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45 Cards in this Set

  • Front
  • Back
What does MISTO stand for ?
M=Mechanism of Injusry
I = Injuries
S = Signs and Symptoms
T = Treatment and Time
O = Other relevant information
What is the TYPE for Promethazine (Phenergan) 224 ? and What are it's actions ?
Type = Antihistamine
Actions = Promethazine is a long acting H1 Blocker with mild atropine-like anticholinergic effects.
*Antihistamine
*Antiemetic
*Sedative
What are the onset, peak and duration times for Promethazine (Phenergan)224 ?
IM times are
Onset = 20 Minutes
Peak = 30 Minutes
Duration - 2 to 8 Hours
What are the USES of Promethazine (Phenergan)224 ?
* Treatment and prevention of motion sickness
* Nausea and Vomiting especially in children (2-12yrs) and patients sensitive to metoclopramide
* Prophylaxis in children with eye or spinal injury
* Urticaria and other allergic reactions
What are the Adverse Effects of Promethazine (Phenergan)224 ?
* Dry mouth, blurred vision, urinary retention
* Sedation, disorientation, coma
* Restlessness, delirium, paradoxical excitation in children, seizures
*Tachycardia, hypotension
What are the Contraindications of Promethazine (Phenergan)224 ?
*Previous known allergy or adverse reaction
*Altered Level of Consciousness (VPU)
*Ingestion of CNS depressants (eg Alcohol, Benzodiazepines, opiates)
*Pre-existing anticholinergic syndrom (eg Tricyclic overdose)
*Hyperthermia
*Paediatric patients under 2 years of age
What is the preparation of Promethazine (Phenergan) 224 ?
50mg in 2ml bottle
What are the doses and repeat doses for Promethazine (Phenergan)224 ?
Both adult and Paediactric
ADULT
25mg to 50mg (1ml to 2ml) IM
Can be repeated after 2 hours
PAEDIATRIC
0.25mg/kg (0.01ml/kg) Promethazine
Can be repeated after 2 hours
Special Notes for Promethazine (Phenergan)224 are ?
* Paediatric patients WILL BE SEDATED with higher cumulative doses of promethazine so take care !!!!

*NOT TO BE ADMINISTERED TO PATIENTS LESS THAN 2 YEARS OF AGE
What is the drug TYPE of Adrenaline 201 ?
Type = A sympathomimetic
What are the ACTIONS of Adrenaline 201 ?
*Simulates the ALPHA and BETA Subdivisions of the sympathetic nervious system to produce the "fight or flight" reaction
*ALPHA stimulation causes peripheral vasoconstriction. It raises the perfusion pressure of vital organs during cardiac arrest. In anaphylaxis it decreases capillary permeability and raises the blood pressure
*BETA 1 stimulation causes increased myocardial excitability with tachycardia and increases myocardial contractility
*BETA 2 stimulation causes bronchodilation
What are the Onset, Peak and Duration times for each route of administration of Adrenaline 201 ?
IM (Intramuscular)
Onset = 30 - 90 seconds
Peak = 4 - 10 minutes
Duration = 5 - 10 minutes

IV (Intravenous)
Onset = 30 seconds
Peak = 3 - 5 minutes
Duration = 5 - 10 Minutes
What are the USES of Adrenaline 201 ?
*CARDIAC ARREST
1) to improve perfusion during external cardiac compression
2) to stimulate myocardial excitability and contractility
*BRADYCARDIA if pulse rate <50bpm, poorly perfused and unresponsive to two doses of atropine
*CARDIOGENIC SHOCK if pulse rate <150bpm and poorly perfused with BP <80mmHg systolic
*ASTHMA if "severe or extreme" with decreased LOC or minimal air movement
*ANAPHYLAXIS with upper or lower airway obstruction or shock
*SEVERE CROUP in children with stridor at rest and any one of the following
1) Altered LOC
2) Retractions
3) Cyanosis
What are the ADVERSE effects of Adrenaline 201 ?
*Tachycardia
*Dysrhythmias, including ventricular fibrillation
*Hypertension
*Pulillary dilatation
*Anxiety
*Nausea & Vomiting
What are the PREPARATIONS of Adrenaline 201 ?
* 1:10,000 Adrenaline (Min-I_Jet preparation) - 1mg per 10ml Min-I-Jet for IV/ET?Intraosseous use

