UK Ambulance Service Paramedic Drugs JRCALC 2013
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| show | Pre Filled syringe or ampule containing 1mg in 1ml (1:1000)
Pre Filled syringe or ampule containing 1mg in 10ml (1:10000)
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| Adrenaline- Indications | show 🗑
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| Adrenaline- Actions | show 🗑
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| show | Do not give repeated doses to hypothermic patients
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| Adrenaline- Cautions | show 🗑
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| Adrenaline- Cardiac Arrest Dosage | show 🗑
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| Adrenaline- Anaphylaxis and Life threatening Asthma Dosage | show 🗑
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| show | Pre filled syringe containing 300mg in 10ml
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| Amiodarone- Indications | show 🗑
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| show | Anti-arrhythmic- lengthens cardiac action potential- prolongs QT interval on ECG
Blocks sodium and potassium channels in cardiac muscle
Acts to stabilise and reduce electrical irritability of cardiac muscle
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| Amiodarone- Contra-indications | show 🗑
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| Amiodarone- Side Effects | show 🗑
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| show | Administer into large vein as extravastion can cause burns
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| Amiodarone- Dosage | show 🗑
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| show | 300mg tablet
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| Aspirin- Indications | show 🗑
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| Aspirin- Actions | show 🗑
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| Aspirin- Contra-indications | show 🗑
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| Aspirin- Side Effects | show 🗑
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| show | As the benefits outweigh the risk, can be given to pts with Asthma, Pregnancy, Kidney or liver failure, Gastric or duodenal ulcers, Current treatment with anticoagulants
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| Aspirin- Dosage | show 🗑
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| show | 1mg in 1ml
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| show | Absolute bradycardia (less than 40bpm), Hypotension, ventricular arrhytmias, inadequate perfusion causing confusion (Note hypoxia is biggest cause of bradycardia in children. Give O2 first)
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| Atropine- Actions | show 🗑
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| Atropine- Contra-indications | show 🗑
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| show | None
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| show | Dry mouth, blurred vision, dilated pupils, Confusion, hallucinations, Tachycardia, urine retention
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| Atropine- Dosage | show 🗑
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| Benzylpenicillin (Pen G)- Presentation | show 🗑
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| Benzylpenicillin (Pen G)- Indications | show 🗑
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| show | Broad spectrum antibiotic
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| show | Known Severe penicillin allergy (more than simple rash)
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| Benzylpenicillin (Pen G)- Cautions | show 🗑
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| show | IV- 1.2g dissolved with 20ml WFI- Given while on-route to hospital
IM- 1.2g dissolved with 4ml WFI- Slow injection- Given while on-route to hospital
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| show | Ampoule containing 10mg in 1ml
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| Chlorphenamine - Indications | show 🗑
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| Chlorphenamine - Actions | show 🗑
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| show | Children less than 1 year, Known hypersensitivity
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| show | Hypotension, Epilepsy, Glaucoma, Hepatic or Prostatic disease
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| show | Sedation, Dry mouth, Headache, Blurred vision, Psychomotor impairment, GI disturbance, Hypotension, convulsions, Elderly more likely to suffer side effects, Warn against driving
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| Chlorphenamine - Dosage | show 🗑
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| show | Tablet containing 75mg or 300mg
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| show | STEMI
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| show | Inhibits platelet aggregation
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| show | Active bleeding, Known allergy, Liver impairment, Breastfeeding
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| Clopidogrel - Cautions | show 🗑
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| show | Dyspepsia (indigestion), Abdo pain, Diarrhoea, Bleeding
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| Clopidogrel - Dosage | show 🗑
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| Diazepam - Presentation | show 🗑
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| Diazepam - Indications | show 🗑
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| Diazepam - Actions | show 🗑
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| show | None
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| show | Respiratory depression, Doses given by carers, If pt has used alcohol or other medications
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| Diazepam - Side effects | show 🗑
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| Diazepam - Dosage | show 🗑
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| Entonox - Presentation | show 🗑
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| show | Moderate to severe pain, Labour pain
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| show | Inhaled analgesic agent
