easy

Fentanyl

AADR 50-100microg

Morphine

AADR renal failure

2.5-10mg

Naloxone

Contras: AADR, new born

Indications: resp depression (secondary to the use of narcotic drugs)

Side effects: combativeness, vomiting sweating, tachycardia, hypertension, withdrawal convulsions, pulmonary oedema

Presentation: amp 400microg/mL

onset: 1-5 min

MOA: Prevents or reverses the effects of opioids by competing for the same receptor sites

Dose: 1.6mg

Dexmethasone

Indications: asthma unable to tolerate oral med, croup

Contras: under 6, AADR, steroid admin within 4 hours, over 8(croup)

Nil side effects

Vial 8 mg/2ml

Dose: 16mg single

Onset 30min

Epinephrine

No contas

1mg for cardiac

500mcg for anaphylactic

Indications: cardiac arrest, anaphylactic, life threatening bronchospasm,shock unresponsive to fluids Brady cardiac with poor perfusion, croup

MOA: acts on Alfa and beta adrenergic receptors to increase HR and contraction force, increase irritability of ventricles, bronchodilltion, and peripheral vasoconstriction

Alpha squeezes, Beta 1 beats, Beta 2 breathes.

GTN

CONTAS: AARD, HR <50 >150, Bp <100, Acute CVA stroke, riocigurate, HEAD TRAUMA, PDE inhibitor

1 spray

Indications:suspected ACS, APO, autonomic dysreflexia, inrukanji syndrome

MOA: potential vascodiltor that decreases preload by increasing generous capacity, pooling blood in venous capacity in peripheral veins, decreases after load,also causes vasodilation in coronary arteries

Nitric Oxide Makes Veins Open.

Salbutamol

Contras: AADR, < 1year

Indications: bronchospasm, suspected hyperkalmia

5mg

MOA: direct sympathmimetic agent affects B2 adreorecptors. Primary act as a bronchodilator also has inotropic and chronotropic actions. Lowers serum potassium levels through stimulation of ATP pump

relaxes smooth muscle to open airways

beta2 =breathe

Ipratropium bromide

Contas: AADR, under 1 year

Indications: moderate bronchospasm (unresponsive to salb), severe bronchospasm

500microg

MOA: antimuscarinic agent which promotes bronchodilation by inhibiting cholinergic bronchomotor tone

Parasympathetic = Constrict and Secretions."
Ipratropium blocks parasympathetic effects.

Glucagon

AADR

Indications: symptomatic hypoglycaemia, refractory anaphylaxis w hypotension

1mg

MOA: hyperglycemic agent that mobilises hepatic glycogen which is released in the blood as glucose,. Has inotropic and chronotropic effects that are not mediated through beta receptors

Ceftriaxone

Contras: AADR, penicillin or carbapenem sensitivity, Under 1 year (negotiation)

Indications: meningococcal, acute upper GI bleeding

2g

MOA: a third generation cephalosporin antibiotic with a bacterial action

Methoxyflurane

AADR

Liver disease

Under 1 year

Malignant hypothermia

Ondansatron

AADR

Congenital long QT syndrome

Current apomorphine therapy

Less 2 years

First trimester pregnancy

Modified Val salva manoeuvres

CONTAS: Requirement for immediate cardioversion, Hypotension, Afib a flutter, Aortic stenosis, Recent MI 3 MONTHS, glaucoma, Retinopathy, Third trimester

15sec blow 15sec down

INDICATIONS: SVT

COMPATIONS: syncope, prolonged hypotension state

I gel

Contras: Conc breathing, Use more than 4 hours

Indications: loss of airway patencey or airway protection

Complications: failure to provide adequate ventilation, patient intolerance, hypoxia, vomiting and aspiration, oropharygeal trauma

CPAP

CONTRAS: Under 16, Gcs under 8, Inadequate ventiatort drive, Hypotension, Pneumothorax, Facial trauma, Epistaxis

INDICATIONS: APO CCP: life threatening asthma

Change 3-5 min max 15 litres

Aspirin

Indications: suspected ACS, APO

CONTRAS: AADR, bleeding or clotting disorder, current gi bleeding or peptic ulcers, >18

300mg

MOA: Aspirin’s mechanism of action primarily relies on the irreversible inhibition of cyclooxygenase (COX) enzymes. By doing so, it stops the body from synthesizing prostaglandins and thromboxanes, which are lipid compounds responsible for pain, fever, inflammation, and blood clotting

Droperidol

Indications: acute behavioural disturbances: unresponsive to de escalating, SAT > 2, prevent harm to themselves or others

Contras:

Absolute- AADR, Lewy body dementia, Parkinson’s disease, prev dystonic reaction to droperadol, under 8

Relative- suspected sepsis, physically restrained with no CCP

precautions: hypoerfused, concurrent use of CNS depressants

Side effects: vascodilation/hypotension, extra pyramidal effects ie dystonic reactions

Pres: 10 mg / 2ml

Onset: 5-15

Dose: 10mg

Glucagon

Indications: symptomatic hypoglycaemia (unable to self admin oral), refractory anaphylaxis with hypotension/shock (unresponsive to 3 IM)

contras: AADR

nil side effects

Pres: vials: 1mg

Onset 4-7min

Dose: 1mg single

Glucose gel

Indications: symptomatic hypoglycaemia (able to tolerate oral med)

Contras: unconscious, difficultly swallowing,

Precaution: less 2

Side effects: nausea/vomiting, diarrhoea

Pres: tube 15 g

Onset 10min

Dose: 15g max 30g

Glucose 10%

Indications: hypoglycaemia (unable to admin oral), unconscious hypoglycaemia

Nil contras

Precautions: hyperglycaemia

Nil side effects

Pres: 250ml

Onset rapid

15 g repeated at 10g every 5min untill bsl at 4

Midazolam

Indications: generalised seizures (gcs12), sedation (for maintaining SAD/ETT, for procedures, CPR induced consciousness, to facilitate safe assessment and treatment of agitated head injury patient, adjunct to opiate analgesia, for ketamine emergence) acute behavioural disturbances with sat score > 2 unresponsive to droperadol

Contras: AADR

precautions: reduced dose in sickly or old, chronic renal failure, congestive heart failure or shock, can cause severe resp depression in patients with COPD, myasthenia gravis, multiple sclerosis

Side effects: hypotension, respiratory depression particularly when associated with other CNS depressants including alcohol and narcotics

Pres: 5mg/1ml

Onset 5-15 min IM 1-3 min IV

dose: 5 mg max 20mg

Amiodarone

Indications: cardiac arrest (shockable rhythm that’s refractive to the three Ds), sustained conscious VT (heamodynamicly stable)

Contras:

Cardiac arrest patients- tricyclic antidepressant OD

Sustained conscious VT- AADR, severe conduction disorders, tricyclic antidepressant od, current amiodieine therapy, concurrent anti arrhythmic therapy that prolongs the qt interval, pregnancy, lactation

Side effects: hypotension, bradycardia, nausea and vomiting, peripheral paresthasia

Pres: 150/3ml

Onset: 5 min

Dose: 300mg slow push max 450

Clopidogrel

Indications: pateunts with STEMI or STEMI equivalent AND - been accepted fir pPCI and the receiving cardiologist is requesting clop admin OR who have recived teneplace (and aspirin and enoxaparin)

Contras: AADR, under 18, modified rankin scale over 4, history of terminal illness or under palliative care, symptoms suggestive of acute aortic dissection, prior intercrainial haemorrhage, active bleeding

Side effects: heamorage

Pres: tablet 75mg

Dose600mg