Clinical Skills Drugs 2

Adrenaline Presentation

1mg/1ml

Adrenaline Contraindications

Nil

Adrenaline Indications

Anaphylaxis, life-threatening asthma, cardiac arrest, post ROSC

Adrenaline Route

Anaphylaxis/Asthma: IM

Cardiac arrest, Post ROSC: IV

Adrenaline Dose, IVD, Repeat (Anaphylaxis/Asthma)

0.5mg, 0.5ml (1:1000), 5 mins no max

Adrenaline Dose, IVD, Repeat (Cardiac Arrest)

1mg, 1ml (1:1000), 3-5 mins (every 2nd loop)

Adrenaline Dose, IVD, Repeat, Notes/Dilution (Post ROSC)

0.5ml (1:10,000), add 9mls NaCl to make 1mg/10ml, every 3-5 mins as required to maintain BP >100mgHg (post 2*250ml saline boluses)

Amiodorone Presentation

150mg/3ml

Amiodorone Contraindications

Nil

Amiodorone Indications

Cardiac Arrest with persistent / shock resistant VF / pulseless VT post 3rd shock

Amiodorone Route

IV

Amiodorone Dose, IVD

300mg, 6ml

Amiodorone Repeat

150mg/3mls may be administered after 5th shock

Aspirin Presentation

300mg Tablet

Aspirin Contraindications

Hypersensitivity to aspirin/salicylates

Aspirin Indications

Chest pain / Discomfort of Presumed Cardiac Origin

Aspirin Route

PO

Aspirin Dose, IVD

300mg, 1 Tablet

Aspirin Repeat

Single dose

Cophenylcaine Presentation

Lignocaine 50mg/ml, Phenylephrine 5mg/ml

Cophenylcaine Contraindications

Hypersensitivity, Pregnancy

Cophenylcaine Indications

Local Pain/Abrasions, Mild-Moderate Epistaxis, Post Tonsillectomy Haemorrhage, Intra-Oral Haemorrhage

Cophenylcaine Route

IN, PO/Topical

Cophenylcaine Dose, IVD (IN)

10 sprays, 1 spray

Cophenylcaine Dose, IVD (PO/Topical)

5 sprays, 1 spray

Cophenylcaine Repeat (IN)

Max 10 sprays

Cophenylcaine Repeat (PO/Topical)

Max 5 sprays (25mg)

Fentanyl Citrate Presentation

100mcg/2ml IV

Fentanyl Citrate Contraindications

Hypersensitivity

Fentanyl and Fentanyl Citrate Indications

Moderate to severe pain

Fentanyl Citrate Route

IV

Fentanyl Citrate Dose, IVD, Notes/Dilution (<70 years)

1mcg/kg (max 100mcg), weight based, Add 8mls NaCl to make 100mcg in 10mls

Fentanyl Citrate Dose, IVD, Notes/Dilution (>70 years)

0.5mcg/kg (max 50mcg), weight based, Add 8mls NaCl to make 100mcg in 10mls

Fentanyl Citrate Repeat

Repeat 25mcg after 5 mins

Fentanyl Presentation

450mcg/1.5ml IN

Fentanyl Contraindications

Hypersensitivity, occluded nasal passages

Fentanyl Route

IN

Fentanyl Dose, IVD, Repeat, Notes/Dilution (Small/elderly/frail)

90mcg, 2 x 0.15ml (90mcg), 45mcg after 5-10 minutes, must prime atomiser first with 0.1ml

Fentanyl Dose, IVD, Repeat, Notes/Dilution (Adult)

180mcg, 3 x 0.2ml (180mcg), 60mcg after 5-10 minutes, must prime atomiser first with 0.1ml

Glucagon Presentation

1mg in 1ml

Glucagon Contraindications

Hypersensitivity, Known Pheochromocytoma

Glucagon Indications

Hypoglycaemia (3rd line agent if unable to obtain IV accent)

Glucagon Route

IM

Glucagon Dose, IVD, Notes/Dilution

1ml, 1ml, Use Hypokit with 3ml Vanishpoint

Glucagon Repeat

10mins repeat once

Glucose 10% Presentation

50g in 500ml

Glucose 10% Contraindications

Nil

Glucose 10% Indications

Hypoglycaemia (1st Line Agent if Patient is Able to Swallow)

