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 (Pediatric) | DOSE PO | INDICATION | CONTRAINDICATION / CAUTION |
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Adrenaline (Epinephrine) | Alpha and beta adrenergic agonist; increases heart rate, blood pressure, and coronary/cerebral perfusion |
Cardiac Arrest (IV/IO): 10 micrograms/kg (0.1 mL/kg of 1:10,000 solution) every 3-5 min
Anaphylaxis (IM): 10 micrograms/kg of 1:1,000 (max 300 micrograms per dose, typically 0.3 mL), given IM into mid-outer thigh |
N/A | Cardiac arrest, anaphylaxis, severe asthma (refractory) | Tissue necrosis if extravasation, arrhythmias; ensure correct dilution (1:10,000 IV vs 1:1,000 IM) |
Atropine | Anticholinergic; increases heart rate by reducing vagal tone on SA/AV node | Bradycardia (IV/IO): 20 micrograms/kg (0.02 mg/kg), minimum dose 100 micrograms (0.1 mg), max single dose 500 micrograms (0.5 mg) | N/A | Symptomatic bradycardia, organophosphate poisoning | Caution in tachyarrhythmias, narrow-angle glaucoma; can cause dry mouth, blurred vision |
Adenosine | Transiently blocks AV node conduction to terminate SVT | SVT (IV Rapid Push): First dose 100 micrograms/kg (0.1 mg/kg), max 6 mg; Second dose 200 micrograms/kg (0.2 mg/kg), max 12 mg | N/A | Stable supraventricular tachycardia (SVT) | Asthma (risk of bronchospasm), known WPW with AFib; administer via rapid IV push followed by flush |
Amiodarone | Class III antiarrhythmic (K+ channel blockade) with Class I, II, IV effects; prolongs repolarization |
VF/ Pulseless VT (IV/IO): 5 mg/kg bolus
Perfusing VT (IV/IO): 5 mg/kg over 20-60 min |
N/A | Ventricular fibrillation, pulseless VT, stable VT | Hypotension, bradycardia; monitor ECG and hemodynamics |
Naloxone (Narcan) | Opioid receptor antagonist; reverses opioid-induced respiratory depression | Opioid Overdose (IV/IO/IM/IN): 100 micrograms/kg (0.1 mg/kg), max single dose 2 mg | N/A | Opioid overdose (respiratory depression) | May precipitate withdrawal in opioid-dependent patients; titrate to desired effect |
Dextrose (Glucose) 10% or 25% | Provides glucose to correct hypoglycaemia |
Hypoglycaemia (IV/IO):
D10W: 5-10 mL/kg bolus D25W: 2-4 mL/kg bolus (usually for older children) |
N/A | Hypoglycaemia | Ensure IV patency; extravasation can cause tissue injury; monitor blood glucose |
Magnesium Sulfate | Stabilizes cardiac membranes, bronchodilation, reduces neuromuscular excitability | Torsades de Pointes/Severe Asthma (IV/IO): 25-50 mg/kg (max 2 g) over 10-20 min | N/A | Torsades de pointes, severe asthma exacerbation, hypomagnesaemia | Hypotension if infused rapidly; monitor respiratory rate, deep tendon reflexes, and ECG |
Salbutamol (Albuterol in US) | Beta-2 agonist causing bronchodilation | Nebulised: 150 micrograms/kg (0.15 mg/kg) per dose (minimum 2.5 mg) q20min x3, then PRN | PO (rarely used in emergency settings): typically 100-200 micrograms/kg/dose (max around 2-4 mg) but dosing variable; check BNFc | Bronchospasm (asthma, wheezing), hyperkalaemia | Tachycardia, tremor, hypokalaemia; use caution in cardiac disease |
Midazolam (Buccolam® for buccal form) | Short-acting benzodiazepine, enhances GABA inhibitory effects |
Seizures (IV/IO): 100 micrograms/kg (0.1 mg/kg), max single dose ~4 mg
Intranasal/Buccal: 200 micrograms/kg (0.2 mg/kg) |
N/A | Seizure termination, sedation for procedures | Respiratory depression, hypotension; monitor airway and breathing |
Racemic Adrenaline (Racemic Epinephrine) | Alpha and beta agonist causing mucosal vasoconstriction and bronchodilation | Croup (Nebulised): 0.5 mL of 2.25% solution diluted in 3 mL NaCl | N/A | Croup (stridor at rest) | Monitor for rebound deterioration as effect wears off; tachycardia, agitation |