ACETYLSALICYLIC ACID

(Aspirin)

PRESENTATION

PHARMACOLOGY

300 mg Tablet

Works by assisting in the inhibiting the synthesis of prostoglandins and thromboxane in the circulating platelettes. this antithrombotic action forms the basis of preventing platelettes from aggregating to exposes collagen fibres at sites of vascular injury.

Indications:

Contra-Indications: 

* KSAR to aspirin or to non-steroidal anti-inflammatory  drugs.

* Bleeding disorders.* Current G.I bleeding or peptic ulcers.

* Possible aortic aneurysm or other condition requiring surgery.

* Pregnancy* History of G.I bleeding or peptic ulcers

* Concomitant with anti- coagulant therapy- does not include Clopidogrel.

Dosage:* Oral 300mg.

SPECIAL NOTE: Patients who have had less than 300mg aspirin in the previous 24 hours and present with suspected cardiac ischemia or A.M.I even if they are pain free should be given a dose of aspirin that equates to a total daily dose 300-450mg.

Effect Time;* 10 minutes however this is frequently dependent on   stomach contents.* Anti-platelet action lasting for several days.

CONTRA-INDICATIONS /  PRECAUTIONS /

SIDE EFFECTS

GLUTOSE GEL

PRESENTATION / PHARMACOLOGY

15gm Glucose in tube.

Pure Glucose absorbed rapidy in intestinal tract after ingestion. Glucose is polymerised in the Liver into Glycogen.

GLUTOSE GEL

INDICATIONS / CONTRA-INDICATIONS

Indications: Hypoglycaemia in the conscious patient

Contra-Indications: KSAR - Unconscious patient - patient having difficulty swallowing

GLUTOSE GEL

PRECAUTIONS / SIDE EFFECTS / ROUTE OF ADMIN / DRUG EFFECT

Precautions: NIL

Side Effects: Nausea / Vomitting - Diarrhoea

Route of Admin: Oral

Drug Effect: Onset 2 - 4min

                Peak 5min

                        Duration 20min

Single doe of 15g may be repeated after 15min if BSL <4mmol for adult or <3mmol for child.

Max dose of 30g

GLYCERYL TRINITRATE (G.T.N)

PRESENTATION / PHARMACOLOGY / METABOLISM

Presentation: Sublingual Spray in 400mcg metered dose aerosole.

Pharmacology: Potent vasodilotor that decreases preload by increaseing venous capacity in the peripheral veins & reducing ventricular filling pressure and decreases arterial blood pressure (after load). It also activates coronary vasodilation of arteries in spasm and may assist in redistribution of blood flow along the collateral chanels of the heart.

Metabolism: Readily absorbed in the buccal mucossa and rapidly metabolised by the liver.

GTN

INDICATIONS

/

CONTRA-INDICATIONS

Indications:

Pain syndromes associated with suspected A.M.I or Myocardial Ischemia.

Cardiogenic APO.

Contra-Indications:

KSAR

CVA (current episode)

Head trauma

Systolic BP <100mmHg

Use of erectile dysfuntion medication:

- in past 6hrs

- between 6-12hrs with BP <140mmHg Systolic.

- between 12-24hrs with BP <120mmHg Systolic.

GTN

PRECAUTIONS / SIDE EFFECTS

Precautions:

Cerebral Vascular Disease

Risk of Hypotension / Syncope

Effects enhanced by the effect of alcohol

Use of medication to treat erectile dysfunction in past 4 days

Side Effects:

Hypotension

Syncope

Dizziness

Vascular Headache

Tachycardia

Facial Flushing

GTN

ROUTE OF ADMIN / DRUG EFFECT / DOSAGE

Route of Admin:

Sublingual (buccal mucosa)

Drug Effect:

Onset: 30sec - 2min

Peak: 4min

Duration: 20-30min

Dosage:

Adult = 400mcg (0.4mg) every 5 mins providing BP >100mmHg Systolic.

Child = NOT APPROVED

 METHOXYFLURANE

PRESENTATION / PHARMACOLOGY / METABOLISM

Presentation: 3 ml Glass Bottle

Pharmacology: Low concentrate inhaled analgesia.

