-
Aspirin Indications
Acute coronary syndrome. cardiogenic pulmonary Oedema
-
aspirin presentation
300 mg chewable or soluble tablet
-
aspirin indications
- • Acute Coronary Syndrome
- > Including Acute Cardiogenic Pulmonary Oedema.
-
Aspirin
contra indications
- • Known allergy or hypersensitivity to NSAIDs
- Chest pain associated with psychostimulant overdose with
- SBP>160mmHg
- • Bleeding or clotting disorders
- • Suspected aortic aneurysm
- • Active and current gastrointestinal bleeding or ulcers
- • Patient <18 years of age.
-
Aspirin
precautions
- • History of peptic ulcers
- • Asthma
- • Patients on other anticoagulant medications
- • Pregnancy.
-
Aspirin
side-effects
- Epigastric discomfort or pain
- Gastritis
- Gastrointestinal bleeding
- • Nausea and/or vomiting
- • Bronchospasm (rare)
- • Increased bleeding times
- • Hypersensitivity reaction.
-
Aspirin
dose
- Adult
- 300 mg PO
- No repeat, not required it evidence of aspirin300mg+ in preceding 12 hours
Max dose 300mg
-
Adrenaline
presentation
1mg / 1 ml Ampoule
-
Adrenaline
indications
- •Cardiac arrest
- • Croup or upper airway stridor
- • Anaphylaxis or severe allergic reaction
- • Severe asthma
- • Inadequate perfusion (cardiac, non-cardiac, excluding
- haemorrhage).
- • Bradycardia with poor perfusion refractory to Atropine
-
Adrenaline
contra indications
- • Known allergy
- • Hypovolaemic shock without adequate fluid replacement.
-
Adrenaline
precautions
- • Elderly and frail
- • Hypertension
- • Patients on monoamine oxidase inhibitors (MAOI)
- • Higher doses may be required for patients on beta blockers.
-
Adrenaline
side-effects
- • Tachycardia/palpitations
- • Hypertension
- • Headache
- • Nausea and/or vomiting
- • Pupil dilation
- • Anxiety
- • Arrhythmia.
-
Adrenaline dose cardiac arrest
Adult
- ADULTS
- 1mg IV/10
- Repeat at 4 min (every second cycle) as required
- No max dose
- ICP
- Infusion if perfusion remains poor post ROSC
- 3mg/50ml (1ml/hr = 1microg/min) commence
- at 2.5-5microg/min (2.5-5ml/hr)
- Max rate 50-100microg/min (50-100ml/hr)
-
Adrenaline cardiac arrest
paediatric
- >1yr 10microg/kg IVI/IO
- <1yr 100microg IVI/IO
- Repeat at 4 min (every second cycle) as required
- ICP
- Infusion if perfusion remains poor post ROSC
- 300microg/50ml (0.1 microg/min = 1ml/hr)
- commenced at 0.05microg/kg/min
- Max rate 0.5microg/kg/min
- Consider adult preparation if rate exceeds 60ml/hr,
- and adjust to concentration accordingly.
-
Adrenaline Dose
Croup or upper airway Stridor
- ADULTS and PAEDIATRIC
- 5mg Nebulised
- For upper airway stridor, repeat once if required
- Max dose 10mg
-
Adrenaline
dose
anaphylaxis or severe allergic reaction
Adult
- 500microg IMI
- Repeat at 5 min as required
- No max dose
- 5mg Nebulised
- For upper airway stridor
- No repeat dose
- ICP
- 10-20microg IV/IO
- Repeat at 1 min as required
- No max dose
- Consider infusion if perfusion remains poor
- 3mg/50ml (1ml/hr = 1microg/min) commence
- at 2.5microg/min
- Max rate 10microg/min
-
Adrenaline
dose
anaphylaxis or severe allergic reaction
paediatric
- >6 years 300microg IMI
- <6 years 150microg IMI
- Repeat at 5 min as required
- No max dose
- 5mg Nebulised
- For upper airway stridor
- No repeat dose
- ICP
- 2microg/kg IV/IO
- Single dose not to exceed 50microg
- Repeat at 2 min
- No max dose
- Consider infusion if perfusion remains poor
- 300microg/50ml (0.1microg/min = 1ml/hr)
- commenced at 0.05microg/kg/min
- Max rate 0.5microg/kg/min
- Consider adult preparation if rate exceeds 60ml/hr,
- and adjust to concentration accordingly.
