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Miscellaneous > Emergency Medications > Flashcards

Emergency Medications Flashcards

Correct as per BNF May 2023.

1
Q

What is the action of adrenaline?

A

Agonises alpha and beta blockers to:
- increase heart rate and contractility (beta1 effects)
- peripheral vasodilation (beta2 effect)
- vasoconstriction (alpha1 effect)

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2
Q

What are the indications of adrenaline as an emergency medication?

A
  • cardiopulmonary resuscitation
  • acute anaphylaxis
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3
Q

What is the dose and route of adrenaline in CPR, for an adult patient?

A

Dose: 1mg of 1:10,000 adrenaline every 3-5 minutes

Route: Slow IV infusion

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4
Q

What is the dose and route of adrenaline in CPR, for an paediatric patient?

A

Dose: 10mcg/kg (max 1mg) of 1:10,000 adrenaline every 3-5 minutes

Route: Slow IV infusion

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5
Q

What is the dose and route of adrenaline in acute anaphylaxis, for a patient aged <5years?

A

Dose: 150mcg of 1:1000 adrenaline, repeating dose after 5 minutes if no response. If life-threatening features persist, further doses can be given every 5 minutes until specialist care available.

Route: IM injection to anterolateral aspect of middle third of the thigh.

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6
Q

What is the dose and route of adrenaline in acute anaphylaxis, for a patient aged 6-11years?

A

Dose: 300mcg of 1:1000 adrenaline, repeating dose after 5 minutes if no response. If life-threatening features persist, further doses can be given every 5 minutes until specialist care available.

Route: IM injection to anterolateral aspect of middle third of the thigh.

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7
Q

What is the dose and route of adrenaline in acute anaphylaxis, for an adult patient (aged >12years)?

A

Dose: 500mcg of 1:1000 adrenaline, repeating dose after 5 minutes if no response. If life-threatening features persist, further doses can be given every 5 minutes until specialist care available.

Route: IM injection to anterolateral aspect of middle third of the thigh.

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8
Q

What is the mechanism of action of hydrocortisone?

A

Has an equal glucocorticoid and mineralocorticoid activity.

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9
Q

What are the indications for hydrocortisone as an emergency medication?

A
  • thyrotoxic crisis
  • anaphylaxis (adjunct to adrenaline)
  • adrenal crisis
  • severe acute asthma
  • life-threatening acute asthma
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10
Q

What is the dose and route of hydrocortisone in thyrotoxic crisis?

A

Dose: 100mg every 6 hours, to be administered as sodium succinate.

Route: IV injection

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11
Q

What is the dose and route of hydrocortisone in anaphylaxis?

A

Dose: 100-300mg, to be administered as sodium succinate.

Route: IV injection

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12
Q

What is the dose and route of hydrocortisone in adrenal crisis?

A

Dose: 100mg, then 200mg every 24 hours diluted in 5% glucose (by continuous intravenous infusion)

Route: IV/IM loading dose

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13
Q

What is the dose and route of hydrocortisone in severe acute asthma?

A

Dose: 100mg every 6 hours until conversation to oral prednisolone is possible, given as sodium succinate.

Route: IV injection

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14
Q

What are the indications of chlorphenamine as an emergency medication?

A
  • anaphylactic reactions
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15
Q

What is the dose and route of chlorphenamine in anaphylactic reaction, for adults (age >12years)?

A

Dose: 10mg, repeated if necessary; max 4 doses per day

Route: IM or IV

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16
Q

What is the indication of atropine as an emergency medication?

A

Bradycardia following myocardial infarction

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17
Q

What is the dose and route of atropine in bradycardia following MI?

A

Dose: 500mcg every 3-5 minutes, to a max of 3mg per course.

Route: IV injection

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18
Q

What is the indication of aspirin as an emergency medication?

A
  • unstable angina
  • NSTEMI
  • STEMI
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19
Q

What is the dose and route of aspirin as an emergency medication?

A

Dose: 300mg

Route: Chewed or dispersed in water (PO)

20
Q

What is the indication of clopidogrel as an emergency medication?

