1. EMERGENCY MEDICINES
Dr.Sadia Shabbir
House surgeon surgical 1

2. ADRENALINE
• The substance is adrenaline tartarate which is
manufactured under the trademark of
adrenaline.
DOSE:
• 0.2-0.5ml S/C or I/M
• 0.25ml dil in saline slow I/V
• 0.5ml intracardiac

3. INDICATIONS:
• Allergic reactions
• Acute attack of bronchial asthma
• Cardiac arrest
• Homeostasis
• Along with local anesthetic
• To have bloodless field

4. ADVERSE REACTIONS
• Palpitations , tremors, pallor,headache
• If injected rapidly or I/V causes marked increase
in BP
• Ventricular arrhythmias
• Acute pulmonary edema
• Anginal pain

5. NOR ADRENALINE
It is available as 0.2% sol in 2ml ampules.
DOSE:
• 2ml of noradrenalin+1000ml of 5% dextrose and
administer at the rate of 0.5ml/minute
• 2ml of noradrenalin+N/S+vit C

6. INDICATIONS:
• Treatment of hypotension of circulatory failure
SIDE EFFECTS:
• Palpitations,tremors,pallor,headache
• Ventricular arrythmias
• Acute pulmonary edema
• Anginal pain
• Extravasation in S/C tissues causes necrosis of skin

7. DOPAMINE
DOSE:
• It is available in 5ml ampoules each containing
40mg/ml solution
INDICATIONS:
• Hypotension to increase peripheral circulation
• Open heart surgery
• Renal failures
• Cardiac failure

8. ADVERSE EFFECTS
• It should be administered via central vein,
extravasation may cause local ischemia
• We should stop or decrease the dosage if the
urine output is diminishing, tachycardia,or
arrythmias.

9. PROPRANOLOL
• It is available in 1mg/ml ampoule
INDICATIONS:
• Thyrotoxic crises
• Pheochromocytoma
• Cardiac arrythmias
• Acute MI

10. ADVERSE EFFECTS
• Congestive heart failure,bradycardia,aggravation
of A-V conduction defect
• Bronchospasm
• Hypoglycemia
• Nausea and vomiting
• Uterine hypomotility and prolonged labour
• Thrombocytopenia and leucopenia

11. ATROPINE SULPHATE
• It is available in two strengths
• 0.65mg/ml ampoule
• 6mg/ml ampoule
INDICATIONS:
• Pre anesthetic medication 30min before surgery to
prevent vasovagal shock and also 2 dryout the secretions
• Before pleural and ascitic tap
• In the treatment of colics and
dysmenorrhea,bradyarrythmias and parkinsonism
• Organophosphorus poisoning

12. ADVERSE EFFECTS
• Dry mouth
• Dysphagia
• Retention of urine
• Blurring of vision,precipitate to glaucoma
• Skin rash and local dermatitis

13. NEOSTIGMINE
• It is available in 0.5mg/ml solution in ampoule
DOSE:
• 0.5-2mg I/M or I/V
INDICATIONS:
• Myasthenia gravis
• Acute congestive glaucoma
• Treatment of NM paralysis due to snake bite

14. ADVERSE EFFECTS
• Salivation,sweating and lacrimation
• Nausea vomiting,diarrhea,abd pain
• Tremors and fasciculation
• HTN

15. HYDROCORTISONE
• It is available in a bulb containing 100mg
hydrocortisone
INDICATIONS:
• Life threatening emergencies e.g anapylactic
shock,status asthamaticus,hypoglycemia,thyrotoxic
crises,addison’s crises,hypercalcemia
• Intra-articularly in osteoarthritis
• Topically in keloids
• As retention enema

16. ADVERSE EFFECTS:
• Gastritis,peptic ulcer,perforation and
pancreatitis
• HTN
• Osteoporosis
• Supresses immunity
• Delays wound healing

