1. Norepinephrine
Common name: Noradrenaline Specification 2mg.1ml
Mechanism of action
It has a strong vasoconstrictive effect, causing contraction of small arteries and veins (but coronary vasodilation), increase in peripheral resistance and rise in blood pressure. It is suitable for hypotension caused by various kinds of shock and drug poisoning.
Usage and dosage
In critical cases, 1~2mg of this drug can be diluted to 10~20ml and slowly pushed intravenously. Adjust the dose according to the blood pressure, and then switch to intravenous drip for maintenance after the blood pressure rises. Jin Hongxu, Department of Anesthesiology, Harrison International Peace Hospital
Precautions
When the concentration is high, reactive vasospasm and local skin pallor will occur in and around the injection area, which may cause ischemic necrosis over time, so it is important to prevent leakage of the drug during drip administration. Hypertension, arteriosclerosis, anuric patients are prohibited to use.
2. Adrenaline
Common name: Paraprenaline Specification 1mg 1ml
Mechanism of action
Alpha and beta-agonist, increase vascular resistance and arterial blood pressure, increase cardiac autoregulation and myocardial contractility, increase heart rate and myocardial oxygen demand. In CPR it increases blood flow to the myocardium and brain and increases perfusion pressure. Applicable to cardiac arrest, anaphylaxis, bronchial asthma.
Dosage
Cardiac arrest 0.25～0.5mg diluted with saline 10ml and injected intravenously; anaphylaxis 0.1mg～0.5mg injected slowly intravenously (saline diluted to 10ml). If the efficacy is not good, it can be changed to 4～8mg intravenous injection (dissolved in 5% glucose injection 500ml～1000ml)
Precautions
Side effects such as palpitations, headache and increased blood pressure may occur. Contraindicated for organic heart disease, hypertension, cerebral arteriosclerosis, diabetes mellitus.
3. Isoprenaline
Common name: Isoprenal specification 1mg 2ml
Mechanism of action
It is a beta-adrenergic agonist with excitatory effect on the heart and can increase the oxygen consumption and cardiac output of the heart muscle. It is used for atrioventricular block; cardiac arrest due to various causes; cardiogenic and infectious shock.
Usage and dosage
For Ⅲ degree AV block, if heart rate is less than 40 times, dissolve 0.5~1mg in 5% glucose injection 200~300ml as a slow drip; for shock, dissolve 0.5~1mg in 5% glucose injection 200ml as a slow drip and adjust the drip rate according to heart rate.
Precautions
Dry mouth and throat, palpitations are common; not recommended for patients with coronary artery disease, myocarditis and hyperthyroidism.
4. Niclosamide
Common name: Colamine 0.375g 1.5ml
Mechanism of action
Directly excites the respiratory center of the medulla oblongata, and acts on the carotid sinus and aortic body chemoreceptors to reflexly excite the respiratory center, and weakly excites the vasomotor center. It is suitable for central respiratory depression, especially for the respiratory depression of morphine poisoning.
Usage and dosage
Intravenous drip 3~3.75g in 500ml of liquid at a rate of 25~30 drops per minute.
Precautions
Facial irritation, irritability, convulsions, nausea and vomiting are common. In high doses, elevated blood pressure, palpitations, sweating, facial flushing, vomiting, tremor, arrhythmia, convulsions, and even coma may occur.
5. Lopressorine
Common name: Lopressorin 3mg 1ml
Mechanism of action
Excitation of carotid sinus and aortic body chemoreceptor reflex excitation of respiratory center, applicable to respiratory depression caused by various reasons
Dosage
Intravenous injection 3mg/time; extreme dose 6mg/time, 20mg/day
Precautions
Adverse reactions may include increased salivation, nausea, vomiting, excessive sweating, headache, bradycardia in high doses, atrioventricular block or tachycardia, respiratory depression and convulsions in increasing doses.
6. Lidocaine
Specification 0.1g 5ml
Mechanism of action
Sodium blocker, inhibits ventricular ectopic rhythm and increases the threshold of ventricular fibrillation. It is suitable for ventricular arrhythmias such as ventricular fibrillation and ventricular tachycardia.
Dosage
Intravenous injection of 1-1.5mg/kg (generally 50-100mg) as the first loading dose intravenously for 2-3 minutes, repeated 1~2 times in 5 minutes if necessary; intravenous drip: the loading dose can be followed by an intravenous drip of 1-4mg/min (0.015~0.03mg/kg/min) for maintenance.
Precautions
May inhibit the central nervous system; nystagmus is one of the early signs of toxicity; severe atrioventricular block and hepatic insufficiency are contraindicated.
