Sr.THAVAMANI KANDASAMY ICU - STAFF NURSE

1. EMERGENCY DRUGS AND
CALCULATIONS
THAVAMANI KANDASAMY
ICU - STAFF NURSE

2. SYSTEMIC CIRCULATION

3. 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)

4. 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

5. 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

6. 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

7. 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

8. 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

9. 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

10. 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

11. 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

12. 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

13. 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

14. 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
•

15. 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

16. 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.

17. 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

18. 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

19. 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

20. 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

21. 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

22. 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

23. 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