EMERGENCY MANAGEMENT & TREATMENT

EMERGENCY MANAGEMENT
& TREATMENT

PREPARED BY
TARIQ AHMAD
DEPARTMENT OF PHARMACY
UNIVERSITY OF LAHORE

732 TARIQ AHMAD | tareeqahmad@hotmail.com | DEPARTMENT OF PHARMACY, UNIVERSITY OF LAHORE 1

 EMERGENCY MANAGEMENT & TREATMENT

INDEX

ABBREVIATIONS 2
1 TREATMENT OF ANAPHYLACTIC SHOCK 3
2 TREATMENT OF ASTHMA 3
3 TREATMENT OF ACUTE RENAL FAILURE 4
4 TREATMENT OF MYOCARDIAL INFARCTION 4
5 TREATMENT OF SEPTIC SHOCK & MULTI ORGAN FAILURE 5
6 TREATMENT OF POISONING 6

ABBREVIATIONS

BW BODY WEIGHT
mg/kg per BW MILLIGRAM PER KILLO GRMA PER BODY WEIGHT
μg MICRO GRAM
meq/L MILLI EQUALENT PER LITER
μ units MICRO UNIT

732 TARIQ AHMAD | tareeqahmad@hotmail.com | DEPARTMENT OF PHARMACY, UNIVERSITY OF LAHORE 2

 EMERGENCY MANAGEMENT & TREATMENT

No. DRUGS CLASS QUANTITY ROUTE NOTE

1) TREATMENT OF ANAPHYLACTIC SHOCK

1 EPINEPHRINE α-AGONIST 0.1-0.5 mg/kg per BW I/M In cardiovascular collapse

2 DIPHENHYDRAMINE 50 mg once
3 CIMETIDINE H2-BLOCKER 300 mg I/V INFUSION
4 METHYLPREDNISOLONE CORTICOSTEROID 125 mg I/V

2) TREATMENT OF ASTHMA

1 ALBUTEROL β2-AGONIST 0.10-0.15 mg/kg BW

every 20 mints in 1-2 hrs
2 BECLOMETHASONE CORTICOSTEROID 400 μg INHALATION
DIPROPIONATE
OR
METHYL PREDNISOLONE CORTICOSTEROID 125 mg I/V
3 FLUTICASONE & CORTICOSTEROID 200 μg INHALATION
MOMETASONE
4 MgSO4 BRONCHODILATOR 10-20 g/hr
0.4 g/hr (maintenance dose)
5 MONTELUKAST LEUKOTRIENE RECEPTOR 10 mg ORALLY
ANTAGONIST

732 TARIQ AHMAD | tareeqahmad@hotmail.com | DEPARTMENT OF PHARMACY, UNIVERSITY OF LAHORE 3

 EMERGENCY MANAGEMENT & TREATMENT

3) TREATMENT OF ACUTE RENAL FAILURE

1 CALCIUM GLUCONATE 10-20 ml (in 3 mints) I/V

2 NaHCO3 40 meq/L 1.26% in 500 ml normal saline
3 INSULIN REGULAR INSULIN 10-20 UNITS
4 GLUCOSE

4) TREATMENT OF MYOCARDIAL INFARCTION

1 STREPTOKINASE (SK) THROMBOLYTIC AGENT 1.5 million used in 100 ml

normal saline in 1hr
2 ALTEPLASE 15 mg initially
75 mg/kg in 30 mints
3 ASPIRIN NSAID 75-300 mg ORALLY
&
CLOPIDROGEL 75 mg
4 HEPARIN ANTI COAGULANT 12500 μ units SUB-
CUTANEOUS
5 GLYCERINE TRINITRATE ORGANIC NITRATE 300-500 mg SUB LINGUAL
6 METOPROLOL β-BLOCKER 5-15 mg I/V

732 TARIQ AHMAD | tareeqahmad@hotmail.com | DEPARTMENT OF PHARMACY, UNIVERSITY OF LAHORE 4

 EMERGENCY MANAGEMENT & TREATMENT

5) TREATMENT OF SEPTIC SHOCK & MULTI ORGAN FAILURE

SYSTEMIC INFLAMMATORY RESPONSE SYNDROME (SIRS)

1 I/V FLUIDS 4-6 Liters I/V

2 DOPAMINE β-AGONIST 5-20 μg/BW
(a) WHEN SOURSE IS UNKNOWN
3 VANCOMYCIN 1 gm every 12 hrs
4 LEVOFLOXACIN FLOROQUINOLONE 750 mg/kg BW every 24 hr
5 GENTAMYCIN AMINOGLYCOSIDE 7 mg/kg BW every 24 hr
(b) WHEN SOURCE IS MENINGITIS
3 VANCOMYCIN 1 gm every 12 hrs
4 CEFTRIAXONE 3rd GENERATION 2 gm every 24 hr
CEPHALOSPORIN
5 DEXAMETHAZONE 10 mg every 24 hr
(c) WHEN SOURSE IS AEROBIC MICRO ORGANISMS
3 METRONIDAZOLE
(d) FOR NEONATES & INFANTS
3 AMPICILLIN OR
TICARCILLIN
4 GENTAMYCIN AMINOGLYCOSIDE
5 CEFATAXIN OR CEPHALOSPORIN
CEFTRIAXONE

732 TARIQ AHMAD | tareeqahmad@hotmail.com | DEPARTMENT OF PHARMACY, UNIVERSITY OF LAHORE 5

 EMERGENCY MANAGEMENT & TREATMENT

6) TREATMENT OF POISONING

(a) FOR EMESIS USE

1 IPECAC SYRUP 1-2 ml/kg
2 HYPERTONIC NACL SOLN 10-100 ml
3 APOMORPHINE 0.04 mg/kg I/V
(b) FOR GASTRIC LEVAGE
1 NORMAL SALINE
2 NaHCO3 SOLN 10 mg/kg
(c) ADSORPTION THERAPY
1 ACTIVATED CHARCOAL 2.5 g/kg
2 CHARCOAL WITH Used in Alcohol, Atropine,
CATHARTIC (70% sorbitol Phenol & Antimony Poisoning
in 1-3 ml/kg)
(d) FOR ACETAMINOPHEN POISONING
1 ACTIVATED CHARCOAL 1 mg/kg Within 4 hrs
2 N-ACETYLCYSTEIN 100-140 mg/kg ORALLY
100-140 mg/kg VASOGASTRIC In vomiting
OR DEUDONAL
TUBE
300 μg/kg I/V
(e) FOR CARBON MONOOXIDE (CO) POINSONING
1 100% OXYGEN In 100% O2 half life of CO is
90 mints
In 21% O2 half life of CO is 4-5
hrs

732 TARIQ AHMAD | tareeqahmad@hotmail.com | DEPARTMENT OF PHARMACY, UNIVERSITY OF LAHORE 6

 EMERGENCY MANAGEMENT & TREATMENT

(f) FOR IRON POISONING

1 DESFERRIOXAMINE
(g) FOR SILVER NITRATE (AgNO3) POISONING
1 NaCl

732 TARIQ AHMAD | tareeqahmad@hotmail.com | DEPARTMENT OF PHARMACY, UNIVERSITY OF LAHORE 7