Pharmacology: Emergency Medication

Question 1

Epinephrine

Answer 1

CPR
- Adult = IV 1mg 1:10,000 every 3-5mins as required (1mg/10ml)

Acute Anaphylaxis
- Adult = IM 500microgram 1:1,000 anterolateral thigh, every 5 mins as required (1mg/1ml)

Question 2

Hydrocortisone

Answer 2

Thyroid storm
- Adult = IV 100mg every 6hrs

Severe/life-threatening acute asthma
- Adult = IV 100mg every 6hrs

Anaphylaxis
- Adult = IV 200mg

Question 3

Chlorphenamine

Answer 3

Anaphylaxis

- Adult = IM/IV 10mg repeat as required, max 4/day

Question 4

Atropine

Answer 4

Beta-blocker overdose (bradycardia)
- Adult = IV 3mg

MI (bradycardia)
- Adult = IV 500 micrograms every 3-5 min, up to 3mg

Other causes of bradycardia
- IV 500 micrograms, max 3mg

Question 5

Aspirin

Answer 5

(N)STEMI/Unstable

- Adult = PO 300mg loading dose, 75mg maintenance

Question 6

Clopidogrel

Answer 6

STEMI

• 18-75yrs = PO 300mg, then 75mg for at least 4 weeks
• > 76yrs = PO 75mg daily for at least 4 weeks

Question 7

Calcium gluconate

Answer 7

Hypocalcaemia
- Adult = slow IV 10-20ml 10% in 50mls of 5% glucose over 10 mins, repeat until asymp to max of 40mls in 24hrs

Hyperkalaemia (>6.5, ECG changes)
- Adult = IV injection 30ml 10% over 5-10 mins

Question 8

Insulin

Answer 8

DKA
- Adult = IV infusion

Hyperkalaemia
- Adult = 5-10 units of insulin 50 mls of 50% dextrose

Question 9

Dextrose Infusion

Answer 9

Hypoglycaemia
- Adult = IV infusion 10g 20%

DKA
- Adult = 10% once [glucose] falls below 14mmol/L, rate of 125mL/hr in addition to NaCl 0.9% infusion

Question 10

Hypoglycaemia treatment

Answer 10

Glucose 10-20g oral, repeated after 10-15 mins as required

Unconscious (no IV access)
- IM 1mg glucagon

If glucagon not effective in 10mins
- IV glucose 20%

Question 11

Diazepam

Answer 11

Alcohol Withdrawal

- Adult = IM/IV slow injection 10 mg, then 10 mg after at least 4 hours if required

Question 12

Lorazepam

Answer 12

Status epilepticus

- Adult = IV injection 4mg, then 4 mg after 10 minutes if required

Question 13

Salbutamol Nebuliser

Answer 13

Moderate, severe, or life-threatening acute asthma

- Adult = 5mg, repeat every 20–30 min

Question 14

Morphine

Answer 14

Acute pain
- Adult = PO/SC/IM 10mg every 4 hours

MI
- Adult = IV injection 5-10mg, followed by 5-10mg if required, rate of 1-2 mg/min

Question 15

Naloxone

Answer 15

Opioid overdose
- Adult = IV Initially 400 micrograms, then 800 micrograms for up to 2 doses at 1 minute intervals if no response to preceding dose, then increased to 2 mg for 1 dose if still no response

Question 16

IV Fluids

Answer 16

Resuscitation

• Adult = 500ml bolus stat, repeat as required
• HF = 250ml bolus stat