The document outlines essential emergency drugs and their administration in medical emergencies, emphasizing the importance of proper storage, labeling, and drug replacement before expiration. It details various critical and non-critical emergency drugs, their dosages, indications, and contraindications while highlighting the principles of drug management during emergencies. Key medications discussed include epinephrine, amiodarone, nitroglycerin, and antihypoglycemics, among others.

1. EMERGENCY DRUGS

2. Emergency – An unforeseen occurrence or combination of
circumstances that calls for immediate action or remedy
-Mosby
Drug – Any substance or product thatis used or is
intended to be used to modify or explore physiological
system or pathological states for the benefit of the
recipient.
- W.H.O

3. Large kit in mobile tool cabinets with several
compartments
Labels should be applied to each compartment in which
drug is stored, listing the drug’s generic and proprietary
names, dosage, indication and expiry date to avoid possible
confusion during emergency.

4. Expired drugs and empty O2 cylinders are
ineffective
Drug should be replaced prior to expiry
date.
An office staff member should be
assigned to check the emergency drug kit
at least once a week

5. THE KISS PRINCIPLE
It should be as simple as possible to use.
Pallasch’s in 1967 stated:-
“complexity in a time of adversity breeds chaos”
The doctor should remember 3 things in preparing
and using emergency drug kits:-
1- Drug administration is not necessary for
immediate management of medical emergencies.
2- Primary management of all emergency situations
involves BLS.
3- When in doubt, don’t medicate

6. Module 3
ACLS Drugs
Module 2
Non- critical drugs and
equipment
Module 1
Basic emergency kit
(Critical drugs and
requirements)
Module 4
Antidotal Drugs

8. IV ROUTE – 20-30 sec
IN ROUTE -
IM ROUTE – 10 mins
SUBLINGUAL-

9. s
INDICATIONS
 Anaphylaxis(Acute allergic reaction) - 1:1000/2000
 Actue asthamatic attack(bronchospasm) -1:1000/2000
 Cardiac arrest(Non- injectable form)- 1:10000
Most important emergency drug
Desirable properties of epinephrine include:-
(1)A rapid onset of action
(2) potent action as a bronchial smooth muscle dilator (β2
properties) (3) histamine blocking properties
(4) vasopressor actions; and
(5)cardiac effects*

11. CRITICAL/ESSENTIAL EMERGENCY DRUGS &
EQUIPMENT

13. DOSE AND ADMINISTRATION
I.M. Or S.C. - 1:1000 concentration In dose of 0.3-0.5 mg for 30 kg or
greater patients and 0.15mg for patients who weigh less than 30kg is
recommended
Preloaded auto injectors are preferred-Ana Guard, Epipen, Epipen
Jr, Auvi Q
Intravenous- 1:10,000- m/m of cardiac arrest

15. Are competitive antagonists of histamine
They do not prevent the release of histamine from cells in
response to injury, drugs, or antigens but do prevent
histamine’s access to its receptor site on the cell, blocking the
response of the effector cell to histamine.
They are also potent local anesthetics, especially
diphenhydramine and tripelennamine.
Histamine blockers may also produce a degree of CNS
depression(sedation, drowsiness) that would be an
undesirable.

16. INDICATIONS
SIDE-EFFECTS & CONTRAINDICATIONS

17. DOSAGE
Diphenhydramine- 10 mg/ mL in 10- and 30-mL multidose vials, 50 mg/mL in
1-mL ampules and 10-mL multidose vials, and 1-mL preloaded syringes.
Chlorpheniramine is available as 10 mg/mL in 1- and 2-mL ampules and as
1-mL preloaded syringes.
A minimum of two 1-mL ampules of either diphenhydramine (50 mg/mL) or
chlorpheniramine (10 mg/mL).
Preloaded syringes of histamine blockers are not recommended because there
is never any urgency associated with their administration.

