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57 Cards in this Set
- Front
- Back
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What are the indications for nitrous oxide?
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Musculoskeletal Pain
Burns (not affecting respiratory tract) Active Labour Ischemic chest pain |
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What are the contraindications of Nitrous Oxide?
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Unable to follow commands
Altered LOC Significant COPD Any traumatic chest injury Suspected Pneumothorax Undiagnosed Abdominal Pain Decompression Sickness Pregnancy (except active labour) |
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Why is nitrous oxide the right drug for a patient?
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It is a gaseous anesthetic which acts on Mu and Kappa opiod receptors. Stimulation results in analgesia, also respiratory depression, sedation and euphoria.
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What are some things to bear in mind with the use of entonox?
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Use in well ventilated area
Invert the tank at least three times prior to use Do not use outside if below minus six degrees celsius (-6) Do not use if frost on the tank |
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What is the right time, dose, route and documenting for entonox?
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Dose is self administered until relief or patient drops mask (consult medical control if patient unable to hold mask due to burns or fractures)
Route - inhalation via positive pressure mask |
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What is it important to check always before giving the medication?
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Colour Clarity and Concentration and Expiration Date
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What are the indications for salbutamol?
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Bronchospasm due to bronchial asthma, chronic bronchitis and other pulmonary disorders.
Respiratory distress with bronchospasm |
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What are contraindications for salbutamol?
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Hypersensitivity
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What are some precautions with the use of salbutamol?
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-Should not be used with cardica asthma
-Cardiovascular disease, dysrhythmias, hypertension -Diabetes mellitus - risk of drug induced hyperglycemia -Hypokalemia -Cardiovascular events |
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Why is salbutamol the right drug?
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Caused bronchodilation relieving the bronchospasm
-It is a sympathomimetic drug. Mimics the effects of epinephrine and norepinephrine at the B2 receptors causing dilation of the bronchial airways. |
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What is the right time, dose and route?
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Adult dose: 2.5-5.0 mg q 10 minutes PRN
MDI 6 puffs, max 20 puffs Pediatric 0.15 mg//kg diluted to 2.5ml with saline via neb Or less than 10 kg 1.25mg with NS to 2.5ml 10-20 kg give 2.5mg greater than 20kg give 2.5-5.0 mg MDI - minimum 2 puffs, maximum 10 |
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What should be checked always before giving a drug?
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Colour, Clarity, Concentration and expiration date
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What are the indications for atrovent or ipratropium bromide?
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Bronchospasm as a result of audible wheezing in asthma, chronic bronchitis and emphysema
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What are the contraindications for ipratropium bromide?
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Hypersensitivity to the drug or atropine or its derivatives
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What are some precautions with the use of ipratropium?
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Hypersensitivity to soy lecithin or related products.
Patients with narrow angle glaucoma Take care to avoid accidental release into the eyes. |
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Why is it the right drug?
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IB is an anticholinergic drug. It inhibits cholinergic receptor sites. It suppresses the contraction of bronchial smooth muscles and production of of pulmonary glandular secretions.
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What is the right dose, route and time and docs?
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Adult dose
250-500mcg via nebulizer with salbutamol repeated up to two times if needed q 10 do not exceed max dose. MDI - 1-4 puffs prn max 10 but give after salbutamol Pediatric (5-11) 25-250 mcg via nebulizer mixed with salbutamol, repeat up to 2x MDI minimum 2 puff prn max 4 |
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What must always be checked when giving a drug?
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The colour, clarity, concentration and expiration date
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What are the indications for oral glucose?
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Hypoglycemia in patients who are alert, able to follow commands and can swallow.
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What are contraindications for the use of the drug?
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Any patient who is no alert
Any patient who cannot follow commands Any patient lacking a gag reflex |
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What are some precautions for the use of oral glucose?
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May cause nausea or the patient may gag when administered
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Why is oral glucose the right drug for hypoglycemia?
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Cellular function requires glucose for energ. Oral glucose raises blood glucose levels.
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What is the right dose and route for oral glucose?
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25g orally, can repeat 10 minutes if needed. Give slowly while the patient swallows.
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What should always be checked before giving a drug?
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Colour, clarity, concentration and expiration date.
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What are the indications for D50W?
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Hypoglycemia
Coma of unknown origin if unable to obtain blood glucose reading |
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What are contraindications for D50W?
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None in the emergency setting
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What are the precautions for D50W?
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-Can be very irritating to the vein and must be given with a slow IV push.