A

Prevention of atherothrombotic events in PCI (adjunct with aspirin) in patients not already on clopidogrel.

21
Q

What is the dose and route of clopidogrel in PCI?

A

Dose: 300mg (loading dose)

Route: PO

22
Q

What is the indication of calcium gluconate as an emergency medication?

A
  • severe acute hypocalcaemia
  • severe acute hyperkalaemia
23
Q

What is the dose and route of calcium gluconate in severe acute hypocalcaemia?

A

Dose: 10-20ml of calcium gluconate (10%), with plasma-calcium and ECG monitoring.

Route: Slow IV injection

24
Q

What is the dose and route of calcium gluconate in severe acute hyperkalaemia?

A

Dose: 30ml of calcium gluconate (10%) administered as a single dose; repeat if no improvement in ECG within 5-10 minutes.

Route: Slow IV injection

25
Q

What is the indication of insulin/dextrose infusion as an emergency medication?

A

Acute severe hyperkalaemia

26
Q

What is the dose and route of insulin/dextrose infusion in severe hyperkalaemia?

A

Dose: 10 units of fast acting insulin (e.g. Novorapid) with 50ml glucose (50%)

Route: IV

27
Q

Give the indication of fast acting carbohydrates as an emergency medication.

A

Blood glucose concentration <4mmol/L, who is conscious and able to swallow, with or without symptoms.

28
Q

Give the indication of glucagon as an emergency medication.

A

Blood glucose concentration <4mmol/L, where the patient has reduced level of consciousness and no IV access.

29
Q

Give the indication of glucose as an emergency medication.

A

Blood glucose concentration <4mmol/L, where the patient has reduced level of consciousness and has IV access.

or

No response within 10 minutes of IM glucagon.

30
Q

What is the dose and route of glucagon in hypoglycaemia?

A

Dose: 1mg (if no response within 10 minutes IV glucose must be given)

Route: IM injection

31
Q

What is the dose and route of glucose in hypoglycaemia?

A

Dose: 200ml glucose (10%) over 15 minutes

Route: IV

32
Q

What are the indications of diazepam as an emergency medication?

A
  • acute alcohol withdrawal
  • status epilepticus
  • febrile convulsions
33
Q

What is the dose and route of diazepam in acute alcohol withdrawal?

A

Dose: 10mg

Route: IM or slow IV injection

34
Q

What is the dose and route of diazepam in status epilepticus for adults?

A

Dose: 10mg, then 10mg after 10 minutes if required

Route: IV / PR

35
Q

What is the indication of lorazepam as an emergency medication?

A
  • status epilepticus
  • febrile convulsions
36
Q

What is the dose and route of lorazepam in status epilepticus for adults?

A

Dose: 4mg, then 4mg after 10 minutes if required

Route: IV

37
Q

What is the indication of nebulised salbutamol as an emergency medication?

A
  • moderate acute asthma
  • severe acute asthma
  • life-threatening acute asthma
  • acute severe hyperkalaemia
38
Q

What is the dose and route of nebulised salbutamol in acute asthma?

A

Dose: 5mg, repeat every 20-30 minutes or when required.

Route: Oxygen-driven nebuliser

39
Q

What is the indication of prednisolone as an emergency medication?

A
  • acute asthma
  • giant cell arteritis
40
Q

What is the dose and route of prednisolone in giant cell arteritis?

A

Dose: 40-60mg daily until remission of disease activity (higher dose used if visual symptoms occur).

Route: PO

41
Q

What is the dose and route of prednisolone in acute asthma for adults?

A

Dose: 50mg daily for at least 5 days

Route: PO

42
Q

What is the indication of morphine as an emergency medication?

A
  • myocardial infarction
43
Q

What is the dose and route of morphine in myocardial infarction?

A

Dose: 5-10mg, followed by 5-10mg if required (half if elderly)

Route: Slow IV injection

44
Q

What is the indication of naloxone as an emergency medication?

A

Acute opioid overdose

45
Q

What is the dose and route of naloxone in acute opioid overdose?

A

Dose: 400mcg > 800mcg > 800mcg >2mg at 1 minute intervals

Route: IV injection

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