Emergency drugs and equipment must be available in every dental office to manage life-threatening situations. They are presented in modules based on the level of training and experience of the doctor. Module one contains basic emergency drugs and equipment. Secondary injectable drugs included in later modules are anticonvulsants, analgesics, vasopressors, antihypoglycemics, corticosteroids, antihypertensives, and anticholinergics. Proper administration techniques are outlined for intramuscular, intravenous, and sublingual medications.

1. KS HariSHanKar
–

2.  Emergency drugs &
equipment must be
available in every dental
office
 Life-saving
 Secondary role to basic life
support in overall
management

3. It is a collection of drugs & equipments highly
effective in managing life-threatening situations
Should be as simple to use as possible
Should be intended to use for adult or pediatric
patients
They are presented in 4 levels or modules based
on level of training & experience of the doctor
Drugs in each module
i. Injectables
ii.Non-injectables

4. Endotracheal
Intravenous
Sublingual or intra lingual
Intramuscular
i. Vastus-lateralis
ii.Mid-deltoid
iii.Gluteal region

5. 1) Cleanse the area of needle insertion
2) Grab the muscle & pull it away from the bone
3) Holding the syringe like a dart, quickly insert the
needle into the muscle mass to a depth of
approximately 1 inch
4) Aspirate to ensure nonvascular penetration
5) Quickly administer the drugs
6) Remove the syringe, placing a dry gauze under
pressure at the injection site for a minimum of 1-2
minutes
7) Rubbing the area may increase vascularity &
speed the rate of drug absorption

7. 1) Place the tourniquet above the antecubital fossa
2) If possible have the patient open & close the fist
to help distend the veins
3) When the patient cannot open & close his/her fist
(unconscious) – place arm below the level of
patient’s heart to help distend the veins
4) Cleanse & then dry the area in which the
venipuncture is to be placed

8. 5) Use an indwelling catheter , scalp-vein needle or
syringe with the bevel of the needle facing up held
at about 30 – 45 angle to the vein to be entered
6) Advance the needle into the vein until a return of
blood is noted
7) Remove the tourniquet & either start the IV
infusion or administer the desired drug
8) Secure the needle with a tape to maintain venous
access

12.  MODULE ONE- Basic emergency kit (critical
drugs &
equipment)
 MODULE TWO – non critical drugs & equipment
 MODULE THREE – advanced cardiac life support
 MODULE FOUR – antidotal drugs

13. Injectable drugs
1. Epinephrine
2. Anti-histamine
Non-injectable drugs
1. Oxygen
2. Vasodialators
Emergency equipment
1. Oxygen delivery system
2. Suction & suction tips
3. Tourniquets
4. syringes

14. Secondary Injectable drugs
1.Anticonvulsaunt
2.Analgesics
3.Vasopressor
4.Antihypoglycemics
5.Corticosteroids
6.Antihypertensive
7.anticholinergic

15. Non-injectable drugs
1.Respiratory stimulant
2.Antihypoglycemic
3.bronchodilators
Emergency equipment
1.Device for cricothyrotomy
2.Artificial airways
3.Laryngoscope & endotracheal tubes

16. 1. Epinephrine
2. Oxygen
3. Lidocaine
4. Atropine
5. Dopamine
6. Morphine sulfate
7. Verapamil

17.  Narcotic antagonists
 Benzodiazepines
 Antiemergence delerium drug
 Vasodilator

19.  Most important emergency drug
 Drug of choice in acute allergic reactions
DESIRABLE PROPERTIES
 Rapid onset of action
 Potent bronchial smooth muscle dilator
 Histamine blocking properties
 Vasopressor action
 Cardiac effects(increased cardiac output)

20. Therapeutic indications
 1:1000 concentration in
- Anaphylaxis
- Acute ashmatic attack
 1:10000 concentration
- Cardiac arrest

21. SIDE EFFECTS
 Tachydysrhythmias
- Supraventricular
- Ventricular
PRECAUTIONS
 In pregnancy
-decreases placental blood flow
-premature labour
NO CONTRA INDICATIONS

