Emergency Drugs

EMERGENCY DRUGS

Emergency drugs or life saving drugs 

EMERGENCY DRUGS DOSES

Drug (concentration) and Indication	Dose	Administration / Remarks
Adenosine (3 mg/ml) Acute treatment of supraventricular tachycardia	1st 0.1 mg/kg/dose 2nd 0.2 mg/kg/dose 3rd 0.3 mg/kg/dose	Rapid IV push over 1-2 seconds Flush line immediately with 5-20 ml NS Infuse as close to IV site as possible IO administration also successful
Atropine (0.1 mg/ml) Bradycardia	0.02 mg/kg/dose IV	May repeat x 1 dose in 3 minutes
Calcium gluconate (100 mg/ml)= 9.4 mg elemental calcium /ml Cardia arrest Hypocalcemia	100 mg/kg/dose IV Not for IM or SQ use	May repeat x 1 dose, then dose per ionized calcium results Administer by slow IV push for cardiac arrest, infuse over 30-60 minutes for other indications. Stop infusion if HR is greater than 100 bpm. Do not give intra-arterially.
Dextrose 10% (0.1 Gm/ml) Hypoglycemia Hyperkalemia in combination with insulin	0.2 Gm/kg/dose IV as D10W Then continuous infusion of D10W at a GIR of 4-8 mg/kg/min. Titrate to attain normoglycemia.	2 ml/kg of Dextrose 10% Hyperkalemia: Continuous infusion of 0.5 g/kg/hr dextrose and 0.1-0.2 units/kg/hr regular insulin. Dextrose and insulin dosages are adjusted based on serum glucose and potassium concentrations. Abrupt discontinuation of dextrose infusion is not recommended due to the risk of rebound hypoglycemia. Glucose concentrations less than D15 should be administered via a central vein to minimize risk of phlebitis and thrombosis.
Dopamine To give 10 mcg/kg/min. @ 1 ml/hr : weight x 30 = mg of dopamine (in kg) in 50 ml D5W/NS Hypotension	Begin at 5 mcg/kg/min. May increase in increments of 2.5 - 5 mcg/kg/min. as needed up to 20 mcg/kg/min.	Consider if poor peripheral perfusion, evidence of shock, or thready pulses after epinephrine and volume expansion (and bicarbonate) Administer into a central vein when possible. Phentolamine used for treatment of IV infiltrates.
Epinephrine 1 : 10,000 (0.1 mg/ml) Resuscitation Severe bradycardia Short term use for systemic hypotension	0.1 - 0.3 ml/kg/dose IV, IO (0.01 – 0.03 mg/kg), - For continuous infusion - start at 0.05 mcg/kg/min to a maximum of 1 mcg/kg/min.	Rapid IV push followed by 0.5-1 ml NS flush May repeat every 3-5 minutes ALWAYS use the diluted 1:10,000 (0.1 mg/ml) concentration for individual doses. Only use the 1:1,000 (1 mg/ml) for continuous infusion solutions NEVER inject into an artery Do not mix with bicarbonate Effectiveness of drug increases if acidosis is corrected May mix dose volume with 3-5 ml NS Follow ET administration with several positive pressure ventilations. Do NOT administer these higher doses intravenously.
Fentanyl (50 mcg/ml) Analgesia Sedation Anesthesia	1 mcg/kg	Consider 10 mcg/ml for doses less than 5 mcg
Hydralazine (20 mg/ ml) Hypertension by vasodilation	0.1-0.5 mg/kg	Doses greater than 2 mg; consider 0.4 mg/ml
Lorazepam (2 mg/ml) Sedation Seizures	0.05-01 mg/kg	Slow IV push Seizures, may repeat q 10-15 minutes
Morphine (1 mg/ml) Pain Sedation	0.05-0.1 mg/kg	Slow IV push over 5-10 minutes, IM, SQ
Naloxone (1 mg/ml) Narcotic antagonist	0.1 ml/kg rapid IV push, IM	May repeat in 3 - 5 minutes if no response during resuscitation. Duration of reversal is brief; may need repeated doses.
Phenobarbital (65 mg/ml) Anticonvulsant	15 - 20 mg/kg -For refractory seizures- Additional 5 mg/kg doses, up to a total of 40 mg/kg can be given.	IV push over 10-15 minutes, no faster than 1 mg/min. Drug can be administered by slow IV push, IM, PR, or PO. Diluted IV product can be used orally.
Sodium Bicarbonate 4.2% (0.5 mEq/ml) Metabolic acidosis	1 - 2 mEq/kg	Slow IV push over 30 minutes. Use only 0.5 mEq/ml solution for infants Infuse 1 mEq/kg over ≥ 1 minute CAUSTIC; don’t infuse faster than 2 ml/kg/minute. NOT routinely given for resuscitation. Can also be given by continuous infusion, IO, or PO
Vecuronium ( 1mg/ml) Paralysis Rapid Sequence Intubation*	0.1 mg/kg	IV push over less than 1 minute
Volume Expanders RBCs, NS Hypotension Hypovolemia