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EMERGENCY DRUGS

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ESSENTIAL DRUGS

1.OXYGEN

2.EPINEPHRINE

3.NITROGLYCERIN

4.INJECTABLE ANTIHISTAMINE

5.SALBUTAMOL

6.ASPIRIN

7.ORAL CARBOHYDRATE

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SUPPLEMENTARY DRUGS

1.GLUCAGON

2.ATROPINE

3.EPHIDRINE

4.CORTICOSTEROID

5.MORPHINE

6.NALOXONE

7.NITROUS OXIDE

8.INJ.BENZODIAZEPINE

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OXYGEN

  • INDICATION
  • USED IN ALL MEDICAL EMERGENCIES EXCEPT HYPERVENTILATION.

OXYGENATION IS DONE

1.CLEAR FULL MASK

2.VALVE BAG MASK

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  • AIRWAY SHOULD BE PATENT(FOREIGN BODIES,BLOOD ETC IS REMOVED)
  • AIRWAY ESTABLISHED BY HEAD TILT OR JAW THRUST TECHNIQUE

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  • OXYGENATION 4-6 LITRES /MINUTE IN CONSCIOUS PATIENT
  • OXYGENATION 10-15 LITRES/MINUTE IN UNCONSCIOUS & APNEIC PATIENT VIA BAG VALVE MASK

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EPINEPHRINE

  • DRUG OF CHOICE FOR

1.ANAPHYLAXIS

2.ASTHMA(DOES NOT RESPOND TO SALBUTAMOL)

3.CARDIAC ARREST

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  • RAPID ONSET &SHORT DURATION OF ACTION 5-10 MINUTES WHEN GIVEN IV

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  • MODE OF ACTION –IT ACTIVATES BOTH ALPHA & BETA RECEPTORS

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DOSE 1:1000MG PER ML

FOR ANAPHYLAXIS -0.3 -0.5 MG IM

CARDIAC ARREST - 1MG IV

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NITROGLYCERIN

INDICATION

1.ACUTE ANGINA

2.MYOCARDIAL INFARCTION

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AVAILABLE AS SUBLINGUAL TABLET/SPRAY

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  • SHORT SHELF LIFE -3 MONTHS ONCE MEDICINE IS EXPOSED TO AIR /LIGHT

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  • DOSE -0.3 -0.4 MG SUGLINGUALLY

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  • RELIEF OF PAIN -3 MINUTES

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  • DURATION OF ACTION -20-30 MINUTES

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  • CONTRAINDICATED IN SYSTOLIC BP BELOW 90 MM OF HG

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INJECTABLE ANTIHISTAMINE

  • NON LIFE THREATENING ALLERGIC REACTION.
  • 25-50 MG OF DIPHENHYDRAMINE
  • 10-20 MG OF CHLOROPHERIRAMINE

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SALBUTAMOL

  • FIRST CHOICE OF DRUG FOR MANAGEMENT OF BRONCHOSPASM
  • DELIVERED BY MEANS OF INHALER: 2 SPRAYS & REPEATED IF NECESSARY

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ASPIRIN

  • REDUCE THE MORTALITY FROM ACUTE MYOCARDIAL INFARCTION

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ORAL CARBOHYDRATE

  • NOT A DRUG,BUT SHOULD BE INCLUDED
  • USED FOR MANAGEMENT OF HYPOGLYCEMIA IN CONSCIOUS PATIENT

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GLUCAGON

  • HYPOGLYCEAMIA esp UNCONSCIOUS PT
  • INSULIN OVERDOSE

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  • ACTION – INCREASES PLASMA GLUCOSE BY STIMULATING GLCUNEOGENESIS

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  • DOSE
  • 1MG IN ADULT IM
  • 0.5 MG IN CHILDREN

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ATROPINE

  • HYPOTENSION
  • ANTICHOLINERGIC & ANTIMUSCARINE
  • 0.5 ML INTIALLY THEN INCREASED TO 3 MG.

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EPHEDRINE

  • MANAGE HYPOTENSION
  • ACTION SIMILAR TO EPINEPHRINE
  • LONGER DURATION OF ACTION(60-90 MINUTES)
  • DOSE - 5MG IM CAN BE GIVEN UPTO 10-20 MG.

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CORTICOSTEROID

  • ANAPHYLAXIS
  • MANAGEMENT OF ADRENAL CRISIS
  • DOSE 100 MG

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  • STEROID ADMINISTRATION FOR THERAPEUTIC PURPOSE – NEGATIVE FEED BACK ON ANTERIOR PITUITARY GLAND – ATROPHY OF ADRENAL CORTEX --- INABILILTY TO SECRETE HYDROCORTISONE IN RESPONSE TO STRESS.
  • SO PREOPERATIVE EXOGENOUS HYDROCORTISONE IS ADMINISTRED

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MORPHINE

  • SEVERE PAIN
  • MYOCARDIAL INFARCTION

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  • DOSE 1-3 MG IN INCREMENTS IV UNTIL PAIN RELIEF IS OBTAINED
  • USED IN CAUTION IN ELDERLY

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NALOXONE

  • USED AS A MORPHINE OVERDOSE ANTAGONIST

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NITROUS OXIDE

  • SECOND CHOICE IF MORPHINE IS NOT AVALIABLE
  • ADMINISTERED WITH OXYGEN IN CONCENTRATION APPROXIMATING 35%

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BENZODIAZEPINE

  • STATUS EPILEPTICUS – PROLONGED SEIZURES OR MULTIPLE SEIZURES

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  • MIDAZOLAM -5MG IM
  • LORZEPAM - 4MG IM
  • DIAZEPAM – 10 MG IV

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FLUMAZENIL

  • BENZODIAZEPINE ANTAGONIST

USES

1.REVERSAL OF ACCIDENTAL OVERSEDATION

2.REVERSAL OF BENZODIAZEPINE INDUCED RESPIRATORY DEPRESSION

DOSE – 0.1 TO 0.2 MG IV INCREMENTALLY

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IV AND IM INJECTIONS