This document provides information on emergency drug doses including: - Adenosine is used to treat supraventricular tachycardia in doses of 0.1-0.3 mg/kg given as rapid IV pushes. - Atropine is used for bradycardia in doses of 0.02 mg/kg and may be repeated once after 3 minutes. - Calcium gluconate is used for cardiac arrest, hypocalcemia, and to stop infusions with heart rates over 100 bpm, in doses of 100 mg/kg given by slow IV push or infusion. - Additional drugs and their indications, doses, and administration methods are provided including dopamine, epinephrine

1. Emergency Drugs
Dr. Rakeshkumar S. Gujar. MS(Ay.), (PhD)(Ay.), MSc-CND.
Assistant Prof., Dept. of PG Studies in Shalyatantra,
BLDEA’S AVS Ayurveda Mahavidyalaya Hospital & Research Centre, Vijayapura.

2. Adenosine (3 mg/ml)
Acute treatment of
supraventricular
tachycardia
 1st 0.1 mg/kg/dose
 2nd 0.2 mg/kg/dose
 3rd 0.3 mg/kg/dose
Rapid IV push over 1-2
seconds
Flush line immediately
with 5-20 ml NS
Infuse as close to IV site
as possible
IO administration also
successful
Drug (concentration)
and Indication
Dose
Administration /
Remarks

3. Drug (concentration)
and Indication
Dose
Administration /
Remarks
Atropine (0.1 mg/ml)
Bradycardia
0.02 mg/kg/dose IV
May repeat x 1 dose in
3 minutes

4. Drug (concentration)
and Indication
Dose
Administration /
Remarks
Calcium gluconate (100
mg/ml)= 9.4 mg
elemental calcium /ml
Cardia arrest
Hypocalcemia
100 mg/kg/dose IV
Not for IM or SQ use
May repeat x 1 dose,
then dose per ionized
calcium results
Administer by slow IV
push for cardiac arrest,
infuse over 30-60
minutes for other
indications. Stop
infusion if HR is greater
than 100 bpm.
Do not give intra-
arterially.

5. Drug (concentration)
and Indication
Dose
Administration /
Remarks
Dextrose 10% (0.1 Gm/ml)
Hypoglycemia
Hyperkalemia in combination with
insulin
0.2 Gm/kg/dose IV as D10W Then
continuous infusion of D10W at a
GIR of 4-8 mg/kg/min. Titrate to
attain normoglycemia.
2 ml/kg of Dextrose 10%
Hyperkalemia: Continuous infusion
of 0.5 g/kg/hr dextrose and 0.1-0.2
units/kg/hr regular insulin. Dextrose
and insulin dosages are adjusted
based on serum glucose and
potassium concentrations. Abrupt
discontinuation of dextrose infusion
is not recommended due to the risk
of rebound hypoglycemia. Glucose
concentrations less than D15 should
be administered via a central vein to
minimize risk of phlebitis and
thrombosis.

6. Drug (concentration)
and Indication
Dose
Administration /
Remarks
Dopamine
To give 10 mcg/kg/min.
@ 1 ml/hr : weight x 30
= mg of dopamine (in
kg) in 50 ml D5W/NS
Hypotension
Begin at 5 mcg/kg/min.
May increase in
increments of 2.5 - 5
mcg/kg/min. as needed
up to 20 mcg/kg/min.
Consider if poor
peripheral perfusion,
evidence of shock, or
thready pulses after
epinephrine and
volume expansion (and
bicarbonate)
Administer into a
central vein when
possible. Phentolamine
used for treatment of IV
infiltrates.

7. Drug (concentration)
and Indication
Dose
Administration /
Remarks
Epinephrine 1 : 10,000 (0.1 mg/ml)
Resuscitation
Severe bradycardia
Short term use for systemic
hypotension
0.1 - 0.3 ml/kg/dose IV, IO (0.01 – 0.03
mg/kg),
- For continuous infusion - start at 0.05
mcg/kg/min to a maximum of 1
mcg/kg/min.
Rapid IV push followed by 0.5-1 ml NS
flush
May repeat every 3-5 minutes
ALWAYS use the diluted 1:10,000 (0.1
mg/ml) concentration for individual
doses.
Only use the 1:1,000 (1 mg/ml) for
continuous infusion solutions
NEVER inject into an artery
Do not mix with bicarbonate
Effectiveness of drug increases if
acidosis is corrected
May mix dose volume with 3-5 ml NS
Follow ET administration with several
positive pressure ventilations.
Do NOT administer these higher doses
intravenously.

8. Drug (concentration)
and Indication
Dose
Administration /
Remarks
Fentanyl (50 mcg/ml)
Analgesia
Sedation
Anesthesia
1 mcg/kg
Consider 10 mcg/ml for
doses less than 5 mcg

9. Drug (concentration)
and Indication
Dose
Administration /
Remarks
Hydralazine (20 mg/
ml)
Hypertension by
vasodilation
0.1-0.5 mg/kg
Doses greater than 2
mg; consider 0.4 mg/ml

10. Drug (concentration)
and Indication
Dose
Administration /
Remarks
Lorazepam (2 mg/ml)
Sedation
Seizures
0.05-01 mg/kg
Slow IV push
Seizures, may repeat q
10-15 minutes

11. Drug (concentration)
and Indication
Dose
Administration /
Remarks
Morphine (1 mg/ml)
Pain
Sedation
0.05-0.1 mg/kg
Slow IV push over 5-10
minutes, IM, SQ

12. Drug (concentration)
and Indication
Dose
Administration /
Remarks
Naloxone (1 mg/ml)
Narcotic antagonist
0.1 ml/kg rapid IV push,
IM
May repeat in 3 - 5
minutes if no response
during resuscitation.
Duration of reversal is
brief; may need
repeated doses.

13. Drug (concentration)
and Indication
Dose
Administration /
Remarks
Phenobarbital (65
mg/ml)
Anticonvulsant
15 - 20 mg/kg
-For refractory seizures-
Additional 5 mg/kg
doses, up to a total of
40 mg/kg can be given.
IV push over 10-15
minutes, no faster than
1 mg/min.
Drug can be
administered by slow IV
push, IM, PR, or PO.
Diluted IV product can
be used orally.

14. Drug (concentration)
and Indication
Dose
Administration /
Remarks
Sodium Bicarbonate
4.2% (0.5 mEq/ml)
Metabolic acidosis
1 - 2 mEq/kg
Slow IV push over 30
minutes.
Use only 0.5 mEq/ml
solution for infants
Infuse 1 mEq/kg over ≥
1 minute
CAUSTIC; don’t infuse
faster than 2
ml/kg/minute.
NOT routinely given for
resuscitation.
Can also be given by
continuous infusion, IO,
or PO

15. Drug (concentration)
and Indication
Dose
Administration /
Remarks
Vecuronium ( 1mg/ml)
Paralysis
Rapid Sequence
Intubation*
0.1 mg/kg
IV push over less than 1
minute

16. Drug (concentration)
and Indication
Dose
Administration /
Remarks
Volume Expanders
RBCs, NS
Hypotension
Hypovolemia
With evidence of acute
blood loss or a decrease
in effective volume
RBCs: 15 ml/kg IV
NS: 10 ml/kg IV
RBCs: Infuse over 4
hours
NS: Infuse over at least
10 minutes, but
preferably over 30-60
minutes.
Consider if poor
response to
resuscitative efforts or
weak pulses with a
good heart rate

17. References
Emergency drug doses
Jeffrey L. Segar, MD and Sarah B. Tierney, PharmD

18. Thank you all for your Patient
hearing…