Emergency Drug Doses and Protocols

Comprehensive vocabulary flashcards covering adult emergency drug dosages, routes, and frequencies as per the lecture transcript.

Aspirin (Acute coronary syndrome)

300mg PO single dose, followed by 75 mg PO daily

Calcium gluconate (Serum potassium $> 6.5\,mmol/L$ or hyperkalaemia with ECG changes)

30ml of 10% calcium gluconate IV (repeat if no ECG improvement in 5-10mins)

Calcium gluconate (Severe acute or symptomatic hypocalcaemia)

10ml IV of 10% calcium gluconate (repeat if no improvement, then consider continuous infusion)

Ceftriaxone (Meningitis)

2g IV BD or 4g IV OD (injection/infusion)

Clopidogrel (Acute coronary syndrome or TIA/small stroke without thrombolysis)

$300\,mg$ po single dose followed by $75\,mg$ po daily.

Dexamethasone (Malignant spinal cord compression or symptomatic brain metastases)

16mg po OD for 4-5 days, then reduce dose if possible

Diazepam (Status epilepticus)

10mg IV OR 10-20mg PR, repeat after 5-10 mins if no response (lower dose in elderly)

Epinephrine/Adrenaline (Anaphylaxis)

500 micrograms of 1mg/ml (1:1000) IM (repeat after 5 minutes if no response)

Hydrocortisone (Adrenal crisis)

100mg IV (1 dose), then 200mg/24hrs continuous infusion (diluted in 5% glucose) OR 50mg qds by IM/IV injection

Hydrocortisone (Acute severe ulcerative colitis)

100mg IV QDS up to 5days OR methylpred 30mg IV BD

Hydrocortisone (Acute hypersensitivity reactions)

100-300mg by IV injection

Hydrocortisone (Asthma exacerbation if oral pred can’t be given)

200mg IV stat, then 100mg IV qds (until conversion to oral pred is possible)

Insulin / dextrose infusion (Acute severe hyperkalaemia)

$10$ Units Actrapid in $50\,mL$ of $50\%$ dextrose over $15$ minutes (or $125\,mL$ of $20\%$ or $250\,mL$ of $10\%$ dextrose).

Ipratropium bromide (Asthma exacerbation)

500mcg neb qds, administered after/mixed with salbutamol

Lokelma (Sodium zirconium cyclosilicate) (Acute severe hyperkalaemia)

10g tds for 72hrs

Lorazepam (Status epilepticus)

$4\,mg$ IV, repeated once after $5-10$ minutes if no response.

Magnesium sulfate (Eclampsia/severe pre-eclampsia)

loading dose 4g IV/20 mins. maintenance dose 1g/hr for 24hrs (IV infusion)

Meropenem (Sepsis)

0.5-1g IV tds

Morphine (Acute pain)

Initially 5-10mg IV every 4hrs.

Reduce dosage in elderly/according to response. Can administer more during titration

Morphine (Acute Coronary Syndrome)

5-10mg by slow IV injection at rate of 1-2mg/min (use 2.5-5mg in frail patients)

Naloxone (Acute opioid overdose)

Initial dose of $400\,\text{micrograms}$ IV; use the IM route if IV access is not feasible.

Oxytocin (Post-partum haemorrhage)

10iu IV

Prednisolone (Asthma exacerbation)

40mg po OD for a min of 5 days

Prednisolone (Giant cell arteritis w/out visual symptoms/jaw claudication)

40mg po stat then daily to follow

Prednisolone (Giant cell arteritis w/ visual symptoms/jaw claudication)

60mg po stat then daily to follow

Salbutamol (Acute severe hyperkalaemia)

10-20mg neb stat (10mg if any history of IHD)

Salbutamol (Asthma exacerbation)

2.5-5mg Neb qds

Tazocin (Piperacillin with tazobactam) (Neutropenic sepsis)

4.5g IV tds (according to UHL guidance)

Morphine sulphate (anticipatory for pain/breathlessness)

2.5-5mg SC PRN (minimum interval 1hr)

Midazolam (anticipatory for anxiety/agitation)

2.5-5mg SC PRN (minimum interval 1hr)

Glycopyrronium bromide (Anticipatory care for excessive respiratory secretions)

200 micrograms SC PRN with a min interval of 4hrs

Levomepromazine (Anticipatory care for nausea & vomiting)

2.5-5mg SC PRN w/ min interval of 1hr

Levomepromazine (anticipatory for agitation/delirium)

6.25-12.5 mg (minimum interval 1hr)

Emergency treatment for Severe Hypoglycaemia (Unconscious)

100ml IV 20% dextrose (or equivalent) over 15 mins OR glucagon 1mg IM

Mild hypoglycaemia (conscious & able to swallow)

15-20 grams fast acting oral carb
e.g.
5 dextrosol tablets
4 glucotabs
200ml pure fruit juice

moderate hypoglycaemia (conscious but unable to swallow)

2 tubes of 40% glucose gel squeezed into mouth between teeth and gums