UK Ambulance Service Paramedic Drugs JRCALC 2013
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| show | Pre Filled syringe or ampule containing 1mg in 1ml (1:1000)
Pre Filled syringe or ampule containing 1mg in 10ml (1:10000)
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| Adrenaline- Indications | show 🗑
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| show | A sympathomimetic that stimulates both alpha and beta adrenergic receptors. Therefore myocardial and cerebral blood flow is enhanced, due to increased peripheral resistance which improves perfusion pressures
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| show | Do not give repeated doses to hypothermic patients
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| show | Hypo tension may occur in pts on beta-blockers, therefore give half doses
For pts on tricyclic antidepressants, half doses used for anaphylaxis
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| Adrenaline- Cardiac Arrest Dosage | show 🗑
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| Adrenaline- Anaphylaxis and Life threatening Asthma Dosage | show 🗑
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| Amiodarone- Presentation | show 🗑
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| show | Cardiac Arrest- Shockable rhythm
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| Amiodarone- Actions | show 🗑
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| show | None in cardiac arrest
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| Amiodarone- Side Effects | show 🗑
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| show | Administer into large vein as extravastion can cause burns
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| show | 300mg IV/IO after 3rd shock- repeated 150mg after 5th shock
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| Aspirin- Presentation | show 🗑
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| Aspirin- Indications | show 🗑
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| Aspirin- Actions | show 🗑
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| Aspirin- Contra-indications | show 🗑
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| show | Gastric bleeding, Wheezing in some asthmatics
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| show | As the benefits outweigh the risk, can be given to pts with Asthma, Pregnancy, Kidney or liver failure, Gastric or duodenal ulcers, Current treatment with anticoagulants
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| Aspirin- Dosage | show 🗑
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| Atropine- Presentation | show 🗑
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| Atropine- Indications | show 🗑
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| show | May reverse the effects of vagal overdrive, May increase heart rate by blocking vagal nerve activity in bradycardia or second or third degree heart block, Enhances AV conduction
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| show | Should not be used in Hypothermic pts
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| Atropine- Cautions | show 🗑
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| show | Dry mouth, blurred vision, dilated pupils, Confusion, hallucinations, Tachycardia, urine retention
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| Atropine- Dosage | show 🗑
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| Benzylpenicillin (Pen G)- Presentation | show 🗑
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| show | Suspected meningococcal disease with non-blanching rash and S&S suggestive of meningococcal septicaemia
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| show | Broad spectrum antibiotic
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| Benzylpenicillin (Pen G)- Contra-indications | show 🗑
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| Benzylpenicillin (Pen G)- Cautions | show 🗑
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| Benzylpenicillin (Pen G)- Dosage | show 🗑
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| show | Ampoule containing 10mg in 1ml
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| Chlorphenamine - Indications | show 🗑
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| show | Antihistamine, anticholinergic (relaxes smooth muscles) properties
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| Chlorphenamine - Contra-indications | show 🗑
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| Chlorphenamine - Cautions | show 🗑
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| show | Sedation, Dry mouth, Headache, Blurred vision, Psychomotor impairment, GI disturbance, Hypotension, convulsions, Elderly more likely to suffer side effects, Warn against driving
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| Chlorphenamine - Dosage | show 🗑
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| show | Tablet containing 75mg or 300mg
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| Clopidogrel - Indications | show 🗑
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| Clopidogrel - Actions | show 🗑
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| Clopidogrel - Contra-indications | show 🗑
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| show | As the benefits' outweigh the risk, can be given to pts with Pregnancy, Renal impairment, NSAIDs
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| Clopidogrel - Side effects | show 🗑
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| show | 300mg oral tablet. Single dose
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| Diazepam - Presentation | show 🗑
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| show | Fits longer than 5 mins and still fitting, Repeated fits, Status epilepticus, Eclamptic fits (if fits last more than 2-3 mins)
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| Diazepam - Actions | show 🗑
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| show | None
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| Diazepam - Cautions | show 🗑
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| show | Respiratory depression, Hypotension, Drowsiness, Confusion
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| Diazepam - Dosage | show 🗑
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| Entonox - Presentation | show 🗑
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| Entonox - Indications | show 🗑
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| show | Inhaled analgesic agent
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| Entonox - Contra-indications | show 🗑
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| show | Pneumothorax, Poly trauma chest injuries
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| show | Self administered 3-10 mins till effect is achieved.
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| Furosemide - Presentation | show 🗑
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| Furosemide - Indications | show 🗑
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| Furosemide - Actions | show 🗑
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| Furosemide - Contra-indications | show 🗑
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| show | Hypokalaemia (low potassium)can induce arrhythmias, Pregnancy, Hypotension
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| Furosemide - Side effects | show 🗑
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| show | IV- 50mg slowly over 5 mins. Single dose. Give GTN first.
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| show | 1mg powder in vial made up with WFI
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| show | Hypoglycaemia where oral glucose administration is not possible due to reduced LOC
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| Glucagon - Actions | show 🗑
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| show | Low glycogen stores (recent use of glucagon), Hypoglycaemic seizures- IV Glucose 10% is preferred
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| show | Avoid IM administration of a drug if thrombolysis is required
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| Glucagon - Side effects | show 🗑
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| show | IM- 1mg (1 vial). Single dose.
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| Glucose 10% - Presentation | show 🗑
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| show | Hypoglycaemia where oral glucose administration is not possible due to reduced LOC
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| show | Reversal of hypoglycaemia
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| show | None
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| Glucose 10% - Cautions | show 🗑
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| Glucose 10% - Side effects | show 🗑
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| Glucose 10% - Dosage | show 🗑
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| Glucose Oral Gel - Presentation | show 🗑
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| Glucose Oral Gel - Indications | show 🗑
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| show | Rapid increase of blood sugars due to buccal absorption
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| show | None
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| show | Reduced LOC, Soaking gauze swab and placing in between lip and gum may help absorption
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| show | None
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| show | Buccal route- 10grams repeated every 5 mins. No Limit.
