Emergency medicines
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Transcript of Emergency medicines
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)