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| show | Severe head injuries, Decompression sickness (The bends), Violently disturbed psychiatric pts
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| show | Pneumothorax, Poly trauma chest injuries
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| Entonox - Dosage | show 🗑
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| show | Ampoules containing 50mg/5ml or 40mg/2ml
Prefilled syringe containing 80mg
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| show | Pulmonary oedema secondary to LVF
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| Furosemide - Actions | show 🗑
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| show | Pre comatose state secondary to liver cirrhosis, Severe renal failure with anuria
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| Furosemide - Cautions | show 🗑
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| show | Hypotension, GI disturbance
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| Furosemide - Dosage | show 🗑
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| Glucagon - Presentation | show 🗑
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| show | Hypoglycaemia where oral glucose administration is not possible due to reduced LOC
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| show | A hormone that converts glycogen to glucose in the liver thereby raising blood sugar levels
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| show | Low glycogen stores (recent use of glucagon), Hypoglycaemic seizures- IV Glucose 10% is preferred
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| show | Avoid IM administration of a drug if thrombolysis is required
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| Glucagon - Side effects | show 🗑
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| Glucagon - Dosage | show 🗑
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| Glucose 10% - Presentation | show 🗑
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| Glucose 10% - Indications | show 🗑
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| show | Reversal of hypoglycaemia
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| Glucose 10% - Contra-indications | show 🗑
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| show | Use large bore cannula into a large vein as glucose is an irritant
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| show | None
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| show | Large bore IV cannula- 10 grams (100ml) Repeated after 5 mins. Max dose 30 grams
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| show | Plastic tube containing 25 grams 40% oral gel.
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| Glucose Oral Gel - Indications | show 🗑
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| Glucose Oral Gel - Actions | show 🗑
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| show | None
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| show | Reduced LOC, Soaking gauze swab and placing in between lip and gum may help absorption
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| Glucose Oral Gel - Side effects | show 🗑
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| Glucose Oral Gel - Dosage | show 🗑
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| GTN - Presentation | show 🗑
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| show | Cardiac chest pain due to angina or MI
Acute cardiogenic pulmonary oedema
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| GTN - Actions | show 🗑
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| GTN - Contra-indications | show 🗑
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| GTN - Cautions | show 🗑
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| GTN - Dosage | show 🗑
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| Hydrocortisone - Presentation | show 🗑
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| show | Severe or Life-threatening asthma, where call to hospital time is greater than 30 mins
Anaphylaxis
Adrenal crisis
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| show | Glucocorticoid drug that reduces and suppresses the immune response
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| show | Known Allergy
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| Hydrocortisone - Cautions | show 🗑
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| show | Asthma and Adrenal crisis- SLOW IV (over 2 mins) 100mg single dose
Anaphylaxis - SLOW IV (over 2 mins) 200mg single dose
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| Ipratropium Bromide - Presentation | show 🗑
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| Ipratropium Bromide - Indications | show 🗑
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| Ipratropium Bromide - Actions | show 🗑
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| show | None in emergency setting
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| Ipratropium Bromide - Cautions | show 🗑
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| Ipratropium Bromide - Side effects | show 🗑
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| show | 0.5mg with 6-8 litres O2, single dose
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| show | Ampoule containing 10mg in 2ml
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| show | Treatment of nausea or vomiting in pts aged 20 and above. Prevention of nausea and vomiting following Morphine
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| Metoclopramide - Actions | show 🗑
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| Metoclopramide - Contra-indications | show 🗑
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| show | Avoid in cases of drug overdose
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| Metoclopramide - Side effects | show 🗑
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| Metoclopramide - Dosage | show 🗑
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| show | IV- Ampoules containing 10mg in 1ml
Oral- Vials containing 10mg in 5ml
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| Morphine Sulphate - Indications | show 🗑
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| show | Strong opioid analgesic, severe musculoskeletal and soft tissue pain.