22. AVAILABILITY
 Preloaded syringes
- 1:1000 intramuscular and subcutaneous
-1:10000 intravenous
1ml ampules
DOSE
Adult dose
 0.3 -0.5 ml intramuscular and subcutaneous
Pediatric dose
 0.15mg

23. In Emergency kits
- 1 preloaded syringe(1 ml of 1:1000 epinephrine)
- 3 or 4 ampules(1:1000 epinephrine)

24.  Drug class - Histamine blockers
 Proprietary - Chlor- Trimeton
 Alternative drug -Diphenhydramine
 Histamine blockers
 Drug of choice
- delayed allergic response
- definitive management of acute allergy
MODE OF ACTION
 Competitive antagonists of histamine
 Prevent histamine’s access to receptor site
 Blocking response of effector to histamine

25. THERAPEUTIC INDICATIONS
 Delayed onset allergic reactions
 As local anesthetics in allergic patient
 Definitive management of acute allergic
reactions
 Side Effects
- CNS Depression
-Decreased Blood Pressure
-Thickening of bronchial secretions
 Contraindications

26.  AVAILABILITY
- 1ml and 2ml ampules(10mg|ml)
-1ml pre loaded syringes
 DIPHENHYDRAMINE
-10&30ml multidose vials(10mgml)
-1ml ampules(50mgml)
-1ml pre-loaded syringes
 IN EMERGENCY KITS
 -Three or Four 1ml ampules
Chlorpheniramine(10mg/ml)
or
Diphenhydramine(50mglml)

27. 1)OXYGEN
2)VASODILATOR
3)BRONCHODILATOR
4)ANTIHYPOGLYCEMIC
5)ASPIRIN

28.  DRUG CLASS -NONE
 ALTERNATIVE DRUG-NONE
 PROPRIETARY -NONE

29.  Most useful drug in emergency kit
 THERAPEUTIC INDICATIONS
 Emergency situations where respiratory
distress is evident
SIDE EFFECTS-NONE
CONTRAINDICATIONS-HYPERVENTILATION

30.  AVAILABILITY
 Compressed gas cylinder
IN EMERGENCY KIT
ONE E CYLINDER

31.  DRUG CLASS-VASODILATOR
 ALTERNATIVE DRUG-AMYL NITRITE
 PROPRIETARY-NITROLINGUALSPRAY
-NITROSTAT TABLETS

32.  THERAPEUTIC INDICATIONS
- CHEST PAIN IN
In acute myocardial infarction
Angina pectoris
- Acute hypertensive episodes

33.  Side Effects
 -Transient pulsating headache
 -Facial flushing
 -Degree of hypotension
 CONTRAINDICATIONS
 -In hypotensive patients

34.  AVAILABILITY
 -0.3,0.4,0.6mg doses of sublingual tablets
 -0.4,0.8mg/dose translingual spray
 -0.3ml doses of amyl nitrate yellow
vaporoles
 IN EMERGENCY KIT
-One bottle of metered trans lingual
nitroglycerine spray

35.  DRUG CLASS-BRONCHODILATOR
 ALTERNATIVE DRUG-METAPROTERENOL
 PROPRIETARY-PROVENTIL,VENTONIL

36.  Drug of choice in asthmatic & allergic
patients
 Mode of action: bronchial smooth muscle
relaxation
 Therapeutic indication: bronchospasms,
acute asthmatic & allergic reactions
 Contraindications : pre-existing
tachydysrhythmias

37.  AVAILABILITY:
 - Albuterol inhalers ( Ventolin, Proventil )
 - Metaproterenol inhalers (Alupent)
 - Epinephrine mistometers (Medihaler-
Epi,
Primatine Mist)
 - Isoproterenol mistometers (Medihaler-
Iso)

38.  DRUG CLASS-ANTIHYPOGLYCEMICS
 DRUG OF CHOICE – ORANGE JUICE
 ALTERNATIVE DRUG-SOFT DRINKS
(NONDIET)
 PROPRIETARY-NONE

39.  Drug of choice in patients with hypoglycemic
reactions in Diabetes mellitus & non-diabetic
patients with hypoglycemia
 Therapeutic indications: management of
unconscious hypoglycemic state
 Contraindications : patients without active
gag reflex, or unable to drink without
assistance
 Side effects: none

