| DRUG
|
INDICATION
|
DOSE
|
Adrenaline
(1000 microgram in 1 mL injection equivalent to 1:1000)
1000 microgram = 1 mg
|
Anaphylaxis1
|
5–10 microgram/kg IM approximates to:
Adults:
>50 kg 0.5 mL
Children:
10 kg (1–2 years) 0.1 mL
15 kg (2–3 years) 0.15 mL
20 kg (4–6 years) 0.2 mL
30 kg (7–10 years) 0.3 mL
Repeat dose every 5 minutes if no response
|
|
|
Cardiac arrest
|
Adults: 0.5–1 mg IV
Flush with normal saline to aid entry into the circulation
Children: 10 microgram/kg slow IV
(Dilute 1 mL adrenaline injection 1:1000 with 9 mL sodium chloride (0.9%) and give 0.1 mL/kg)
|
Atropine
(0.6 mg in 1 mL injection)
|
Severe bradycardia, asystole
|
Adults: 1 mg IV, repeat every 3–5 minutes until desired heart rate is reached or to a maximum of 3 mg
Children: 20 microgram/kg IV (maximum dose 0.5 mg), repeat every 5 minutes until desired heart rate is reached or to a total maximum of 1 mg
|
Benztropine
(2 mg in 2 mL injection)
|
Acute dystonic reactions
|
Adults: 1–2 mg IM or IV
Children >3 years: 20 microgram/kg IM or IV (maximum 1 mg). Repeat after 15 minutes if needed.
|
Benzylpenicillin
(600 mg or 3 g powder, dissolve in water for injections)
|
Severe infections, including suspected meningococcal disease
|
Adults and children ≥10 years: 1.2 g IV or IM
Children aged 1–9 years: 600 mg IV or IM
Children
|
Chlorpromazine
(50 mg in 2 mL injection)
|
Acute psychosis, severe behavioural disturbance
|
Avoid parenteral use – injections cause pain and skin irritation. Use haloperidol instead.
Adults: If there is no alternative, chlorpromazine 25–50 mg (12.5–25 mg in the elderly) can be given by deep IM injection (buttock or deltoid)
|
Dexamethasone sodium phosphate
(4 mg in 1 mL injection)
|
Acute severe asthma2
|
Adults: 4–12 mg IV slowly
|
| Severe croup
|
Children: 0.15 mg/kg IM if oral route is not possible
|
| Bacterial meningitis
|
Start before or at the same time as antibiotic
Adults: 10 mg IV
Children aged >3 months: 0.15 mg/kg IV
|
Diazepam
(10 mg in 2 mL injection)
|
Severely disturbed patients
|
Adults: 5–10 mg IV over 1–2 minutes (halve dose in elderly) in a large vein. Repeat if necessary every 5–10 minutes (maximum 30 mg).
|
| Seizures
|
Adults: 10 mg IV slowly in a large vein. Repeat once if necessary.
10–20 mg rectally if IV access not possible. Repeat once if necessary.
Children: 0.2–0.3 mg/kg IV slowly in a large vein (maximum 10 mg). Repeat once if necessary.
0.3–0.5 mg/kg rectally (maximum 10 mg). Repeat once if necessary.
|
Dihydroergotamine
(1 mg in 1 mL injection)
|
Severe migraine
|
Adults: 0.5–1 mg SC or IM. Repeat every hour if needed (maximum 3 mg daily).
|
Diphtheria and tetanus booster vaccine
(0.5 mL pre-filled syringe)
|
Tetanus prophylaxis
|
Adults and children >8 years: 0.5 mL IM
|
Frusemide
(20 mg in 2 mL injection)
|
Left ventricular failure, acute pulmonary oedema
|
Adults: 20–40 mg IV slowly or IM
|
Glucagon
(injection kit containing 1 mg glucagon and 1 mL solvent in syringe)
|
Severe hypoglycaemia
|
Adults and children >5 years: 1 mg SC, IM or IV
Children
|
Glyceryl trinitrate
(400 microgram per dose, 200 doses as sublingual spray)
|
Acute angina, acute left ventricular failure
|
Adults: 1–2 sprays under the tongue. Repeat after 5 minutes if needed (maximum 3 sprays).
