This document provides information on the preparation and administration of various emergency drugs including dopamine, dobutamine, levophed, nitroglycerine, adrenaline, insulin, heparin, lasix, phenytoin, amiodarone, omeprazole, labetalol, hydrallazine, vasopressin, phenylephrine, propofol, sandostatin, atracrium, fentanyl, and midazolam. For each drug, it lists the concentration per vial or ampoule, how to prepare an IV infusion solution, the drug concentration in the prepared solution, and how to calculate the infusion rate based on the desired dose. The goal is to provide

1. EMERGENCY DRUGS AND
CALCULATIONS
THAVAMANI KANDASAMY
ICU - STAFF NURSE

2. SYSTEMIC CIRCULATION

3. CHANNELS OF DRUG ADMINISTRATION
• ENTERAL
( ORAL,SL,BUCCAL,RECTAL)
• PARENTERAL
( IM,IV,IA,SC,ID, INTRATHECAL, INTRA ARTICULAR )
• TOPICAL
(EYE,NOSE,EARS,LUNGS,VAGINA,URETHRA,COLON)

4. DOPAMINE
• 1 ampoule= 200mg/5ml
• AMOUNT OF DRUG NEEDED per 50 ml infusion solution :
• Amount of drug to dilute = Body weight x 3
• Ex. 70 kg x 3= 210 mg
Amount of drug = 210mg x5ml = 5.25ml
2oomg
• PREPARATION : 44.75 ml NSS +5.25ml drug = 50ml
• 1ml = 210mg x 1000 = 4200mcg
• 50ml
• RATE OF INFUSION : mcg x body weight x 60 min
drug concentration
• Example : 5 mcg x 70 x 60 = 5 ml/hr
4,200 mcg

5. DOBUTAMINE
• 1 ampule= 250mg/5mL
• AMOUNT OF DRUG NEEDED in 50 ml solution
• Amount of drug = body weightx 3
• Ex. 70 kg x 3= 210 mg
• Amount of drug in ml = 210mg x5ml = 4.2ml
250MG
• PREPARATION : 45.8 ml NSS + 4.2ml drug = 50 ml
• Rate of Infusion : mcg x body weight x 60 min
Drug concentration
• Example: 4 mcg x 70 kg x 60 = 4ml/hr
4200 mcg/ml

6. LEVOPHED
• 1 ampoule 3mg / 3ml
• PREPARATION : 3 mg +47 ml D5W = 50ml
• DRUG CONCENTRATION : 3mg/50ml=0.06mg/1ml
• 0.06mg x 1000mcg =60mcg/ml
• Rate of Infusion : Desired Dose x 60 min
60 mcg
• Example : 2 mcg x 60 min = 2 ml / hr
60 mcg

7. NITROGLYCERINE
• 1 ampule= 50 mg ( 10 ml)
• PREPARATION: 40 ml NSS + 10 ml NTG
• DRUG CONCENTRATION : 50 mg/ 50 ml = 1mg/1ml
• 1mg x 1000 = 1,000mcg /1ml
• Rate of Infusion : Desired Dose x 60
Drug Concentration
• Example : 5 mcg x 60 min = 0.3 ml/hr
1000 mcg

8. ADRENALINE
• 1 ampoule = 1ml/1mg
• PREPARATION: 12 ml of Adrenaline + 38 ml D5W = 50 ml
• DRUG CONCENTRATION = 12 mg/ 50 ml=0.24mg
• 0.24mg x1000= 240mcg /ml
• Rate of Infusion: Desired dose x 60 = ml /hr
240mcg
• Example : 2mcg x 60 min = 0.5 ml/hr
240mcg

9. INSULIN
• PREPARATION: 49.5 ml NSS + 50 units (0.5 ml R.I )
• Rate of Infusion : Desired Dose x Quantity
50 units
• Example : 3 units x 50 ml = 3 ml / hr
50 units

10. HEPARIN
• 1 ampule : 25,000 IU / 5ml
• PREPARATION : 45 ml NSS + 25,000 (5 ml) Heparin
• Rate of Infusion : Desired dose x Quantity
Drug Concentration
• Example : 100 units x 50 = 0.2 ml/hr
25, 000 units

11. LASIX
• 1 ampule = 20mg (2 ml)
• Drug Concentration : 10 ampule = 200mg (20ml)
• PREPARATION: 20 ml Lasix + 20 ml NSS
• 40 ml = 200 mg
• 1 ml = 5mg
• Rate of Infusion : Desire dose x quantity = ml/hr
Drug concentration
• Example : 10 mg/hr x 40 ml = 2 ml /hr
200 mg

12. PHENYTOIN
• 1 ampoule : 250 mg / 5 ml
• LOADING DOSE: 15 mg/kg at a rate not greater than
50 mg/min for 20 – 30 mins.
• MAINTENENCE DOSE: followed by 100 mg every 6-
8 hours
PROPHYLAXIS: 200-600 mg/day PO/IV
• ANTIARRYTHMIC : 10 mg IV every 15 minutes
until arrhythmia stops

