Makindo Medical Notes"One small step for man, one large step for Makindo" |
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Related Subjects: |Emergency Drugs |Emergency Drug Antidotes |Emergency Cardiac Drugs |Emergency Endocrine Drugs |Emergency Gastrointestinal Drugs |Emergency Haematology Drugs |Emergency Neuropsychiatric drugs |Emergency Pain drugs |Emergency Respiratory drugs |Emergency Obstetric and Gynaecology Drugs |Emergency Paediatric Drugs
DRUG (UK Name) | MOA | DOSE IV | DOSE PO | INDICATION | CONTRAINDICATION |
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Salbutamol (Albuterol) | Selective beta-2 agonist causing bronchodilation |
Nebulised: 2.5–5 mg every 20 min for the first hour, then 2.5–10 mg every 1–4 h as needed
Alternatively, 10–15 mg over 1 h by nebuliser (check local protocol) |
N/A | Acute bronchospasm, hyperkalaemia | May cause hypokalaemia, tachycardia, hyperglycaemia; caution in pregnancy (Pregnancy C) |
Adrenaline (Epinephrine) | Alpha and beta receptor agonist increasing HR, BP, and improving perfusion |
ACLS: 1 mg of 1:10,000 IV (Paediatric: 10 micrograms/kg IV of 1:10,000)
Anaphylaxis (IM): 0.1–0.5 mg of 1:1,000 (usually 500 micrograms [0.5 mg] IM in adults) Paeds anaphylaxis (IM): 10 micrograms/kg of 1:1,000 (max 300 micrograms) Hypotension refractory to fluids: 1–10 micrograms/min IV infusion (titrate to effect) |
N/A | Anaphylaxis, cardiac arrest (ACLS/Paediatric ALS), severe asthma | Risk of dosing errors, tissue necrosis if extravasation, arrhythmias; caution in pregnancy (Pregnancy C) |
Etomidate | GABA-like effect, providing rapid hypnosis (anaesthetic induction agent) | 0.3 mg/kg IV (single bolus for RSI) | N/A | Rapid sequence induction (RSI) of anaesthesia | Adrenal suppression with repeated doses, may lower seizure threshold; caution in pregnancy (Pregnancy C) |
Furosemide (Frusemide) | Loop diuretic inhibiting Na+ and Cl- reabsorption in the loop of Henle | 20–40 mg IV initially, reassess; can increase up to 200 mg single dose if needed | N/A | Acute pulmonary oedema, CHF exacerbation, hyperkalaemia (if diuresis achieved) | Volume depletion, hypokalaemia, metabolic alkalosis, ototoxicity; caution in pregnancy (Pregnancy C) |
Ketamine | NMDA receptor antagonist providing dissociative anaesthesia, analgesia |
Subdissociative analgesia: 0.1–0.5 mg/kg IV
Procedural sedation: 0.5–1 mg/kg IV RSI induction: 1–2 mg/kg IV (commonly ~2 mg/kg) |
N/A | Analgesia, sedation, induction for RSI | Emergence reactions, laryngospasm, raised IOP/ICP, tachycardia, hypertension; Pregnancy D |
Magnesium sulfate | Reduces neuromuscular excitability, stabilises cardiac membranes, bronchodilation |
Eclampsia: 2–4 g IV over ~5 min
Torsades de Pointes: 2 g IV push Asthma exacerbation: 2 g IV over 15 min |
N/A | Torsades de Pointes, severe asthma exacerbation, eclampsia seizure prophylaxis | Hypotension if given rapidly, respiratory depression, monitor reflexes; Pregnancy A (commonly used in preeclampsia/eclampsia) |
Methylprednisolone (Solu-Medrone) | Corticosteroid with glucocorticoid and mineralocorticoid activity |
Severe asthma: 1 mg/kg IV
Severe allergic reaction: 1 mg/kg IV PCP pneumonia: 30 mg IV twice daily for 5 days, then taper per protocol |
N/A | Severe asthma, PCP pneumonia, acute hypersensitivity reactions | Immunosuppression, hyperglycaemia, caution in pregnancy (Pregnancy C) |
Propofol | GABA_A agonist, provides sedation and anaesthesia |
Procedural sedation: ~1 mg/kg IV bolus, then 0.5 mg/kg increments q3min
RSI: 1.5–2.5 mg/kg IV x1 Ventilator sedation: 5–50 micrograms/kg/min infusion |
N/A | Procedural sedation, induction for RSI, sedation in ventilated patients | Hypotension, risk of anaphylaxis, bradycardia, respiratory depression; Pregnancy B |
Rocuronium | Non-depolarising neuromuscular blocker (aminosteroid) | 1 mg/kg IV for RSI | N/A | RSI paralysis | Prolonged paralysis; caution in pregnancy (Pregnancy B) |
Suxamethonium (Succinylcholine) | Depolarising neuromuscular blocker | 1–1.5 mg/kg IV (or 3–4 mg/kg IM if no IV access) | N/A | RSI paralysis | Hyperkalaemia, contraindicated in burns/crush injuries after 48–72 hrs, raised IOP/ICP; Pregnancy C |