| Drug |
|
dose |
Indication |
Contraindication |
Acetylcysteine
=Parvolex® |
|
150/kg(max.16500) in 200mL/15'; then 50/kg(max.5500) in 500mL/4h; then 100/kg(max.11000) in 1L/16h |
+: Paracetamol OD |
(-): asthma |
Adenosine
=Adenocor® |
|
[3/2s, then] 6/2s after 1-2', then 12/2s after 1-2' |
+: SVT [incl WPW]; diff betw broad/narrow complex SVT |
-:2-3°HB; SSS [unless PPM]; asthma; (-): AF with accessory pathway; heart transplant (v. sensitive!) |
Adrenaline
(Epinephrine) |
|
0.5IM=0.5mLIM of 1:1,000 solution;
or (if doubtful circulation, with extreme caution): 1:10,000 SLOW IV |
+: anaphylactic shock |
-: |
| Aminophylline |
|
10ml Amp (25mg/ml)=250 eg in 250ml N/Sal=1mg/mL: [if not prevly tx with Aminophylline: loading: 0.25-0.5(5/kg~350/70kg) over 20+min ~ 350ml/70kg (of 500 in 500ml N/Sal=1/ml); then] 0.5/kg/h(~35/70kg/h) as per plasma concentration |
+: acute severe asthma |
-: hypokalaemia(!) |
| Amiodarone |
|
300/20min in 250ml 5%Dex then 900/24h into 500mg 5%Dex |
+ |
- |
| Atropine |
|
3iv |
+: vagal suppression |
-: |
| Calcium gluconate |
|
10-30mL10%IV |
+:severe hyperkalaemia |
-: |
Chlorphenamine
=Piriton® |
|
10qds{SC|IM|IV:1'}; 4POqds[-q4h] |
+:anaphylactic shock |
(-):prostatic hypertrophy, glaucoma, hepatic disease, CKD, epilepsy [; safe in porphyria] |
| Digoxin |
|
0.5PObd[-tds]Ã24h; or 0.75-1IVI/2h, then PO |
+: supraventr arrhythmia (esp. AF); heart failure |
-: intermittent CHB, 2°AV Block, SVT with accessory pathway (WPW,..), VT/VF; (-): hypertrophic CMP |
| Diltiazem |
 |
0.25/kg~18.5/70kg â¤max 25 IV over 2min |
+: acute AF with SBP>95: unlicensed (trial) |
- |
| Dobutamine |
|
0.0025-0.01/kg/min ~ 10-42/h/70kg=2-8mL/h/70kg with 250/20mL into 50mL N/Sal=5/mL |
+ |
- |
| Doxapram |
 |
1.5-4/min=90-240/h [100/5mL amp; or 1000 in 500mL 5%Dex=45-120mL/hr] |
+: acute respir fail |
- |
Flumazenil
=Anexate® |
 |
0.2/15s, then 0.1q60s, usu 0.3-0.6; max.1[-2 in ICU] |
+:BDA reversal |
-:Status epil |
Glucagon
GlucaGen® HypoKit |
 |
1{SC|IM|IV} [if no response within 10': IV Dextrose] |
+: insulin-induced hypoglycaemia; beta-blocker poisoning |
-: phaeochromocytoma |
| GTN |
|
1/mLIVI (Nitrocene(R), Nitronal(R)) @ 0.6-12/hr |
+: angina, LVF |
-: |
Haloperidol
=Haldol® |
 |
1.5-3[-5] po bd-tds, or: [eld:1-]2-10[-18] im/iv tds-qds |
+: acute psychomotor agitiation |
--: coma, CNS depression, phaeo; (-): hep, ren, cv, PD, epil, depr, MG |
Hydrocortisone
=Solu-Cortef®.. |
|
100qds[-tds]IVI |
+: acute adrenocortical insuff; thyrotoxic crisis; etc etc |
-: systemic infections (unless antimicrobial therapy given) |
| Insulin (soluble) |
|
5-10u with 50mL50%Glucose IVI/5-15' |
+: severe hyperkalaemia |
-: |
| Lidocaine |
|