OR

* 1:1000 Adrenaline (Ampoule), 1mg per 1ml ampoule for IM, ETT and nebulised use only
What is the dose and route of Adrenaline 201 for an Adult in Cardiac Arrest ?
CARDIAC ARREST
*Routes of administration are IV or ET
*Dose = 10ml of 1:10,000 (1mg) ADRENALINE IV as a bolus through the Hartman's Line. Repeat every 3 minutes while in arrest. There is no maximum dose
* Endotracheal dose: Give twice the IV dose (2mg) down the endotracheal tube if a vein is not available and give 5 ventilations. MAXIMUM 5 doses via ETT.
What is the dose, repeat dose and route of Adrenaline 201 for an Adult and Paediatric ASTHMA or ANAPHYLAXIS ?
ADULT
*Route is IM
* 0.5ml of 1:1,000 (500mcg) Adrenaline IM into the lateral aspect of the thigh. Must only be used for SEVERE cases.
Can be repeated every 5 minutes if no response
PAEDIATRIC
*Route is IM
* 0.01ml/kg of 1:1,000 (10mcg/kg) Adrenaline IM into the lateral aspect of the thigh. Must only be used for SEVERE cases.
Can be repeated every 10 minutes if no response
What are the IMPORTANT notes to remember regarding Adrenaline 201 ?
No Paediatric dose should exceed an adult dose
What is the drug TYPE of Glucose
Gel 205 ?
A hypertonic sugar solution for oral use
What is the ACTION of Glucose Gel 205 ?
ACTION = Principal energy source for the body cells, especially the Brain.
What are the Onset, Peak & Duration times for Glucose Gel 205 ?
Onset time is within 15 minutes. No other times are listed in our pharmocology
What are the ADVERSE Effects of Glucose Gel 205 ?
May percipitate Wernicke's encephalopathy in alcoholics with thiamine deficiency.
What are the CONTRAINDICATIONS for Glucose GEL 205 ?
Oral presentation is not to be administered to patients with decreased LOC or altered Gag reflex.
What is the preparation of Glucose Gel 205 ?
Glucose Gel presentation = 15g Tube containing 40% dextrose.
What are the ROUTES of administration for Oral Glucose 205 for both adults and paediatrics ?
ADULTS & PAEDIATRICS = Administer entire contents of 15g tube. If no response, can be repeated after 15 minutes?
What are the SPECIAL notes associated with Oral Glucose Gel 205 ?
SPECIAL Notes = Not to be administered to children less than two years of age.
What is the TYPE of drug GLUCAGON 208 ?
TYPE = Pancreatic Hormone
What is the action of Glucagon 208 ?
ACTIONS = Converts liver glycogen to glucose. Glucagon may not work if liver glycogen is depleted due to starvation or chronic liver disease
What is the ROUTE and Onset, Peak & Duration Times for Glucagon 208 ?
Route = S/C (Sub Cutaneous)
Times are
Onset = 4 - 7 mins
Peak = 8 - 10 mins
Duration = 11 - 30 mins.
What is the USE of Glucagon 208 ?
USE = Hypoglycaemia is unable to cannulate for administration of IV Dextrose 50% .
What are the ADVERSE effects of Glucagon 208 ?
Adverse Reactions =
*Nausea and Vomiting
*Allergic reactions rarely occur
What is the PREPARATION of Glucagon 208 ?
PREPARATION =
*Glucagon Novo - 1mg vile
*Syringe containing 1ml of sterile water.
Dissolve the glucagon powder by adding the entire contents of the syringe in the vile containing the glucagon. The solution must be prepared immediately prior to use
What is the ROUTE and ADULT and PAEDIATRIC dose of Glucagon 208 ?
ADULT
Route = S/c
Dose = 1ml(1mg) of reconstitted solution

PAEDIATRIC
Route = S/c
Dose = 0.5ml (500mcg) of Reconstituted solution
What are the SPECIAL NOTES for Glucagon 208 ?
When the patient regains consciousness give supplemental sweet drink or food to prevent recurrence of hypoglycaemia
What is the TYPE for GTN 209 ?
TYPE = A Vasodilator
What are the ACTIONS of GTN 209 ?
ACTIONS
*Dilates coronary arteries
*Dilates systemic veins and arteries which decreases both preload and afterload as well as causing a drop in BP
What is the ROUTE and Onset, Peak & Duration times of GTN 209 ?
Route = Sub Lingual (S/l)
Onset time is with in 2 mins.
Duration is up to 30 minutes.
No peak time is listed in our pharmocology
What are the USES of GTN 209 ?
USES of GTN 209
*If mycardial infarction or ischaemia is suspected
*Cardiogenic pulmonary oedema provided BP > or = 100mmHg Systolic
*If autonomic dysreflexia develops after spinal cord injury
What are the ADVERSE effects of GTN 209 ?
ADVERSE EFFECTS

*Hypotension
*Flushing
*Headache
What are the CONTRAINDICATIONS for GTN 209 ?
CONTRAINDICATIONS
*BP <100mmHg
*Use of Nitric Oxide donors
Eg
Sildenafil (Viagra) <12 hours
Vardenafil (Levitra) <24 hours
Tadalafil (Cialis) < <72 hours
What is the PREPARATIOM of GTN 209 ?
GTN Tablets 600mcg
Exposure reduces potency. The bottle must be dated when first opened and all tablets discarded 3 months after opening the bottle.
What is the DOSE for GTN 209 for Suspected Myocardial Ischaemia ?
GTN for suspected MI = ONE tablet (600mcg) GTN sub lingual. Can be repeated ever 5 minutes to a maximum of 3 tablets (1.8mg). Monitor BP closely.
EXTENDED CARE: If chest pain recurs or persists 30mins after last administration, repeat 1 tablet (600mcg) every 5 minutes to a maximum of 3 tablets (1.8mg). Monitor BP Closely
What is the DOSE for GTN 209 for Pulmonary Oedema ?
GTN for Pulmonary Oedema = ONE tablet (600mcg) GTN sub lingual. Can be repeated ever 5 minutes to a maximum of 3 tablets (1.8mg). Monitor BP closely.
EXTENDED CARE: If chest pain recurs or persists 30mins after last administration, repeat 1 tablet (600mcg) every 5 minutes to a maximum of 3 tablets (1.8mg). Monitor BP Closely
What is the DOSE for GTN 209 for Autonomic Dysreflexia ?
GTN for Autonomic Dysreflexia = One Half Table (300mcg) GTN Sub Lingual to a maximum of 3 doses (900mcg). Monitor BP Closely.
What are the SPECIAL Notes for GTN 209 ?
special notes=
*Total maximum dose for any patient is 6 tablets
*GTN is NOT approved for Paediatric Use