Emergency Drug & Their Actions List by WHO PDF

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Emergency Drug & Their Actions List by WHO

The Emergency drug guidelines overlap with some conditions already covered in the other booklets – particularly those in the cardiovascular, diabetes, and respiratory guidelines. Some, like the management of cardiac arrest, are treated more fully in the Emergency Guidelines but the information in each set of guidelines is consistent.

WHO Emergency Drug Guidelines were requested as a “stand-alone” booklet by the medical staff of Tungaru Hospital, Kiribati.

Emergency Drug & Their Actions List by WHO PDF - 2nd Page
Page No. 2 of Emergency Drug & Their Actions List by WHO PDF

Emergency Drug & Their Actions List

Emergency Drug Doses
Drug (concentration) and IndicationDoseAdministration / 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 IVMay 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/kgConsider 10 mcg/ml for doses less than 5 mcg
Hydralazine (20 mg/ ml)
Hypertension by vasodilation
0.1-0.5 mg/kgDoses greater than 2 mg; consider 0.4 mg/ml
Lorazepam (2 mg/ml)
Sedation
Seizures
0.05-01 mg/kgSlow IV push
Seizures, may repeat q 10-15 minutes
Morphine (1 mg/ml)
Pain
Sedation
0.05-0.1 mg/kgSlow IV push over 5-10 minutes, IM, SQ
Naloxone (1 mg/ml)
Narcotic antagonist
0.1 ml/kg rapid IV push, IMMay 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/kgSlow 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/kgIV push over less than 1 minute
Volume Expanders RBCs, NS
Hypotension
Hypovolemia
With evidence of acute blood loss or a decrease in effective volume
RBCs: 15 ml/kg IV
NS: 10 ml/kg IV
RBCs: Infuse over 4 hours
NS: Infuse over at least 10 minutes, but preferably over 30-60 minutes.
Consider if poor response to resuscitative efforts or weak pulses with a good heart rate

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