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Year 3 Medicine Block > Emergency Drugs > Flashcards

Flashcards in Emergency Drugs Deck (43)
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1
Q

What dose of adrenaline would you give an adult for cardiac arrest?

A

1mg every 3-5mins as required. Usually as 100micrograms/mL solution. Aka 1 in 10,000

2
Q

How is adrenaline administered for adult with cardiac arrest?

A

Slow IV injection

3
Q

What dose of adrenaline would you give an adult with acute anaphylaxis?

A

500 micrograms using 1 in 1000 injection (1mg/mL injection). Repeat after 5 mins if no response.

4
Q

Where is adrenaline injected for acute anaphylaxis?

A

Anterolateral aspect of middle third of the thigh

5
Q

How is adrenaline for acute anaphylaxis administered?

A

IM injection

6
Q

How is hydrocortisone administered for adult with thyroid storm? What dose?

A

IV injection. 100mg every 6 hrs.

7
Q

How is hydrocortisone administered for adult with adrenal insufficiency after septic shock? What dose?

A

IV injection. 50mg every 6 hrs. With fludrocortisone.

8
Q

Hydrocortisone can be given in acute hypersensitivity reactions, including as an adjunct to adrenaline. How is it given, and at what dose?

A

IV injection. 100-300mg

9
Q

A patient is undergoing minor surgery with GA. She usually takes 20mg (so, over 10mg) prednisolone each day. What dose would you give and how would you administer this dose?

A

Dose - 25-50mg.

Administration - IV injection or IV infusion, at induction of surgery.

10
Q

How would you treat adrenal crisis? Give dose and administration route.

A

With hydrocortisone.
IV injection.
100mg as initial dose. Then 200mg hydrocortisone every 24hrs diluted in 5% glucose (by continuous IV infusion).

11
Q

In severe acute or life threatening acute asthma attacks, how is hydrocortisone administered? What dose?

A

IV injection.

100mg every 6hours until can convert to oral prednisolone

12
Q

How can chlorphenamine be administered as emergency treatment of anaphylactic reactions?

A

IM injection or IV injection

13
Q

What dose of chlorphenamine would you prescribe for emergency treatment of anaphylactic reactions?

A

10mg IV / IM - max 4 times a day

14
Q

What drug might you prescribe for post - MI bradycardia?

Give name, route and dose.

A

Atropine, IV, 500 micrograms

15
Q

What dose and administration route of atropine would you give for post-MI bradycardia?

A

500micrograms every 3-5mins. Up to 3mg per course.

IV injection

16
Q

How would you treat STEMI, NSTEMI? Give name of drug, dose and administration

A

Aspirin
300mg
By mouth - chewed or dispersed in water

17
Q

What is the usual route of administration of clopidogrel?

A

By mouth/oral

18
Q

What dose of clopidogrel is given to patients experiencing TIA or acute ischaemic stroke with hypersensitivity to aspirin?

A

75mg once daily

19
Q

What dose of clopidogrel is given to patients (who don’t already take it) alongside aspirin for percutaneous coronary intervention?

A

Loading dose 300mg before procedure.

20
Q

A pt has had an MI within 35 days. Another pt has had a stroke within the last 6 months. The third patient you see has peripheral arterial disease. What dose of clopidogrel is commonly given to all these groups of patients?

A

75mg once daily

21
Q

What dose of clopidogrel is given for prevention of atherothrombotic events in ACS WITHOUT ST elevation (given with aspirin)?

A

Initially 300mg then 75mg once daily up to 12 months

22
Q

What dose of clopidogrel is given for prevention of atherothrombotic events in ACS WITH ST elevation (given with aspirin)?

A

Initially 300mg then 75mg od for at least 4 weeks.

If over 76+ = 75mg od for at least 4 weeks

23
Q

What dose of clopidogrel would you prescribe for pt with AFib ? Note: for this pt, warfarin is unsuitable

A

75mg once daily

24
Q

How is calcium gluconate administered for severe acute hypocalcaemia?

A

Slow IV injection

25
Q

What dose of calcium gluconate would you prescribe for severe acute hypocalcaemia ?

A

Initially: 10-20ml calcium gluconate 10% - administered with plasma-calcium and ECG monitoring.
Then repeated as required or followed as a continuous Iv infusion to prevent acute hypocalcaemia again.

26
Q

What dose and administration route would you suggest for calcium gluconate to treat acute severe hyperkalaemia ?

A

Dose: 30ml Calcium gluconate 10%. Single dose.

Admin route: Slow IV infusion

27
Q

Insulin infusion dose for DKA?