-Patients with increased ICP half dose and reassess - never withhold -Ensure patency of IV, can cause necrosis or sloughing of tissue if interstitial |
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Why is D50W the right drug?
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Cellular function requires glucose and D50W raises blood glucose levels.
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What is the right dose and route for D50W?
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Adult - 25g D50W slow IVP
second dose if the first dose is ineffective Sespected head injury 12.5g Chem strip should be checked in the oposite extremity! Pediatric 0.5-1.0 g/kg of D25W Neonates 200mg/kg of D10W (mix 10ml of D50W in 40 ml of NS |
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What should always be checked with any drug?
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Colour, Clarity, Concentration and Expiration date!
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What are the indications for glucagon?
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Hypoglycemia where IV access is proving problematic or cannot be established.
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What are the contraindications for glucagon?
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-Hypersensitivity to beef or pork proteins.
-Pheochromocytoma (rare tumor of the adrenal gland tissue) |
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What are precautions for glucagon?
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After LOC is sufficient need to provide suplemental carbs.
It can lower serum potassium levels causing hypokalemia |
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What is necessary for glucagon to work?
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Hepatic stores of glycagon
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What is the right dose and route for glucagon?
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1mg in 1ml IM q 15-20 minutes
Pediatric <5 years 0.5mg IM |
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What should be checked before giving the medication?
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Colour, clarity, concentration and expiraton date
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What are the indications for epinephrine?
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Anaphylaxis
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What are the contraindications for epinephrine?
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Non in the emergent setting
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What are precautions for the use of EPI?
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-Light sensetive
-Administer EPI pen into the anterolateral aspect of the thigh -Extreme caution to avoid veinal administration -Caution for cardiac patients |
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What can hasten absorption?
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The site can be massaged to hasten absorption
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Why is epinephrine the right drug?
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Epi counters the effects of histamine release and inhibits further release.
Exogenous epinephrine binds to the A1 B1 and B2 receptors resulting in increased heart rate, blood pressure and dilation of the bronchial airways. |
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What is the right dose and route?
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Adult - 0.3mg (1:1000) IM
Pediatric - 0.01mg/kg (1:1000) IM do not exceed 0.3mg or Epipen junior 0.15mg IM into the deltoid muscle or with the epipen into the thigh. |
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What should you always check with epinephrine?
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The colour, clarity, concentration and expiration date.
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What is are the indications for ASA?
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Acute coronary syndromes suggesting an AMI
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What are the contraindications for ASA?
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Hypersensitivity, severe known allergy
Bleeding disorders hemophilia, von willebrands disease. |
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Why is ASA the right drug?
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ASA suppresses platelet aggregation in damaged arteries reducing the incidence of thrombus formation and suppressing thromboxane mediated vasoconstriction and platelet aggregation.
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What is the right dose and route for ASA?
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160-325 mg asa chewed as soon as possible orally.
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What should be checked with any drug?
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Colour, Clarity, Concentration and Expiration date.
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What are the indications for nitroglycerin?
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-Acute coronary syndromes indicative of an AMI
-Suspected cardiac chest pain |
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What are the contraindications of hypoglycemia?
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-Hypersensitivity to nitrates
-Use of erectile dysfunction drugs -Uncorrected hypovolemia -Systolic less than 100 -Drop on blood pressure of 30% if patient is hypertensive and 10% if normotensive Suspected cardiac tamponade or pericarditis Extreme tachycardia 180bpm + Extreme bradycardia <50bpm Suspected right ventricular infarction |
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What are some precautions for the use of nitroglycerin?
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Orthostatic hypotension may occur place patient recumbent on stretcher or seated prior to administration
Remove other nitro sources before SL nitro. |
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Why is nitro the right drug?
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Adult 0.3 mg tab or 0.4 mg SL spray as long as BP remains > 100mmHg
The route is SL, ensure it is absorbed. Can redose at 5 min intervals to a max dose of 1.2mg |
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What are the indications for dimenhydrinate or gravol?
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Nausea and vomiting
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What are contraindications?
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Hypersensitivity (contains benzyl alcohol)
Seizures Any condition that may be worsened by anticolinergic effects |
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Why is dimenhydrinate the right drug?
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It inhibits nausea and vomiting by depressing the stimuli to the vomiting centre of the brain.
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What is the right dose and route?
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Adult
50 - 100mg IM Pediatric 1mg/kg 2-5 years - do not exceed 25mg 6-12 years - do not exceed 50mg |
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What should always be checked when administering a drug?
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The colour, clarity, concentration and expiration date.
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