19. “E-cylinders” recommended due
to their ease of portability at time
of emergency
Where E is for emergency

20. E cylinder provides O2 for approximately 30 minutes.
Larger cylinders (H cylinders) provide significantly more O2 but are less
portable; whereas; smaller cylinders (A through D cylinders) contain too little
O2 to be clinically effective for more than an extremely short duration.
Evident respiratory distress.
Management of hyperventilation
Chronic Obstructive Pulmonary Disease
INDICATIONS
CONTRAINDICATIONS
One E cylinder of oxygen is the minimum requirement for an emergency kit.

21. Uses-
Immediate management of chest pain (Angina pectoris or
Acute myocardial infarction)
Route of administration- Sublingual or translingual spray

23. SIDE-EFFECTS
A transient, pulsating headache;
Facial flushing; and
A degree of hypotension (especially if
the patient is in an upright position)
CONTRAINDICATION:-
Patients with chest pain who exhibit
clinical signs and symptoms of
hypotension.
Similar to, but more intense than that
Facial flushing, Pounding pulse, Dizziness,
Intense
Headache, and Hypotension.
CONTRAINDICATION:-
Not to be administered to patients seated
in upright positions because significant
postural changes develop.
NITROGLYCERINE AMYL NITRITE
DOSAGE:- 0.3-, 0.4-, 0.6-mg doses of sublingual tablets; 0.4- and 0.8-mg
doses of translingual spray.
Amyl nitrite is available as 0.3-mL doses in yellow Vaporole.

24.  Acute Asthmaticepisodes
 Allergic reactions
(where bronchospasm is a component)
Route of administration- Metered Dose Inhaler(MDI)
Spacer(for pediatric patients)
Inhalation allows the drug to reach the bronchial
mucosa, where it acts directly on bronchial smooth
muscle.
BRONCHODIALATORS

25. ALBUTEROL- one or two inhalations every
4-6 hours is recommended dosage.
Metaproterenol, epinephrine, and isoproterenol mistometers
produce cardiovascular side effects, including tachycardia and
ventricular dysrhythmias.
Contraindicated in patients with preexisting
tachydysrhythmias.
1 Albuterol MDI.
Consider spacer if many asthmatics, pediatric or adult, are
treated.
DOSAGE
SIDE-EFFECTS
CONTRAINDICATION

26. USES-
Hypoglycemic with diabetes mellitus
In non-diabetic pt. With hypoglycemia (fasting)
CONTAINDICATION-
administration of any liquid or substance that might become liquid at body
temperature is contraindicated in the unconscious patient.
Any of the forms, including Glucola, Gluco-Stat, Insta-Glucose, nondiet cola
beverages, fruit juices, granulated sugar, and tubes of decorative icing
Can be kept.
ANTIHYPOGLYCEMICS

27. MOA- irreversibly acetylates platelet cyclooxygenase, removing all
cyclooxygenase activity for the life span of the platelet.
Stops production of proaggregatory thromboxane A2
160-324mg orally.
Management of patients with suspected myocardial
infarction or unstable angina
Kit should include powdered or chewable asprin (325mg)
ANTIPLATELETS
DOSAGE:-
INDICATION:-

28. CRITICAL EMERGENCY
EQUIPMENTS
1. O2 delivery system
Pocket mask

30. NON- CRITICAL EMERGENCY DRUGS & EQUIPMENT

31. INDICATIONS:-
Prolonged seizures
LA induced seizures
Hyperventilation
Thyroid strom
Hypoglycemia
Febrile convulsions
ANTICONVULSANTS

32. SIDE-EFFECT:-
DOSAGE:-

33. ANALGESICS
Pain or anxiety increases the myocardial workload which increases the
myocardial requirement for O2, which may prove detrimental to the patient’s
well-being.
Acute myocardial infarction
Intense pain or anxiety
Congestive heart failure
It is administered through an IV route to victims suspected of having AMI.
In victims of injury and multiple trauma;
Morphine sulfate is available 8, 10, and 15 mg/mL (in 2-mL
ampules and 20-mL vials).
INDICATIONS:-
CONTRAINDICATIONS:-
DOSAGE:-

34. VASOPRESSOR
Ephedrine releases endogenous norepinephrine.
Norepinephrine, in turn, stimulates various α- and
β-receptors.
Because storage sites of norepinephrine can be depleted, tachyphylaxis can
develop to ephedrine’s pressor and cardiac effects.
Effects of ephedrine on coronary blood flow may be dose dependent, but in
general, ephedrine usually increases coronary blood flow.
Ephedrine increases systolic and diastolic blood pressure.

