1. Naloxone Adult dose for analgesic overdose?
    Dilute 1ml with 3mls Nacl which 1ml=100mcg

    IV- 1ml every 2mins

    IM- 1ml every 5 mins
  2. Naloxone Adult dose for a suspected Narcotic Overdose?
    1ml or 400mcg IM or IV every 2 mins to a max dose of 2mg or 5 doses if inadequate clinical response.
  3. Adrenaline action?
    • Stimulates the alpha & Beta subdivision of the sympathetic nervouse system to cause fight or flight.
    • Alpha stimulations causes peripheral vasoconsrtricion, it raises the perfusion pressure of vital organs during cardia arrest.
    • Beta 1 stimulation causes increased myocardial excitablity withtachycardia and increased myocardial contractility.
    • Beta 2 causes bronchial dilation.
  4. Naloxone Adult dose for ETORPHINE or BUPRENORPHINE reversal
    • 5ml or 2mg undiluted IV or IM bolus dose
    • Can be repeated every 5 mins until adequate clinical response.
  5. Naloxone Adverse Effects.
    • Can cause vomiting, sweating, tachycardia & hypertension.
    • In patients with cardia disease VT, Vf and Pulmonary Oedemamay ocassionally occur particularly in patients with inadequate ventilation and high carbon dioxide levels.
  6. Naloxone can reverse which drugs?
    • Buprenorphine
    • Codeine
    • Di-Gesic
    • Lomitil
    • Fentanyl
    • Heroin
    • Methadone
    • Morphine
    • Pethidine
  7. Naloxone Paediatric dose for Suspected Narcotic Overdose
    • .25ml/kg undiluted Naloxone as a bolus IV or IM
    • Each bolus dose nust not exceed the adult done of 400mcg.
    • Can be repeated every 2 mins up to 2mg if inadequate clinical response
  8. Naloxone peadiatric dose for analgesic overdose.
    • Dilute 1ml (400mcg) with 3ml Nacl.
    • IV .5ml as a bolus and repeat every 2mins until adequate clinical response
    • IM 0.5ml initial boluse and repeat every 5 mins
  9. Morphine Type
    Opioid Analgesic
  10. Morphine use
    • Pain Management
    • Pulmonary Oedema
  11. Morphine Adverse effects
    • Decreased LOC
    • Hypotension
    • Respiritory depression
    • Nausia and Vomiting
  12. Morphine Coontraindications
    • Altered LOC
    • Patient is poorly perfused
    • Women in Labour
    • Known Allergy
  13. Morphine Adult dose for Pain
    • Initial regimen
    • IV. 5ml(5mg) as an initial bolus
    • Repeat 2.5ml- 5ml as required every 2 mins until pain is relieved or max dose of 0.5ml/kg
  14. Morphine Persistant or recurrent pain
    The initial pain regimen can be repeated after 30 mins
  15. Morphine IM dose for pain
    0.5ml-2ml (5mg-20mg) of undiluted to a max of 20mg

    Dose should be halved with smaller than average pts, CAL and general debility.
  16. IV Morphine dose for Paediatrics for Pain
    • 0.1ml/gk of diluted Morphine
    • Repeat every 5mins until either pain is relieved or max of 4 doses
  17. Morphione paediatric Persistant or recurrant pain
    Initial regimen can be repeated after 30 mins every 5mins to max of 4 doses
  18. Morphine Paediatric dose for IM
    0.025ml/kg of undiluted morphine. dose must not exceed the adult dose
  19. Morphine min age for administration
  20. Maxalon type
  21. Maxalon Action
    • Supresses vomiting by acting on both the chemoreceptor trigger zone and stomach.
    • Accelerates gastric emptying by stimulating the motility of the stomach and upper GIT
  22. Maxalon uses
    • Vomiting
    • Prophylaxis to prevent vomiting in either eye or spinal injuries in adults
    • Prophalaxis if the patients airway may be compromised due to vomiting
  23. Maxalon adverse effects
    • Drowsiness, lethergy and dry mouth
    • Extrapyranidal stimulation rarely results in spasm of facial muscles, trismus, speech difficulties and unnatural body positioning
  24. Maxalon contraindications
    Previous adverse reaction or allergy
  25. Maxalon dose
    2ml or 10mg IM or IV Slowly
  26. Hartmanns type
    crystalloid solutuion
  27. Hartmans Action
    Following intravenious infusion it is distributed throughout the extracellular fluid space. Approx 25% of the volume stays in the intravascular space
  28. Hartmanns use
    • Fluid replacement
    • Dehydration
    • Diving emergencies

