CPG Phamacology

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

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

• 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

1-  Hypovolemic shock with inadequate fluid replacement

• 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

• IV
• IM
• IO
• NEBULISED
• IV INFUSION
• IO

• 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

• 300 mg chewable tablets
• 300 mg soluble or water dispersible tablets

ACS

• 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

• 1-  Heartburn, Nausea, gastrointestinal bleeding
• 2-  Increased bleeding time
• 3-  Hypersensitivity reactions

• 1-  Peptic Ulcer
• 2-  Asthma
• 3-  Pts on anticoagulants

25mg in 250mL infusion soft pack (IV Infusion)

1-  Diabetic Hypoglycemia (BGL<4mmol/L) in Pts with an altered conscious state who are unable to self administer oral glucose

Nil significance in the above indication

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

Route: IV IN

• 1-  Sedation to facilitate intubation
• 2-  Sedation to maintain intubation
• 3-  Drug facilitated intubation 
• 4-  Analgesia - IV/IN

• 1-  Known hypersensitivity
• 2-  IV Amiodarone

• 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

• 1-  Respiratory depression
• 2-  Apnoea
• 3-  Rigidity of the diaphragm and intercostal muscles
• 4-  Bradycardia

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)]

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

C&P- Nil significance in the above indication

Nausea and vomiting (rare)

• 0.6 mg tablets 
• Transdermal GTN Patch (50mg 0.4 mg/hr release)

• 1-  Chest pain with ACS
• 2-  Acute LVF (Left Ventricular Failiure)
• 3-  Hypertension assosiated with ACS
• 4-  Autonomic Dysreflexia
• 5-  Preterm labour (Consult)

• 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

• 1-  No previous administration
• 2-  Elderly Pts
• 3-  Recent MI
• 4-  Concurrent use with other tocolytics

• SL
• Buccal
• Transdermal
• Infusion (inter-hospital transfer only)

• Tachycardia
• Hypotension
• Headache
• Skin flushing (uncommon)
• Bradycardia (Occasionally)

• 250mcg in 1mL nebule or polyam
• & Nebulised (in combination with Salbutamol)

Severe respiratory distress associated with bronchospasm

• 1. Known hypersensitivity to Atropine or its derriritives

• 1.  Glaucoma
• 2.  Avoid eye contact with eyes

• 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)

3mL Glass bottle

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

Pain relief

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

• 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

• 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

10mg in 2mL polyamp

• 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

• 1. Children
• 2.  Suspected