35. INDICATIONS:-
CONTRAINDICATIONS:-

36. ANTIHYPOGLYCEMIC
In severely obtunded or unconscious patient,
30 mL of a 50% dextrose solution should be administered IV.
Glucagon is effective only when hepatic glycogen is available.
Hypoglycemia
Diagnostic aid in unconsciousness or seizures of unknown origin
Glucagon administered either IV or IM is
contraindicated in patients in starvation states or with
chronic hypoglycemia.
.
INDICATIONS:-
CONTRAINDICATIONS:-

37. DOSAGE:-

38. Indications:- Definitive m/m of acute allergy
Adrenal insufficiency
Asthma
Recurrent anaphylactic episodes
Corticosteroids are considered second-line drugs primarily because of their
slow onset of action.
Hydrocortisone sodium succinate (Solu-Cortef) is available as
50 mg/mL (2-mL vials).
CORTICOSTEROIDS
DOSAGE:-

39. No contraindications to the administration of corticosteroids in the management
of life-threatening medical emergencies
Suggested for emergency kit. Hydrocortisonesodium succinate (one 2-mL vial).
CONTRAINDICATIONS:-

40. ANTIHYPERTENSIVES
ESMOLOL LABETALOL
β1-selective (cardioselective) adrenergic
receptor blocking agent.
Very short duration of action (9mins)
Indication:- as an antidysrhythmic agent
in paroxysmal supraventricular
tachycardia (PSVT) and for the
management of intraoperative and
postoperative tachycardia and
hypertension.
β1-receptors in heart, β2-receptors in
bronchial and vascular smooth muscle,
and α1-receptors in vascular smooth
muscle.
Produces a dose-related decrease in
blood pressure without reflex
tachycardia or a significant reduction in
heart rate.
the onset of hypotensive action occurs
within 2 to 5 minutes. Peak effects occur
within 5 to 15 minutes with a duration of
action usually between 2 and 4hours.

41. INDICATION:-
CONTRAINDICATION:-

42. DOSAGE:-

43. ANTICOLINERGICS

44. bradycardia
hemodynamically significant bradydysrhythmias
Atropine is contraindicated in patients with glaucoma
or prostatic hypertrophy.
Large doses of atropine (2 mg and above)
may produce clinical signs of overdose, including hot, dry
skin; headache; blurred nearsightedness; dry mouth and
throat; disorientation; and hallucinations
0.5 mg/mL in 1-mL vials and as 1 mg/mL in 10-mL preloaded syringes
Two or three ampules of 0.5 mg/mL (for IM administration) or
two 10-mL syringes with 1 mg per syringe (for IV administration).
INDICATION:-
CONTRAINDICATION:-
DOSAGE:-

45. RESPIRATORY STIMULANT
INDICATION:-

46. CONTRAINDICATION:-
DOSAGE:-

47. ANTIHYPERTENSIVE
(non-injectable)
Two drugs that help manage acute elevations in blood pressure—
esmolol for parenteral administration
nitroglycerin for sublingual or translingual administration.
HYDRALAZINE-is a peripheral vasodilator, causing relaxation
of arteriolar smooth muscle via a direct effect.
The peripheral vasodilating effects of hydralazine result in decreased
arterial blood pressure (diastolic more than systolic) and peripheral
vascular resistance.
In addition, hydralazine-induced reflex
Autonomic response increases the heart rate, stroke volume, cardiac
output and left ventricular ejection fraction.
ANTIHYPERTENSIVE
(non-injectable)