    • Hypovolaemia trauma-adult and Paed
    • Hypovolaemia non trauma
    • Meningococcyl Septicaemia
    • Hyperglycaemia
    • Burns
    • Flush for drugs
    • TKVO in limb realignment and or difficult extrication
  29. Hartmanns Adverse effects
    • Excess administration can cause Pulmonary Oedema
    • Over infusion will cause coagulpathy,hypothermia and acidosis in the trauma patient
  30. Hartmanns dose for Adult Trauma Hypovolaemia
    • 100-200mls aliquots to maintain a radial pulse
    • For traumatic brain injuries maintain a radial pulse >90mmhg
  31. Hartmans Doe Paediatric Trauma Hypovolaemia
    5ml/kg which can be repeated if any of the key signs of shock remain
  32. Hartmanns dose Non Trauma Hypovolaemia
    1ltr Stat dose
  33. Hartmanns dose paediatric Non trauma hypoglycaemia
    20mls/kg rapis bolus infusion
  34. Hartmanns dose for Adult and Paed Hyperglycaemia
    20mls/kg up to 1ltr rapid bolus infusion
  35. Hartmanns dose for Adult dehydration and diving emergencies
    • 10mls/kg rapid infusion up to 1 ltr
    • Then 10mls /kg every hour while signs of dehydration persists or with diving emergencies
  36. Hartmanns dose Burns
    Volume = BSA x Weight(kg) to be given over 4hrs from time of burn
  37. Hartmanns dose for flush for drugs
    20-30ml To Flush drugs for ADULT ONLY
  38. Hartmanns dose Meningococcyl Septicaemia Adult
    1ltr rapid bolus infusion for Adults
  39. Hartmanns Meningococcal septicaemia Dose for Paed
    20mls/kg rapis bolus infusion
  40. Fentanyl Type
    A Liquid-soluble synthetic short acting analgesic
  41. Fentanyl Action
    • Potent analgesic
    • Effective drug for intranasal use because it is rapidly absorbed across mucous membranes
  42. Fentanyl Use
    Management of moderate to severe pain in patients aged 1 and above
  43. Fentanyl adverse effects
    • Respiritory depression
    • Hypotension
    • Nausia and vomiting
  44. Fentanyl contraindications
    • Altered LOC
    • Patient is poorly perfused
    • Pervious known allergy or advese effect
    • Bleeding nose or occluded nasal passages
    • Women in labour
    • Patient <1yr old
  45. Fentanyl Dose Adult
    Initial dose 180mcg-240mcg pending on patients size

    • To give 180mcg
    • 0.4ml =120mcg
    • 0.3ml =90mcg

    • To Give 240mcg
    • 0.4ml =120mcg
    • 0.3ml = 90mcg
    • 0.3ml = 90mcg


    • Subsequent Doses:
    • 0.2ml (60mcg) - up to 0.4ml (120mcg) every 5 mins pending on response
  46. Fentanyl Dose for Advanced age,Smaller than average size and general debility
    Initial dose of 120mcg or 0.3ml (90mcg) then 0.2ml (60mcg)

    • Subsequent dose
    • 0.2ml every 5 mins depending on response
  47. Fentanyl dose Paeds aged 1-5 years
    • Initial dose 30mcg or
    • 1 spray of 0.2ml or 60mcg allowing for 30mcg deadspace

    • Subsquent dose
    • Aged 1-3 = 0.1ml or 30mcg at 10min intervals depending on response
    • Aged 4-5 =0.1ml or 30mcg at 5 min intervals

    May only be repeated to a max of 2 doses

    For Persisitant pain 30 mcg can be given and repeated after 10 mins
  48. Fentanyl dose for 6 to 15 years
    Initial dose of 60mcg or 75mcg

    • To administer 60 mcg = 0.3ml or 90mcg allowing for deadspace of 30mcg
    • To Administer 75mcg = 0.35ml or 105mcg

    • Subsequent dose
    • 0.1ml or 30mcg at 5 min intervals depending on response
  49. Midazolam Type
    Anti-convulsant and minor tranquilliser
  50. Midazolam Action
    Reduces seizure activity and has a tranquillising and amnesic effect
  51. Midazolam Uses for P1
    To control seizures
  52. Midolam Adverse effects
    • Upper airway obsrtruction due to depression of consciousness
    • Respiritory and cardiovascular depression