13. AMIODARONE
• 1 ampoule = 150 mg (3ml)
• LOADING DOSE : 1 ampule ( 150 mg /3 ml) + 12 ml D5W
• A .MAINTANENCE DOSE : 360 mg in 6 hours
• 360 mg x 3 ml = 7.2 ml
150 mg
• 7.2 ml ( amiodarone) + 42.8 ml D5%W = 50 ml = 8.3 ml/hr
B. 540 mg in 18 hours
• 540 mg x 3 ml = 10.8 ml
150 mg
• 10.8 ml ( amiodarone ) + 39.2 ml D5%W= 2.7ML /hr

14. OMEPRAZOLE
• 1 vial = 40 mg
• PREPARATION : 5 vial (200mg) Omeprazole + 50 ml NS
• 50 ml = 200mg
• 1 ml = 4 mg
• Rate of Infusion : Desired dose x Quantity =
ml/hr
Drug Concentration
• Example : 8 mg x 50 ml = 2 ml /hr
200mg
•

15. LABETALOL
• 1 ampule(20 ml) = 100 mg
• Preparation : 20 ml Labetalol + 30 ml NSS
• Drug Concentration : 1 ml = 2 mg
• Rate of Infusion : Desired Dose x Quantity
Drug concentration
• Example : 5 mg x 50 = 2.5 ml / hr
100 mg

16. HYDRALAZINE
• 1 ampoule = 20 mg
• PREPARATION: 20 mg dilute in 1 ml water of inj.
• LOADING DOSE: 10-20 mg over 3-5 minutes, further dilute
with 10 ml NS over 3-5 mins.
• then repeat after 20-30 minutes.
• INFUSION: Reconstitute 3 ampoules (60 mg) Hydralazine
with 1 ml water of inj. Each.
• Make up to 60 ml with NSS.
• Drug Concentration: 1 ml : 1 mg
• Note : Give rate between 2 and 15 mg / hr depending on BP
and pulse.

17. VASOPRESSIN
• 1 ampoule = 20 units / 1 ml
• USUAL DOSE: 0.01 to 0.03 units/ minute
• PREPARATION : 20 units in 50 ml NSS
• DRUG CONCENTRATION: 20units / 50ml = 0.4units /
ml
• Rate of Infusion: Desired Dose x 60
Drug Concentration
• Example : 0.01 units/min x 60 = 1.5 ml/hr
0.4 units / ml

18. PHENYLEPHRINE
• 1 ampoule: 10 mg / 1ml
• PREPARATION: 10 mg in 250 ml NSS
• 1ml = 40 mcg/min
• Rate of Infusion : Desired Dose x 60 = ml/hr
40 mcg/ml
• Example : 1 mcg /min x 60 = 1.5 ml/hr
40 mcg/ min

19. PROPOFOL
• INFUSION: 1 ampoule: 200 mg = 20 ml
• PREPARATION : 500 mg = 50 ml without dilution
• DRUG CONCENTRATION: 1 ml = 10 mg
• Rate of Infusion : Desired Dose x quantity
Drug Concentration
• Example : 10 mg x 50ml = 1ml/hr
500mg

20. SANDOSTATIN ( OCTREOTIDE)
• 1 ampoule : 100 mcg/ml
• 3 ampules (300 mcg /3 ml) + 27 ml NSS = 30 ml
• Drug Concentration: 30 ml = 300 mcg
• 1 ml = 10 mcg
• NOTE : 25 MCG BOLUS FOLLOWED BY 25 – 50 MCG /
HR

21. ATRACURIUM
• 1 ampule : 25 mg ( 2.5 ml)
• PREPARATION : 4 ampule (100mg) + 40 ml NSS
• DRUG CONCENTRATION: 100 mg /50ml
• Rate of Infusion: Desired Dose x 50 ml
Drug Concentration
• Example : 5 mg x 50 ml = 5 ml / hr
100mg

22. FENTANYL
• INFUSION:1 ampoule = 500 mcg (10 ml)
• PREPRATION : 10 ml Fentanyl + 40 ml NSS
• Drug Concentration : 50 ml = 500 mcg
• 1 ml = 10 mcg
• Rate of Infusion : Desired Dose x Quantity
Drug Concentration
• Example : 25 mcg x 50 ml = 2.5 ml
500mcg

23. DORMICUM( MIDAZOLAM)
• 1 ampoule = 15 mg (3ml)
• PREPARATION: 45 mg ampule (9 ml) + 36 ml NSS
• Drug Concentration : 45mg /45ml =1mg/1ml
• Rate of Infusion : Desired Dose x Quantity
Drug Concentration
• Example : 2mg x 45 ml = 2ml / hr
45mg