-
Adrenaline
dose
severe asthma adult
- 500 microg IMI
- Repeat at 5 min as required
- No max dose
- ICP
- 10-20 microg IV/IO
- Repeat at 1 min as required
- No max dose
- Consider infusion if multiple boluses required
- 3mg/50ml (1ml/hr = 1 microg/min) commenceat 2microg/min (2ml/hr)
- Max rate 15microg/min (15ml/hr)
-
Adrenaline
dose
severe asthma paediatric
- >6 years 300 microg IMI
- <6 years 150microg IMI
- Repeat at 5 min as required
- No max dose
- ICP
- 1-2microg/kg IV/10
- Single dose not to exceed 50mcg.
- Repeat at 2 min
- No max dose
- Consider infusion if multiple boluses required
- 300microg/50ml (0.1microg/min = 1ml/hr)
- commenced at 0.05microg/kg/min
- Max rate 05microg/kg/min
- Consider adult preparation if rate exceeds 60ml/hr,
- and adiust to concentration accordingly.
-
Adrenaline
dose
inadequate profusion refectory to fluid resuscitation excluding haemorrhagic causes
ICP ONLY
- 10-20microg IV/IO boluses initially, if
- extremely poorly perfused consider
- 50-100microg if required
- Repeat at 1 min as required
- no maximum dose
- Paediatric
- 1-2microg/kg IV/IO boluses if required
- Single dose not to exceed 50microg
- Repeat at 2 min
- No max dose
- Infusion adult
- 3mg/50ml (1ml/hr = 1microg/min) commence
- at 5microg/min (5ml/hr)
- Max rate 50-100microg/min (50-100ml/hr)
- Infusion Paediatric
- 300microg/50ml (0.1microg/min = 1ml/hr)
- commenced at 0.05microg/kg/min
- Max rate 0.5microg/kg/min
- Consider adult preparation if rate exceeds 60ml
- and adjust to concentration accordingly.
-
Adrenaline
dose bradycardia with Poor or inadequate perfusion refractory to Atropine
ICP ONLY
- Adult
- 20-50microg IV/IO
- Repeat at 1 min as required
- 10microg/min
- Paediatric
- 2microg/kg IV/IO
- Single dose not to exceed 50 microg
- Repeat at 2 min
- No max dose
- Consider infusion if perfusion remains poor
- adult
- 3mg/50ml (1ml/hr = 1microg/min) commence
- at 2.5microg/min
- Max rate 10microg/min, then consider TCP.
- Paediatric
- 300microg/50ml (0.1microg/min = 1ml/
- commenced at 0.05microg/kg/min
- Max rate 0.5microg/kg/min
- Consider adult preparation if rate exceeds 60ml/hrand adjust to concentration accordingly.
-
Droperidol
presentaion
- 10mq/2ml Ampoule
- or
- 2.5mg/1 ml Ampoule
-
Droperidol
indications
- • Acute psychosis
- • Acute agitation and behavioural disturbance (SAT Score 2+).
-
Droperidol
contraindications
- • Known allergy
- • Known Parkinsonism (Same symptoms as disease but caused by medication)
- • Children <8 years of age
- • Previous dystonic reaction to Droperidol.
-
Droperidol
precautions
- • Elderly and frail
- • Concomitant use with other CNS depressants
- • Patients on medications which may cause QT prolongation, or
- history of congenital long QT syndrome.
-
Droperidol
side effects
- • Brady or tachycardia,
- • Extrapyramidal effect or dystonia (rare)
- • Hypotension
- QT prolongation (rare).
