Drugs used in medical emergency

Question 1

Use of adrenaline in emergency

Answer 1

Anaphylactic shock

Question 2

Dosage of adrenaline

Answer 2

1mg IV push q3-5mins

Question 3

Use of atropine in emergency

Answer 3

Symptomatic bradycardia

Question 4

Dosage of atropine

Answer 4

0.5mg IV bolus, repeat q3-5mins

Question 5

Use of amiodarone in emergency

Answer 5

1. 1st choice use in pulseless ventricular fibrillation (VF)/pulseless ventricular tachycardia (VT)
2. Fast AF / Atrial flutter

Question 6

Use of lignocaine 2%

Answer 6

Ventricular fibrillation (VF)/pulseless ventricular tachycardia (VT) if amiodarone is CI

Question 7

Dosage of CaCl2 10% for hyperK

Answer 7

5-10mL slow IV push over 2-3mins

Question 8

Use of MgSO4 49.3% in emergency

Answer 8

1. VF/pulseless VT associated with torsades de pointes
2. Acute severe asthma exacerbation
3. Eclampsia/preeclampsia

Question 9

Use of terbutaline SC in emergency

Answer 9

Bronchospasm (narrowing of airways) associated with asthma, bronchitis, and emphysema

Question 10

Use of NaHCO3 8.4% in emergency

Answer 10

HyperK

Question 11

Onset & duration of CaCl2 & NaHCO3 respectively for hyperK

Answer 11

CaCl2 = 1-3mins --> 30-60mins
NaHCO3 = 5-10mins --> 2hrs

Question 12

Use of ATP in emergency

Answer 12

Supraventricular tachycardia

Question 13

Dosage of amiodarone for fast AF / atrial flutter

Answer 13

Loading = 150mg make up to 100mL D5 over 30mins 
Maintenance = 150mg in 100mL D5 IV infusion over 8hrs q8h OR 600mg in 500mL D5 over 24hr q24h

Question 14

Max dose of amiodarone per day

Answer 14

1.2g/d

Question 15

Use of digoxin 500mcg/2mL in emergency

Answer 15

Fast AF / Atrial flutter

Question 16

Common dosage of digoxin for fast AF / Atrial flutter

Answer 16

Loading dose

• 250mcg in 50mL NS over 20min OR
• 250mcg PO stat, then 250mcg PO q8h for 2 more doses

Question 17

Use of diltiazem in emergency

Answer 17

Fast AF / Atrial flutter

Question 18

Use of verapamil 5mg/2mL in emergency

Answer 18

Supraventricular tachycardia

Question 19

Use of isoprenaline in emergency

Answer 19

Severe bradycardia

Question 20

Use of labetalol 25mg/5mL

Answer 20

Hypertensive crisis

Question 21

Use of sodium nitroprusside 50mg

Answer 21

Hypertensive crisis

MOA = Peripheral vasodilation by direct action on venous and arteriolar smooth muscle

Question 22

Use of phentolamine 10mg/mL

Answer 22

Catecholamine crisis (too much dopamine / norepinephrine / adrenaline)

Question 23

Use of octreotide500mcg/5mL

Answer 23

Variceal haemorrhage

Question 24

Use of terlipressin 1mg

Answer 24

Variceal haemorrhage

Question 25

Drugs for status epilepticus

Answer 25

Lorazepam / Diazepam / Phenytoin / Valproate / Levetiracetam / Phenobarbitone

Question 26

Use of suxamethonium

Answer 26

Intubation / Long surgical procedure | - neuromuscular blocking agent for producing muscular relaxation during anaesthesia