone - -indicationsAnswer: Allergy Question: Hydrocortisone - Answer: None relevant to a single dose. Avoid IM if pt likely to need thrombolysis Question: Hydrocortisone - Answer: Asthma and Adrenal crisis- SLOW IV (over 2 mins) single dose
Anaphylaxis - SLOW IV (over 2 mins) 200mg single dose Question: Bromide - PresentationAnswer: Nebules containing 0.25mg in 1 ml or 0.5mg in Question: Bromide - IndicationsAnswer: Acute severe or life threatening asthma, Acute asthma unresponsive to salbutamol. COPD to salbutamol Question: Bromide - ActionsAnswer: Antimuscarinic bronchodilator. May provide short term relief in acute , but beta 2 agonists (salbutamol) work quicker
Considered of greater benefit in children and adults with COPD Question: Bromide - Contra-indicationsAnswer: None in setting Question: Ipratropium - CautionsAnswer: Use with care in pts with , Pregnancy and breastfeeding, Prostatic hyperplasia Question: Ipratropium Bromide - Side Answer: Headache, Nausea & vomiting, Dry , Tachycardia/Arrhythmia, Chest tightness, Reaction Question: Ipratropium Bromide - Answer: 0.5mg with 6-8 litres O2, dose Question: Metoclopramide - Answer: Ampoule containing 10mg in Question: - IndicationsAnswer: Treatment of nausea or vomiting in pts aged 20 and above. Prevention of nausea and following Morphine Question: Metoclopramide - Answer: Antiemetic which acts centrally as well as on the GI Question: Metoclopramide - -indicationsAnswer: Age less than 20, Renal failure, Tumour on adrenal gland, GI , GI problems Question: - CautionsAnswer: Avoid in cases of drug Question: Metoclopramide - Side Answer: Drowsiness and restlessness, Cardiac , Diarrhoea, Rash Question: Metoclopramide - Answer: IV- 10mg (2ml) over 2 mins. Single dose Question: Sulphate - PresentationAnswer: IV- Ampoules containing 10mg in - Vials containing 10mg in 5ml Question: Morphine Sulphate - Answer: Pain associated with MI, Severe Question: Sulphate - ActionsAnswer: Strong opioid analgesic, severe musculoskeletal and soft tissue pain.
Produces , euphoria and analgesia. It may both depress respiration and induce hypotension
Histamine is released and this may contribute to the vasodilatory effect. Question: Morphine - Contra-indicationsAnswer: Child under 1 year
Adult RR less than 10, Child RR less than 20
Hypotension. Adult less than 90 sys. Child less than 80 sys. Preschool less than 70 sys
Head Injury with impaired LOC (below P on AVPU, below 9 GCS)
Known hypersensitivity Question: Morphine Sulphate - Answer: Severe renal or hepatic impairment-?small dose
Extreme care if with chest injury
If DIB caused by pain, it may improve after analgesia
Asthma, COPD
Head Injury-hypoxia or pain
Intoxication
Meds may potentiate effects
Question: Morphine Sulphate - Side Answer: Respiratory depression, Cardiovascular depression, and vomiting, Drowsiness, Pupil constriction Question: Morphine Sulphate - Additional Answer: Class A-CD-schedule 2 of the Misue of Drugs Regs 1985-must be and its prescription and admin documented properly
Unused morphine discarded in the presence of witness
Narcan can reverse the effects of morphine
Consider Metoclopramide
Question: Morphine Sulphate - Answer: Record pain score
May take 2-3mins-peak between 10-20mins
Diluted with saline 0.9%, to make a of 10mg in 10ml (1mg/1ml)
IV/IO route, given slowly approx 2mg/min
IV 10mg repeated 5 mins. Max 20mg
Oral 20mg repeated 60mins-Max 40mg Question: - PresentationAnswer: containing 0.4mg/1ml Question: Naloxone - Answer: Opioid overdose producing respiratory, cardiovascular and central nervous system depression
Unconsciousness with respiratory depression of unknown cause
Reversal of respiratory or central nervous depression in a neonate following maternal use
Question: - ActionsAnswer: Antagonism of the effects of drugs Question: - Contra-indicationsAnswer: Neonates born to opiate addicted mothers - can produce withdrawal effects. Emphasis on BVM and O2 Question: Naloxone - Answer: None Question: Naloxone - Side Answer: Pts dependant on may have violent withdrawal symptoms. Better to titrate dose to reverse the effects but to keep pt groggy Question: Naloxone - Answer: IV - 0.4mg repeated every 3 mins. Max dose 4.4mg
IM-0.4mg every 3 mins. Max dose 4.4mg. Vary injection site.
Question: - PresentationAnswer: Oral solution- 120mg/5ml Used from 3 months to 5 years
250mg/5ml Used from 5 upwards
Tablets- 500mg each
Question: - IndicationsAnswer: Relief of mild to pain and/or high temp Question: Paracetamol - Answer: Analgesic and properties Question: Paracetamol - -indicationsAnswer: Known allergy
Do not give if a paracetamol containing product has been given within 4 hrs, or with 24hrs
Question: Paracetamol - Answer: Question: Paracetamol - Side Answer: Question: - DosageAnswer: As Question: - PresentationAnswer: containing 2.5mg /2.5ml or 5mg/2.5ml Question: - IndicationsAnswer: Acute asthma, Expiratory wheeze due to allergy/ anaphylaxis/ smoke inhalation or other lower airway cause. Exacerbation of COPD, SOB due to Question: - ActionsAnswer: A selective adrenareceptor stimulant. Relaxes smooth muscle in the medium and smaller airways Question: - Contra-indicationsAnswer: None in emergency Question: Salbutamol - Answer: Used in care with Hypertension, , overactive thyroid, late pregnancy, severe hypertension may occur on pts on beta blockers use half doses. If COPD limit neb to 6 mins Question: - Side effectsAnswer: Tremor, Tachycardia, Palpitations, Headache, Feeling of tension, Peripheral vasodilatation, , Rash Question: Salbutamol - Answer: 5mg Nebulised with 6-8l O2, given every 5 mins. No . Question: 0.9% Chloride - PresentationAnswer: presentations of flushes and packs/bags Question: 0.9% Sodium - IndicationsAnswer: Adult and fluid therapy, Flush to confirm IV patency and/or following IV drug administration Question: 0.9% Sodium Chloride - Answer: Increases vascular fluid volume which raises output and improves perfusion Question: 0.9% Sodium Chloride - -indicationsAnswer: Question: 0.9% Sodium Chloride - Answer: Question: 0.9% Chloride - Side effectsAnswer: Over may precipitate pulmonary oedema and cause breathlessness Question: 0.9% Sodium - DosageAnswer: Flush 2ml-10ml PRN
Fluid challenge- 250ml repeated PRN max. Max dose 2 litres.
Refer to Question: Tranexamic Acid - Answer: Vial containing in 5ml Question: Acid - IndicationsAnswer: Pts with time critical injury where significant or external haemorrhage is suspected Question: Acid - ActionsAnswer: Anti-fibrinolytic reduces the breakdown of blood clots Question: Tranexamic Acid - -indicationsAnswer: Isolated head injury, Critical required (they must be done first), Bleeding now stopped Question: Tranexamic Acid - Answer: Question: Acid - Side effectsAnswer: Rapid injection might cause Question: Acid - DosageAnswer: IV- 1gram given slowly over 10 |
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