40.  AVAILABILITY:
 - Glucola
 - Gluco-stat
 - Insta-glucose
 - nondiet cola beverages
 - fruit juices
 - granulated sugar
 - tubes of decorative icing

41.  DRUG CLASS-ANTI-PLATELET
 ALTERNATIVE DRUG-NONE
 PROPRIETARY-NONE

42.  Drug of choice in suspected myocardial infarction
 Mode of action:
- irreversibly acetylates the platelet cycloxygense
- removes all cycloxygenase activity for the
lifespan of platelet
- stops production of proaggregatory thromboxane
A2
- non platelet effects: diminishes formation of
prostacyclines
 Therapeutic indications: suspected myocardial
infarction
unstable angina
 Contraindications & side effects :life-threatening
haemorrhage (bleeding peptic ulcer), history of aspirin

43.  AVAILABILITY:
 -65, 81, 162 , 325 mg tablets
 In emergency kit
 3-4 baby chewable aspirin- 162 mg

44.  Oxygen delivery system
 Automated external defibrillator
 Syringes
 Suction & suction tips
 Tourniquets
 Magill intubation forceps

45. TECHNIQUE PERCENTAGE O2 DELIVERED
MOUTH-TO-MOUTH 16
MOUTH-TO-MASK 16
BAG-VALVE MASK 21
BAG VALVE
MASK+SUPPLEMENTAL O2
>21 - <100
POSITIVE PRESSURE OXYGEN 100

46. POSITIVE PRESSURE
 Adaptable to the E-cylinder
 Delivers oxygen under positive pressure
 Examples: Positive pressure or demand valve
- Reservoir bag
 The devices should be fitted with a clear face mask
 Efficient delivery of 100% oxygen
 Permit the rescuer to inspect the victim’s mouth for
the presence of foreign matter like vomitus, blood,
saliva, water
 Should be available in child, small adult & large adult
sizes

47.  Portable
 Self-inflating
 Source of positive pressure oxygen or
ambient air or enriched oxygen
(>21%, <100%)
 Attached to oxygen delivery tube
 Rescuer should be able to maintain an air-tight seal
 Should have patent airway with one hand while
using the other hand to activate the device &
ventilate the victim

48.  Clear, full-faced mask
 Rescuer applies exhaled air ventilation ( 16%
oxygen) to ventilate the victim
 Exhalation occur through one way valve located on
the side of the mask
 Also available with supplemental oxygen port
permitting the attachment of the mask to an
oxygen tube & deliver enriched oxygen ventilation
 It enables the rescuer to provide mouth to mask
ventilation
 Advantage: prevention of transmission of disease,

49.  IN PEDIATRIC PATIENTS
 Simply invert the mask, holding the narrow
nose side of the mask in the cleft of the chin
& the wider chin side on the bridge of the
child’s nose

50.  IN EMERGENCY KIT
 One portable oxygen cylinder (E-cylinder)
with positive pressure mask
 One portable, self-inflating, bag-valve-mask
device
 One pocket mask for each staff member
 Sizes: child, small adult, large adult
 Advanced training for safe &effective use

51.  Sophisticated,simple,battery operated
,computerised device,reliable &easy to use.
 Use-to recognise cardiac dysrrythmias-
ventricular fibrillation&pulseless ventricular
tachycardia.
 In emergency kit:one automated external
defibrillator

52.  Plastic , disposable syringes with 18 or 21
gauge needles
 2 ml syringes – emergency drug delivery
 In emergency kit: 2-4 2 ml disposable
syringes

53.  In emergency kit: 2 plastic evacuators or
tonsil suction tips

54.  To administer IV drugs
 For bloodless phlebotomy in acute pulmonary
oedema
 In emergency kit: 3 tourniquets & a
sphygmomanometer

55.  To place endotracheal tube
during nasal intubation
 It is a blunt ended scissor with
a right angled bend which
permits the forceps to grasp
objects deep in the
hypopharynx
 In emergency kit: one pediatric
size Magill intubation forceps

