Emergency medicines
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This document summarizes emergency medicines including adrenaline, noradrenaline, dopamine, propranolol, atropine sulfate, neostigmine, hydrocortisone, aminophylline, morphine, pethidine, diazepam, chlorpheniramine maleate, insulin, sodium bicarbonate, frusemide, mannitol, potassium chloride, and calcium gluconate. For each medicine, it provides information on dose, indications for use, and potential adverse reactions. The document is intended as a reference for appropriate and safe administration of these emergency medications.
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Emergency medicines
- 1. EMERGENCY MEDICINES Dr.Sadia Shabbir House surgeon surgical 1
- 2. ADRENALINE • The substance is adrenaline tartarate which is manufactured under the trademark of adrenaline. DOSE: • 0.2-0.5ml S/C or I/M • 0.25ml dil in saline slow I/V • 0.5ml intracardiac
- 3. INDICATIONS: • Allergic reactions • Acute attack of bronchial asthma • Cardiac arrest • Homeostasis • Along with local anesthetic • To have bloodless field
- 4. ADVERSE REACTIONS • Palpitations , tremors, pallor,headache • If injected rapidly or I/V causes marked increase in BP • Ventricular arrhythmias • Acute pulmonary edema • Anginal pain
- 5. NOR ADRENALINE It is available as 0.2% sol in 2ml ampules. DOSE: • 2ml of noradrenalin+1000ml of 5% dextrose and administer at the rate of 0.5ml/minute • 2ml of noradrenalin+N/S+vit C
- 6. INDICATIONS: • Treatment of hypotension of circulatory failure SIDE EFFECTS: • Palpitations,tremors,pallor,headache • Ventricular arrythmias • Acute pulmonary edema • Anginal pain • Extravasation in S/C tissues causes necrosis of skin
- 7. DOPAMINE DOSE: • It is available in 5ml ampoules each containing 40mg/ml solution INDICATIONS: • Hypotension to increase peripheral circulation • Open heart surgery • Renal failures • Cardiac failure
- 8. ADVERSE EFFECTS • It should be administered via central vein, extravasation may cause local ischemia • We should stop or decrease the dosage if the urine output is diminishing, tachycardia,or arrythmias.
- 9. PROPRANOLOL • It is available in 1mg/ml ampoule INDICATIONS: • Thyrotoxic crises • Pheochromocytoma • Cardiac arrythmias • Acute MI
- 10. ADVERSE EFFECTS • Congestive heart failure,bradycardia,aggravation of A-V conduction defect • Bronchospasm • Hypoglycemia • Nausea and vomiting • Uterine hypomotility and prolonged labour • Thrombocytopenia and leucopenia
- 11. ATROPINE SULPHATE • It is available in two strengths • 0.65mg/ml ampoule • 6mg/ml ampoule INDICATIONS: • Pre anesthetic medication 30min before surgery to prevent vasovagal shock and also 2 dryout the secretions • Before pleural and ascitic tap • In the treatment of colics and dysmenorrhea,bradyarrythmias and parkinsonism • Organophosphorus poisoning
- 12. ADVERSE EFFECTS • Dry mouth • Dysphagia • Retention of urine • Blurring of vision,precipitate to glaucoma • Skin rash and local dermatitis
- 13. NEOSTIGMINE • It is available in 0.5mg/ml solution in ampoule DOSE: • 0.5-2mg I/M or I/V INDICATIONS: • Myasthenia gravis • Acute congestive glaucoma • Treatment of NM paralysis due to snake bite
- 14. ADVERSE EFFECTS • Salivation,sweating and lacrimation • Nausea vomiting,diarrhea,abd pain • Tremors and fasciculation • HTN