- akathisia =
- restless. hard 2 sit still
- tapping fingers hands- legs crossed n uncrossing.
- Dystonia = involuntarily Muscle contractions
-
Droperidol
dose
adult
- >16 and <65 years 10mg IMI
- Repeat once if required at 20 mins
- Max dose 20mg
- >65 years or frail 5mg IMI
- Repeat once if required at 20 minutes. max dose 10mg
- ICP
- >16 and <65 years 10mg IV
- Repeat once if required at 20 minS
- max dose 20mg
- >65 years or frail 5mg IV
- Repeat once if required at 20 mins
- max dose 10mg
-
Droperidol
dose
paediatric
- 8-15 years 0.1mg/kg IMl
- Single maximum dose 5mg
- Repeat once if required at 20 min
- Max dose 10mg
- (Note: paediatric administration for
- non-ICP is consult only)
- ICP
- 8-15 years 0.1mg/kg IV
- Single maximum dose 5mg
- Repeat once if required at 20 min
- Max dose 10mg
-
Oxytocin
Presentation
10iu/1ml ampoule
-
Oxytocin
Indications
- •Active management of third stage labour
- •management of post partum Haemorrhage
-
Oxytocin
contraindications
- • known allergy
- • Undelivered foetuses
- • severe toxaemia (pre-eclampsia)
-
oxytocin
side effects
- • Nausea and/or vomiting
- • Headache
- • Bradycardia
- • Tachycardia.
-
Oxytocin
side effects
- • Nausea and/or vomiting
- • Headache
- • Bradycardia
- • Tachycardia.
-
Oxytocin
dose
Active management of the stage Labour.
PPH
- 10iu/1ml IMI
- Max dose 10iu (3rd stage labour)
- (PPH) Repeat once at 5 min if bleeding continues
- Max dose 20iu (PPH)
-
Olanzapine
Presentation
10mg orally dissolving tablet
-
Olanzapine
indications
Mild to moderate agitation -SAT score 1-2
-
Olanzapine
contraindications
Known allergy
-
Olanzapine
precautions
- • Alcohol intoxication, avoid over sedation
- • Elderly, frail and young children are more susceptible to adverse effects
- • May be less effective with alcohol withdrawal and patients on stimulant
- • In pregnancy only administer if benefit outweighs any potential risks
- • Similar presentation to Ondansetron, care must be taken to ensureright medication given.
-
Olanzapine
side effects
- • Dizziness
- • Sedation
- • QT prolongation and extrapyramidal reactions unlikely at approved doses
-
Olanzapine
dose
- 10mg SL
- 5mg SL if under 60kg, frail or elderly.
- Repeat after 30 min
- Max dose 20mg
- Consult only for <16 years
-
Amiodarone
Presentation
300mg / 3ml ampoule
-
Amiodarone
indicatons
- • Cardiac arrest with VF or VT refractory to cardioversion
- • Sustained conscious VT without haemodynamic compromise.
-
Amiodarone
Contra indications
- • Second or Third degree heart block without PPM
- • Hyperkalaemia
- » Known allergy
- »› Haemodynamically unstable
- > Other therapies that prolong QT intervals
- › Pregnancy
- •Tricyclic and certain other cardiotoxic overdoses.
-
Amiodarone
Precautions
- • Thyroid disease
- • Ondansetron administration in past 24 hours
- • Hypotension
-
Amiodarone
side-effects
- • Hypotension
- • Bradycardia
- • Nausea and/or vomiting
- • Peripheral paraesthesia.
-
Amiodarone
doses adult
cardiac arrest with VF or VT
- Adult
- 300mg IV/IO
- Repeat at 150mg per guideline
- Max dose 450mg
-
amiodarone
doses
paediatric
- 5mg/kg IV/IO
- Repeat once per guideline
- Max dose 10mg/kg or total of 450mg
-
Amiodarone
dose adults
sustained conscious VT
ICP ONLY
- Infusion 5mg/kg
- 300mg in 20mls at 60ml/hr (20 min)
- single-dose only
- Max – 300 mg
|
|