Emergency drugs and tx Flashcards
Cardiac arrest
Unshockable rhythm
1mg adrenaline IV
Every 3-5mins
Narrow complex tachycardia
Vagal manoeuvre: carotid, valsalva
6mg adenosine + saline flush
12mg adenosine + saline flush
Bradycardia
Atropine 500 micrograms IV No response \+ 500 microgram to 3mg max Adrenaline 2-10 micrograms/ min Transcutaneous pacing
Anaphylaxis
0.5mg adrenaline IM every 5 min
10mg chlorphenamine IV
200mg hydrocortisone IV
?IM glucagon 1mg on b blocker
AF/ atrial flutter
New onset
Compromised: HR>150, HF, - DC cardiovert, - or metoprolol up to 5mg IV Uncomprimised - bisoprolol 5-10mg PO - Flecainide 2mg/kg IV
AF/ atrial flutter
Pre existing >48h
Comprimised - metoprolol 5mg over 5 min - 500 micrograms digoxin IV - amiodarone 300mg Uncomprimised - bisoprolol PO, 5-10mg - digoxin 500 microgram PO
VF/VT
1mg adrenaline IV (3-5)mins
300mg Amiodarone IV
STEMI
GTN spray 300mg aspirin PO 5-10mg morphine IV 10mg Metoclopramide IV PCI
NSTEMI
GTN spray 300mg aspirin 300mg clopidogrel PO 2.5mg fondaparinux SC (eGFR>30) Simvastatin 40mg ON Bisoprolol PO (HR>70, BP>110)
Acute asthma
Sit up + O2 5mg salbutamol nebs 0.5mg ipratropium nebs 40mg prednisolone - or 100mg hydrocortisone IV CXR- pneumothorax Life threatening: - 1.2 to 2mg IV magnesium sulphate
P edema
Sit up + O2 2.5 to 5mg diamorphine slow IV 40-80mg furosemide slow IV GTN spray GTN infusion (BP>110)
Hypoglycaemia
No swallow - 1mg glucagon IM - 100ml 20% glucose IV Swallow - Hypostop - 160ml, 10% glucose IV Repeat BM 10mins
Status epilepticus
Repeat every 10mins Lorazepam 2-4mg slow IV Or Buccal midazolam 10mg Or Rectal diazepam 10mg
Keppra 30mg/kg
Hyperkalaemie
Severe: >6.5 or symptomatic
Cardiac monitor
IV calcium gluconate 10%, 10ml over 2mins
10 units actrapid in 50ml 50% glucose over 15mins
20mg salbutamol nebs: resistant
? Sodium bicarbonate
Hyperkalaemia
Severe = x
Severe > 6.5
Adenosine
6,12,12mg fast IV, every 5 mins
Amiodarone infusion
300mg over 30mins
Atropine
Brady
- 0.5mg, every min, IV, max 3mg
Arrest
3mg once only IV
Calcium gluconate
10% in 10ml IV, over 2 mins, every 15 mins to max 50ml
Digoxin infusion
500micrograms in 30mins
Once only IV