Emergency Drug Doses

Question 1

Epinephrine / adrenaline for CPR

Answer 1

1mg 1:10000 pre filled syringe (1mg in 10ml) IV

Question 2

Epinephrine / adrenaline for acute anaphylaxis

Answer 2

500 mic.g (1:1000, 1mg/ml) IM

Question 3

Hydrocortisone for Acute asthma attack / thyrotoxicosis

Answer 3

100mg IV

Question 4

Chlorphenamine for acute anaphylaxis

Answer 4

10mg IV or IM (max 4 per 24hrs)

Question 5

Atropine for Bradycardia 2nd to MI

Answer 5

500mic.g IV every 3-5 mins up to 3mg

Question 6

Atropine for Bradycardia 2nd to BB overdose

Answer 6

3mg IV

Question 7

Atropine for bradycardia not due to MI or BB overdose

Answer 7

500mic.g IV

Question 8

Aspirin for MI or unstable angina

Answer 8

300mg loading dose PO (75mg maintenance)

Question 9

Clopidogrel for prevention in MI for PCI

Answer 9

300mg loading dose PO (4 x 75mg tablets)

Question 10

Calcium Gluconate for severe hypocalcaemia

Answer 10

Slow IV 10 mls of 10% calcium gluconate in 50mls of 5% glucose over ten minutes. Repeat until asymp to max of 40 mls in 24 hrs

Question 11

Calcium Gluconate for hyperkalaemia with ECG changes (K+ >6.5)

Answer 11

Slow IV 30mls of 10% calcium gluconate over 5-10min

Question 12

Insulin/Dextrose for hyperkalaemia

Answer 12

5-10 units insulin in 50ml of 50% dextrose

Question 13

Glucose for hypoglycaemic emergency

Answer 13

10-20g of glucose in many forms (glucogel, 5 glucose tablets, 100 to 200ml of full sugar cola, lemonade etc or fruit juice. 4 to 5 sugar lumps or teaspoons of sugar). 1mg of glucagon (IM)- if no response within 10 minutes IV glucose given via infusion at 20%.

Question 14

Diazepam for Status epilepticus, febrile convulsions, convulsions due to poisoning

Answer 14

split dose of 10mg IV - 5mg per min

Question 15

Diazepam for Life-threatening drug-induced dystonic reactions

Answer 15

5-10mg IV

Question 16

Lorazepam for acute panic attacks

Answer 16

Slow IV or IM 25-30micro.g/kg every 6 hrs (around 2mg for 70kg)

Question 17

Lorazepam for Status epilepticus, febrile convulsions, convulsions due to poisoning

Answer 17

4mg IV

Question 18

Salbutamol for asthma attack moderate or above in adults

Answer 18

5mg every 20-30 minutes, O2 driven Neb

Question 19

Salbutamol for *pediatric* asthma attack moderate or above

Answer 19

<4y.o 2.5mg <11y.o 2.5mg-5mg in O2 driven neb (with appropriate size mask)

Question 20

Morphine for MI /or/ acute pulmonary oedema

Answer 20

5-10mg slow IV,
half this for elderly pts

Question 21

Morphine for acute pain

Answer 21

10mg PO, SC or IM every 4 hrs

Question 22

What else should you prescribe acutely with morphine?

Answer 22

Consider using an anti-emetic e.g. metaclopramide: <60kg up to 500mic.g per kg daily in 3 doses, if >60kg 10mg up to 3 times a day slow IV over 3 minutes, PO or IM