57. Secondary injectable drugs
1.Anticonvulsants
2.Analgesics
3.Vasopressors
4.Antihypoglycemics
5.Corticosteroids
6.Antihypertensive
7.Anticholinergic

58.  DRUG OF CHOICE: Midazolam
 PROPRIETARY: Versed
 DRUG CLASS: Benzodiazepine
 ALTERNATIVE DRUG: Diazepam

59.  DRUG OF CHOICE: Morphine sulphate
 PROPRIETARY: none
 DRUG CLASS: Opioid agonist
 ALTERNATIVE DRUG: Meperidine; nitrous oxide &
oxygen (N2O-O2)
 THERAPEUTIC INDICATIONS: Pain & anxiety in
ischemic chest pain
 SIDE EFFECTS: potent CNS & respiratory depressants
 CONTRAINDICATIONS: injury & multiple trauma
 AVAILABILITY: 8,10, 15 mg/ml in 2 ml ampules & 20 ml vials
morphine sulfate,
50, 100 mg/ ml Meperidine in 1 ml ampule & 20, 30 ml
vials
 In emergency kit: 10 mg/ml morphine sulfate (2, 2ml
ampules)
50 mg/ml Meperidine (2, 2ml ampules)

60.  DRUG OF CHOICE: Phenylephrine
 PROPRIETARY: Many
 DRUG CLASS: Vasopressor
 ALTERNATIVE DRUG: none
 THERAPEUTIC INDICATIONS:
1.manage hypotension
2.Syncopal reactions
3.Drug-overdose reactions
4.Post-seizure states
5.Acute adrenal insufficiency
6.allergy

61.  PRECAUTIONS: hyperthyroidism, bradycardia,
partial heart block, myocardial disease, severe
atherosclerosis
 CONTRAINDICATIONS: parenteral
administration is contraindiacted in patients
with high BP, or ventricular tachycardia
 AVAILABILITY: 10 mg/ml in 1 ml ampules
 IN EMERGENCY KIT: 10 mg/ml 2 – 3, 1 ml
ampules

62.  DRUG OF CHOICE: Dextrose, 50 % solution
 PROPRIETARY: none
 DRUG CLASS: Antihypoglycemics
 ALTERNATIVE DRUG: Glucagon
 THERAPEUTIC INDICATIONS: treatment of hypoglycemia,
diagnostic aid in unconsciousness or seizures of unknown
origin
 SIDE EFFECTS: 50% dextrose solution administered IV –
tissue necrosis if extravascular infiltration occurs
 CONTRAINDICATIONS: IV or IM glucagon in starvation or
chronic hypoglycemia
 AVAILABILITY: 50 % dextrose in 30 ml glass
 Glucagon in 1mg of dry powder with 1 ml of diluents
 IN EMERGENCY KIT: 50% dextrose 1-2 vials (IV) or 1mg/ml
glucagon (IV or IM)

63.  DRUG OF CHOICE: Hydrocortisone sodium
succinate
 PROPRIETARY: Solu-Cortef
 DRUG CLASS: Adrenal glucocorticosteroid
 ALTERNATIVE DRUG: none

64.  THERAPEUTIC INDICATIONS: definitive
management of acute allergy, in acute
adrenal insufficiency
 PRECAUTIONS: peptic ulcer, pre-existing
infection, hyperglycemia
 AVAILABILITY: Hydrocortisone sodium
succinate 50 mg/ml, (2ml vials)
 IN EMERGENCY KIT: 1, 2ml vial

65.  DRUG OF CHOICE: Esmolol
 PROPRIETARY: Brevibloc
 DRUG CLASS: β-Adrenergic blocker
 ALTERNATIVE DRUG: Propanolol
 THERAPEUTIC INDICATIONS: acute hypertensive episodes,
as antidysrhythmic agent in PSVT, intra-operative & post-
operative tachycardia
 CONTRAINDICATIONS: sinus bradycardia, heart block
greater than 1st
degree, cardiogenic shock, overt heart
failure
 AVAILABILITY: 2.5 g in 10 ml ampule which is diluted to a 10
mg/ml concentration prior to infusion
 IN EMERGENCY KIT: 2 ampules (100 mg/ml) with diluents

