SAAS Drugs

Paracetamol

Indication: Analgesic, antipyretic

PO tablet: Presentation: 500mg, Dose: 1000mg (500mg x 2) (O/A 15-30mins)

PO liquid: Presentation: 250mg/5ml (50mg/1ml), Dose: 15mg/kg > 1000mg (O/A 15-30mins)

IV infusion (>16yrs): Presentation: 1000mg/100ml, Dose: 1000mg/100ml (3-4 drips/min), flush with 100ml saline (O/A 5-10mins)

Contras: Allergy

 

RPT: Every 4hrs PRN to max 4000mg/24hrs

Ibuprofen

Class: NSAID

Indication: Analgesic, antipyretic, anti-inflammatory

PO tablet: Presentation: 200mg, Dose: 400mg (200mg x 2) (O/A 30mins)

PO liquid: Presentation: 100mg/5ml (20mg/1ml), Dose: 10mg/kg > 400mg (O/A 30mins)

 

Contras: CKD, active peptic ulcer disease, GI bleed, CCF, MI hx., ACS presentation, pregnancy, hypoperfused state, NSAID allergy

Cautions: Cardiovascular disease, pre-existing renal disease, ACEi/ ARB use, diuretics, dehydration, >65, major trauma/ head injury, currently anticoagulated

Side effects: Nausea, dyspepsia, GI ulceration or bleeding, increased risk of bleeding

RPT: Every 6hrs PRN to max 2400mg/24hrs

Methoxyflurane

Indication: Analgesic

INH: Presentation: 3ml, Dose: 3ml (O/A 6 breaths, duration 20 mins)

Breathe in through mouth, out through nose, cover hole to increase strength

Contras: Malignant hyperthermia (severe adverse anaesthetic reaction), renal impairment, pregnancy

RPT: Max 6ml/day, max 15ml/week, not for use on consecutive days

Fentanyl

Class: Opioid

Indication: Analgesic (uncontrolled pain)

IN: Presentation: 450mcg/1.5ml, Adult dose: 90-180mcg, Paed dose: 1.5mcg/kg > max 75mcg single dose (RPT every 5min PRN to total max dose 400mcg)(0.1ml to prime MAD)

IV: Presentation: 100mcg/2ml (dilute 2ml with 8ml saline) = 100mcg/10ml, Adult dose: 25mcg/2.5ml-50mcg/5ml, Paed dose: 0.5mcg/kg > max 25mcg single dose (administer over >1min, RPT every 5min PRN to total max dose 300mcg in 1^st hr, 100mcg/hr thereafter)

 

O/A: 30-60mins

 

Contras: Renal/ hepatic impairment, elderly, <1yo, respiratory depression, allergy, GCS <13

 

½ max dose for frail adults (<45kg), >65yo

*Elderly/ <1yo more sensitive to opioid-induced CNS depression

*Shorter O/A and longer elimination half-life than morphine

*Duration of respiratory depression is typically longer than duration of analgesia

Salbutamol

Class: SABA, bronchodilator

Indication: Asthma, COPD, anaphylaxis with wheeze post-adrenaline

MILD-MOD MDI INH: Presentation: 100mcg/puff, Adult dose: 1200mcg (12 puffs), Paed dose: 600mcg (6 puffs)

MOD NEB: Presentation: 5mg/2.5ml, Adult dose: 5mg/2.5ml, Paed dose (<6yo): 2.5mg/1.25ml

SEV NEB: Presentation: 5mg/2.5ml, Adult dose: 15mg/7.5ml, Paed dose (<6yo): 7.5mg/3.75ml

 

MOA: Salbutamol (SABA) binds to B2 receptors, activates Ac, increase cAMP, modulates intracellular Ca+, reduced Ca+ = reduced actin-myosin filament contraction, causing bronchodilation

• Increases CBF

Ipratropium