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EMERGENCY MEDICINES
Dr.Sadia Shabbir
House surgeon surgical 1
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
INDICATIONS:
• Allergic reactions
• Acute attack of bronchial asthma
• Cardiac arrest
• Homeostasis
• Along with local anesthetic
• To have bloodless field
ADVERSE REACTIONS
• Palpitations , tremors, pallor,headache
• If injected rapidly or I/V causes marked increase
in BP
• Ventricular arrhythmias
• Acute pulmonary edema
• Anginal pain
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
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
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
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.
PROPRANOLOL
• It is available in 1mg/ml ampoule
INDICATIONS:
• Thyrotoxic crises
• Pheochromocytoma
• Cardiac arrythmias
• Acute MI
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
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
ADVERSE EFFECTS
• Dry mouth
• Dysphagia
• Retention of urine
• Blurring of vision,precipitate to glaucoma
• Skin rash and local dermatitis
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
ADVERSE EFFECTS
• Salivation,sweating and lacrimation
• Nausea vomiting,diarrhea,abd pain
• Tremors and fasciculation
• HTN
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
ADVERSE EFFECTS:
• Gastritis,peptic ulcer,perforation and
pancreatitis
• HTN
• Osteoporosis
• Supresses immunity
• Delays wound healing
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
ADVERSE EFFECTS:
• Nausea,vomiting
• Fits preceded by twitching of mouth or severe
hyperventilation
• Collapse and death
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
ADVERSE EFFECTS
• Vomiting
• Hypotension
• Respiratory depression
• Drug dependency
• Urinary retention
• Miosis
• bradycardia
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
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
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
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
SODIUM BICARBONATE
• Available in 10ml ampoule
INDICATIONS:
• Metabolic acidosis
• Lactic acidosis
• Respiratory acidosis
• Hyperkalemia
ADVERSE EFFECTS:
• Metabolic alkalosis
• Edema due to Na+ retentions
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
ADVERSE EFFECTS
• Water and elecrolyte disturbance
• Orthostatic hypotension
• Retention of urine
• Hepatic coma
• Cardiac arrest
• Hearing loss
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
ADVERSE EFFECTS
• Precipitate CHF
• Fluid overload causes the ARF
CONTRAINDICATIONS:
• Shock
• Cardiac failure
• Renal impairment
POTASSIUM CHLORIDE
• Available in 10ml ampoule(150mg/ml)
INDICATION:
• Hypokalemia
ADVERSE EFFECTS:
• Cardiac arrest if given rapidly
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)
Emergency medicines

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Emergency medicines

  • 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)