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

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 :

Example

Desired Dose x 60
Drug Concentration

5 mcg x 60 min = 0.3 ml/hr

1000 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

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 :
Example :

Desired Dose x Quantity

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