Glucose 10% Route

IV

Glucose 10% Dose, IVD, Notes/Dilution

15g, 150ml, Have IV Fluid bag in-situ for immediate flush

Glucose 10% Repeat

5-10 mins give 10g titrating to effect

Glucose Gel Presentation

15g

Glucose Gel Contraindications

Nil

Glucose Gel Indications

Hypoglycaemia (1st Line Agent if Patient is Able to Swallow)

Glucose Gel Route

PO

Glucose Gel Dose, IVD

15g, Single Tube

Glucose Gel Repeat

Repeat after 10mins once if indicated

Glyceryl Trinitrate Presentation

400mcg spray

Glyceryl Trinitrate Contraindications

Hypersensitivity; Hypotension

Glyceryl Trinitrate Indications

Chest pain/discomfort of presumed cardiac origin not relieved by rest and reassurance with systolic BP > 90 mmHg where the heart rate is within 50-150 beats per minute; Acute Cardiac Pulmonary Oedema with systolic BP >90 mmHg; Autonomic Dysreflexia with systolic BP > 160 mmHg.

Glyceryl Trinitrate Route

SL

Glyceryl Trinitrate Dose, IVD

400mcg, 1 spray

Glyceryl Trinitrate Repeat

5 min intervals, No Max

Ipratropium Bromide Presentation

250mcg/1ml

Ipratropium Bromide Contraindications

Hypersensitivity

Ipratropium Bromide Indications

Severe bronchospasm

Ipratropium Bromide Route

NEB, MDI

Ipratropium Bromide Dose, IVD, Notes/Dilution (NEB)

500mg, 2ml (add 2 - 3ml NaCl 0.9%), Administer with Salbutamol

Ipratropium Bromide Dose, IVD, Notes/Dilution (MDI)

8 puffs (160mcg), 20mcg per puff, Recommended to use with spacer

Ipratropium Bromide Repeat

Every 20 mins maximum 3 doses

Lignocaine 1% Presentation

20mg/2ml

Lignocaine 1% Contraindications

Hypersensitivity

Lignocaine 1% Indications

Local anaesthesia for IV cannulation

Lignocaine 1% Route

ID

Lignocaine 1% Dose, IVD

0.1mg, 0.1ml

Lignocaine Repeat

Single site dose, second site if needed

Loratadine Presentation

10mg

Loratadine Contraindications

Children under 30 kgs, known allergy or adverse drug reaction to Loratadine

Loratadine Indications

Symptomatic urticaria (without evidence of anaphylaxis)

Loratadine Route

PO

Loratadine Dose, IVD

10mg, 10mg

Loratadine Repeat

Single dose

Methoxyflurane Presentation

3ml

Methoxyflurane Contraindications

Allergy to fluorinated anaesthetics, children under 1 year of age, patients unable to co-operate including those affected by alcohol or illicit drugs, patients with a severe head injury and altered state of consciousness, patients susceptible to malignant hyperthermia

Methoxyflurane Indications

Pain

Methoxyflurane Route

IH

Methoxyflurane Dose, IVD

3ml, 3ml

Methoxyflurane Repeat

15 mins, Single Repeat (6ml daily)

Midazolam Presentation

15mg/3ml

Midazolam Contraindications

Hypersensitivity

Midazolam Indications

Prolonged Seizure Activity

Midazolam Route

IM, IV

Midazolam Dose, IVD (IM)

5mg, 1ml

Midazolam Dose, IVD, Dilution/Notes (IV)

2.5mg, 2.5ml, Add 12mls NaCl to make 15mg in 15mls

Midazolam Repeat

IM: 5mg repeat once after 10 mins

IV: 2.5mg repeat every 5 mins (max dose 15mg)

Naloxone Presentation

400mcg/1ml

Naloxone Contraindications

Hypersensitivity to Naloxone

Naloxone Indications

Respiratory Depression in suspected Narcotic Overdose

Naloxone Route

IM, IV

Naloxone Dose, IVD (IM)

400-800mcg, 1ml