50-100IV/2', then 4/'Ã30', then 2/'Ã2h, then 1/' |
+: ventricular arrhythmias (esp. post MI) |
-: SA/AV block (any °); porphyria; (-): CCF, post cardiac surgery, elderly, hepatic impairm, CKD, pregn |
Lorazepam
=Ativan® |
|
status epil: 4 large Iv x 1[-2 after 10']; panic: 0.025-0.03iv/kg[usu.1.5-2.5iv]q6h |
+: status epil; |
-: resp depr/fail/weakness(MG,...); severe hepatic impairment; |
| Magnesium sulfate |
|
1200-2000iv/20' |
+: acute severe asthma
(unlicensed) |
-: |
Metaraminol
[special order] |
|
0.5-5iv, then 15-100ivi, adjusted a/t response |
+: acute hypotension |
-: hypertension, pregnancy |
| Metoprolol |
|
-5mg over 2.5-5min +- repeat after 5min, total dose 10-15mg |
+: AF with SBP>95 |
- |
Midazolam
=Hypnovel® |
|
conscious sedation: [eld:0.5-1-]2-2.5SlowIv(2/min), icrd in steps of [eld:0.5-]1; usu. total dose 3.5-5, max. [eld. 3.5-]7 |
+: status epil (unlicensed) |
-: resp depr/fail/weakness; |
| Naloxone |
|
0.4-2q2-3' (max.10) [Minijet=400/mL×1[-2]mL] |
+: opioid OD |
(-):opioid dependence, cardiac irritability |
| Noradrenaline acid tartrate |
|
4(=2 of NA base) in 50mL=0.08/mL starting 0.16-0.33mL/min=10-20mL/h centralIVI |
+: |
-: |
Phenytoin
=Epanutin® |
|
loading 18mg/kg~1260g/70kg at max 50mg/min ~ 1200mg over 24min: 1200mg into 500mL N/Sal over 24min IVI (via filter); then ~100tds/qds as per plasma conc |
+: status epilepticus |
-: sinusbrady, SABlock, 2/3deg heart block, Stokes-Adams syndr, porphyria; (-): hypotension, HF; SE: CNS depr, respir arrest; ECG monitoring |
Propranolol
=Inderal® |
|
1IV/1', repeat at 2' intervals, max 10[-5 in anaesthesia] |
+: arrhythmias, thyrotoxic crisis |
-: ashtma, uncontrolled HF, marked brady, hypotension, SSS, 2-3°AV block, shock, metabolic acidosis, severe PVD, phaeochromocytoma (unless with alpha-blockers: Phenoxybenzamine/Phentolamine) |
| Salbutamol |
|
[3-]5[-20]mcg/min IVI=[180-]300[-1200]mcg/h=[18-]30[-120]mL/h of 5mg in 500mL N/Sal or 5%Dex=10mcg/mL |
+: asthma/reversible airways obstruction |
-: hypokalaemia(!); DKA |
Terlipressin
=Glypressin® |
 |
2IVqds[-q4h] |
+:bleeding from oesophageal varices |
-:(extreme caution:)CAD, vascular disease; chronic nephritis |
Thiamine
=Pabrinex® |
|
High-Potency injection [1-]2-3pairs IVI/30' tds[1 pair IM bd] |
+:coma/delirium from alcohol, from opioids, barbiturates, collapse/psychosis following narcosis; i.e. risk of Wernicke's encephalopathy |
SE: anaphylaxis |
Verapamil
=Cordilox®
=Secoron® |
|
5-10mg IV over [eld:3-]2min, further 5mg after 5-10min if required |
+: SVT |
-: hypotension, bradycardia, 2-3°AV block, SSS, shock, SA block; Hx of HF (even if treated!); AF/AFlutter with accessory pathway; porphyria; (-): beta-blocker treatment(!) |
