EMERGENCY DRUGS AND

CALCULATIONS

THAVAMANI KANDASAMY
ICU - STAFF NURSE
SYSTEMIC CIRCULATION
 CHANNELS OF DRUG ADMINISTRATION

ENTERAL
( ORAL,SL,BUCCAL,RECTAL)

PARENTERAL
( IM,IV,IA,SC,ID, INTRATHECAL, INTRA ARTICULAR )

TOPICAL
(EYE,NOSE,EARS,LUNGS,VAGINA,URETHRA,COLON)
 DOPAMINE
1 ampoule= 200mg/5ml

AMOUNT OF DRUG NEEDED per 50 ml infusion solution :

Amount of drug to dilute = Body weight x 3

Ex. 70 kg x 3= 210 mg
Amount of drug = 210mg x5ml = 5.25ml
2oomg
PREPARATION : 44.75 ml NSS +5.25ml drug = 50ml
1ml = 210mg x 1000 = 4200mcg
50ml
RATE OF INFUSION : mcg x body weight x 60 min
drug concentration
Example : 5 mcg x 70 x 60 = 5 ml/hr
4,200 mcg
 DOBUTAMINE
1 ampule= 250mg/5mL
AMOUNT OF DRUG NEEDED in 50 ml solution
Amount of drug = body weightx 3
Ex. 70 kg x 3= 210 mg
Amount of drug in ml = 210mg x5ml = 4.2ml
250MG
PREPARATION : 45.8 ml NSS + 4.2ml drug = 50 ml
Rate of Infusion : mcg x body weight x 60 min
Drug concentration
Example: 4 mcg x 70 kg x 60 = 4ml/hr
4200 mcg/ml
 LEVOPHED
1 ampoule 3mg / 3ml
PREPARATION : 3 mg +47 ml D5W = 50ml

DRUG CONCENTRATION : 3mg/50ml=0.06mg/1ml

0.06mg x 1000mcg =60mcg/ml

Rate of Infusion : Desired Dose x 60 min

60 mcg

Example : 2 mcg x 60 min = 2 ml / hr

60 mcg
 NITROGLYCERINE

1 ampule= 50 mg ( 10 ml)
PREPARATION: 40 ml NSS + 10 ml NTG

DRUG CONCENTRATION : 50 mg/ 50 ml = 1mg/1ml

1mg x 1000 = 1,000mcg /1ml

Rate of Infusion : Desired Dose x 60

Drug Concentration

Example : 5 mcg x 60 min = 0.3 ml/hr

1000 mcg
 NICARDIPIN

1 ampule= 25 mg ( 10 ml)
PREPARATION: 40 ml NSS + 10 ml NTG

DRUG CONCENTRATION : 20 mg/ 50 ml = 0,5mg/ml

0,5mg x 1000 = 500mcg /ml

Rate of Infusion : Desired Dose x 60

Drug Concentration

Example : 1 mcg x 60 min = 0.12 ml/hr

500 mcg
 ADRENALINE
1 ampoule = 1ml/1mg
PREPARATION: 12 ml of Adrenaline + 38 ml D5W = 50 ml
DRUG CONCENTRATION = 12 mg/ 50 ml=0.24mg
0.24mg x1000= 240mcg /ml
Rate of Infusion: Desired dose x 60 = ml /hr
240mcg
Example : 2mcg x 60 min = 0.5 ml/hr
240mcg
 INSULIN

PREPARATION: 49.5 ml NSS + 50 units (0.5 ml R.I )

Rate of Infusion : Desired Dose x Quantity

50 units

Example : 3 units x 50 ml = 3 ml / hr
50 units
 HEPARIN
1 ampule : 25,000 IU / 5ml

PREPARATION : 45 ml NSS + 25,000 (5 ml) Heparin

Rate of Infusion : Desired dose x Quantity
Drug Concentration
Example : 100 units x 50 = 0.2 ml/hr
25, 000 units
 LASIX
1 ampule = 20mg (2 ml)
Drug Concentration : 10 ampule = 200mg (20ml)
PREPARATION: 20 ml Lasix + 20 ml NSS
40 ml = 200 mg
1 ml = 5mg
Rate of Infusion : Desire dose x quantity = ml/hr
Drug concentration
Example : 10 mg/hr x 40 ml = 2 ml /hr
200 mg
 PHENYTOIN
1 ampoule : 250 mg / 5 ml
LOADING DOSE: 15 mg/kg at a rate not greater than
50 mg/min for 20 30 mins.
MAINTENENCE DOSE: followed by 100 mg every 6-
8 hours

