Drugs: Presentation, Dose and Max Dose: Flashcards
TXA:
Presentation: Vial containing 500 mg tranexamic acid in 5 ml (100 mg/ml).
Route: IV/IM
Dose: 1g
Max Dose: 1g
Intravenous/intraosseous – administer SLOWLY over 10 minutes – can be given as 10 aliquots administered 1 minute apart.
Intramuscular – give into a large muscle (or in divided doses for small muscle mass, e.g. for an adult, 2 x 5 mL IM at separate sites).
SLB
Presentation: Nebules containing salbutamol 2.5 milligrams/2.5 ml or 5 milligrams/2.5 ml.
Route: Nebulised with 6–8 litres per minute of oxygen.
Dose: 5mg
Max Dose: No limit
If COPD is a possibility limit nebulisation with oxygen to 6 minutes.
DZP:
Presentation:
Diazepam 10mg/2ml solution for injection.
Route:
Intravenous/intraosseous – administer SLOWLY over 2 minutes for adults (3–5 minutes for children).
INITIAL DOSE: 10 milligrams
DOSE INTERVAL 10 minutes
MAX DOSE: 20mg
ASP:
Presentation: 300 milligrams aspirin (acetylsalicylic acid) in tablet form. Dispersible or chewable.
Route: Oral – chewed or dissolved in water.
INITIAL DOSE 300 milligrams
MAX DOSE 300 milligrams
300 milligrams must be given unless the patient has already had 300 milligrams for this episode. If the patient has had a smaller dose that day (less than 300 milligrams) a dose of 300 milligrams should be given.
GTN:
Presentation
Sublingual spray containing 400 micrograms glyceryl trinitrate per metered dose.
Sublingual tablets containing glyceryl trinitrate 300, 500 or 600 micrograms per tablet.
The oral mucosa must be moist for GTN absorption, moisten if necessary.
ANGINA or MYOCARDIAL INFARCTION (systolic BP >90 mmHg)
Route: Sublingual tablet/spray (administer under the patient’s tongue and close mouth).
INITIAL DOSE 600 micrograms
DOSE INTERVAL 5–10 minutes
MAX DOSE:
No limit No limit No limit No limit
NB The effect of the first dose should be assessed over 5 minutes; further doses can be administered provided the systolic blood pressure is >90 mmHg. Remove the tablet if side effects occur, for example, hypotension.
BPN
Injection vial containing 600 milligrams of benzylpenicillin sodium as powder for solution for injection.
Administered intravenously, intraosseously or intramuscularly.
NB Different concentrations and volumes of administration (refer to dosage and administration tables).
Route: Intravenous/intraosseous – by slow injection.
INITIAL DOSE 1.2 grams
VOLUME 20 ml
MAX DOSE 1.2 grams 1.2 grams
Route: Intramuscular (antero-lateral aspect of thigh or upper arm – preferably in a well perfused area) if rapid intravascular access cannot be obtained.
INITIAL DOSE 1.2 grams
CONCENTRATION 1.2 grams dissolved in 3.2 ml water for injection
VOLUME 4 ml
MAX DOSE 1.2 grams
ODT
Presentation : Ampoule containing 4 milligrams of ondansetron (as hydrochloride) in 2 ml.
Ampoule containing 8 milligrams of ondansetron (as hydrochloride) in 4 ml.
NB Both these preparations share the same concentration (2 milligrams in 1 ml).
Route: Intravenous (SLOW IV injection over 2 minutes)/intramuscular.
INITIAL DOSE 4 milligrams
REPEAT DOSE 4 milligrams
DOSE INTERVAL 30 minutes
VOLUME 2 ml
MAX DOSE 8mg
NB Monitor pulse, blood pressure, respiratory rate and cardiac rhythm before, during and after administration.
MOR
Solution for injection ampoules: morphine sulfate 10 mg/ml (morphine sulfate 10 mg per 1 ml).
Oral solution: morphine sulfate 10 mg/5 ml (morphine sulfate 2 mg per 1 ml).
Administration must be in conjunction with pain score monitoring,
Morphine should be diluted with sodium chloride 0.9% to make a concentration of 10 milligrams in 10 ml (1 milligram in 1 ml) unless it is being administered by the intramuscular or subcutaneous route when it should not be diluted.
ADULTS – If pain is not reduced to a tolerable level after 10 milligrams of IV/IO morphine, then further 2 milligrams doses may be administered by slow IV/IO injection every 5 minutes to 20 milligrams maximum . The patient should be closely observed throughout the remaining treatment and transfer. Smaller doses should be considered for lightweight children over age 12 and for older, frail patients who may be more susceptible to complications.
Route: Intravenous/intraosseous – administer by slow IV injection (rate of approximately 2 milligrams per minute, titrate to effect up to initial dose). Observe the patient for at least 5 minutes after completion of initial dose before repeating the dose if required.
Smaller initial doses (e.g. 1 milligram) should be used for frail and/or older patients.
INITIAL DOSE 10 milligrams
REPEAT DOSE 10 milligrams
DOSE INTERVAL 5 minutes
MAX DOSE 20 milligrams
Route: Subcutaneous/intramuscular.(probably won’t need for this OSPE)
NOO
Adults:
Nitrous oxide should be self-administered via a facemask or mouthpiece, after suitable instruction. It takes about 3–5 minutes to be effective, but it may be 5–10 minutes before maximum effect is achieved
HYC
Solution for injection: Hydrocortisone sodium phosphate 100mg/1mL solution for injection ampoules
Route: Intravenous (SLOW injection over a minimum of 2 minutes to avoid side effects) OR Intramuscular (upper arm or thigh).
INITIAL DOSE 100 milligrams
MAX DOSE 100 milligrams
ADM 1:1000
Pre-filled syringe or ampoule containing 1 milligram of adrenaline (epinephrine) in 1 ml (1:1,000) ADM.
Route: Intramuscular – antero-lateral aspect of thigh.
NB Patients with a higher BMI will need a longer IM needle.
INITIAL DOSE 500 micrograms
DOSE INTERVAL 5 minutes
MAX DOSE No limit
so 0.5 of pre-filled syringe
FRM
Presentation:
20 milligrams in 2 ml injection ampoules
50 milligrams in 5 ml injection ampoules
Intravenous
Route: Intravenous
Administer SLOWLY OVER 2 minutes in accordance with the table below.
INITIAL DOSE 40 milligrams
MAX DOSE 40 milligram
PAR
Both oral and intravenous preparations are available.
Paracetamol tablets
500 milligram tablets (tablets may be broken in half).
Intravenous
Bottle containing paracetamol 1 gram in 100 ml (10 mg/ml) for intravenous infusion for adults, adolescents and children weighing more than 33kg.
Bottle containing paracetamol 500 milligrams in 50ml (10mg/ml) for intravenous infusion for term newborn, infants, toddlers and children weighing less than 33kg.
Route: Oral – tablet.
Ensure that:
Paracetamol (or an alternative paracetamol-containing product) has not been taken within the previous 4 hours (6 hours in renal impairment).
The maximum cumulative daily dose has not already been taken.
Oral – tablet
INITIAL DOSE 500 milligrams – 1 gram
Route: Intravenous infusion; given over 15 minutes.
Ensure that:
Paracetamol (or an alternative paracetamol-containing product) has not been taken within the previous 4 hours (6 hours in renal impairment).
The maximum cumulative daily dose has not already been taken.
IV paracetamol is only used when managing moderate and severe pain (use an oral preparation when managing fever with discomfort).
Intravenous infusion; given over 15 minutes
INITIAL DOSE 1 gram
OXG
SCP
