level 1 pharmacology

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level 1 pharmacology
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  1. what type is glucagon
    pancreatic hormone
  2. what is the action of glucagon
    • converts liver glycogen to glucose. Glucagon may not work if liver glycogen is depleted due to starvation or chronic liver disease.
  3. what is the use of glucagon
    • hypoglycaemia if unable to cannulate for administration of glucose 10%
  4. what are the adverse effects of glucagon?
    • 1. Nausea and vomiting.
    • 2. Allergic reactions rarely occur.
  5. what is the preparation of glucagon?
    • 1mg vial and syringe containing 1ml of sterile water.
    • dissolve the glucagon powder by adding the entire contents of the syringe to the vial containing the glucagon. the solution must be prepared immediately prior to use.
  6. what is the dose for glucagon?
    • patients ≥ 16yrs of age
    • 1mg (1ml) of reconstituted solution SC/IM
    • patients < 16yrs of age
    • 500mcg (0.5ml) reconstituted solution SC/IM
    • ** when the patient regains consciousness give food to prevent recurrence of

    • hypoglycaemia. Carbohydrates constitute the main source of energy for all body functions especially the brain. Cereals, vegetables, fruits, rice, potatoes, legumes and flour products are the main source of carbohydrates**
  7. what type is Glyceryl Trinitrate (GTN)?
    Vasodilator
  8. What are the actions of Glyceryl Trinitrate (GTN)?
    • Dilates coronary arteries.
    • Dilates systemic veins and arteries.
    • Decreases preload, afterload and blood pressure.
  9. what is the route of Glyceryl Trinitrate (GTN)?
    • Sublingual S/L
  10. what is the onset of GTN?
    • Within 2 minutes
  11. How long does GTN last?
    • up to 30minutes
  12. What are the uses for Glyceryl Trinitrate (GTN)?
    • Suspected coronary artery syndrome
    • Cardiogenic pulmonary oedema
    • Autonomic dysreflexia.
  13. What are the adverse effects of GTN?
    • Hypotension
    • Flushing
    • Headache
  14. What are the contraindications of GTN?
    • BP < 100mmHg
    • Heart rate < 50/min or >150/min
    • Patients <16yrs of age
    • Use of drugs to treat erectile dysfunction e.g.
    • Sildenafil - Viagra - within 24hrs
    • Vardenafil - Levitra - within 24hrs
    • Tadalafil -  Cialis - within 96hrs
  15. What is the preparation of GTN?
    600mcg tablet

    ** discard 3months after opening the bottle as exposure reduces potency. Bottles must have the date opened written on the label.**

    UNUSED HALF TABLETS OF GTN MUST BE DISCARDED.
  16. What is the dose of GTN for Cardiogenic Pulmonary Oedema?
    • Patients ≥ 16yrs of age 600mcg (1 tablet) S/L repeat every 5 mins, monitor BP closely. maximum dose 1.8mg (3 tablets)
    • This regime can be repeated 30 minutes after last administration. If indicated.
  17. What is the dose of GTN for Autonomic Dysreflexia?
    • Patients ≥ 16yrs of age 300mcg (1/2 tablet) S/L
    • repeat every 5 mins, monitor BP closely. maximum dose 900mcg (1.5 tablets).

  18. What is the dose of GTN for Suspected Acute Coronary Syndrome?
    • Patients ≥ 16yrs of age
    • 600mcg (1 tablet) S/L
    • repeat every 5 mins, monitor BP closely.
    • maximum dose 1.8mg (3 tablets)
    • This regime can be repeated 30 minutes after last administration. If indicated.
  19. What is the note for patient with advanced age or smaller than average size in regards to dosage of GTN?
    • Patients with advanced age, smaller than average size or general debility should receive an initial dose of 300mcg (1/2 tablet) with subsequent doses of either 300mcg or 600mcg depending on response to a max of 1.8mg (3 tablets).
  20. What type is Salbutamol?
    • Sympathomimetic
  21. What is the action of Salbutamol?
    Stimulates the beta 2 receptors in bronchial smooth muscle resulting in bronchodilation.
  22. what is the route for Salbutamol?
    Nebulised
  23. what is the onset for Salbutamol?
    2-5 minutes
  24. what is the peak for Salbutamol?
    5-10 minutes.
  25. what is the duration of Salbutamol?
    1-2 hours.
  26. What are the uses for Salbutamol?
    To relieve bronchospasm.
  27. What are the adverse effects of Salbutamol?
    • Dysrhythmias in large doses
    • Shakes and tremors.
  28. What is the preparation for Salbutamol?
    • 5mg in (2.5ml) nebule
    • 2.5mg in (2.5ml) nebule.
  29. What is the dose of Salbutamol for relief of bronchospasm?
    • Patients ≥ 5yrs of age
    • 5mg (2.5ml) via nebuliser at 8lts/min oxygen.
    • repeat whilst indications persist.
    • Maximum dose: no maximum dose.