17. AMINOPHYLLINE
• It is available in 10ml ampoule
DOSE:
• 10ml dil in 20ml of 10% dextrose is given I/V or
slowly
INDICATION:
• Bronchial asthma
• Cardiac asthma
• Cheyne stroke respiration

18. ADVERSE EFFECTS:
• Nausea,vomiting
• Fits preceded by twitching of mouth or severe
hyperventilation
• Collapse and death

19. MORPHINE
• It is available in 1ml ampoule(15mg/ml)
DOSE:
• 5-20mg S/C or I/M
INDICATIONS:
• As analgesic
• As preanesthetic medication
• Acute LVF

20. ADVERSE EFFECTS
• Vomiting
• Hypotension
• Respiratory depression
• Drug dependency
• Urinary retention
• Miosis
• bradycardia

21. PETHIDINE
• Available in 2ml ampoule(50mg/ml)
INDICATIONS:
• Given I/M or I/V
• As analgesic
• As preanesthetic medication
ADVERSE EFFECTS:
• Same as that of morphine

22. DIAZEPAM
• Available in 2ml ampoule(5mg/ml)
DOSE:
10mg I/V or I/M
INDICATIONS:
• Muscle relaxant in tetanus
• Pre anesthetic medication
• Treatment of convulsions
• As tranquillizer

23. AVIL(CHLORPHENARAMINE
MALEATE)
• Available in 2ml ampoule(22.75mg/ml)
INDICATIONS:
• Allergic reactions
• Pruritis
• Hypnotics
ADVERSE EFFECTS:
• Sedation and fatigue
• Dryness of mouth and blurring of vision
• Nausea and vomiting
• Blood dyscrasias

24. INSULIN
• Available in 40 units/ml and 100 units/ml in 10ml bulb
DOSE:
Given S/C
INDICATIONS:
• Diabetic ketoacidotic coma
• Glucose insuline drip in hyperkalemia
• Diabetes
ADVERSE EFFECTS:
• Hypoglycemias

25. SODIUM BICARBONATE
• Available in 10ml ampoule
INDICATIONS:
• Metabolic acidosis
• Lactic acidosis
• Respiratory acidosis
• Hyperkalemia
ADVERSE EFFECTS:
• Metabolic alkalosis
• Edema due to Na+ retentions

26. LASIX(FRUSEMIDE)
DOSE:
20mg I/M or I/V
INDICATIONS:
• Pulmonary edema
• To induce forced diuresis in barbiturates poisoning
• Treatment of mannitol resistant acute oliguria
• Advanced RF
• Prostatectomy

27. ADVERSE EFFECTS
• Water and elecrolyte disturbance
• Orthostatic hypotension
• Retention of urine
• Hepatic coma
• Cardiac arrest
• Hearing loss

28. MANNITOL:
• It is a sugar available as 20% sol in 350ml glass bottel
DOSE:
0.5-1g/kg
INDICATIONS:
• Induce diuresis in barbiturate poisoning
• Acute oliguric RF
• After severe traumatic injuries
• To reduce intracranial pressure
• After CVA,cerebral edema,hepatic encaphlopathy

29. ADVERSE EFFECTS
• Precipitate CHF
• Fluid overload causes the ARF
CONTRAINDICATIONS:
• Shock
• Cardiac failure
• Renal impairment

30. POTASSIUM CHLORIDE
• Available in 10ml ampoule(150mg/ml)
INDICATION:
• Hypokalemia
ADVERSE EFFECTS:
• Cardiac arrest if given rapidly

31. CALCIUM GLUCONATE
• Available in 10ml ampoule(1g)
DOSE:
• 2g I/V slowly in tetany
• 1g I/V slowly in epididymo-orchitis
INDICATIONS:
• Tetany
• After 1000ml of blood transfusion
• As inotropic drug in cardiac arrest
• Hyperkalemia
• Hypoparathyroidisim
• As a coagulant(factor 5)