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156 Cards in this Set
- Front
- Back
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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 due to increased peripheral resistance which improves perfusion pressures. -reverses anaphylaxis -relieves bronchospasm in asthma
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Adrenaline: Contra-indications |
Do not give repeat doses in hypothermic patients. |
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Adrenaline: Dose |
Cardiac arrest- IV 1mg every 3-5 mins no max non shock- ASAP Shockable- 3rd Shock Anaphylaxis/ asthma- IM 500mcgm every 5 mins no max (Both rapid bolus) |
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Amiodarone: Indications |
Shockable rhythms if unresponsive to defib on 3rd and 5th shock. |
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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. Not used at Birth!! |
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Amiodarone: Dose |
Administer into large vein (extravasation can cause burns) 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 NSAID |
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Aspirin: Contra- indications |
Haemophilia or other blood clotting disorders. Active GI bleed.
Known allergy or hypersensitivity. Severe hepatic disease. |
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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 Bradycardia in ROSC (ABC 1st line treatment for children as most likely hypoxia) |
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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 |
IV 600mcgm 3-5 mins max 3 mg (rapid bolus) |
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Benzylpenicillin: Indications |
Suspected menigococcal disease with: Non- blanching rash (petechial or purpuric) &/or 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/IM 1.2gm (slow injection) Two sites should be used for IM injection when more than 2ml |
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Chlorphenamine: Indications |
Severe anaphylactic reactions (after IM Adrenaline) Symptomatic allergic reactions falling short of anaphylaxis but causing pt distress. |
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Chlorphenamine: Actions |
Antihistamine that blocks the effects of histamine release during a hypersensitivity reaction. Anticholinergic properties |
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Chlorphenamine: Contra-indications |
Known hypersensitivity Monoamine oxidase Inhibitors (MAOI) in the last 14 days |
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Chlorphenamine: Dose |
IV- 10mg (slowly over 1 min) 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 |
Known allergy Known severe hepatic impairment Active pathological bleeding (Peptic ulcer, intracranial) |
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Clopidogrel: Dose |
Thrombolysis: 300mg PPCI: 600mg |
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Dexamethasone: Indications |
Mild-Moderate- Severe croup |
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Dexamethasone: Actions : Contra-indications |
A- Corticosteriod that reduces subglottic imflammation C-I- Impending respiratory failure |
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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 or recurrent) 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 |
Pt with known hypersensitivity |
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Diazepam: Dose |
Rectal (small)- 10mg no repeat max 10mg Rectal (large)- 20mg no repeat max 10mg IV- 10mg, every 5 mins, repeat 10 mg, max 20mg |
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Entonox: Indications |
Moderate- severe 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) Recent Intraocular surgery Intestinal obstruction |
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Entonox: Dose |
PRN, 3-5 mins to be effective 5-10 max effect Children if they can physically work device |
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Furosemide: Indications |
Pulmonary oedema 2nd to LVF |
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Furosemide: Actions |
Potentate diuretic with a rapid onset (within 30 mins) short lasting. |
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Furosemide: Contra-indications |
Reduced GCS secondary to liver cirrhosis Cardiogenic shock
Severe renal failure with anuria Under 18!! |
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Furosemide: Dose |
IV: 40-50mg (IV slowly over 2 minutes) |
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Glucagon: Indications |
Hypoglycaemia with BM <4 Clinically suspected hypo where oral glucose not possible 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 |
Phaechromocytoma Not IV |
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Glucagon: Dose |
IM: 1mg no repeat (thigh or arm) |
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Glucose 10%: Indications |
Hypoglycaemia with BM <4 Clinically suspected hypo where oral glucose not possible and unresponsive to glucagon Unconscious pt where hypo likely cause |
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Glucose 10%: Actions |
Reversal of hypoglycaemia |
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Glucose 10%: Contra-indications |
None |
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Glucose 10%: Dose |
10g, repeat every 5 mins Max dose 30g (Infusion drip, restore normal gcs, no response after 2nd dose pre-alert) |