|
Haloperidol
(5 mg in 1 mL injection)
|
Acute psychosis, severe behavioural disturbance
|
Adults: 2–10 mg IM (0.5–2 mg in the elderly)
|
Hydrocortisone sodium succinate
(100 mg or 250 mg with
2 mL solvent for injection)
|
Acute severe asthma
|
Adults: 100 mg IV
Children: 4 mg/kg IV
|
| Anaphylaxis
|
Adults: 100 mg IV or IM
Children: 2–4 mg/kg IV
|
| Acute adrenal insufficiency
|
Adults: 100 mg IV or IM
Children 1–12 years: 50 mg IV or IM
Children 1–12 months: 25 mg IV or IM
|
Lignocaine
(100 mg in 5 mL injection)
|
Sustained ventricular tachycardia
|
Lignocaine has serious adverse effects including the potential to worsen arrhythmia and cardiac failure. Do not use outside of hospital.
Adults and children: 1 mg/kg IV over 1–2 minutes. Repeat after 5 minutes if needed.
|
Metoclopramide
(10 mg in 2 mL injection)
|
Nausea and vomiting
|
Adults: IV or IM
>60 kg 10 mg starting dose
30–59 kg 5 mg starting dose
(maximum 0.5 mg/kg daily)
Not generally recommended in children as there is a risk of extrapyramidal adverse effects
|
Methoxyflurane
(3 mL plus inhaler)
|
Pain after acute trauma
|
Adults and children (who are able to use the device, usually ≥ 5 years): 6–8 breaths at a time (maximum 6 mL/day)
|
Morphine sulfate
(15 mg or 30 mg in 1 mL injection)
|
Severe pain
|
Adults: SC or IM starting at lower dose
40–59 years 5–10 mg
60–69 years 2.5–7.5 mg
70–85 years 2.5–5 mg
>85 years 2–3 mg
Can also be given as IV increments of 0.5–2 mg titrated to effect
Children >1 year and
|
Naloxone
(2 mg in 5 mL injection)
|
Opioid overdose
|
Adults and children: 0.4–0.8 mg IV, IM or SC repeated as necessary
Neonates born with low APGAR scores to mothers taking opioids:
0.1 mg/kg IV, IM or SC. Repeat if needed.
|
Procaine penicillin
(1.5 g in 3.4 mL injection) |
Severe infections (only suitable for infections where prolonged low concentrations are appropriate)
|
Adults: 1–1.5 g by deep IM injection
Children: 50 mg/kg by deep IM injection
|
Prochlorperazine
(12.5 mg in 1 mL injection)
|
Nausea and vomiting, vertigo
|
Adults: 12.5 mg IM or IV
|
Promethazine hydrochloride
(50 mg in 2 mL injection)
|
Allergic reactions
|
Adults and children >12 years: 25–50 mg IM
Children >2 years: 0.125 mg/kg IM
|
| Nausea and vomiting
|
Adults and children >12 years: 12.5–25 mg IM
|
Salbutamol inhaler
(100 microgram per dose,
200 doses)
|
Acute asthma, bronchospasm
|
Adults and children: 4 puffs (400 microgram) via spacer. Repeat after 4 minutes if needed. If still no improvement, continue giving 4 puffs every 4 minutes until ambulance arrives.
|
Salbutamol nebuliser solution
(2.5 mg or 5 mg in 2.5 mL per dose, 30 doses)
|
Acute asthma, bronchospasm
|
Adults and children >2 years: 2.5–5 mg by nebuliser as required
Children
For anaphylaxis give 5 mg by nebuliser to adults and children, repeat if required
|
Terbutaline
(500 microgram in 1 mL injection)
|
Acute asthma
|
Adults: 250 microgram SC
Children: 5 microgram/kg SC
|
Tramadol
(100 mg in 2 mL injection)
|
Pain
|
Adults: 50–100 mg IV over 2–3 minutes or IM
|
Verapamil
(5 mg in 2 mL injection)
|
Paroxysmal supraventricular tachycardia in patients who are not:
- taking beta blockers
- having an infarction
- in second or third degree atrioventricular block
|
Do not use outside of hospital
Adults: 5 mg IV slowly (over at least 3 minutes), repeat after 5–10 minutes if no response
Children: 0.1–0.3 mg/kg IV, repeat after 30 minutes if no response (maximum 5 mg)
|
* Pharmaceutical Benefits Scheme
IM intramuscular IV intravenous SC subcutaneous
|
|
A guide to paediatric weights 10 kg at 1–2 years 15 kg at 2–3 years 20 kg at 4–6 years 30 kg at 7–10 years
|