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| GTN - Presentation | show 🗑
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| show | Cardiac chest pain due to angina or MI
Acute cardiogenic pulmonary oedema
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| show | Potent vasodilator. Dilatation of coronary arteries/relief of coronary spasm. Dilations of systemic veins causing lower pre load. Reduced blood pressure
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| show | Hypo tension (Systolic less than 90mmHg), Hypovolaemia, Head trauma, Cerebral haemorrhage, Viagra type medications, Unconscious pt.
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| show | None
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| GTN - Dosage | show 🗑
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| Hydrocortisone - Presentation | show 🗑
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| show | Severe or Life-threatening asthma, where call to hospital time is greater than 30 mins
Anaphylaxis
Adrenal crisis
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| Hydrocortisone - Actions | show 🗑
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| show | Known Allergy
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| show | None relevant to a single dose. Avoid IM administration if pt likely to need thrombolysis
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| Hydrocortisone - Dosage | show 🗑
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| Ipratropium Bromide - Presentation | show 🗑
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| show | Acute severe or life threatening asthma, Acute asthma unresponsive to salbutamol. COPD unresponsive to salbutamol
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| show | Antimuscarinic bronchodilator. May provide short term relief in acute asthma, but beta 2 agonists (salbutamol) work quicker
Considered of greater benefit in children and adults with COPD
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| Ipratropium Bromide - Contra-indications | show 🗑
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| show | Use with care in pts with Glaucoma, Pregnancy and breastfeeding, Prostatic hyperplasia
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| show | Headache, Nausea & vomiting, Dry mouth, Tachycardia/Arrhythmia, Chest tightness, Reaction
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| show | 0.5mg with 6-8 litres O2, single dose
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| show | Ampoule containing 10mg in 2ml
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| show | Treatment of nausea or vomiting in pts aged 20 and above. Prevention of nausea and vomiting following Morphine
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| show | Antiemetic which acts centrally as well as on the GI tract
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| show | Age less than 20, Renal failure, Tumour on adrenal gland, GI obstruction , GI problems
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| Metoclopramide - Cautions | show 🗑
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| Metoclopramide - Side effects | show 🗑
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| Metoclopramide - Dosage | show 🗑
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| show | IV- Ampoules containing 10mg in 1ml
Oral- Vials containing 10mg in 5ml
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| show | Pain associated with MI, Severe pain
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| Morphine Sulphate - Actions | show 🗑
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| show | 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 significantly impaired LOC (below P on AVPU, below 9 GCS)
Known hypersensitivity
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| show | Severe renal or hepatic impairment-?small dose
Extreme care if pregnant
Caution 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
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| Morphine Sulphate - Side effects | show 🗑
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| show | Class A-CD-schedule 2 of the Misue of Drugs Regs 1985-must be stored and its prescription and admin documented properly
Unused morphine discarded in the presence of witness
Narcan can reverse the effects of morphine
Consider Metoclopramide
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| Morphine Sulphate - Dosage | show 🗑
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| Naloxone - Presentation | show 🗑
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| Naloxone - Indications | show 🗑
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| Naloxone - Actions | show 🗑
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| show | Neonates born to opiate addicted mothers - can produce serious withdrawal effects. Emphasis on BVM and O2
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| Naloxone - Cautions | show 🗑
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| Naloxone - Side effects | show 🗑
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| Naloxone - Dosage | show 🗑
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| show | Oral solution- 120mg/5ml Used from 3 months to 5 years
250mg/5ml Used from 5 years upwards
Tablets- 500mg each
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| show | Relief of mild to moderate pain and/or high temp
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| Paracetamol - Actions | show 🗑
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| show | Known allergy
Do not give if a paracetamol containing product has been given within 4 hrs, or 4grams with 24hrs
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| Paracetamol - Cautions | show 🗑
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| Paracetamol - Side effects | show 🗑
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| show | As described
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| Salbutamol - Presentation | show 🗑
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| Salbutamol - Indications | show 🗑
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| show | A selective beta2 adrenareceptor stimulant. Relaxes smooth muscle in the medium and smaller airways
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| Salbutamol - Contra-indications | show 🗑
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| show | Used in care with Hypertension, Angina, overactive thyroid, late pregnancy, severe hypertension may occur on pts on beta blockers use half doses. If COPD limit neb to 6 mins
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| show | Tremor, Tachycardia, Palpitations, Headache, Feeling of tension, Peripheral vasodilatation, Cramps, Rash
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| show | 5mg Nebulised with 6-8l O2, given every 5 mins. No Limit.
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| 0.9% Sodium Chloride - Presentation | show 🗑
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| show | Adult and Child fluid therapy, Flush to confirm IV patency and/or following IV drug administration
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| 0.9% Sodium Chloride - Actions | show 🗑
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| 0.9% Sodium Chloride - Contra-indications | show 🗑
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| show | None
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| 0.9% Sodium Chloride - Side effects | show 🗑
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| 0.9% Sodium Chloride - Dosage | show 🗑
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| show | Vial containing 500mg in 5ml
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| Tranexamic Acid - Indications | show 🗑
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| show | Anti-fibrinolytic which reduces the breakdown of blood clots
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| show | Isolated head injury, Critical interventions required (they must be done first), Bleeding now stopped
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| Tranexamic Acid - Cautions | show 🗑
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| Tranexamic Acid - Side effects | show 🗑
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| show | IV- 1gram given slowly over 10 mins
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