Makindo Medical Notes

🧪 MOA: Replenishes glutathione stores; acts as a glutathione substitute; enhances sulphate conjugation of paracetamol.

💉 Dose IV: Loading 150 mg/kg in 200 mL 5% glucose over 1 hr → then 50 mg/kg in 500 mL 5% glucose over 4 hrs → then 100 mg/kg in 1 L 5% glucose over 16 hrs (total 21 hrs). Consider ongoing LFTs & paracetamol levels.

💊 Dose PO: 140 mg/kg once, then 70 mg/kg every 4h ×17 doses (total 72 hrs).

🎯 Indication: Paracetamol overdose.

⚠️ Caution: Rare hypersensitivity reactions (slow infusion or switch to oral). Check BNF for pregnancy advice.

🧪 MOA: Anticholinergic; reduces parasympathetic influence on heart and secretions.

💉 Dose IV: OP/carbamate poisoning: 1–6 mg every 3–5 min until secretions stop (doses can be doubled). Adult bradycardia: 0.5 mg every 3–5 min (max 3 mg). Paediatric bradycardia: 0.02 mg/kg once (max single 0.5 mg; max total 1 mg).

💊 Dose PO: N/A

🎯 Indication: OP poisoning; symptomatic bradycardia.

⚠️ Caution: Use care in hyperthermia and tachyarrhythmias. Check BNF for pregnancy advice.

🧪 MOA: Alcohol dehydrogenase inhibitor; prevents formation of toxic metabolites.

💉 Dose IV: 15 mg/kg loading → 10 mg/kg every 12 h ×4 doses → then 15 mg/kg every 12 h until ethylene glycol/methanol < 20 mg/dL and patient stable with normal pH.

💊 Dose PO: N/A

🎯 Indication: Methanol or ethylene glycol poisoning.

⚠️ Caution: Generally well tolerated; check BNF for pregnancy advice.

🧪 MOA: Increases cAMP → glycogenolysis & gluconeogenesis independent of β‑receptors.

💉 Dose IV/IM/SC: β‑blocker/CCB overdose: 3–10 mg bolus → 1–10 mg/h infusion if responsive. Hypoglycaemia: 1 mg.

💊 Dose PO: N/A

🎯 Indication: β‑blocker/CCB overdose; severe hypoglycaemia.

⚠️ Caution: Anaphylactoid reactions, hypotension, vomiting (aspiration risk). Check BNF for pregnancy advice.

🧪 MOA: Facilitates glucose uptake; shifts K⁺ intracellularly; may improve contractility in CCB overdose.

💉 Dose IV: Hyperkalaemia: 5–10 units once (co‑administer glucose if needed). CCB overdose: 1 unit/kg bolus + 25 g glucose if BG < 13.9 mmol/L (250 mg/dL), then 0.1–1 unit/kg/h infusion with glucose to maintain BG 5.5–11 mmol/L. DKA/HHS: 0.1 unit/kg bolus then 0.1 unit/kg/h infusion per protocol.

💊 Dose PO: N/A

🎯 Indication: Hyperkalaemia; CCB overdose; DKA/HHS.

⚠️ Caution: Hypokalaemia, hypoglycaemia. Only IV soluble (regular) insulin. Check BNF for pregnancy advice.

🧪 MOA: Positively charged peptide that ionically binds heparin, neutralising anticoagulant effect.

💉 Dose IV: ~1 mg neutralises 100 units heparin (max 50 mg); give ≤ 5 mg/min.

💊 Dose PO: N/A

🎯 Indication: Reversal of heparin anticoagulation.

⚠️ Caution: Anaphylaxis risk (fish allergy/previous exposure); hypotension if rapid infusion. Check BNF for pregnancy advice.

🧪 MOA: Raises serum bicarbonate and buffers acids (1 mEq ≈ 1 mmol).

💉 Dose IV: Hyperkalaemia/metabolic acidosis: 50 mEq (1 amp) once. TCA toxicity: 1–2 mEq/kg bolus to target pH 7.45–7.55 & narrow QRS. Salicylate toxicity: 3 amps (150 mEq) in 1 L 5% glucose; bolus 10–20 mL/kg then 2–3 mL/kg/h to keep urine pH 7.5–8.0.

💊 Dose PO: N/A

🎯 Indication: Hyperkalaemia; TCA toxicity; salicylate toxicity; metabolic acidosis.

⚠️ Caution: Fluid/sodium load (care in heart failure); metabolic alkalosis; hypernatraemia. Check BNF for pregnancy advice.