DRUG DOSES

Question 1

Cardiac arrest

Answer 1

Adrenaline 1mg of 1 in 10,000
amiodarone 300mg IV (if shockable rhythm)

Question 2

Anaphylaxis

Answer 2

adrenaline 500 micrograms IM 1 in 1000

Question 3

Seizure in community

Answer 3

diazepam 10mg PR

Question 4

Seizure in Hospital

Answer 4

Lorazepam 4mg IV

Question 5

Hypoglycaemia if not IV access

Answer 5

glucagon 1mg IM

Question 6

Hypoglycemia is IV access

Answer 6

20% glucose 100ml IV (repeat as needed), or

Question 7

Hyperkalaemia

Answer 7

1: Calcium chloride 10% 10ml
2: Insulin 10 units actrapid in 50ml of 50% glucose over 15 mins
4: Air-neb salbutamol 10mg
5: Resonium (calcium)

Question 8

Bradycardia

Answer 8

atropine 500mcg IV (repeat every 3-5 minutes to maximum of 3mg if needed)

Question 9

SVT

Answer 9

adenosine 6mg IV (can be followed by 12mg then 18mg if unsuccessful)

Question 10

VT with Pulse

Answer 10

amiodarone 300mg IV over 10-60 minutes followed by 900mg over 24 hours through a central line

Question 11

Rapid tranquillisation of agitated patient at risk of self harm to self / others:

Answer 11

lorazepam 1-2mg PO/IM

Question 12

Paracetamol

Answer 12

1 gram PO/IV, PRN 4-6 hourly (max. 4 grams), or QDS

Question 13

Ibuprofen

Answer 13

400mg PO, QDS (contraindicated if gastritis history)

Question 14

Co-codamol 30/500

Answer 14

2 tablets PO, PRN 4-6 hourly (max. 8 tablets), or QDS

Question 15

Codeine

Answer 15

30-60mg PO, PRN 6 hourly (max. 240mg), or QDS (if regular

Question 16

Morphine sulphate oral solution (Oramorph)

Answer 16

10mg/5ml 5-10ml PO, PRN 2 hourly (reduce dosing interval or use alternative in renal impairment)

Question 17

IV Morphine

Answer 17

Morphine 1-10mg IV/IM/SC, PRN 4 hourly (max. 60mg; reduce dosing interval or use alternative in renal impairment)

Question 18

Rough guide of morphine dose?

Answer 18

As a rough guide, the IV dose of morphine is 0.1mg/kg. So for a 70kg person, the dose would be 7mg. If given in a non-monitored environment (theatres / intensive care / resus) this should be given with caution.

Question 19

How many times stronger is IV morphine than oral morphine?

Answer 19

3x

Question 20

How many times stronger is SC morphine than oral morphine?

Answer 20

2X

Question 21

Background and breakthrough morphine?

Answer 21

he initial dose of background analgesia should be equivalent to the average dose of PRN analgesia they are currently needing over 24 hours. Breakthrough analgesia should be about 1/6 the dose of the total background analgesia dose. Prescribe this 4-hourly PRN.or example, if a patient has been needing 60mg Oramorph a day, convert them to 30mg MST BD, and also prescribe 10mg Oramorph PRN 4-hourly for breakthrough pain.

Question 22

senna

Answer 22

7.5-15mg PO, ON (stimulant laxative – first line for acute and opiate constipation)

Question 23

what type of laxitive is senna?

Answer 23

Stimulant laxitive

Question 24

what type of laxitive is Movicol?

Answer 24

Osmotic laxative

Question 25

Ondansetron dose?

Answer 25

4mg IV/IM/PO, PRN 4-6 hourly (max. 16mg) – can cause QT prolongation

Question 26

S;abutamol

Answer 26

Salbutamol 2.5-5mg NEB, PRN 4-6 hourly (max. 20mg)

Question 27

Ipratropium bromide

Answer 27

250-500micrograms NEB, PRN 4-6 hourly (max. 2mg)

Question 28

Prednisolone

Answer 28

30-40mg PO, OD

Question 29

Treatment of Mild (>2.5mmol/L): hypokalaemia?

Answer 29

Sando-K 2 tablets TDS x 3/7, or add 20-40mmol/L potassium chloride to each litre of IV fluids

Question 30

Treatment of Severe hypokalaemia (<2.5mmol/L or ECG changes)?

Answer 30

40mmol/L potassium chloride in 1L 0.9% saline over 4-6 hours (NEVER >10mmol/hour K+ outside ICU)

Question 31

Treatment of mild (>1.9mmol/L and asymptomatic): hypocalcaemia?

Answer 31

calcium (e.g. Sandocal or Calcichew) 1000mg BD + vitamin D if deficient

Question 32

Treatment of severe (>1.9mmol/L and asymptomatic): hypocalcaemia?

Answer 32

(<1.9mmol/L or symptomatic): calcium gluconate 10ml 10% IV over 10 minutes – can be repeated until asymptomatic and usually needs to be followed by an infusion (50ml 10% calcium gluconate in 500ml 0.9% saline over 12 hours)

Question 33

Treatment of mild Hypercalcaemia?

Answer 33

Replace fluid deficit with 0.9% saline and keep patient well hydrated (continuous IV fluids)

Question 34

Treatment of severe (>3.5mmol/L or symptomatic):hypercalcaemia?

Answer 34

if calcium stops falling with IV fluids alone, consider IV bisphosphonate, e.g. zoledronic acid 4mg IV, depending on renal function (one-off dose)