CPG Phamacology

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Alejandraso
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283565
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CPG Phamacology
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2014-10-03 09:13:15
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CPG Phamacology
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CPG Phamacology
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  1. Adrenaline

    Presentation
    1mg in 1mL glass ampoule(1:1,000)

    1mg in 10mL glass ampoule(1:10,000)
  2. Adrenaline

    Primary Indications
    • 1-  Persistent VF or unconscious, pulseless, VT
    • 2-  Asystole
    • 3-  PEA
    • 4-  Inadequate Perfusion (Cardiopgenic)
    • 5-  Inadequate Perfusion (non-cardiopgenic, non-hypovolemic)
    • 6-  Anaphylaxis
    • 7-  Severe Athsma
    • 8-  Unconscious asthma with no recordable BP
    • 9-  Croup
    • 10- Bradycardia with poor perfusion
  3. Adrenaline

    Contradiction
    1-  Hypovolemic shock with inadequate fluid replacement
  4. Adrenaline

    Precsutions
    • 1-  Elderly Pts
    • 2-  Pts with Cardiovascular disease
    • 3-  Pts on monoamine oxidase inhibitors
    • 4-  Pts on Beta blockers as higher doses may be required
  5. Adrenaline

    Route
    • IV
    • IM
    • IO
    • NEBULISED
    • IV INFUSION
    • IO
  6. Adrenaline

    Side Effects
    • 1-  Sinus Tachicardia
    • 2-  Supraventricular arrhythmias
    • 3-  Ventricular arrhythmias
    • 4-  Hypertension
    • 5-  Pupillary dilation
    • 6-  May increase size of MI
    • 7-  Feeling of anxiety/palpitatins in the conscious Pt
  7. Asprin

    Presentation
    • 300 mg chewable tablets
    • 300 mg soluble or water dispersible tablets
  8. Asprin

    Primary Indication
    ACS
  9. Asprin

    Contradictions
    • 1-  Hypersensitivity to asprin / salicyates
    • 2-  Actively bleeding peptic ulcers
    • 3-  Bleeding disorders
    • 4-  Suspected dissecting aortic aneurysm
    • 5-Chest pain assosiated with psychostimulant OD if SBP>160 mmHg
  10. Asprin

    Side Effects
    • 1-  Heartburn, Nausea, gastrointestinal bleeding
    • 2-  Increased bleeding time
    • 3-  Hypersensitivity reactions
  11. Asprin

    Precautions
    • 1-  Peptic Ulcer
    • 2-  Asthma
    • 3-  Pts on anticoagulants
  12. Dextrose 10%

    Presentation (Route)
    25mg in 250mL infusion soft pack (IV Infusion)
  13. Dextrose 10%

    Primary Indication
    1-  Diabetic Hypoglycemia (BGL<4mmol/L) in Pts with an altered conscious state who are unable to self administer oral glucose
  14. Dextrose 10%

    CONTRA/PREC/SIDE EFFECTS
    Nil significance in the above indication
  15. Fentanyl

    Presentation & Route
    • 100 mcg in 2mL glass ampoule
    • 600mcg in 2 mL glass vial (IN use only)

    Route: IV IN
  16. Fentanyl

    Primary indication
    • 1-  Sedation to facilitate intubation
    • 2-  Sedation to maintain intubation
    • 3-  Drug facilitated intubation 
    • 4-  Analgesia - IV/IN
  17. Fentanyl

    Contradiction
    • 1-  Known hypersensitivity
    • 2-  IV Amiodarone
  18. Fentanyl

    Precautions
    • 1-  Elderly patients
    • 2-  Impaired renal / hepatic function
    • 3-  Respiratory depression, e.g. COPD
    • 4-  Current asthma
    • 5-  Pts on monoamine oxidase inhibitors
    • 6-  Known addiction to opiods
    • 7-  Rhinitis, rhinorrhea or facial trauma (IN route)
    • 8-  Oral Amiodarone

  19. Fentanyl

    Side effects
    • 1-  Respiratory depression
    • 2-  Apnoea
    • 3-  Rigidity of the diaphragm and intercostal muscles
    • 4-  Bradycardia
  20. Glucagon

    Presentation & Route
    1mg (IU) in 1mL hypokit - IM

    [Special Note - Not all Pts will respond to Glucagon eg- those Pts with inadequate glycogen stores in the liver (alcoholics, malnourished)]
  21. Glucagon

    Primary Indication
    1-  Diabetic hypoglycemia (BGL<4mmol/L) in Pts with an altered conscious state who are unable to self -administer oral glucose
  22. Glucagon

