Emergency Drugs

Question 1

Oxygen

Answer 1

Stored in cylinders or liquid - supports combustion
Can be given in fixed or variable supply
Used in shock, cardiac or respiratory arrest
SEs–> fire, CO2 narcosis, atelectasis, retrolental fibroplasia, convulsions, pulmonary O2 toxicity, depressed haemopoesis

Question 2

Adrenaline

Answer 2

Can be in 1/1000 or 1/10000 ampoules or Epipens
a & B agonist used in anaphylaxis, Cardiac arrest, inotrope, prolongs local analgesia
SEs–> tachy, arrhythmia, MI, cerebral haemorrhage

Question 3

Atropine

Answer 3

Can be in ampoules of 600mcg/1ml or minijet of 3mg
Dose–> 20mcg/kg or vagolytic dose 3mg
A tertiary amine and muscarinic antagonist
used to counter bradycardia, cardiac arrests along with neostigmine
SEs–> central anticholinergic syndrome, urinary retention, increased temp, impaired vision, decreased exocrine secretion

Question 4

Sodium Bicarbonate

Answer 4

1.4% isotonic, 84% hypertonic or 300mg tablets
used for metabolic acidosis
SEs–> intracellular acidosis, hyperosmolarity, hypernatraemia, alkalosis and left shift of Hb/O2 curve
Dose –>( base deficit x kg x 0.3 )/2

Question 5

Salbutamol

Answer 5

Tabs 2,4,8mgs, 2.5mg/ml syrup, 100mcg/puff aerosol, nebs or IV
Beta 2 agonist which increases cAMP
used for asthma
SEs–> headaches, tremor, low K+, tachy, palpitations

Question 6

Diazepam

Answer 6

Tabs 2,5,10mg, 10mg suppositories, IV or IM
Increases GABA release
Uses –> amnesia, anticonvulsant, anxiolysis, hypnosis, sedation, muscle relaxant
1/2 life –> 36hrs, has an active metabolite

Question 7

Half lives of Bezodiazepines

Answer 7

Midazolam 2hrs 1/2 life None have active metabolites
Temazepam 8hrs 1/2 life
Lorazepam 15hrs 1/2 life

Question 8

Dextrose

Answer 8

Can be 5%, 10%, 20%, 50% or 4.5% with 0.9% saline
SEs–> over 10% can cause thrombophlebitis
Used to treat hypoglycemia
20-50ml of 50% solution stat

Question 9

Insulin

Answer 9

Daily output 30-40units from pancreas
Used in hyperkalaemia and type 1 diabetes
decreases blood glucose, increases gluconeogenesis,protein formation, glycogen synthesis

Question 10

Aminophylline

Answer 10

Xanthine derived, used in COPD & HF
Increases cAMP and stablises mast cells so acts as a bronchodilator
Give IV or oral with loading lose then infusion

Question 11

Ephedrine

Answer 11

Sympathomimetic amine, directly stimulates A & B receptors and causes NA release – increases BP
Also a respiratory stimulant and bronchodilator

Question 12

Lignocaine

Answer 12

LA which blocks Na channels and also a class 1b anti-dysrhythmic – used for VF/VT resistant to DC shock

Question 13

Naloxone

Answer 13

Reverses U opioid receptor activation but induces acute withdrawal in addicts. lasts 20mins