    Vital signs must be carefully monitiredand equipment to support respiration must be available. Apnea can occur in elderly and Pts with respiritory disease. Adverse effect are in crease with opiates and alcohol
  53. Midazolam Adult dose for fitting IM
    • 1.5mls or (7.5mg) by IM injection.
    • Repeat once after 5 mins
  54. Midazolam Adult dose for fitting IV
    3 mls or 3mg of diluted Midazolam by IV slowly.If fitting continues repeat every 3 mins to a max of 15mg or 15ml
  55. Midazolam dose for fitting paed IM
    0.03ml/kg or 0.15mg/kg repeat once after 5 mins
  56. Midazolam dose for fitting Pead IN
    0.06ml/kg or .3mg/kg via a MAD. Repeat once after 10 mins

    Each IN dose must not exceed the adult dose of 7.5mg or 1.5 ml
  57. Midazolam dose fior fitting paed IV
    0.15ml/kg or 0.15mg/kg of diluted midazolam

    Repeat every 3 mins to max of 3 doses or 0.45mg/kg
  58. Glucose 10% Type
    Hypertonic sugar solution for IV use
  59. Glucose 10% Action
    Principle energy source for body cells especially the brain
  60. Glucose 10% Use
    Correction of hypoglycaemia
  61. Glucose adverse effects
    • Tissue necrosis if extravasation from vein occurs
    • May aggrivate brain damage in head injuriess and strokes
    • May precipitate Werneicks encephalopathy in alcoholics with thiamine deficiency
  62. Glucose 10% Adult Dose
    INitial dose of 150ml or 15g via a burette and then flush with 10ml Nacl.

    If inadequate response and GCS < 15 after 3 mins, give 100mls or 10g titrating to patients state and then flush

    Can be repeated once if no response
  63. Glucose 10% Paed dose
    • Single dose of 5ml/kg or 0.5g/kg and then flush with 10ml Nacl
    • Repeat once if no response
  64. Ondansetron type
    Antiemetic and anit nauseant
  65. Ondansetron Action
    Blocks central and peripheral 5-ht3 receptors
  66. Ondansetron uses
    • Nausia and vomiting in adult where Maxalon is ineffective or contraindicated
    • Nausia and vomiting in children
    • Prophylazis to prevent vomiting in eye or spinal injuries
    • Prophylaxis if the patients airway may be compromised due to vomiting
  67. Ondansetron Adverse effects
    • Headache and or flushing
    • Seizures and movement disorders
    • visual disturbances
    • hypersensativity including anaphylaxis
  68. Ondasetron Contraindications
    • Previous known allergy or adverse reaction
    • Paediatric patients under 2 years of age
  69. Ondansetron dose for Adult and Paed
    • Age 2-7 = 1ml or 2mg IM or iIV
    • Age 8 and above = 2ml or 4mg IM or IV
  70. Fexofenadine type
  71. Fexofenadine action
    Antagonises the action of histamine onH1 receptors
  72. fexofenadine use
    Mild allergic reactions eg. rash/urticaria, allergic rhinitis
  73. Fexofenadine Adverse effects
    • Headache
    • Drowsieness
    • Nausia
    • Dry mouth
  74. Fexofenadine contraindication
    • Known allergy or hypersensativity to fexofenadine
    • Severe renal impairment
  75. Fexofenadine preparation
    180mg tablet
  76. Fexofenadine Dose Adult and Paed
    1 tablet daily

    Not for children under 12
  77. Adrenaline Uses for P1
    • Asthma if severe or extreme with decreased LOC or minimal air movement
    • Sever croup in children with stridor at rest or any one of Altered LOC, Retractions or cyanosis
    • Patients with moderates to severe allergies and anaphylaxis reactions
  78. Adrenaline Adverse effects
    • Dysrythmias including VF
    • Tachycardia
    • Hypertensionn
    • Pupilary dilation
    • Anxiety
    • Nausia and vomiting
  79. Adrenaline Dose for Adult IM in Asthma or anaphylaxis
    • 0.5ml or 500mcg of adrenaline 1:1000 inthe lateral aspect of the thigh
    • Can be repeated eery 5 mins
    • Must be used for only extreme cases
  80. Adrenaline dose for Adult IV Asthma or Anaphylaxis
    • 1ml or Adrenaline 1:10,000 or 100mcg every 60 secs.
    • Must be used only for extreme and immediatly lifethreatening situations and when there are no delays in gaining IV access
  81. Adrenaline dose for Paed in Asthma or anaphylaxis IM
    • 0.1ml/kg of adrenaline1:1000 or 10mcg/kg IM
    • Repeat every 10 mins
  82. Adrenaline dose for Paed in Asthma or anaphylaxis IV
    • 0.1ml/kg of adrenaline 1:1000 or 10mcg/kg over 3 mins.
    • Can be repeated every 5 mins
Card Set
All P1 Drugs