    Contraindications & Precautions
    C&P- Nil significance in the above indication
  23. Glucagon

    Side Effects
    Nausea and vomiting (rare)
  24. Glyceryl Trinitrate (GTN)

    Presentation
    • 0.6 mg tablets 
    • Transdermal GTN Patch (50mg 0.4 mg/hr release)
  25. Glyceryl Trinitrate (GTN)

    Primary Indication
    • 1-  Chest pain with ACS
    • 2-  Acute LVF (Left Ventricular Failiure)
    • 3-  Hypertension assosiated with ACS
    • 4-  Autonomic Dysreflexia
    • 5-  Preterm labour (Consult)
  26. Glyceryl Trinitrate (GTN)

    Contraindications
    • 1-  Known hypersensitivity 
    • 2-  Systolic BP < 110 mmhg TABLET
    • 3-  Systolic BP < 90 mmhg PATCH
    • 4-  Sildenafil Citrate (Viagra) or Vardenafil (Levitra) administration in the previous 24hrs or Tadalafil (Cialis) administration in the previous 4 days (PDE5 Inhibitors)
    • 5-  Heart Rate >150 bpm
    • 6-  Bradycardia HR<50 bpm (Excluding autonomic dysreflexia) 
    • 7-  VT
    • 8-  Inferior STEMI with SBP<160 mmhg
    • 9-  Right Inferior MI
  27. Glyceryl Trinitrate (GTN)

    Precautions
    • 1-  No previous administration
    • 2-  Elderly Pts
    • 3-  Recent MI
    • 4-  Concurrent use with other tocolytics
  28. Glyceryl Trinitrate (GTN)

    Route
    • SL
    • Buccal
    • Transdermal
    • Infusion (inter-hospital transfer only)
  29. Glyceryl Trinitrate (GTN)

    Side effects
    • Tachycardia
    • Hypotension
    • Headache
    • Skin flushing (uncommon)
    • Bradycardia (Occasionally)
  30. Ipratropium Bromide (Atrovent)

    Presentation & Route
    • 250mcg in 1mL nebule or polyam
    • & Nebulised (in combination with Salbutamol)
  31. Ipratropium Bromide (Atrovent)

    Primary Indications
    Severe respiratory distress associated with bronchospasm
  32. Ipratropium Bromide (Atrovent)

    Contraindications
    • 1. Known hypersensitivity to Atropine or its derriritives
  33. Ipratropium Bromide (Atrovent)

    Precautions
    • 1.  Glaucoma
    • 2.  Avoid eye contact with eyes
  34. Ipratropium Bromide 

    Side effects
    • 1.  Headache
    • 2.  Nausea
    • 3.  Dry Mouth
    • 4.  Skin rash
    • 5.  Tachycardia (Rare)
    • 6.  Palpitations (Rare)
    • 7.  Acute angle closure glaucoma secondary to direct eye contact (Rare)
  35. Methoxyflurane

    Presentation & Route & Primary indication
    3mL Glass bottle

    Self-administration under supervision using the hand held Penthrox Inhaler with or without 02 Supplementation.

    Pain relief
  36. Methoxyflurane

    Contraindication
    • 1.  Pre-existing renal disease / renal impairment
    • 2.  Concurrent use of tetracycline antibiotics
    • 3.  Exceeding total dose of 6mL in a 24 hr period
  37. Methoxyflurane

    Precautions
    • 1.  The Penthrox inhaler must be hand held by its Pt so that if unconsciousness occurs it will fall from Pts face. Occasionally the operator may need to assist but must continuously assess the level of consciousness.
    • 2.  Pre-eclampsia
    • 3.  Concurrent use with Oxytocin may cause hypotension
  38. Methoxyflurane

    Side Effects
    • 1.  Drowsiness
    • 2.  Decrease in blood pressure & bradycardia (Rare)
    • 3.  Exceeding the maximum total dose of 6mL in a 24 hr Period may lead to renal toxicity
  39. Metoclopramide (Maxalon)

    Presentation
    10mg in 2mL polyamp
  40. Metoclopramide (Maxalon)

    Prrimary Indication
    • 1.  Nausea / vomiting associated with
    •   -Chest pain / Discomfort of a cardiac nature
    •   -Opioid administration for pain
    •   -Cytotoxic or Radiotherapy
    •   -Previously diagnosed migraine
    •   -Severe gastroenteritis

    • 2.  Prophylaxis:
    •   -Awake spinal immobilised Pts
    •   -Eye Trauma
  41. Metoclopramide (Maxalon)

    Contraindication
    • 1. Children
    • 2.  Suspected

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