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Glucose 40%: Indications |
Hypo with BM <4, where there is no risk of choking 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%: Dose |
10g, repeat every 5 mins, no max. |
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GTN: Indiactions |
Cardiac chest pain due to angina or MI or cocaine toxicity with BP above 90mmHg Acute pulmonary oedema with BP above 110mmHg |
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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 or <110 Hypovolaemia Head trauma Cerebral haemorrhage Unconscious known severe aortic or mitral stenosis |
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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. Initial bolus given prior to thrombolytic agents. |
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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 Nervous System Acute bacterial endocarditis Spinal or epidural anaesthesia |
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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 Anaphylaxis Adrenal crisis- pt in established adrenal crisis -steroid-dependant pts Refer to JRCALC for further info on 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 (sodium succinate/ phosphate) |
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Hydrocortisone: Dose |
Asthma + Adrenal crisis: IV: 100mg Anaphylaxis: IV:200mg (IV over 2 mins) |
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Ibuprofen: Indications |
Mild- moderate pain and/or high temp Soft tissue injuries Pyrexia |
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Ibuprofen: Actions |
Analgesic Anti-inflammatory Anti-pyretic |
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Ibuprofen: Contra-indications |
Dehydration Renal/hepatic/ heart failure Hypovolaemia Active GI disturbance Pregnant Child with chickenpox If previous NSAID used in the last four hours |
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Ibuprofen: Dose |
400mg, repeat 8hrs, max 1.2gms per 24 hrs |
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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: 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 |
Age less than 20 Renal failure Pheochromocytoma GI Obstruction Perforation/haemorrhage/ 3-4 days post-surgery Cases of Overdose |
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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 (>140/90) Misoprostol last resort if other oxcytocins ineffective after 15 mins. |
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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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Misoprostol: Dose |
Oral 600mcg (3 tabs 200mcg) , no repeat Rectal 1mg (5 tabs 200mcg), no repeat |
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Morphine: Indications |
Pain associated with MI Severe pain as a component of a balanced analgesic regimen Clinical judgement for analgesia |
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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 Hypotension 90, 80, 70 Head injury with reduced GCS <9 Resp depression < 10 resp per min Known hypersensitivity Severe headache |
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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: Dose |
IV: 400mcgms, repeat every 3 mins, max 4000mcgm |
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Ondansetron: Indications |
Adults: Treatment/ prevention of opioid induced nausea or vomiting Treatment for nausea or vomiting Children: Same as above and travel-induced nausea |
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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: 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: 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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Paracetamol: Indications |
Mild to moderate pain relief and/or high temp with discomfort 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: Dose |
Oral: 1g, every 4-6 hrs, Max 4g in 24 hours IV: Same dose as oral in 100ml, given slowly over 5-10 mins infusion |
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Reteplase: Indications |
STEMI, 12 hr of symptom onset where PPCI NOT readily available. Ensure pt fulfils criteria for drug administration. |
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Reteplase: Actions |
Activates the fibrinolytic system, inducing the break up of intravascular thrombi and emboli. |
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Reteplase: Contra-indications |
See local trust checklist |
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Reteplase: Dose |
1) Administer IV bolus of Heparin first 2) >18 1st bolus 10 units 3) 2nd bolus 10 units after 30 mins 4) At hospital, staff need to administer 2nd bolus (if not already done so) and commence Heparin infusion. |
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Salbutamol: Indications |
Acute asthma attack where inhalers have failed Expiratory wheeze associated with allergy, anaphylaxis, smoke inhalation or other low airway cause Exacerbation 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 attack. |
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Salbutamol: Contra-indications |
None |
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Salbutamol: Dose |
Neb: 5mg, every 5 mins, no max |
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Sodium Chloride 0.9%:Dose |