7. Atropine
Common name: Atropine Sulfate Specification 1mg 1ml
Mechanism of action
M-cholinergic receptor blocking drug; suitable for various visceral colic, vagal hyperexcitation resulting in arrhythmia, anti-shock, antitoxic agent, preanesthetic inhibition of glandular secretion
Usage and dosage
Intravenous injection: anti-shock 1~2mg/time, diluted with 50% glucose with 5~10 minutes injection, 15~30 minutes/time; antiarrhythmia 0.5~1mg/time, can be every 1~2h/time, the maximum dose is 2mg; organophosphorus poisoning 1~2mg/time, repeat every 10~20 minutes; intravenous drip: anti-shock to improve microcirculation: once 0.02~0.05 mg/kg, diluted with glucose and then drip
Precautions
Common dry mouth, photophobia, blurred vision, skin flushing, urination difficulties, the drug has a variety of pharmacological effects, clinical application of one of the effects, the other effects become adverse reactions; glaucoma, prostate hypertrophy is prohibited.
8. dihydroxypropyl theophylline
Common name: Astaxanthin 250mg 2ml
Mechanism of action
It can dilate the coronary arteries and bronchial tubes. It is suitable for bronchial asthma, wheezing bronchitis and obstructive emphysema to relieve wheezing symptoms. It is also used for asthma caused by cardiogenic pulmonary edema.
Dosage
Intravenous drip, 250-750mg once, diluted with 5% or 10% glucose injection, total amount less than 2g in 1 day.
Precautions
Nausea, vomiting, agitation, insomnia, tachycardia, arrhythmia may occur in excessive doses. Even fever, dehydration, convulsions and other symptoms may occur, and even respiratory and cardiac arrest in severe cases.
9. Dopamine
Specification 20mg 2ml
Mechanism of action
It has β-adrenergic receptor excitatory effect, which can enhance myocardial contraction, increase cardiac output and elevate blood pressure. It has a mild to moderate constricting effect on peripheral blood vessels. It has a dilating effect on visceral blood vessels, increases blood flow, especially increases renal blood flow and glomerular filtration rate, increases urine volume and urinary sodium excretion, and helps to improve blood supply to important organs in shock. It is suitable for cardiogenic shock, hypotension and congestive heart failure.
Usage and dosage
Shock: Start intravenous dose of 5ug/kg/min, later adjusted according to blood pressure, urine output and clinical condition, extreme dose of 20ug/kg/min
Precautions
Replenish blood volume and correct acidosis before using this drug. Blood pressure, heart rate, urine output and general condition should be observed, and CVP should be monitored if necessary, which may cause excessive vasoconstriction, local tissue necrosis, blood pressure drop, cardiac arrhythmia, nausea and vomiting.
10. Dobutamine
Specification 20mg 2ml
Mechanism of action
Dobutamine hydrochloride has a stronger positive inotropic effect than dobutamine and a weaker excitatory effect on β2-receptors and α-receptors. The therapeutic amount can increase myocardial contractility, increase cardiac blood output, rarely increase myocardial oxygen consumption, reduce peripheral vascular resistance, reduce ventricular filling pressure and promote atrioventricular node conduction. It is suitable for heart failure caused by decreased myocardial contractility in organic heart disease.
Usage and dosage
Add to 5% glucose solution or 0.9% sodium chloride injection and then dilute and administer quietly at a drip rate of 2.5~10μg/K/min.
Precautions
There are headache, nausea, palpitation, chest pain, shortness of breath and angina pectoris, and serious arrhythmia.
11. Deacetyl Trichosanthin
Common name: Cidilan Specification 0.4mg 2ml
Mechanism of action
Positive inotropic effect, increase myocardial contraction and cardiac output. Negative frequency effect, slowing down the heart rate. Cardiac electrophysiological effect, suitable for congestive heart failure, also can be used to control atrial fibrillation or atrial flutter of ventricular rate too fast.
Usage and dosage
Intravenous injection: 0.4~0.6mg for the first dose, 0.2~0.4mg every 2~4 hours thereafter, 1~1.6mg in total diluted with 5% glucose solution and injected slowly intravenously (for not less than 10 minutes)
Precautions
The most common side effects are the development of new arrhythmias and digitalis toxicity. Use with caution in the following conditions: hypokalemia, hypercalcemia, incomplete AV block, hypothyroidism, ischemic heart disease, early acute infarction, renal impairment.
12. Furosemide
Common name: Tachyphylaxis Specification 20mg 2ml
Mechanism of action
It is a potent medullary diuretic for edematous diseases, hypertension, prevention of acute renal failure, hyperkalemia and hypercalcemia, acute drug and poison poisoning, etc.
Dosage
Intravenous injection: edema 20-40mg, hypertensive crisis 40-80mg, hypercalcemia 20-80mg
Precautions
Mild nausea, diarrhea, drug rash, itching, blurred vision and other adverse reactions may occur, causing dehydration and electrolyte imbalance; use with caution in patients with advanced hepatic sclerosis; hearing loss or temporary deafness may occur when high doses are injected too rapidly. Hypokalemia and hepatic coma are prohibited.
13. Promethazine
Common name: Fenagin Specification 50mg 2ml
Mechanism of action
It can competitively block histamine Hl receptors and produce antihistamine effect. It can counteract the capillary dilation caused by histamine, reduce its permeability, and relieve wheezing caused by bronchial smooth muscle contraction, and is suitable for skin and mucous membrane allergy, motion sickness, anesthesia and pre- and post-surgical aids.
