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what type is glucagon
pancreatic hormone
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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.
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what is the use of glucagon
- hypoglycaemia if unable to cannulate for administration of glucose 10%
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what are the adverse effects of glucagon?
- 1. Nausea and vomiting.
- 2. Allergic reactions rarely occur.
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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.
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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**
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what type is Glyceryl Trinitrate (GTN)?
Vasodilator
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What are the actions of Glyceryl Trinitrate (GTN)?
- Dilates coronary arteries.
- Dilates systemic veins and arteries.
- Decreases preload, afterload and blood pressure.
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what is the route of Glyceryl Trinitrate (GTN)?
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what is the onset of GTN?
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What are the uses for Glyceryl Trinitrate (GTN)?
- Suspected coronary artery syndrome
- Cardiogenic pulmonary oedema
- Autonomic dysreflexia.
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What are the adverse effects of GTN?
- Hypotension
- Flushing
- Headache
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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
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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.
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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.
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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).
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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.
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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).
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What is the action of Salbutamol?
Stimulates the beta 2 receptors in bronchial smooth muscle resulting in bronchodilation.
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what is the route for Salbutamol?
Nebulised
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what is the onset for Salbutamol?
2-5 minutes
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what is the peak for Salbutamol?
5-10 minutes.
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what is the duration of Salbutamol?
1-2 hours.
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What are the uses for Salbutamol?
To relieve bronchospasm.
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What are the adverse effects of Salbutamol?
- Dysrhythmias in large doses
- Shakes and tremors.
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What is the preparation for Salbutamol?
- 5mg in (2.5ml) nebule
- 2.5mg in (2.5ml) nebule.
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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.
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What type is Paracetamol?
- Analgesic and antipyretic
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What are the actions of Paracetamol?
- Temporary relief of pain and discomfort in arthritis, headache, muscular and neuralgic conditions and reduces fever.
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what is the onset of Paracetamol?
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What is the duration of Paracetamol?
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What are the uses for Paracetamol?
- Mild pain
- low acuity patient specifically:
- strains and sprains of the ankle / foot
- localised dental pain
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What are the adverse effects of Paracetamol?
- nausea
- liver failure in overdose situations
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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.
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What is the preparation of Paracetamol?
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what is the dose for Paracetamol?
- Patients ≥ 12 years of age500mg-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.
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What type is Ipratropium bromide?
- Anticholinergic bronchodilator
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What is the action of Ipratropium bromide?
- Bronchodilation
- Blocks vagal reflexes which mediate Bronchoconstriction
- Synergistic when used in combination with salbutamol
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What is the route for Ipratropium bromide?
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What in the onset for Ipratropium bromide?
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What is the duration for Ipratropium bromide?
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What is the use for Ipratropium bromide?
- Moderate to severe Asthma
- COPD
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What are the contraindications for Ipratropium bromide?
- Allergy or hypersensitivity to ipratropium bromide
- Glaucoma
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What are the adverse effects of Ipratropium bromide?
- Mild anticholinergic effects, e.g. urine retention
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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
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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)
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What type is Adrenaline?
- Adrenaline is a sympathomimetic
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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.
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What is the onset of nebulised adrenaline for croup?
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What is the duration of nebulised adrenaline for croup?
Up to 20 minutes.
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What are the uses for adrenaline?
- Cardiac arrest
- Bradycardia
- Cariogenic shock
- Severe / life threatening asthma
- Anaphylaxis
- Severe croup (nebulised)
- Newborn care
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What are the adverse effects of adrenaline?
- Tachycardia
- Dysrhythmias, including ventricular fibrillation
- Hypertension
- Pupillary dilation
- Anxiety
- Nausea and vomiting
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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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