48. INDICATION:-
CONTRAINDICATION:-
DOSAGE:-
One bottle 25mg tablet

49. OROPHARYNGE
ALAIRWAYS

51. ENDOTRACHEA
L TUBE

54. ANTIHYPERTENSIVE
(non-injectable)
Epinephrine’s importance in cardiac arrest lies in the fact that no other
drug can maintain coronary artery blood flow while CPR is in progress,
which is essential for preserving a chance of survival to hospital
discharge in cardiac arrest.
Epinephrine also preserves blood flow to the brain, helping to minimize
neurologic damage.
Cardiac arrest (including ventricular fibrillation, pulseless
ventricular tachycardia,asystole, and pulseless electrical activity).
NO contraindication in emergent situation.
epinephrine may induce or exacerbate ventricular ectopy, especially in
patients who are receiving digitalis.
ACLS essential: CARDIAC ARREST
INDICATION:-
CONTRAINDICATION:-

55. Epinephrine is available as a 1-mg dose in preloaded syringes containing either 1
Ml (1:1000 concentration) or 10 mL (1:10,000) of solution.
The 1:10,000 concentration is for IV or endotracheal administration, whereas the
1:1000 solution is designed for intramuscular administration.
Two or threepreloaded syringes may be included in the kit.
DOSAGE:-

56. ACLS essential: ANTIDYSRHYTHMIC
It is both an antidysrhythmic and a potent vasodialator.
Amiodarone is the first-line management of VF and pulseless VT that
is unresponsive to CPR, defibrillation, and vasopressor therapy
(epinephrine).
If amiodarone is unavailable, lidocaine may be considered.
IV amiodarone affects sodium, potassium, and calcium channels and
has α- and β-adrenergic blocking properties.

57. INDICATION:-
CONTRAINDICATION:-

58. ACLS essential: SYMPTOMATIC
BRADYCARDIA
Atropine is the drug of choice for hemodynamically unstable
bradydysrhythmias.
A bradydysrhythmia is considered to be
hemodynamically unstable when the following
conditions are present90:
Symptoms:
1. Chest pain
2. Shortness of breath
3. Decreased level of consciousness
4. Weakness, fatigue
5. Exercise intolerance
6. Lightheadedness, dizziness, and “spells”

60. DOSAGE:-
CONTRAINDICATION:-
INDICATION:-

61. ACLS essential: PEROXYSMAL
SUPRAVENTRICULAR TACHYCARDIA
Verapamil is included in the ACLS category because it is extremely effective in
the management of supraventricular tachycardia.
Verapamil slows conduction through the atrioventricular node, reducing
ventricular response to atrial flutter and fibrillation.
Used primarily to treat PSVT that does not require
cardioversion
Verapamil is available for injection as 2.5 mg/mL in 2-mL and 4-
mL ampules.
One or two 4-ml ampules.
INDICATION:-
DOSAGE:-

62. Categories of antidotal drugs include the following:
1. Opioid antagonist
2. Benzodiazepine antagonist
3. Antiemergence delirium drug
4. Vasodilator

63. Antidotal Drugs: OPOIDS ANALGESICS
Significant side effect of parenteral opioid agonists is their ability to produce
respiratory depression by diminishing the responsiveness of the brain’s
respiratory centers to arterial carbon dioxide.
Naloxone also reverses other properties of opioids, namely analgesia and
sedation.
Naloxone may be administered endotracheally in situations in which IV
access is not available.
Administered via an IV route or endotracheally, improved respiratory
function is noted within 2 minutes.
Nalbuphine- successfully to reverse respiratory depression induced by
opioid agonists

64. INDICATION:-
DOSAGE:-

65. Antidotal Drugs: BENZODIAZEPINE ANTAGONIST

66. INDICATION:-
DOSAGE:-

67. Antidotal Drugs: ANTIEMERGENCE DELIRIUM
DRUG

68. INDICATION:-
CONTRAINDICATION:-
SIDE-EFFECTS:- MOST COMMON

69. DOSAGE:-

70. Antidotal Drugs: VASODIALATOR
INDICATION:-

71. CONTRAINDICATION:-
DOSAGE:-