Usage and dosage
Intramuscular injection: 25mg/time for anti-allergy, 12.5~25mg/time for antiemetic; 25~50mg/time for sedation and hypnosis.
Precautions
Adverse reactions are drowsiness, dry mouth, pyloric obstruction, prostatic hypertrophy, bladder neck obstruction, closed-angle glaucoma, hyperthyroidism and hypertension patients. Acute poisoning may cause drowsiness, dizziness, dryness of mouth, nose and throat, abdominal pain, diarrhea, vomiting, etc. Severe poisoning may cause convulsions followed by central depression. In this case, Valium can be used for sedation, and central excitatory drugs should not be used.
14. Dexamethasone
Specification 5mg 1ml
Mechanism of action
Adrenocorticosteroid. It has anti-inflammatory, anti-allergic, anti-rheumatic and immunosuppressive effects. It is suitable for the treatment of severe bacterial infections and severe allergic diseases, various thrombocytopenic purpura, granulocytopenia, severe skin diseases, immune rejection of organ transplantation, tumor treatment and eye inflammation sensitive to glucocorticoids, etc.
Precautions
Prolonged use may cause psychiatric symptoms of Cushing’s syndrome of medical origin, co-infection, glucocorticoid withdrawal syndrome.
15. Scopolamine
Common name: 654-2 Specification 10mg 1ml
Mechanism of action
M-cholinergic receptor blocking drug, suitable for colic caused by spasm of gastrointestinal tract, bile duct, pancreatic duct, ureter, circulatory disorders caused by vascular spasm and embolism, such as cerebral infarction, conus arteriosus, thrombo-occlusive vasculitis and infectious toxic shock. The relief effect of organophosphorus poisoning is weaker than that of atropine.
Usage and dosage
Intravenous injection: 10~40mg/dose for infectious toxic shock; 10~15mg for thrombo-occlusive vasculitis; IV drip: 30~40mg for cerebral thrombosis, add 5% glucose injection to drip.
Precautions
Dry mouth, skin flushing, increased heart rate, blurred vision, difficulty in urination may occur. Excessive doses may cause symptoms similar to atropine-like toxicity.
16. Diazepam
Common name: Valium 10mg 2ml
Mechanism of action
Long-acting benzodiazepines, achieved by strengthening the inhibitory function of central GABAergic nerves. It is used for antiepileptic and anticonvulsant, sedation and hypnosis.
Usage and dosage
Intramuscular injection: 10-30mg for a single dose of basic anesthesia or intravenous general anesthesia; sedation, hypnosis or acute alcohol withdrawal: 10mg for the initial dose, limited to 40-50mg for 24 hours in total; anxiety neurosis: 2-10mg once, repeated 3-4 times a day as needed.
Precautions
Use with caution in the following conditions: alcoholism, severe myasthenia gravis, closed-angle glaucoma, hypoproteinemia, hyperactivity, COPD. slow sedation is recommended, otherwise it may cause cardiovascular and respiratory depression.
17. Mannitol
Specification 50g250ml/bag
Mechanism of action
Tissue dehydration agent, suitable for cerebral edema caused by various reasons, glaucoma, prevention of acute renal failure.
Usage and dosage
20% solution 250-500ml, and finish the drip within 30-60 minutes.
Precautions
Water and electrolyte disorders are most common and can cause central nervous system symptoms, thrombophlebitis, and intracranial hemorrhage are prohibited.
18. sodium bicarbonate
Common name: Baking soda Specification 12.5g250ml/bag
Mechanism of action
Suitable for metabolic acidosis, alkalinization of urine, treatment of symptoms caused by excessive stomach acid, barbiturate poisoning, etc.
Usage and dosage
Severe acidosis: give 200-300ml of this product as a sedative drip, the first dose of 1mmol/kg for cardiopulmonary resuscitation, and later adjust the dose according to the results of blood gas analysis, etc.
Precautions
Do not use in patients with ulcer disease that may produce perforation; do not combine with acidic drugs.
19. 50% Glucose
Specification 10g 20ml/pc
Precautions
When injecting hypertonic glucose injection, pay attention to the leakage of the drug outside the blood vessels to avoid phlebitis, and subcutaneous injection is recommended to avoid subcutaneous necrosis.
20. Amiodarone
Common name: Cortarone Specification 0.15g 3ml
Mechanism of action
It is a class III antiarrhythmic drug with non-competitive anti-sympathetic effect, sodium and calcium channel blocking effect, in addition, it has a direct dilating effect on coronary arteries and peripheral blood vessels, and is suitable for ventricular fibrillation/pulseless ventricular tachycardia, supraventricular and ventricular arrhythmias.
Dosage
Intravenous injection: the dose is 5mg/kg, the injection time should not be less than 3min under any circumstances, intravenous drip: 1. loading dose: the dose is 5mg/kg, add 5% glucose solution 250ml and drip within 2 hours 2. maintenance dose: 600-800mg/day, can be increased to 1200mg/day.
Precautions
May cause a drop in blood pressure, slow heartbeat, and lead to tip-twisting ventricular tachycardia, thyroid dysfunction, pulmonary fibrosis and adult respiratory distress syndrome.