Emergency medication and doses Flashcards
Epinephrine in the pharmacological management of anaphylaxis
0.5mg (500micrograms) adrenaline IM (1:1000) - middle third of the anterolateral thigh
- repeat after 5 mins if no response
- give every 5 mins if persists until help arrives
Epinephrine in the pharmacological management of cardiac arrest
- 1mg of adrenaline (10mls of 1:10,000 solution)
- (given after 3 cycles of CPR)
- Repeat adrenaline 1mg every 3-5 minutes whilst ALS continues
defibrillation advice
- 1 shock for VF/pulseless VT followed by 2 minutes of CPR
- 3 quick successive shocks if the cardiac arrested is witnessed in a monitored patient (e.g. in a coronary care unit)
Hydrocortisone in the management of asthma exacerbation
100mg every 6 hours (IV) until conversion to oral prednisolone is possible
Hydrocortisone in the management of anaphylaxis
100mg IV delivered adjunct to adrenaline
Hydrocortisone in the management of Addisonian crisis
100mg IM or IV, then continuous IV infusion 200mg every 24h
Chlorphenamine in the management of anaphylaxis
antihistamine (IV or IM)
- 10 mg, repeated if necessary; maximum 4 doses per day
Atropine in the management of post-MI brady cardia
- 500 micrograms every 3–5 minutes; maximum 3 mg per course
Aspirin in the management of unstable angina, NSTEMI, STEMI
300mg
Aspirin in the management of secondary prevention of CVD
- 75mg (baby aspirin)
Aspirin in the management of TIA
300mg once daily
Aspirin in the management of ischaemic stroke
- 300mg
- Initiated 24h after thrombolysis or as soon as possible within 48 hours of symptoms in patients not receiving thrombolysis
Aspirin in the management of AF
- 300mg for 14 days
Clopidogrel in the management of ACS- NSTEMI
Loading dose 300 mg, then 75 mg daily for up to 12 months.
Clopidogrel in the management of ACS- STEMI
- Loading dose 300 mg, then 75 mg daily for at least 4 weeks
Calcium gluconate in the management of hyperkalaemia
Stabilises myocardium
- 30 mL of 10% calcium gluconate IV
- if no improvement in ECG within 5 to 10 minutes repeat
Insulin/dextrose infusion in the management of hyperkalaemia
- 10 unit of Actrarapid in 50mls of 50% dextrose IV over 15 mins
Measure CBG at 0,15 and 30 minutes after starting treatment
emergency management of hypoglycaemia
- Fluid resus
- Glucose
- PO- if they can swallow
- IV
Diazepam in the management of seizures (status epilepticus, febrile convulsion)
- IV 10mg, then 10mg afters 10 mins if required, administered at a rate of 1mL per min
- By rectum- 10-20mg, then 10-20 mg after 10-15 mins if required
Lorazepam in the management of seizures (status epilepticus, febrile convulsion)
- 4mg for 1 dose, then 4mg after 10 minutes if required (IV)
Salbutamol in the management of acute asthma
- 5mg
- Repeat every 20-30 mins when require
- Give via oxygen driven nebuliser
Salbutamol in the management of hyperkalaemia
10-20mg
Prednisolone in the management of asthma
- 40-50mg daily for at least 5 days
Prednisolone in the management of COPD exacerbation
30mg daily for 7-14 days
Prednisolone in the management of severe croup
1-2mg/kg
Prednisolone in the management of UC/Crohns exacerbation
- 20-40mg daily until remission
- By mouth
Prednisolone in the management of allergic disorders
60mg daily
Morphine in the management of MI
Slow IV injection- 5-10mg, followed by 5-10mg if required, delivered at rate of 1-2mg/minute
Morphine in the management of pain
PO, subcut or IM 10mg every 4 hours
Morphine in the management of cough/SoB
- 5mg every 4 hours
naloxone in the management of opioid overdoses
- IV
- 400micrograms, then 800micrograms for up to 2 doses at 1minute intervals if no response to preceding dose, then increased to 2mg for 1 dose if still no response
- Non medical setting
- IM injection
- 400 micrograms every 2-3 mins
- IM injection
IV fluid prescribing in the management of hypovoleamia (<90)
- IV infusion
- Initially 500mL, NaCl 0.9% over 15 mins
- Repeat if BP remains <90mmHg
- If congestive failure or renal problems give 30mins
IV fluid prescribing for NBM
maintenance fluids
30ml/kg/day of water
1mmol/kg/day Na,K and Cl
50g of glucose
IV fluid prescribing in DKA
- (if systolic <90mmHg)
- IV infusion
- Initially 500mL, NaCl 0.9% over 15 mins
- Repeat if BP remains <90mmHg
- Add potassium
then give Insulin
IV fluid prescribing in HSS
- IV infusion
- 500ml NaCl 0.9% over 15 mins
- Serum osmolality aim 3-8mOsm/kg/hour
- dont give insulin- hypoglycaemic risk