Produces sedation, euphoria and analgesia. It may both depress respiration and induce hypotension
Histamine is released and this may contribute to the vasodilatory effect.
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| show | Child under 1 year
Adult RR less than 10, Child RR less than 20
Hypotension. Adult less than 90 sys. Child less than 80 sys. Preschool less than 70 sys
Head Injury with significantly impaired LOC (below P on AVPU, below 9 GCS)
Known hypersensitivity
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| Morphine Sulphate - Cautions | show 🗑
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| show | Respiratory depression, Cardiovascular depression, Nausea and vomiting, Drowsiness, Pupil constriction
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| show | Class A-CD-schedule 2 of the Misue of Drugs Regs 1985-must be stored and its prescription and admin documented properly
Unused morphine discarded in the presence of witness
Narcan can reverse the effects of morphine
Consider Metoclopramide
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| show | Record pain score
May take 2-3mins-peak between 10-20mins
Diluted with saline 0.9%, to make a concentration of 10mg in 10ml (1mg/1ml)
IV/IO route, given slowly approx 2mg/min
IV 10mg repeated 5 mins. Max 20mg
Oral 20mg repeated 60mins-Max 40mg
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| show | Ampoule containing 0.4mg/1ml
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| Naloxone - Indications | show 🗑
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| show | Antagonism of the effects of opiate drugs
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| show | Neonates born to opiate addicted mothers - can produce serious withdrawal effects. Emphasis on BVM and O2
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| Naloxone - Cautions | show 🗑
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| Naloxone - Side effects | show 🗑
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| show | IV - 0.4mg repeated every 3 mins. Max dose 4.4mg
IM-0.4mg repeated every 3 mins. Max dose 4.4mg. Vary injection site.
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| show | Oral solution- 120mg/5ml Used from 3 months to 5 years
250mg/5ml Used from 5 years upwards
Tablets- 500mg each
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| Paracetamol - Indications | show 🗑
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| Paracetamol - Actions | show 🗑
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| show | Known allergy
Do not give if a paracetamol containing product has been given within 4 hrs, or 4grams with 24hrs
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| show | None
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| Paracetamol - Side effects | show 🗑
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| show | As described
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| show | Nebules containing 2.5mg /2.5ml or 5mg/2.5ml
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| show | Acute asthma, Expiratory wheeze due to allergy/ anaphylaxis/ smoke inhalation or other lower airway cause. Exacerbation of COPD, SOB due to LVF
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| Salbutamol - Actions | show 🗑
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| Salbutamol - Contra-indications | show 🗑
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| show | Used in care with Hypertension, Angina, overactive thyroid, late pregnancy, severe hypertension may occur on pts on beta blockers use half doses. If COPD limit neb to 6 mins
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| Salbutamol - Side effects | show 🗑
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| show | 5mg Nebulised with 6-8l O2, given every 5 mins. No Limit.
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| 0.9% Sodium Chloride - Presentation | show 🗑
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| show | Adult and Child fluid therapy, Flush to confirm IV patency and/or following IV drug administration
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| show | Increases vascular fluid volume which raises cardiac output and improves perfusion
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| show | None
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| show | None
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| 0.9% Sodium Chloride - Side effects | show 🗑
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| show | Flush 2ml-10ml PRN
Fluid challenge- 250ml repeated PRN max. Max dose 2 litres.
Refer to JRCALC
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| show | Vial containing 500mg in 5ml
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| show | Pts with time critical injury where significant internal or external haemorrhage is suspected
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| Tranexamic Acid - Actions | show 🗑
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| Tranexamic Acid - Contra-indications | show 🗑
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| show | None
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| Tranexamic Acid - Side effects | show 🗑
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| Tranexamic Acid - Dosage | show 🗑
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