66.  DRUG OF CHOICE: Atropine
 PROPRIETARY: none
 DRUG CLASS: Anticholinergic
 ALTERNATIVE DRUG: none
 THERAPEUTIC INDICATIONS:bradycardia,
hemodynamically significant bradydysrhythmias
 SIDE EFFECTS: hot, dry skin, headache, blurred near-
sightedness , dry mouth throat, disorientation &
hallucinations
 CONTRAINDICATIONS: glaucoma, prostatic hypertrophy
 AVAILABILITY:0.5 mg/ml in 1 ml vials 7 1 mg/ml in 10 ml
pre-loaded syringes
 IN EMERGENCY KIT: 2 or 3 ampules of 0.5 mg/ml (IM) or 2,
1o ml syringes (IV)

67. 1. Respiratory stimulant
2. Antihypertensives

68.  DRUG OF CHOICE: Aromatic ammonia
 PROPRIETARY: none
 DRUG CLASS: Respiratory stimulant
 ALTERNATIVE DRUG: none

69. THERAPEUTIC INDICATIONS:to treat
respiratory depression not induced by opioid
analgesics ,vasodepressor syncope
SIDE EFFECTS:irritating effects on mucous
membrane of upper respiratory tract
precipitates bronchospasm
CONTRAINDICATIONS: chronic obstructive
pulmonary disease or asthma
Availability :silver grey vaporoles containing 0
.3ml of ammonia
IN EMERGENCY KIT: one or two boxes of
vaporoles

70.  DRUG OF CHOICE: Nifedipine
 PROPRIETARY: Procardia
 DRUG CLASS: Calcium channel blocker
 ALTERNATIVE DRUG: Nitroglycerin
 THERAPEUTIC INDICATIONS:hypertension,acute
anginal pain
 SIDE EFFECTS:excessive hypotension
 CONTRAINDICATIONS: in patients receiving β-blockers,
patients undergoing anasthesia with high doses of
fentanyl
 AVAILABILITY:10mg or20 mg capsules
 IN EMERGENCY KIT: one bottle of 10mg capsules

71. 1. Scalpel or cricothyrotomy needle
2. Artificial airway
3. Laryngoscope & endotracheal tubes
4. Laryngeal mask airway

72.  Indicated when all other noninvasive
procedure fail to secure a patent airway
 In emergency kit: 1 scalpel with a disposable
blade
1 cricothyrotomy device

73.  Plastic or rubber oropharyngeal or nasopharyngeal
airways used
 Used to assist in maintenance of patent airway in
unconscious patient
 Act by lifting the base of the tongue off the posterior
pharyngeal wall
 In patients who are not deeply unconscious – gagging,
regurgitation, vomiting
 Available in variety of sizes: child, small adult & large
adult
 In emergency kit: 1 set of each adult & pediatric
nasopharyngeal airways

75.  These are advanced airway devices
 Endotracheal intubation uses a laryngoscope
to visualize the trachea & an endotracheal
tube
 Advantages: isolation of the airway
preventing aspiration
 Facilitation of ventilation & oxygenation
 For the easy administration of emergency
drugs
 In emergency kits: 1 laryngoscope & a set of

76.  Laryngeal mask airway maintains airway
during anaesthesia
 The airway is a tube & a small mask with an
inflatable circumferential cuff intended for
placement in victim’s posterior pharynx
which seals the base of the tongue &
laryngeal opening
 Very high success rate; low complication rate

77.  Essential ACLS drugs include:
 Epinephrine
 Oxygen
 Lidocaine
 Atropine
 Dopamine
 Morphine sulfate
 Verpamil

78. CATEGORY GENERIC
NAME
PROPRIETARY
NAME
ALTERNATIVE QUANTITY AVAILABILTY
Cardiac arrest Epinephrine Adrenaline - 3×10 ml
syringe
1:10,000
concentration
Oxygen Oxygen - - 1E
cylinder
Antidysrhythmic Lidocaine Xylocaine Procainamide 1× 5ml
ampule
100 mg
Symptomatic
bradycardia
Atropine Atropine Isoproternol 2×10ml
syringe
1 mg/10 ml
Symptomatic
hypotension
Dopamine Intropin Dobutamine 2×5 ml
ampules
80 mg/ml
Analgesic Morphine Morphine Meperidine 2×2 ml
ampules
10 mg /ml
PSVT Verapamil Isoptin - 1×4 ml
ampules
2.5 mg/ml

