Emergency drugs Flashcards
What is the fluid given in the first hour of DKA?
1L 0.9% sodium chloride - 1000ml over 1hr
What is the fluid given in the second hour of DKA?
1L 0.9% sodium chloride + potassium chloride - 1000ml over 1hr
What is the insulin management in DKA?
FRII at 0.1unit/kg/hr
Alongside FRII- give long term insulin but stop short term
When is dextrose added in DKA management and at what rate?
When CBG is <14mmol/L add 10% dextrose at 125mls/hr alongside insulin at 0.1units/kg/hr
When should you swap to subcut insulin?
When pt is eating/drinking
When do you use insulin in HHS and at what rate?
If presence of ketones / hyperglycemia is not controlled/ decreasing with fluids
0.05 units/kg/hr
When do you use insulin in HHS and at what rate?
If presence of ketones
0.05 units/kg/hr
What is given in Addisonian crisis and at what dosages?
100mg hydrocortisone
(alongside IV 0.9% saline infusion 1L/hr until haemoynamic improvement )
Dose of adrenaline in CPR
1mg every 3-5 mins
(1 in 10,000) IV?
Dose of adrenaline in acute anaphylaxis and route of administration
500micrograms (1 in 1000) repeated every 5 min
IM into anterolateral thigh
Hydrocortisone dose in thyrotoxic crisis
100mg every 6hrs IV
Hydrocortisone in anaphylaxis
100-300mg IV
Hydrocortisone in adrenal crisis
100mg initally then 200mg every 24hrs diluted in 5% glucose IV
OR
50mg IV or IM every 6hrs
Chlorphenamine in anaphylaxis (angioedema)
(H1 antagonist)
10mg repeated up to 4 times/ day if needed IV or IM
atropine in Bblocker OD
0.5-1.2mg IV
atroprine in bradycardia after MI
(how often)
500micrograms every 3-5 min up to a max of 3mg
aspirin for suspected TIA
300mg
aspirin for MI
300mg chewed then 75mg OD for life
aspirin for acute ischemic stroke
300mg OD for 14 days orally
clopidogrel acute NSTEMI
300mg then 75mg for up to 12 months orally
calcium gluconate in acute severe hyperkalemia
(+why is it given)
potassium >6.5mmol/L
IV 30ml calcium gluconate 10% (6.8mmol Ca) given as single dose
repeat if no improvement on ECG after 5-10min
(stablise the myocardium)
how do you lower K+ temporarily
give salbutamol nebs
insulin dextrose infusion in acute severe hyperkalemia
(+why is it given)
10 units insulin + 25g dextrose IV
(shifts K+ from ECF > ICF short term)
glucagon in hypoglycemia
1mg IM, if no response in 10 mins then give 15-20g of 10-20% glucose over 15 min IV (use large vein bc irritant)
glucagon in Bblocker OD
5-10mg over 1-2mins
diazepam in status epilipticus and convulsions
10mg then another 10mg after 10 mins if required
diazepam for tetanus
300 micrograms /kg every 1-4 hrs IV
lorazepam in acute panic attack
25-30micrograms/kg every 6hrs
lorazepam in status epilipticus
4 mg for 1 dose, then 4 mg after 5–10 minutes if required for 1 dose, to be administered into a large vein
salbutamol nebs in moderate, severe or LT asthma
5 mg, repeat every 20–30 minutes or when required, give via oxygen-driven nebuliser if available
prednisolone in asthma
oral 40–50 mg daily for at least 5 days.
morphine in MI
2.5–5 mg, followed by 2.5–5 mg if required, dose to be administered at a rate of 1–2 mg/minute IV
morphine in acute pulmonary oedema
Adult
5–10 mg, dose to be administered at a rate of 2 mg/minute, use dose for elderly in frail patients.
Elderly
2.5–5 mg, dose to be administered at a rate of 2 mg/minute.
naloxone in opioid OD
400 micrograms then 800 micrograms up to 2 doses 1 minute apart
if no response - 2mg for 1 dose