Question 23

Naloxone for opioid OD

Answer 23

400mic.g IV then 800mg for up to 2 doses 1 min apart

Question 24

Immediate management for meningitis in adults

Answer 24

AtoE assessment 1.2g IM or IV benzylpenicillin or ceftotaxime

Question 25

# what is the indication? 1mg 1:10000 pre filled syringe (1mg in 10ml) IV

Answer 25

Epinephrine / adrenaline for CPR

Question 26

# what is the indication? 500 mic.g (1:1000, 1mg/ml) IM

Answer 26

Epinephrine / adrenaline for acute anaphylaxis

Question 27

# what is the indication? 100mg IV

Answer 27

Hydrocortisone for Acute asthma attack / thyrotoxicosis

Question 28

# what is the indication? 10mg IV or IM (max 4 per 24hrs)

Answer 28

Chlorphenamine for acute anaphylaxis

Question 29

# what is the indication? 500mic.g IV every 3-5 mins up to 3mg

Answer 29

Atropine for Bradycardia 2nd to MI

Question 30

# what is the indication? 3mg IV

Answer 30

Atropine for Bradycardia 2nd to BB overdose

Question 31

# what is the indication? 500mic.g IV

Answer 31

Atropine for bradycardia not due to MI or BB overdose

Question 32

# what is the indication? 300mg loading dose PO (75mg maintenance)

Answer 32

Aspirin for MI or unstable angina

Question 33

# what is the indication? 300mg loading dose PO (4 x 75mg tablets)

Answer 33

Clopidogrel for prevention in MI for PCI

Question 34

# what is the indication? Slow IV 10 mls of 10% calcium gluconate in 50mls of 5% glucose over ten minutes. Repeat until asymp to max of 40 mls in 24 hrs

Answer 34

Calcium Gluconate for severe hypocalcaemia

Question 35

# what is the indication? Slow IV 30mls of 10% calcium gluconate over 5-10min

Answer 35

Calcium Gluconate for hyperkalaemia with ECG changes (K+ \>6.5)

Question 36

# what is the indication? 5-10 units insulin in 50ml of 50% dextrose

Answer 36

Insulin/Dextrose for hyperkalaemia

Question 37

# what is the indication? 10-20g of glucose in many forms (glucogel, 5 glucose tablets, 100 to 200ml of full sugar cola, lemonade etc or fruit juice. 4 to 5 sugar lumps or teaspoons of sugar). 1mg of glucagon (IM)- if no response within 10 minutes IV glucose given via infusion at 20%.

Answer 37

Glucose for hypoglycaemic emergency

Question 38

# what is the indication? split dose of 10mg IV - 5mg per min

Answer 38

Diazepam for Status epilepticus, febrile convulsions, convulsions due to poisoning

Question 39

# what is the indication? 5-10mg IV

Answer 39

Diazepam for Life-threatening drug-induced dystonic reactions

Question 40

# what is the indication? Slow IV or IM 25-30micro.g/kg every 6 hrs (around 2mg for 70kg)

Answer 40

Lorazepam for acute panic attacks

Question 41

# what is the indication? 4mg IV

Answer 41

Lorazepam for Status epilepticus, febrile convulsions, convulsions due to poisoning

Question 42

# what is the indication? 5mg every 20-30 minutes, O2 driven Neb

Answer 42

Salbutamol for asthma attack moderate or above in adults

Question 43

# what is the indication? \<4y.o 2.5mg \<11y.o 2.5mg-5mg in O2 driven neb (with appropriate size mask)

Answer 43

Salbutamol for \*pediatric\* asthma attack moderate or above

Question 44

# what is the indication? 5-10mg slow IV, half this for elderly pts

Answer 44

Morphine for MI /or/ acute pulmonary oedema

Question 45

# what is the indication? 10mg PO, SC or IM every 4 hrs

Answer 45

Morphine for acute pain

Question 46

# what is the indication? Consider using an anti-emetic e.g. metaclopramide: \<60kg up to 500mic.g per kg daily in 3 doses, if \>60kg 10mg up to 3 times a day slow IV over 3 minutes, PO or IM

Answer 46

What else should you prescribe acutely with morphine?

Question 47

# what is the indication? 400mic.g IV then 800mg for up to 2 doses 1 min apart

Answer 47

Naloxone for opioid OD

Question 48

# what is the indication? AtoE assessment 1.2g IM or IV benzylpenicillin or ceftotaxime

Answer 48

Immediate management for meningitis in adults