A

0.1 units /kg/hour

28
Q

What to give adults with symptoms of hypoglycaemia who have a blood-glucose concentration greater than 4 mmol/litre?

A

Small carb snack e.g. slice of bread

29
Q

What do you give to pt with blood glucose less than 4 mmol/litre who is conscious and able to swallow?

A

Fast-acting carbohydrate by mouth. Fast-acting carbohydrates include Lift® glucose liquid (previously Glucojuice®), glucose tablets, glucose 40% gels (e.g. Glucogel®, Dextrogel®, or Rapilose®), pure fruit juice, and sugar (sucrose) dissolved in an appropriate volume of water.

30
Q

Diazepam dose for status epilepticus, Febrile convulsions, Convulsions due to poisoning?

A

IV 10 mg, then 10 mg after 10 minutes if required, administered at a rate of 1 mL (5 mg) per minute.

31
Q

Diazepam dose for Acute anxiety and agitation

A

PR
For Adult
500 micrograms/kg, then 500 micrograms/kg after 12 hours as required.

For Elderly
250 micrograms/kg, then 250 micrograms/kg after 12 hours as required.

32
Q

Diazepam dose for Severe acute anxiety,
Control of acute panic attacks,
Acute alcohol withdrawal

A

IM or slow IV
For Adult
10 mg, then 10 mg after at least 4 hours if required, intravenous injection to be administered into a large vein, at a rate of not more than 5 mg/minute.

33
Q

Lorazepam dose for Acute panic attacks

A

intramuscular injection, or by slow intravenous injection

For Adult
25–30 micrograms/kg every 6 hours if required; usual dose 1.5–2.5 mg every 6 hours if required, intravenous injection to be administered into a large vein, only use intramuscular route when oral and intravenous routes not possible.

34
Q

Lorazepam dose for Status epilepticus,
Febrile convulsions,
Convulsions caused by poisoning

A

By slow intravenous injection

For Adult
4 mg for 1 dose, then 4 mg after 10 minutes if required for 1 dose, to be administered into a large vein.

35
Q

Nebulised salbutamol dose for Moderate, severe, or life-threatening acute asthma

A

For Adult

5 mg, repeat every 20–30 minutes or when required, give via oxygen-driven nebuliser if available.

36
Q

Dose and frequency of Nebulised salbutamol for exacerbations? (reliever)

A

2.5–5 mg, repeated up to 4 times daily or more frequently in severe cases.

37
Q

Prednisolone for Mild to moderate acute asthma,

Severe or life-threatening acute asthma

A

For Adult

40–50 mg daily for at least 5 days.

38
Q

Morphine is used for acute pain.

Dose, route, frequency?.

A

5mg, Slow IV injection, every 4 hours.

10mg, Oral, SC or IM, every 4 hours. Or 5mg in elderly in this route

39
Q

Naloxone is used for acute opioid overdose.

What is route, dose scheme and frequency?

A

Route: IV or IM
Dose: 400mcg —> 800mcg for up to two doses at 1 min intervals —> 2mg for 1 dose —> review diagnosis

—> = what to do if no response to that dose.

40
Q
Resuscitation fluids for adults:
What is used?
Volume?
Over what time period?
Max volume you can resus with?
What to do after each bolus is given?
A
What is used?
- saline or hartmann's
Volume?
- 500ml (or 250ml in elderly)
Over what time period?
- over 15 mins 
Max volume you can resus with?
- can continue this until 2L is reached. After this need to get inotropic support.
What to do after each bolus is given?
- reassess
41
Q

Maintenance fluids for adults:
?ml/kg/day
Na/K = ?mmol/kg/day
Glucose = ?g/day

A

25-30ml/kg/day
Na/K = 1mmol/kg/day
Glucose = 50-100g/day

42
Q

What concentration does potassium come in?

When to prescribe alongside fluids?

A

20mmol and 40mmol bags - need to be prescribed separately

Need to be prescribed to replace acid and bicarb in D&V

43
Q

Paediatric fluids:

1) Resus fluids - what is the vol/kg?
2) Maintenance fluids - what fluids to use?
3) Explain the Holliday Segar method of prescribing fluids in paediatrics (4-2-1 rule)?

A

1) 20ml/kg or 10ml/kg in less than 15 mins (10ml usually used in trauma setting)
2) 0.45% saline +/- 5% glucose
3) First 10kg = 4ml/kg/hr. Second 10kg of that child’s body weight = 2ml/kg/hour. Thereafter, every kg left = 1ml/kg/hr

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