Emergency drug doses & routes

Question 1

For CPR

Answer 1

Adrenaline 1mg 1:10000 IV

Question 2

For anaphylaxis

Answer 2

Adrenaline 500micrograms 1:1000 IM
Establish airway, high flow oxygen, IV fluid challenge
Chlorphenamine 10mg slow IV/IM
Hydrocortisone 200mg slow IV/IM

Question 3

For MI

Answer 3

Morphine slow IV 5mg every 4hrs
Oxygen if <94%
Aspirin 300mg PO
Clopidogrel 300mg PO

Question 4

For bradycardia following MI

Answer 4

Atropine 500micrograms IV every 3-5mins, max 3g

Question 5

For opioid OD

Answer 5

Naloxone 400micrograms IV, can increase to 800micro

Question 6

For acute exacerbation of asthma

Answer 6

Oxygen high flow non-rebreathe 15L
Salbutamol 5mg NEB
Hydrocortisone 100mg IV
Ipratropium bromide 500micrograms

Question 7

Severe hyperkalaemia (>6.5 + ECG changes)

Answer 7

1. 30mls 10% calcium gluconate over 10 mins
   (then repeat ECG)
2. Give salbutamol 4x5mg back to back
3. IV insulin 10units with glucose 25g IV (or in 50ml of glucose 50%)

Check K on VBG 45-60mins after treatment

Other methods: (not in leicester pathway)

4. Sodium bicarbonate 500mls 1.4% if acidotic
5. Furosemide can increase elimination

Question 8

Status epilepticus

Answer 8

Diazepam 10mg PR, can repeat after 15mins
OR
Lorazepam 4mg slow IV if IV access

Question 9

for paracetamol OD

Answer 9

Acetylcysteine 150mg/kg over 1 hour in 200ml 5% glucose

Question 10

Hypocalcemia

Answer 10

10mls 10% calcium gluconate slow IV in 50mls of 5% glucose over 10mins

Question 11

Hypoglycemia

Answer 11

10-20g glucose PO (fruit juice 150-200ml)
(if can only swallow give 1.5-2 tubes of 40% glucose gel)
1mg glucagon IM if no response in 10mins
IV glucose 20% 75ml

Question 12

Severe pain

Answer 12

10mg morphine PO or slow IV 5mg

+ antiemetic slow IV metochlopromide 500micrograms if <60kg, 1g if >60kg