79.  Drug class: catecholamine
 Alternative drug: none
 Proprietary name: Ana-guard, Epi-pen,
Twinject,

80.  DRUG CLASS: Endogenous catecholamine
 ALTERNATIVE DRUG : none
 PROPRIETARY: Adrenaline
 ACTIONS: Maintains coronary artery blood flow while CPR
in progress- life saving in cardiac arrest
 THERAPEUTIC INDICATIONS: Cardiac arrest including
ventricular fibrillation,
pulseless ventricular tachycardia,
asystole, pulseless electrical activity
 SIDE EFFECTS: exacerbate ventricular ectopy in patients
receiving Digitalis
 AVAILABILITY: 1:10,000 conc in pre-loaded 10 ml syringes
 In emergency kit: 2 - 3 pre-loaded syringes

81.  Essential in cardiac resuscitation &
emergency cardiac care
 Prevents hypoxia
 Side effect: toxicity on long term
administration
 AVAILABILITY: 1 E-cylinder

82. DRUG CLASS: local anesthetic, anti-dysrhythmic
ALTERNATIVE DRUG: Procainamide
PROPRIETARY: Xylocaine
THERAPEUTIC INDICATIONS:
i. Primary anti-dysrhythmic drug
ii.In premature ventricular contraction ( coupled,
multi-focal
iii.Ventricular tachycardia
iv.Ventricular fibrillation

83. SIDE EFFECTS: myocardial, circulatory & CNS
depression
• Overdose:Drowsiness, paraesthesia, muscle
twitching
• Severe overdose: Tonic clonic seizures
CONTRAINDICATION: Depressed hepatic function
AVAILABILITY:
- as IV injection in 5 ml pre-filled
syringes(50/100mg)
- 5 ml ampules of 100 mg
IN EMERGENCY KIT: 1 -100 mg pre-loaded syringe
1 - 5 ml ampule

84.  DRUG CLASS: Parasympatholytic
 ALTERNATIVE DRUG: Isoprotrenol
 PROPRIETARY: Atropine
 THERAPEUTIC INDICATION:
i. haemodynamically significant
bradydysrhythmias
ii.Asystole refractory to epinephrine
ISOPROTRENOL
 Synthetic sympathomimetic amine
 Increases cardiac output
 Increases myocardial oxygen consumption

85.  DRUG CLASS: Sympathomimetic amine
 ALTERNATIVE DRUG: Dobutamine
 PROPRIETARY: Intropin
 THERAPEUTIC INDICATION: haemodynamically
significant hypotension in absence of
hypovolemia
 MODE OF ACTION: Large doses stimulates both α
& β
adrenergic receptors
• Small doses dialates mesentric, renal & cerebral
arteries

86. SIDE EFFECTS
i. Exacerbate supraventricular or ventricular
dysrhythmias
ii.Exacerbates myocardial ischemia
CONTRAINDICATIONS:In patients receiving
monoamine oxidase
inhibitors
(Isocarboxazid, pargyline, tranyl-cypromine,
phenelzine)
AVAILABILITY: 200, 400 & 800 mg in 5 ml ampules

87.  DRUG CLASS: Opioid agonist
 ALTERNATIVE DRUG: Meperidine
 PROPRIETARY: Morphine
 THERAPEUTIC INDICATIONS:Pain & anxiety in
ischemic chest pain
 SIDE EFFECTS: potent CNS & respiratory
depressants
 CONTRAINDICATIONS: injury & multiple trauma
 AVAILABILITY: 10 mg/ml morphine sulfate,
50 mg/ ml Meperidine

