‫‪ICU &Emergency Drugs‬‬

‫إعداد‪/‬بدر الجابري‬
‫زكريا السنحاني‬

‫إشراف الدكتور‪/‬عبدربه ابو بارعه‬

 Acetazolamide

ICU indication
1. Diuretic (particularly in the presence of
metabolic alkalosis)
2. Correction of severe metabolic alkalosis

dose
For diuresis, the dose is usually 250-375 mg stat. If,
after an initial response, the patient fails to continue
to diurese, do not increase the dose but allow for
kidney recovery by skipping medication for a day.
 Acetylcysteine

1. ICU indication
2. paracetamol overdose
3. non-paracetamol induced fulminant hepatic
failure
Dose
Paracetamol Overdose.
1 50mg/kg over 1 5 minutes; 50mg/kg over
the next 4 hours,J 00mg per kg over the next
16 hours. Total dose 300mg/kg in 20 hours
• Initial dose‘ 150mg/kg in 200mI of DSW
over 15 minutes
• Second dose: 50mg/kg in 500ml of DSW
over 4 hours
• Third dose: 100mg/kg in 1000mI of
DSW over 16 hours
 Adenosine
‹
ICU Indication
1. Conversion to sinus rhythm of paroxysmal
supraventricular tachycardia (PSVT), including
that associated with accessory bypass tracts
(Wolff-Parkinson-White Syndrome).
 Allopurinol

1. ICU indication
2. Prophylaxis against gout
3.The management of patients with
leukaemia, lymphoma and malignancies who
are receiving cancer therapy which causes
elevations of serum and urinary uric acid
levels.
 Aminophylline

ICU indication
|1. Management of acute life threatening asthma!)
"(particularly in children)

Asthma and COPD:

:.IV aminophylline is very rarely used for '..reatment
in asthma or COPD in adults in our 'Intensive Care
Unit.

i|
 Amitriptyline
ADMINISTRATION ROUTES: PO, NG

ICU indication
1. Neurogenic pain (eg GBS)
2. Nocturnal sedation
 Atenolol
ADMINISTRATION ROUTES: PO, NG

I C U
i n d i c a t
i o n
1. Hypertension
2. Acute myocardial infarction
3.Secondary prevention in patients with
coronary artery disease
4. Angina
5. Rate control
 Atorvastatin
ADMINISTRATION ROUTES: PO, NG

ICU indication
1.Secondary prevention in patients with
coronary artery disease
2. Treatment of hypercholesterolaemia

Po:
Commence at 10-20mg daily at night;
slowly
increase to a maximum of 80mg if
required.
 Calcitriol
ADMINISTRATION ROUTES: PO, NG

ICU indication
1. Post-menopausal osteoporosis
2. Renal osteodystrophy
3. Secondary hyperparathyroidism
4. Hypoparathyroidism
5.Prevention of corticosteroid-induced
osteoporosis
Note: initiation of calcitriol in ICU is rarely
indicated and this therapy is often withheld
while patients are critically ill (see
PRECAUTIONS).
 Calcium Chloride

ADMINISTRATION ROUTES: IV

ICU indication
1. Hypocalaemia (particu ar if there is refractory
shock or bleeding)
2.ECG abnormalities caused by hyperkalaemia
(acts as a membrane stabiliser)
3. Magnesium toxicity
 Captopril
ADMINISTRATION ROUTES: PO, NG
ICU indication

1. Hypertension
2. Congestive heart failure or left ventricular
dysfunction after myocardial infarction
3. Diabetic nephropathy

Captopril is a specific competitive inhibitor of

angiotensin I-converting enzyme (ACE), the
enzyme responsible for the conversion of
angiotensin I to angiotensin II.

4. Hypersensitivity to captopril or any other

angiotensin-converting enzyme inhibit).
5. Cardiogenic shock
 Carbamazepine
ADMINISTRATION ROUTES: PO, NG

1. Epilepsy
2.Trigeminal neuralgia and other neuropathic
pain
(Note: this medication is usually prescribed in
ICU patients who were taking it for a pre- existing
indication prior to admission; it may occasionally
be commenced de novo in patients with new
seizures or neurogenic pain but is not first line
therapy for either of these conditions)
 Carvedilol
ADMINISTRATION ROUTES: PO / NG
ICU indication
1. Hypertension
2. Acute myocardial infarction
3.Secondary prevention in patients with
coronary artery disease
4. Angina
5. Rate control

PO/NG:
Commence at 3.125mg BD and increase
gradually as required.
 Ceftazidime

1. Treatment of infections caused by

susceptible organisms (esp Pseudomonas)
2. Empiric treatment of hospital acquired
pneumonia

IV:
1-2gm 8hrly

25-50mg/kg 8 hourly
 Ceftriaxone
ADMINISTRATION ROUTES:
IV or IM

ICU indication
1.Treatment of infections caused by
susceptible organisms
2. Empirical treatment of bacterial
meningitis

IV:
1-2 gm daily; for bacterial meningitis 4gm daily is
required and is often administered as 2gm 12 hrly
 Citalopram
ADMINISTRATION ROUTES: PO

ICU indication
1. Treatment of depression

Note: citalopram is usually used in ICU patients

with a pre-existing diagnosis of depression who are
already taking the medication at admission.
 Clindamycin
ADMINISTRATION ROUTES: IV, PO,

ICU indication
1. Treatment of infections caused by
susceptible organisms (particularly
Streptococcal or Staphylococcal toxic shock
syndrome)

IV:
d00mg 6 hourly

PO:
300-450mg 6 hourly
 Clonidine
ICU indication
1. Agitated delirium
2. Analgesia
3. Hypertension

.
 Clopidogrel
ADMINISTRATION ROUTES: PO, NG

ICU indication
1. Treatment of a'cute coronary syndromes
(especially post angioplasty when stents are
deployed)
2.Prophylaxis of vascular ischaemic events
(mainly in patients with coronary stents)
 Codeine Phosphate

ICU indication
1. Relief of mild to moderate pain

Codeine phosphate is a centrally active

analgesic

1. Hypersensitivity to codeine.
 Colchicine

ADMINISTRATION ROUTES: PO

1. Acute gout
EMERGENCY DRUGS