Flush: 2-5ml, PRN Flush (Glucose infuse): 10-20ml, PRN Medical conditions, no haem: 250ml, PRN, Max 2L Sepsis (inf + <90+TachyRR): 1 litre, 30 mins, Max 2L Medical conditions + haem: 250ml, PRN, Max 2L Blunt/head/ penetrating limb trauma + <90: 250ml, PRN, Max 2L Penetrating torso+ <60: 250ml, PRN, Max 2L Burns 15-25% TBSA +Hosp >30 mins OR >25% TBSA: 1L once only. Limb crush: 2L once only |
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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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Syntometrine: Actions |
Stimulates uterine contraction Onset 7-10 mins |
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Syntometrine: Contra-indications |
Hypertension and severe pre-eclampsia Known hypersensitivity
Active labour Possible multiple pregnancy/ suspected fetus in utero |
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Syntometrine: Dose |
IM: 500mcgm ergometrine and 5 units of oxytocin |
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Tenecteplase: Indications |
STEMI within 6hrs of symptom onset where PPCI NOT readily available. Pt fulfils drug administration criteria. |
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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: 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 |
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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. PPH if after administration of uterotonic drug pt continues to bleed |
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Tranexamic Acid: Actions |
Anti-fibrinolytic which reduces the breakdown of blood clots. |
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Tranexamic Acid: Contra-indications |
Bleeding has stopped If interventions delay transport to hospital
Allergy PPH before administration of uterotonic Bleeding started more than 3 hours ago |
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Tranexamic Acid: Dose |
IV: 1gm in 10 ml |
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Midazolam- Indications |
Convulsions lasting 5 mins and still fitting 3+ focal or generalised convulsions in 1 hour Convulsion continuing 10 mins after first dose of medication |
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Midazolam- Actions |
Benzodiazepine derivative. Onset of action 2 mins, peak effect @ 5-10 mins Short-acting, decreasing from 15 min Titrate to response |
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Midazolam- Contra-indications |
None |
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Midazolam- Dose |
IV 2mg per 2 mins, MAX 10mg Buccal 10mg per 10 mins, MAX 20mg Sedation <60 yrs 7.5mg >60 yrs 3.5mg |
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Anti-epileptics |
Carbamazepine Valporates Phenytoin |
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GI- Regulate stomach acid |
Cimetidine
Ranitidine Famotidine Nizatidine |
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GI- Inhibit acid secretion |
Omeprazole Lansoprazole |
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GI |
Magnesium + Aluminium hydroxide Calcium carbonate Sodium bicarbonate |
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Calcium channel blockers- Hypertension |
Amlodipine Diltiazem Felodipine Nicardipine Nifedipine Verapamil |
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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 |
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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. |
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Antibotics- Cephalosporins |
Cefaclor Cefalexin Cefradine |
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Antibotics- Tetracyclines |
Oxytetracycline Tetracycline Doxycycline Lymecycline |
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Antibotics-Macrolides |
Erythromycin Clarithromycin Azithromycin |
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Viagra |
Sildenafil Alprostadil Tadalafil Vardenafil |
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Diuretics- Hypertension and Oedema |
Bendroflumethiazide Furosemide Bumetanide Amiloride |
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Tetracaine 4%- Indications |
Venepuncture required in a non-urgent situation in individuals with a fear of procedure. Time of application should be handed over to ED |
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Tetracaine 4%- Actions |
Local anaesthetic |
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Tetracaine 4%- Contra-indications |
Should not take place over life-threatening procedures Area considered requiring venepuncture in less than 15mins Known allergy to drug and/or brand of occlusive dressing |
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Tetracaine4%- Dose |
Topical- 1-1.5g Apply directly onto vein Do not rub Occlusive dressing over blob Repeat procedure if necessary on other site |
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Activated Charcoal: Indications |
Emergency treatment of acute oral poisoning or overdose Adults and children aged 1 or over ingested substance less than 1 hour before arrival OR Toxbase indicates that it should be administered, regardless of time. |
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Activated Charcoal: Contra Indications |
Children under 1 Patients presenting more than 1 hour Administration not advised by Toxbase Patients who are vomiting Corrosive substances |
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Activated Charcoal: Dose |
Adults 50g (250 ml) Children 1-12 25g (125ml) |