88. DRUG CLASS: Calcium channel blockers
ALTERNATIVE DRUG: none
PROPRIETARY: Isoptin
THERAPEUTIC INDICATIONS:Paroxysmal
supraventricular
tachycardia
SIDE EFFECTS: transient decrease in arterial
pressure,
severe hypotension, ventricular
fibrillation
CONTRAINDICATIONS: ventricular tachycardia
AVAILABILITY: 2.5 mg/ml in 2 ml & 4 ml ampules

89.  OPIOID ANTAGONISTS
 BENZODIAZEPENES
 ANTIEMERGENCE DELIRIUM DRUG
 VASODILATOR

90. CATEGORY GENERIC
NAME
PROPRIETARY
NAME
ALTERNATIVE QUANTITY AVAILABILTY
Narcotic
antagonist
NALOXONE NARCAN NALBUPHINE 2×1 ml
ampules
0.4 mg/ml
Benzodiazepine
antagonist
FLUMAZENIL MAZICON - 1×10 ml
vial
0.1 mg/ml
Antiemergence
delirium
PHYSOSTIGMINE ANTILIRIUM - 2×2 ml
ampules
1 mg/ml
vasodilator PROCAINE NOVOCAIN - 2×2ml
ampules
10mg/ml

91.  DRUG CLASS: Thebaine derivative
 ALTERNATIVE DRUG: Nalbuphine
 PROPRIETARY: Narcan
 THERAPEUTIC INDICATIONS:Opioid induced
depression including respiratory
depression
 SIDE EFFECTS: respiratory depression recurs when
administered parenterally
 CONTRAINDICATIONS: use with extreme care in
physical
dependance
 AVAILABILITY: 0.4 mg/ml in 1 ml ampules & 10 ml vials
 PEDIATRIC ADMINISTRATION: 0.02 ml in 2 ml

92.  DRUG CLASS: Benzodiazepine antagonist
 ALTERNATIVE DRUG: None
 PROPRIETARY: Romazicon
 MODE OF ACTION:
o Rapid reversal of sedation
o Increased alertness
o Decreased amnesic effect in geriatric population
 THERAPEUTIC INDICATIONS:
o Reverse the clinical actions of parenterally administered
Benzodiazepenes
 SIDE EFFECTS & CONTRAINDICATIONS:
o Rebound anxiety
 AVAILABILITY: 0.1 mg/ml in 5 ml ampules & 10 ml vials
 IN EMERGENCY KIT: 1 - 10 ml vial

93.  DRUG CLASS: Cholinesterase inhibitor
 ALTERNATIVE DRUG: None
 PROPRIETARY: Antilirium
 THERAPEUTIC INDICATIONS:Reverse emergence delirium
 Emergence delirium:
i. loss of contact with reality due to drugs like Scopolamine,benzodiazepenes,
diazepam, midazolam.
ii. Patient makes unintelligible sounds, increased muscular movement
 MODE OF ACTION: reversible cholinesterase inhibitor, can cross BBB

94. SIDE EFFECTS
i. Increased salivation
ii. Possible emesis
iii.Involuntary urination & defecation
iv.Bradycardia & hypersalivation
CONTRAINDICATIONS:
i. Asthma
ii. Diabetes
iii.Cardiovascular diseases
iv.Mechanical obstruction of gastrointestinal genito-urinary
tract
 AVAILABILITY: 1 mg/ml in 2 ml ampules
 IN EMERGENCY KIT: 2-3 ampules

95.  DRUG CLASS: Local anesthetic
 ALTERNATIVE DRUG: None
 THERAPEUTIC INDICATIONS:
i. Vasospasm & compromised circulation following intra-arterial
administration of a drug
ii. Management of pain & vascular compromise following
extravascular administration of irritating drugs
 SIDE EFFECTS & CONTRAINDICATIONS:History of local
anesthetic allergy
 AVAILABILITY: 1% (10 mg/ml) solution in 2 & 6 ml ampules
 IN EMERGENCY KIT: 2 - 2ml ampules

96.  Should not be complicated
 Only those drugs and equipment which
doctor is familiar should be included
 Should be stored in plastic box with several
compartments
 Labels should be applied in each
compartment containing generic and
proprietary names and dosage and expiry
dates