Emergency Drug Doses
Jeffrey L. Segar, MD and Sarah B. Tierney, PharmD
Peer Review Status: Internally Peer Reviewed
|Drug (concentration) and Indication||Dose||Administration / Remarks|
|Adenosine (3 mg/ml)
Acute treatment of supraventricular tachycardia
||Rapid IV push over 1-2 seconds
Flush line immediately with 5-20 ml NS
Infuse as close to IV site as possible
IO administration also successful
|Atropine (0.1 mg/ml)
|0.02 mg/kg/dose IV||May repeat x 1 dose in 3 minutes|
|Calcium gluconate (100 mg/ml)= 9.4 mg elemental calcium /ml
|100 mg/kg/dose IV
Not for IM or SQ use
|May repeat x 1 dose, then dose per ionized calcium results
Administer by slow IV push for cardiac arrest, infuse over 30-60 minutes for other indications. Stop infusion if HR is greater than 100 bpm.
Do not give intra-arterially.
|Dextrose 10% (0.1 Gm/ml)
Hyperkalemia in combination with insulin
|0.2 Gm/kg/dose IV as D10W Then continuous infusion of D10W at a GIR of 4-8 mg/kg/min. Titrate to attain normoglycemia.||2 ml/kg of Dextrose 10% Hyperkalemia: Continuous infusion of 0.5 g/kg/hr dextrose and 0.1-0.2 units/kg/hr regular insulin. Dextrose and insulin dosages are adjusted based on serum glucose and potassium concentrations. Abrupt discontinuation of dextrose infusion is not recommended due to the risk of rebound hypoglycemia. Glucose concentrations less than D15 should be administered via a central vein to minimize risk of phlebitis and thrombosis.|
To give 10 mcg/kg/min. @ 1 ml/hr : weight x 30 = mg of dopamine (in kg) in 50 ml D5W/NS
|Begin at 5 mcg/kg/min.
May increase in increments of 2.5 - 5 mcg/kg/min. as needed up to 20 mcg/kg/min.
|Consider if poor peripheral perfusion, evidence of shock, or thready pulses after epinephrine and volume expansion (and bicarbonate)
Administer into a central vein when possible. Phentolamine used for treatment of IV infiltrates.
|Epinephrine 1 : 10,000 (0.1 mg/ml)
Short term use for systemic hypotension
|0.1 - 0.3 ml/kg/dose IV, IO (0.01 – 0.03 mg/kg),
- For continuous infusion - start at 0.05 mcg/kg/min to a maximum of 1 mcg/kg/min.
|Rapid IV push followed by 0.5-1 ml NS flush
May repeat every 3-5 minutes
ALWAYS use the diluted 1:10,000 (0.1 mg/ml) concentration for individual doses.
Only use the 1:1,000 (1 mg/ml) for continuous infusion solutions
NEVER inject into an artery
Do not mix with bicarbonate
Effectiveness of drug increases if acidosis is corrected
May mix dose volume with 3-5 ml NS
Follow ET administration with several positive pressure ventilations.
Do NOT administer these higher doses intravenously.
|Fentanyl (50 mcg/ml)
|1 mcg/kg||Consider 10 mcg/ml for doses less than 5 mcg|
|Hydralazine (20 mg/ ml)
Hypertension by vasodilation
|0.1-0.5 mg/kg||Doses greater than 2 mg; consider 0.4 mg/ml|
|Lorazepam (2 mg/ml)
|0.05-01 mg/kg||Slow IV push
Seizures, may repeat q 10-15 minutes
|Morphine (1 mg/ml)
|0.05-0.1 mg/kg||Slow IV push over 5-10 minutes, IM, SQ|
|Naloxone (1 mg/ml)
|0.1 ml/kg rapid IV push, IM||May repeat in 3 - 5 minutes if no response during resuscitation.
Duration of reversal is brief; may need repeated doses.
|Phenobarbital (65 mg/ml)
|15 - 20 mg/kg
-For refractory seizures- Additional 5 mg/kg doses, up to a total of 40 mg/kg can be given.
|IV push over 10-15 minutes, no faster than 1 mg/min.
Drug can be administered by slow IV push, IM, PR, or PO.
Diluted IV product can be used orally.
|Sodium Bicarbonate 4.2% (0.5 mEq/ml)
|1 - 2 mEq/kg||Slow IV push over 30 minutes.
Use only 0.5 mEq/ml solution for infants
Infuse 1 mEq/kg over ≥ 1 minute
CAUSTIC; don’t infuse faster than 2 ml/kg/minute.
NOT routinely given for resuscitation.
Can also be given by continuous infusion, IO, or PO
|Vecuronium ( 1mg/ml)
Rapid Sequence Intubation*
|0.1 mg/kg||IV push over less than 1 minute|
|Volume Expanders RBCs, NS
With evidence of acute blood loss or a decrease in effective volume
|RBCs: 15 ml/kg IV
NS: 10 ml/kg IV
|RBCs: Infuse over 4 hours
NS: Infuse over at least 10 minutes, but preferably over 30-60 minutes.
Consider if poor response to resuscitative efforts or weak pulses with a good heart rate