Emergency Drugs and Their Actions Reference - Summary
Knowing about emergency drugs and what they do is very important in critical situations. Emergency drug guidelines often include information that overlaps with other health issues, especially those related to the heart, diabetes, and breathing problems. Some topics, like how to handle cardiac arrest, are explained more fully in emergency guidelines, but the information stays the same across different guides.
Emergency drugs can be divided into two main groups. The first group is the essential drugs that should always be in an emergency drug kit. The second group includes helpful drugs that aren’t always required. Whether you need these optional drugs depends on how much training a medical helper has in emergency procedures and if they use medicine to calm nervous patients or put them to sleep for treatments.
WHO Emergency Drug Guidelines were made as an easy-to-use booklet for the medical team at Tungaru Hospital in Kiribati. If you want a full list of these medications, you can find a useful resource. You can download emergency drugs and their actions PDF for quick reference.
List of Emergency Drugs & Their Actions (WHO Guidelines)
| Drug (concentration) and Indication | Dose | Administration / Remarks |
|---|---|---|
| Adenosine (3 mg/ml) Acute treatment of supraventricular tachycardia |
|
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 works. |
| Atropine (0.1 mg/ml) Bradycardia | 0.02 mg/kg/dose IV | May repeat once after 3 minutes. |
| Calcium gluconate (100 mg/ml)= 9.4 mg elemental calcium /ml Cardiac arrest Hypocalcemia | 100 mg/kg/dose IV. Not for IM or SQ use. | May repeat once, then dose based on ionized calcium results. Give by slow IV push for cardiac arrest, infuse over 30-60 minutes for other reasons. Stop infusion if heart rate is over 100 bpm. Do not give into arteries. |
| Dextrose 10% (0.1 Gm/ml) Hypoglycemia Hyperkalemia with insulin | 0.2 Gm/kg/dose IV as D10W, then continuous infusion of D10W at a GIR of 4-8 mg/kg/min. Adjust to reach normal blood sugar. | 2 ml/kg of Dextrose 10%. For Hyperkalemia: Continuous infusion of 0.5 g/kg/hr dextrose and 0.1-0.2 units/kg/hr regular insulin. Dextrose and insulin doses change based on blood glucose and potassium levels. Don’t stop dextrose suddenly because of rebound low blood sugar. Glucose less than D15 should be given through a central vein to lower risk of vein inflammation and clots. |
| Dopamine For 10 mcg/kg/min. @ 1 ml/hr: weight x 30 = mg of dopamine (in kg) in 50 ml D5W/NS Hypotension | Start at 5 mcg/kg/min. Increase by 2.5 – 5 mcg/kg/min. as needed, up to 20 mcg/kg/min. | Use if poor blood flow, signs of shock, or weak pulses after epinephrine and fluids (and bicarbonate). Give into a central vein if possible. Use phentolamine if IV leaks. |
| 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 up to 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. Use the 1:1,000 (1 mg/ml) only for continuous infusion. Never inject into an artery. Do not mix with bicarbonate. Drug works better if acidosis is fixed. You can mix dose volume with 3-5 ml NS. After ET administration, give several positive pressure breaths. Don’t give these higher doses through an IV. |
| Fentanyl (50 mcg/ml) Pain relief Sedation Anesthesia | 1 mcg/kg | Consider 10 mcg/ml for doses less than 5 mcg. |
| Hydralazine (20 mg/ ml) High blood pressure by widening blood vessels | 0.1-0.5 mg/kg | Doses over 2 mg; consider 0.4 mg/ml. |
| Lorazepam (2 mg/ml) Sedation Seizures | 0.05-0.1 mg/kg | Slow IV push. For seizures, may repeat every 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 effect during resuscitation. Effects don’t last long; may need repeated doses. |
| Phenobarbital (65 mg/ml) Anticonvulsant | 15 – 20 mg/kg. For ongoing seizures, add 5 mg/kg doses up to a total of 40 mg/kg. | IV push over 10-15 minutes, no faster than 1 mg/min. Can be given by slow IV push, IM, PR, or PO. Diluted IV product can be taken 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 usually given for resuscitation. Can also be given by continuous infusion, IO, or PO. |
| Vecuronium (1 mg/ml) Paralysis Rapid Sequence Intubation* | 0.1 mg/kg | IV push in under 1 minute. |
| Volume Expanders RBCs, NS Low blood pressure Low blood volume With acute blood loss or less effective blood volume | RBCs: 15 ml/kg IV NS: 10 ml/kg IV | RBCs: Give over 4 hours. NS: Give over at least 10 minutes, but preferably over 30-60 minutes. Use if weak response to resuscitation or weak pulses with good heart rate. |
Essential Emergency Drugs in 2025
| Drug | Use | Dose | Amount |
|---|---|---|---|
| Oxygen | Almost any emergency | 100% inhalation | 1 “E” cylinder with adjustable regulator (0-15L) |
| Epinephrine | Anaphylaxis Asthma not responding to albuterol/salbutamol | 1: 1000 (1mg/ml), auto-injector 0.3 mg/ml (EpiPen), 0.15 mg/ml (EpiPen Jr) | 1:1000 mg/ml ampule, 1 EpiPen, 1 EpiPen Jr auto-injectors |
| Nitroglycerin | Chest pain from angina | 0.4 mg under the tongue every 3-5 minutes | 1 metered spray bottle (0.4 mg) |
| Diphenhydramine | Allergic reactions | 1 mg/kg IM/IV; max 50 mg | 50 mg/ml vials and 1 box of 25 mg tablets |
| Albuterol/salbutamol | Asthmatic bronchospasm | 2 puffs; repeat as needed | Metered-dose inhaler 2.5 mg/3ml nebulized solution |
| Aspirin | Heart attack | 81 mg chewable tablet | Chewable tablets, bottle of baby aspirin (81 mg) |
| Glucose | Low blood sugar (patient unconscious) | 37.5 mg; repeat as needed | 1 tube (37.5 mg) |
Knowing about emergency drugs and what they do is very important in healthcare. For a quick guide, you can download the Emergency Drugs and their Actions PDF.
