Drug Administration - Paramedic Science

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What are the 5 r's?
Right Patient
Right time
Right route
Right dose
Right drug
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What are the indications of Adrenaline?
Anaphylaxis
Life threatening asthma when nebuliser has failed
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What are the Contra-indications of Adrenaline?
None
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What is the code for Adrenaline?
ADM
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What are the cautions of Adrenaline?
Hypertension may occur with non-cardioselective beta blockers
Do not administer through IV with anaphylaxis
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How does Adrenaline work?
Its a Sympathomimetic that stimulates adrenergic receptors, so blood flow is increased
Reverses manifestations of anaphylaxis
Relieves Bronchospasms in asthma
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What is the adult dose for an IM route
500mcg
0.5ml
no max dose
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How does Adrenaline present itself?
In a pre-filled syringe or ampoule containing 1mg
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What is the code for Aspirin?
ASP
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What are the indications of Aspirin?
Adults presenting a myocardial infarction or ischemia
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What are the contra-indications of aspirin?
Allergies
Under 16 y/o (can causes reyes syndrome)
Gastrointesial bleeding
Haemophilia
Hepatic Disease
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What are the cautions of Aspirin?
Benefits do outweigh risks so can be given to
Asthmatics
Pregnancy
kindey/liver failure
Gastric Ulcers
those on anti-coagulants
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Side effects of aspirin
Increased Gastric bleeding
wheezing in asthmatics
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How does aspirin work?
Has an anti-platelet property so reduces clotting
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How does aspirin present itself?
As a tablet of 300mg
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Wat dose of aspirin would you give to an adult?
300mg- 1 tablet max
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What is the code for Chlorphenamine?
CPH
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What are the indications for Chlorphenamine?
Severe anaphylaxis after resurrection
Severe allergic reaction causing distress
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What are the contra-indications for Chlorphenamine?
Allergies
do not inject if patient has had monoamine oxidase inhibitors within 14days
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What should you be cautious of when giving Chlorphenamine?
Pregnancy
Hypotension
Epilepsy
Glaucoma
Liver disease
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What are the side effects of Chlorphenamine?
Dry mouth
Headache
Sedations
Blurred vision
Psychomotor impairment
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How does Chlorphenamine work?
Its an anti-histamine that blocks histamine that is released during an allergic reaction
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How does Chlorphenamine present itself?
An ampoule with 10mg
Tablet containing 4mg
Oral solution containing 2mg per 5ml
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What dose of Chlorphenamine would you give to an adult in tablet form
1 tablet - 4mg
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What dose of Chlorphenamine would you give to an adult in IM form
10mg, 1ml
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What is the code for Glucagon?
GLU
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What are the indications for Glucagon?
Hypoglycaemia with blood glucose less than 4.0
should only be used if oral glucose has failed or iv glucose 10% has failed
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What are the contra-indications for Glucagon?
Pheochromocytoma
Not be given IV
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What cautions are associated with glucagon?
Takes 15 mins to work
for hypoglycaemic seizures iv glucose is preferred
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side effects of glucagon?
vomiting
hypotension
abdominal pain in adults
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How does glucagon work?
induces conversion of glycogen into glucose in the liver
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What dose would you give to an adult of glucogon?
1mg - 1vial
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How does glucagon present itself?
Injection that requires mixing with water and 1mg of powder
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What route does glucagon take?
IM
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What is the code for glucose 40% oral gel?
GLG
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How does glucose 40% oral gel present?
A tube containing 25g of glucose
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What are the indications for glucose 40% oral gel?
Hypoglycaemia in a conscious patient with no choking hazard
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What are the contra-indications for glucose 40% oral gel?
none
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what are the cautions of glucose 40% oral gel?
choking
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What are the side effects of glucose 40% oral gel?
none
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Wat are the actions of glucose 40% oral gel?
increase of blood sugar levels through buccal absorption, failure would prompt use of iv glucose 10% or glucagon
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What dose would you give to an adult of glucose 40% oral gel?
1-2 tubes
10-20g
every 5 mins
20g max
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What is the code for glyceryl Trinitrate?
GTN
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What form does glyceryl Trinitrate take?
Sublingual spray 400mcg
Sublingual tablets containing 300mcg 500mcg or 600mcg
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What are the indications for glyceryl Trinitrate?
Cardiac chest pains due to MI or angina: systolic greater than 90mmHg
Breathlessness due to pulmonary oedema in acute heart failure: systolic greater than 110mmHg
Chest pain due to cocaine
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What are the contra-indications to glyceryl Trinitrate
MI systolic less than 90mmHg
Heart failure systolic less than 110mmHg
head trauma
cerebral haemorrage
has had sildenafil (viagra) in last 24 hours
Unconscious
Hypovolaemia
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What are the cautions for glyceryl Trinitrate?
Suspected posterior MI / right ventricular infarction
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What are the side effects of glyceryl Trinitrate?
Headaches
Dizziness
Hypotension
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How does glyceryl Trinitrate work?
dilates coronary arties and systemic veins which reduces bp
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how many doses of all forms of glyceryl Trinitrate would you give to an adult?
1
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What is the code for Hydrocortisone?
HYC
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How does Hydrocortisone present itself?
A solution for injection, 100mg/1ml
Powder for solution for injection 100mg/2ml
An ampoule ready for mixing with water 100mg/2ml
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What are the indications for Hydrocortisone?
Life Threating asthma
Anaphylaxis
Adrenal crisis - people on long term steroid
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What are the contra-indications for Hydrocortisone?
Allergies
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Cautions of Hydrocortisone?
Avoid IM administration if patient is likely to require thrombolysis
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what are the side effects of Hydrocortisone?
stinging or burning
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How does Hydrocortisone work?
Restores Bp, blood sugar and cardiac synchronicity and volume
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What dose of Hydrocortisone would you give to an adult with asthma?
100mg
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what dose of Hydrocortisone would you give to an adult with anaphylaxis?
200mg
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what is the code for Ipratropium bromide ?
IPR
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What form does Ipratropium bromide take?
Nebuliser liquid 250mg/1ml
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What are the indications for Ipratropium bromide?
Acute asthma - unresponsive to salbutamol

