Common drugs used in the Emergency

Routes of administration
IV
Intravenous administration is when the drug is given in liquid form directly into a vein. This is often
done by placing a venous catheter to allow easy administration.
IM
Direct injection into the muscle. Often a painful mode of administration, and provides a slow route
of absorption.
PO
By mouth (Per Orum). Typically intermediate between IM and IV in speed of absorption. (is this
true?)
PR
Rectal administration (Per Rectum). The rectum is actually a very quick method of drug
administration as the rectum is highly vascular. This route is often used in children.
ET
Certain drugs can be given down an endotracheal tube. The drugs are given at 2-2.5 times normal
IV dose. Drugs are followed with a saline bolus of ~10ml. The acronym for drugs that can go down
an ET tube is ALONE:
• A – Atropine
• L – Lidocaine
• O – Oxygen
• N – Naloxone (Narcan)
• E – Epinephrine

This is solutiom are important in Emergency:

NS:
NS stands for Normal Saline, which is 0.9% Sodium Chloride, and is the usual fluid given to a
patient who needs fluid due to dehydration. It is approximately isotonic.

LR:
LR stands for Lactated Ringers, which is Normal Saline with other
electrolytes. Due to the presence of the other electrolytes, there is a limit to how much can be administered within
aspecific period of time.

D5, D10, D25 and D50:

The D stands for Dextrose, which is a stable form of glucose. This solution is given IV to give
the patient glucose. This is never given IM, as high concentrations of glucose cause tissue death
outside the vasculature.
Common Drugs Indications

Adrenaline(Epinephrin) Anaphylaxis or cardiac arrest.

Nor-epinephrin Hypotension&shock

Adenosine antidysrhythmic

Lidocaine local anesthetic&antidysrhythmic

Dopamine Hypotension

Dobutamin Short term management of cardiac decompensation result from depressed

contractility
Digoxin slow conduction the heart( atrial-fibrillation).

Diltiazem(Cardizem) slow the heart down in patients with certain

types of tachycardias (atrial fibrillation).
Frusemide Relief of pulmonary oedema associated with LVF

Diamorphine Severe pain or acute left ventricular failure

Atropine Bradycardia&sever asthma

Streptokinase thrombolytic agent. blood clots in patients with

myocardial infarction(heart attacks), non-hemorrhagic CVA’s (strokes)&
pulmonary emboli

Heparin anticoagulant

Morphine Sulfate analgesic

Naloxone (Narcan) antidote to narcotic

Diazepam(valum) anticonvulsant

Glucagon Hypoglycaemia

Flumazenil Reversal of benzodiazepine induced respiratory depression

Furosemide (Lasix) diuretic

NTG Ischemia chest pain
Druge Rout Dose Action Side effect
e
Epineph I.V& 0.01-0.2 beta1, beta 2 & alpha H.T.N-tachycardia
ri ETT mcg/kg/min agonist,cardiac
stimulation, relax bronchial muscles
Norepin I.V 0.01-0.2 Stimulates beta1 & alpha adrenergic Bradyycardia-hyperglacemia-
ephrin mcg/kg/min receptors; incr. Contractility & HR, decrease urine output
vasoconstriction, incr SBP
Adenosi I.V 100mcg/kg; Interrupts reentry pathway through S.O.B-Chest pressure
ne max12mg AV
node; for PSVT
Lidocain I.V& 20-50 mcg/kg/min Suppress automaticity of conduction Confusion- decrease liver function.
e ETT tissue,
incr. elect. threshold of ventricle,
Dopami I.V 3-12 mcg/kg/min Stimulate adrenergic and Tachycardia- hyperglacemia
ne dopaminergic
receptors, positive inotrope, renal
vasodilation
Dobuta I.V 3-10 mcg/kg/min Stimulate beta 1 receptors, incr. H.T.N
min contractility &
heart rate, minor effect on alph and
beta 2
receptors
Digoxin I.V 0.5-1mg Cardiac glycoside thate incr. cardiac Arrhythmia-N\V
contractility Action(positive
inotropic)&slows conduction in the
AV node(negative dromotropic
effects)
Diltiaze I.V 30-200mg Produce coronary vascular smooth H.F- Arrhythmia-hypotension
m muscke relaxation& lower BP.slow
(Cardize HR.and AVnode conduction
m)

Frusemi I.V 20-50mg An ultra short acting beta-adrenergic Hypotension-nausea-

de blocker used to lower BP&HR GI_distrubuance

Diamorp I.V 5-10mg Prevent conversion of angiotensionI Hypotension-nausea-

hine to angiotensionII resulte in dilation of GI_distrubuance
arteries &veins.

Atropin I.V& 0.02 mg/kg/dose; Anti-cholinergic agent; vagally Urine retention-dry mouth-blurred
e ETT minimum dose induced vision.
0.1mg symptomatic bradycardia;
symptomatic
bradycardia refractory to
oxygenation,ventilation
&epinephrine
Strepto I.V 250000unit Thrombolytic drugs thate breake Hemorrhage
kinase over30minut down existing clotes.

Heparin I.V 10.000 unit\ml Anticoagulant enhances inhibitory Bleeding- GI_distrubuance

effect of antithrombin,its prevents
clote from enlarging but can,t
dissolve those already formed.

Morphin I.V 0.05 mg Opoid receptors in spinal cord&the Constipation- decrease bowel sound
e CNS
Sulfate

Naloxon I.V& 0.1 m Reversal of respiratory and H.T.N-pain-N\V-

e ETT g/kg; neurologic
(Narcan minimum dose depression due to opiate intoxication
) 0.01
mg
Diazepa I.V 10 mg
m Its anticonvulsive effect is due to Hypotension-resp.depression
(valum) enhancement of the inhibitory
neurotransmitted gamma-
aminobutyric acid to neurons in the
brain
Glucago I.V 0.5-1 mg Glucagon increases plasma glucose Hepatic impairment-hypcalemia
n by stimulating glycogenolysis and
gluconeogenesis in the liver. An
additional action is inhibition of
glycogen synthesis and
glucose oxidation. In adipose and
hepatic tissues, glucagon causes
lipolysis, resulting
in the production of fatty acids which
further increase gluconeogenesis
Flumaze I.V 200 mcg Blocke benzodiazepine reseptores& Seizure
nil over 15 seconds, antagonizes the action of
then 100 mcg at benzodiazepine on the CNS
60-second
intervals to a
maximum
of 1 mg, if
required.
Furose I.V 20-50mg reduce the fluid overload in patients Hypcalemia- hypotension-dizzness-
mide with headach
(Lasix) congestive heart failure (CHF) or
hypertension
NTG I.V 0.5-4 mcg/kg/min Dilates coronary artery, relax Hypotension- headach-N\V