PROPHYLAXIS: 200-600 mg/day PO/IV

ANTIARRYTHMIC : 10 mg IV every 15 minutes
until arrhythmia stops
 AMIODARONE
1 ampoule = 150 mg (3ml)
LOADING DOSE : 1 ampule ( 150 mg /3 ml) + 12 ml D5W
A .MAINTANENCE DOSE : 360 mg in 6 hours
360 mg x 3 ml = 7.2 ml
150 mg
7.2 ml ( amiodarone) + 42.8 ml D5%W = 50 ml = 8.3 ml/hr
B. 540 mg in 18 hours
540 mg x 3 ml = 10.8 ml
150 mg
10.8 ml ( amiodarone ) + 39.2 ml D5%W= 2.7ML /hr
 OMEPRAZOLE
1 vial = 40 mg
PREPARATION : 5 vial (200mg) Omeprazole + 50 ml NS
50 ml = 200mg
1 ml = 4 mg
Rate of Infusion : Desired dose x Quantity =
ml/hr
Drug Concentration
Example : 8 mg x 50 ml = 2 ml /hr
200mg

 LABETALOL

1 ampule(20 ml) = 100 mg

Preparation : 20 ml Labetalol + 30 ml NSS
Drug Concentration : 1 ml = 2 mg
Rate of Infusion : Desired Dose x Quantity
Drug concentration
Example : 5 mg x 50 = 2.5 ml / hr
100 mg
 HYDRALAZINE
1 ampoule = 20 mg
PREPARATION: 20 mg dilute in 1 ml water of inj.
LOADING DOSE: 10-20 mg over 3-5 minutes, further dilute
with 10 ml NS over 3-5 mins.
then repeat after 20-30 minutes.

INFUSION: Reconstitute 3 ampoules (60 mg) Hydralazine

with 1 ml water of inj. Each.
Make up to 60 ml with NSS.
Drug Concentration: 1 ml : 1 mg
Note : Give rate between 2 and 15 mg / hr depending on BP
and pulse.
 VASOPRESSIN
1 ampoule = 20 units / 1 ml
USUAL DOSE: 0.01 to 0.03 units/ minute
PREPARATION : 20 units in 50 ml NSS

DRUG CONCENTRATION: 20units / 50ml = 0.4units /

ml

Rate of Infusion: Desired Dose x 60

Drug Concentration

Example : 0.01 units/min x 60 = 1.5 ml/hr

0.4 units / ml
 PHENYLEPHRINE
1 ampoule: 10 mg / 1ml

PREPARATION: 10 mg in 250 ml NSS

1ml = 40 mcg/min
Rate of Infusion : Desired Dose x 60 = ml/hr
40 mcg/ml
Example : 1 mcg /min x 60 = 1.5 ml/hr
40 mcg/ min
 PROPOFOL
INFUSION: 1 ampoule: 200 mg = 20 ml
PREPARATION : 500 mg = 50 ml without dilution
DRUG CONCENTRATION: 1 ml = 10 mg

Rate of Infusion : Desired Dose x quantity

Drug Concentration
Example : 10 mg x 50ml = 1ml/hr
500mg
 SANDOSTATIN ( OCTREOTIDE)

1 ampoule : 100 mcg/ml

3 ampules (300 mcg /3 ml) + 27 ml NSS = 30 ml
Drug Concentration: 30 ml = 300 mcg
1 ml = 10 mcg
NOTE : 25 MCG BOLUS FOLLOWED BY 25 50 MCG /
HR
 ATRACURIUM
1 ampule : 25 mg ( 2.5 ml)
PREPARATION : 4 ampule (100mg) + 40 ml NSS
DRUG CONCENTRATION: 100 mg /50ml
Rate of Infusion: Desired Dose x 50 ml
Drug Concentration
Example : 5 mg x 50 ml = 5 ml / hr
100mg
 FENTANYL
INFUSION:1 ampoule = 500 mcg (10 ml)
PREPRATION : 10 ml Fentanyl + 40 ml NSS
Drug Concentration : 50 ml = 500 mcg
1 ml = 10 mcg
Rate of Infusion : Desired Dose x Quantity
Drug Concentration
Example : 25 mcg x 50 ml = 2.5 ml
500mcg
 DORMICUM( MIDAZOLAM)

1 ampoule = 15 mg (3ml)

PREPARATION: 45 mg ampule (9 ml) + 36 ml NSS

Drug Concentration : 45mg /45ml =1mg/1ml

Rate of Infusion : Desired Dose x Quantity

Drug Concentration
Example : 2mg x 45 ml = 2ml / hr
45mg