Exacerbation of COPD unresponsive to salbutamol
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what are the contra-indications for Ipratropium bromide ?
non during an emergency
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What are the cautions of using Ipratropium bromide ?
Patients with:
Glaucoma - protect eyes
Pregnancy and Breastfeeding
Prostatic hyperplasia
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What are the side effects of Ipratropium bromide?
Nausea
dry mouth
allergies
tachycardia/ arrthymia
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Actions of Ipratropium bromide ?
better for children with asthma and adults with COPD
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What mcg of Ipratropium bromide would you give to an adult
500mcg
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What is the code for Naloxone Hydrochloride?
NLX
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What form does Naloxone Hydrochloride take?
Ampoule of 400mcg per 1ml
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What are the indications for Naloxone Hydrochloride?
Opioid induces cardiac arrest, respiratory arrest/ depression - unconscious
Antidote to exposure to high potency anaesthetic if they are unconscious or within 10 mins of exposure
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what are the contra-indications for Naloxone Hydrochloride?
Neonates born to opioid addict mothers can experience severe withdrawal
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What are the cautions of Naloxone Hydrochloride?
Some people on end of life use opioids so NLX should only be used if overdose is expected and causing resp issues
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What are the side effects of NLX?
Violent withdrawal symptoms
Vomiting
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In children how much Naloxone Hydrochloride would you give?
full dose 2000mcg due to likihood of overdose being accidental
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In adults how much Naloxone Hydrochloride would you give to an adult?
start at 400mcg every 3 mins up to 4000mcg to stop aggression
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What this the code for Nitrous Oxide?
NOO
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What form does Nitrous Oxide take?
Stored in medical cylinders at 50% oxygen and 50% Nitrous Oxide
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What are the indications for Nitrous Oxide?
Moderate to serve Pain
labour pains
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What are the contra-indications for NOO?
Bad effects for those with closed body cavities:
head injuries
decompression sickness
disturbed psychiatric patients
intraocular injection within 4 weeks
abdominal obstruction suspected
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what are the cautions for Nitrous Oxide?
Pneumothorax, pneumomediastinum
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How long in adults does Nitrous Oxide take to work?
3-5 mins
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What is the code for oxygen?
OXG
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How does oxygen present itself?
In a compressed cylinder
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What are the indications for OXG?
in children : significant injury
critical and moderate injury
COPD
monitor O2 levels
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What are the contra-indications for oxygen?
explosive environments
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What are the cautions for oxygen?
Risk of fire hazards at scene
Careful when using defib
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What are the side effects of oxygen?
dry mouth
in COPD can increase c02 levels
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What is the dose advice for adults with OXG?
use ox meter
with moderate levels use nasal cannule
those with tracheostomy and laryngectomy may need another method
for dosage refer to tables
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what is the dose advice for children with oxygen?
all children with significant injury or illness should receive high levels of oxygen
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what is the code for Paracetamol ?
PAR
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What form does paracetamol take?
oral or IV
Tablets 500mg
120mg- infants 250mg children
IV 1G
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What are the indications for Paracetamol?
Oral mild pain relief and high temp
IV helps with opioid issues and for severe pain
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What are the contra-indications for PAR?
Allergies
had already had some within 4 hours
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What are the cautions for paracetamol?
Watch for confusion between mg and ml
those weighing less than 50kg be careful
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What are the side effects for Paracetamo?l
IV may cause hypotension if given too rapidly
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How does paracetamol work?
analgesic (pain relief) and antipyretic (temp control) drug
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What is the code for Salbutamol ?
SLB
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What form does Salbutamol take?
Nebuliser containing 2.5mg
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What are the indications for Salbutamol?
acute asthma where inhaler has failed
wheezing: anaphylaxis, smoke inhalation or allergies
COPD
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What are the contra-indication for SLB?
None during an emergency
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What are the cautions for Salbutamol?
hypertension
angina
overactive thyroid
late pregnancy
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What are the side effects for SLB?
Tremor
Palpitations
Headache
cramps
rash
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How does Salbutamol work?
Has a relaxant effect on the smooth muscle in the medium and smaller airways
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What dose would you give and adult of Salbutamol?
5mg every 5 mins no limit
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What would you give someone first during acute asthma?
Salbutamol
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What would you give some first during Hypoglycaemia?
Glucose gel
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What would u do if glucose fails?
use glucagon
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What would you use if salbutamol has failed?
Ipratropium bromide
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Card 2

Front

What are the indications of Adrenaline?

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Anaphylaxis
Life threatening asthma when nebuliser has failed

Card 3

Front

What are the Contra-indications of Adrenaline?

Back

Preview of the front of card 3

Card 4

Front

What is the code for Adrenaline?

Back

Preview of the front of card 4

Card 5

Front

What are the cautions of Adrenaline?

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