    • Patients < 5yrs of age
    • 2.5mg (2.5ml) via nebuliser at 8lts/min oxygen. repeat whilst indications persist.
    • Maximum dose: no maximum dose.

    if patient is severe/life threatening DO NOT wait on scene for salbutamol to be effective.

    • because 2 concentrations are available, read the label carefully and check this with our partner.
  30. What type is Paracetamol?
    • Analgesic and antipyretic
  31. What are the actions of Paracetamol?
    • Temporary relief of pain and discomfort in arthritis, headache, muscular and neuralgic conditions and reduces fever.  
  32. what is the onset of Paracetamol?
    • 1-60 minutes
  33. What is the duration of Paracetamol?
    • Up to 4 hours.
  34. What are the uses for Paracetamol?
    • Mild pain
    • low acuity patient specifically:
    • strains and sprains of the ankle / foot
    • localised dental pain
  35. What are the adverse effects of Paracetamol?
    • nausea
    • liver failure in overdose situations
  36. what are the contraindications for Paracetamol?
    • Allergy or hypersensitivity to Paracetamol
    • multiple previous doses i.e: previous self-administration within 4/24 or 4g (8 tablets) within 24hours.
    • patients < 12 years of age.
  37. What is the preparation of Paracetamol?
    • 500mg tablet
  38. what is the dose for Paracetamol?
    • Patients ≥ 12 years of age
    • 500mg-1g (1-2 tablets)
    • may be repeated after 4 hours whilst indications persist
    • maximum dose: 1g (2 tablets) per dose, 4g (8 tablets) in 24 hours.
  39. What type is Ipratropium bromide?
    • Anticholinergic bronchodilator
  40. What is the action of Ipratropium bromide?
    • Bronchodilation
    • Blocks vagal reflexes which mediate Bronchoconstriction
    • Synergistic when used in combination with salbutamol
  41. What is the route for Ipratropium bromide?
    • Nebulised
  42. What in the onset for Ipratropium bromide?
    • 3-5 minutes
  43. What is the duration for Ipratropium bromide?
    • 2-4 hours
  44. What is the use for Ipratropium bromide?
    • Moderate to severe Asthma
    • COPD
  45. What are the contraindications for Ipratropium bromide?
    • Allergy or hypersensitivity to ipratropium bromide
    • Glaucoma
  46. What are the adverse effects of Ipratropium bromide?
    • Mild anticholinergic effects, e.g. urine retention
  47. What is the preparation of Ipratropium bromide?
    • 500mcg in 1ml nebule for patients ≥ 6 years of age
    • 250mcg in 1ml nebule for patients < 6 years of age
  48. What is the dose of Ipratropium bromide for moderate to severe asthma and COPD?
    • Patients over 6 years of age
    • 500mcg (1ml)nebulised mixed with salbutamol
    • repeat once whilst indications persist
    • maximum dose: 1mg (2ml)

    • Patients under 6 years of age
    • 250mcg (1ml) nebulised mixed with salbutamol
    • repeat once whilst indications persist
    • maximum dose: 500mcg (2ml)
  49. What type is Adrenaline?
    • Adrenaline is a sympathomimetic
  50. What is the action of Adrenaline?
    Stimulates the ALPHA and BETA subdivisions of the sympathetic nervous system to produce the "Fight" or "Flight" reaction.

    • ALPHA stimulation causes peripheral vasoconstriction. it raises the perfusion pressure of vital organs during cardiac arrest and it decreases capillary permeability and increases blood pressure in anaphylaxis
    • BETA 1 stimulation causes increased myocardial excitability, tachycardia, and increased myocardial contractility.
    • BETA 2 stimulation causes bronchodilation.



  51. What is the onset of nebulised adrenaline for croup?
    • 1-5 minutes.
  52. What is the duration of nebulised adrenaline for croup?
    Up to 20 minutes.
  53. What are the uses for adrenaline?
    • Cardiac arrest
    • Bradycardia
    • Cariogenic shock
    • Severe / life threatening asthma
    • Anaphylaxis
    • Severe croup (nebulised)
    • Newborn care
  54. What are the adverse effects of adrenaline?
    • Tachycardia
    • Dysrhythmias, including ventricular fibrillation
    • Hypertension
    • Pupillary dilation
    • Anxiety
    • Nausea and vomiting
  55. What is the dose of adrenaline given for severe croup?
    • Patients under 16 years of age
    • 500mcg/kg (0.5ml/kg) 1:1,000 Nebulised adrenaline
    • Maximum bolus dose: 5mg (5ml)
    • Repeat after 30minutes whilst indications persist.

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