- 15. HYDROCORTISONE • It is available in a bulb containing 100mg hydrocortisone INDICATIONS: • Life threatening emergencies e.g anapylactic shock,status asthamaticus,hypoglycemia,thyrotoxic crises,addison’s crises,hypercalcemia • Intra-articularly in osteoarthritis • Topically in keloids • As retention enema
- 16. ADVERSE EFFECTS: • Gastritis,peptic ulcer,perforation and pancreatitis • HTN • Osteoporosis • Supresses immunity • Delays wound healing
- 17. AMINOPHYLLINE • It is available in 10ml ampoule DOSE: • 10ml dil in 20ml of 10% dextrose is given I/V or slowly INDICATION: • Bronchial asthma • Cardiac asthma • Cheyne stroke respiration
- 18. ADVERSE EFFECTS: • Nausea,vomiting • Fits preceded by twitching of mouth or severe hyperventilation • Collapse and death
- 19. MORPHINE • It is available in 1ml ampoule(15mg/ml) DOSE: • 5-20mg S/C or I/M INDICATIONS: • As analgesic • As preanesthetic medication • Acute LVF
- 20. ADVERSE EFFECTS • Vomiting • Hypotension • Respiratory depression • Drug dependency • Urinary retention • Miosis • bradycardia
- 21. PETHIDINE • Available in 2ml ampoule(50mg/ml) INDICATIONS: • Given I/M or I/V • As analgesic • As preanesthetic medication ADVERSE EFFECTS: • Same as that of morphine
- 22. DIAZEPAM • Available in 2ml ampoule(5mg/ml) DOSE: 10mg I/V or I/M INDICATIONS: • Muscle relaxant in tetanus • Pre anesthetic medication • Treatment of convulsions • As tranquillizer
- 23. AVIL(CHLORPHENARAMINE MALEATE) • Available in 2ml ampoule(22.75mg/ml) INDICATIONS: • Allergic reactions • Pruritis • Hypnotics ADVERSE EFFECTS: • Sedation and fatigue • Dryness of mouth and blurring of vision • Nausea and vomiting • Blood dyscrasias
- 24. INSULIN • Available in 40 units/ml and 100 units/ml in 10ml bulb DOSE: Given S/C INDICATIONS: • Diabetic ketoacidotic coma • Glucose insuline drip in hyperkalemia • Diabetes ADVERSE EFFECTS: • Hypoglycemias
- 25. SODIUM BICARBONATE • Available in 10ml ampoule INDICATIONS: • Metabolic acidosis • Lactic acidosis • Respiratory acidosis • Hyperkalemia ADVERSE EFFECTS: • Metabolic alkalosis • Edema due to Na+ retentions
- 26. LASIX(FRUSEMIDE) DOSE: 20mg I/M or I/V INDICATIONS: • Pulmonary edema • To induce forced diuresis in barbiturates poisoning • Treatment of mannitol resistant acute oliguria • Advanced RF • Prostatectomy
- 27. ADVERSE EFFECTS • Water and elecrolyte disturbance • Orthostatic hypotension • Retention of urine • Hepatic coma • Cardiac arrest • Hearing loss
- 28. MANNITOL: • It is a sugar available as 20% sol in 350ml glass bottel DOSE: 0.5-1g/kg INDICATIONS: • Induce diuresis in barbiturate poisoning • Acute oliguric RF • After severe traumatic injuries • To reduce intracranial pressure • After CVA,cerebral edema,hepatic encaphlopathy
- 29. ADVERSE EFFECTS • Precipitate CHF • Fluid overload causes the ARF CONTRAINDICATIONS: • Shock • Cardiac failure • Renal impairment
- 30. POTASSIUM CHLORIDE • Available in 10ml ampoule(150mg/ml) INDICATION: • Hypokalemia ADVERSE EFFECTS: • Cardiac arrest if given rapidly
- 31. CALCIUM GLUCONATE • Available in 10ml ampoule(1g) DOSE: • 2g I/V slowly in tetany • 1g I/V slowly in epididymo-orchitis INDICATIONS: • Tetany • After 1000ml of blood transfusion • As inotropic drug in cardiac arrest • Hyperkalemia • Hypoparathyroidisim • As a coagulant(factor 5)