Metabolism: By the Liver and excreted mainly by the Lungs.

METHOXYFLURANE

INDICATIONS / CONTRA-INDICATIONS / PRECAUTIONS

Indications:

Pain relief

Contra-Indications:

KSAR

Hx of significant Liver or renal disease.

Malignant Hyperthermia.

Precautions:

Intoxicated patients

Patients presenting with ALOC

METHOXYFLURANE

SIDE EFFECTS / ROUTE OF ADMIN / DRUG EFFECT / DOSE

Side Effects:

ALOC

Cough

Renal / Hepatic failure due to repeated high dose exposure.

Route of Admin:

Inhalation

Drug Effect:

Onset: 1-3min

Duration: 5-10min

Dose:

Adult = 3ml repeated after 20 min if required to max 6ml.

Child = under 1yr not approved. 1-12yr 3ml.

OXYGEN

PRESENTATION / PHARMACOLOGY / METABOLISM

Presentation:

- High pressure 'Medical Oxygen' in black cylinder with white shoulders.

- C size 440lt

- D size 1500lt

Pharmacology:

A colourless, odourless gas that naturally makes up approx 21% of the atmosphere and is essential for cellular metabolism.

Metabolism:

N/A

OXYGEN

INDICATIONS / CONTRA-INDICATIONS / PRECAUTIONS

Indications:

Tx of Hypoxia / Hypoxemia

To assist organ oxygenation in patients who are poorly perfused.

Contra-Indications:

Known Paraquat poisoning.

Lung disease secondary to Bleypmicin Therapy.

Precautions:

Prolonged administration to premature neonates

High concentrations given to C.O.A.D patients with Hypoxic Drive.

OXYGEN

SIDE EFFECTS / ROUTE OF ADMIN / DRUG EFFECT

Side effects:

- Hypoventolation in some C.O.A.D patients wityh Hypoxic drive.

- Drying of the mucous membrane of the airway.

Route of Admin:

Inhilation via mask:

Hudson - NRB - NEB - BVM - LMA - ETT

Drug Effect:

Supplemental O2 is administered for the purpose of relieving hypoxaemia & preventing tissue / cell damage as a result of hypoxia

PARACETAMOL

PRESENTATION / PHARMACOLOGY / METABOLISM

Presentation:

500mg Tablet

Elixer / Syrup - each 5ml contains 120mg Paracetamol (alcohol & sugar ree only).

Pharmacology:

Paracetamol is a p-aminophenol that exhibits analgesic & antipyretic activity. it does not posess anti-inflammatory activity.

Metabolism:

By the Liver

Excreted by the Kidneys.

PARACETAMOL

INDICATIONS / CONTRA-INDICATIONS / PRECAUTIONS

Indications:

Relief of minor pain & fever.

Contra-Indications:

KSAR

Precautions:

Hepatic or Renal dysfunction.

Pre-existing aenemia

Patients taking anti-coagulant medications

PARACETAMOL

SIDE EFFECTS / ROUTE OF ADMIN / DRUG EFFECT / DOSE

Side Effects:

Nausea

Route of Admin:

Oral

Drug Effect:

Onset: 10 - 60 min depending on stomach contents

Duration: 4hrs

Dose:

Adult = 500mg - 1gm every 4 hrs to 4gm in 24hr period.

Child = 12.5mg / kg oral elixir.

SALBUTAMOL

PRESENTATION / PHARMACOLOGY / METABOLISM

Presentation:

5mg in 2.5ml nebule.

500mcg in 1ml ampoule

Pharmacology:

Direct acting sympathomimetic agent which mainly has B2-adrenoceptors and acts as a Bronchodilator.

Metabolism:

By the Liver

Excreted by the Kidneys

SALBUTAMOL

INDICATIONS / CONTRA-INDICATIONS / PRECAUTIONS

Indications:

Asthma

Severe allergic reaction

Smoke / Gas inhilation.

COAD

Contra-Indications:

KSAR

Precautions:

Ischemic heart disease

APO

SALBUTAMOL

SIDE EFFECTS / ROUTE OF ADMIN / DRUG EFFECT

Side Effects:

Tremors

Anxiety

Tachycardia

Tachyarrhythmia's