Makindo Medical Notes Comprehensive Medical Encyclopedia | Education for Healthcare Professionals

DRUG (UK Name)	MOA	DOSE IV	DOSE PO	INDICATION	CONTRAINDICATION / CAUTION
Adenosine	Acts on A1 receptors in the AV node to transiently block conduction	6 mg IV rapid push; if no effect, 12 mg IV after 1–2 min; may repeat 12 mg once	N/A	Stable SVT, stable narrow complex tachycardia	Avoid in 2nd/3rd degree AV block without pacing; can cause transient bradycardia/asystole; check BNF for pregnancy
Amiodarone	Class III antiarrhythmic (K+ channel block), also Class I, II, IV effects	VF/VT arrest: 300 mg IV push, then 150 mg if needed Stable wide complex tachy: 150 mg IV over 10 min, then infusion (1 mg/min x6h, then 0.5 mg/min)	N/A	VF/VT, wide complex tachyarrhythmias	Hypotension, potential proarrhythmia; long half-life; check BNF for pregnancy advice
Atropine	Anticholinergic, reduces vagal influence on SA/AV node	Organophosphate poisoning: 1–6 mg IV every 3–5 min until secretions stop Paediatric bradycardia: 0.02 mg/kg IV once (max single 0.5 mg, max total 1 mg) Adult bradycardia: 0.5 mg IV every 3–5 min (max 3 mg)	N/A	Bradycardia, organophosphate/carbamate poisoning	Hyperthermia, tachyarrhythmias; consult BNF for pregnancy
Calcium Gluconate/Chloride	Increases serum Ca²⁺, stabilises cardiac membrane	Typically 10% solution: 1 g (in 10 mL) IV	N/A	Hyperkalaemia, hypocalcaemia with arrhythmias	CaCl is more irritant and 3x more potent than Ca gluconate; central line preferred for CaCl; check BNF for pregnancy
Diltiazem	Non-dihydropyridine Ca²⁺ channel blocker; slows AV conduction	0.25 mg/kg IV bolus, may repeat 0.35 mg/kg IV after 15 min; infusion 5–15 mg/h	N/A	Stable AF with RVR, stable SVT	May cause hypotension, bradycardia; use caution in heart failure; check BNF for pregnancy
Dobutamine	Beta-1 agonist (with some Beta-2)	2–20 micrograms/kg/min IV infusion	N/A	Acute heart failure, cardiogenic shock	Tachycardia, arrhythmias; ensure adequate volume status; check BNF for pregnancy
Dopamine	Alpha, Beta-1, and dopaminergic receptor agonist (dose-dependent)	<5 micrograms/kg/min (renal/dopaminergic - not typically recommended) 5–10 micrograms/kg/min (beta effects) 10–20 micrograms/kg/min (alpha effects)	N/A	Hypotension, heart failure	Arrhythmias, tissue necrosis with extravasation (use central line); check BNF for pregnancy
Adrenaline (Epinephrine)	Alpha and Beta agonist	Cardiac arrest: 1 mg of 1:10,000 IV every 3–5 min Anaphylaxis: 0.5 mg of 1:1,000 IM (adults) Hypotension/shock: 1–10 micrograms/min IV infusion (titrate)	N/A	Cardiac arrest, anaphylaxis, severe hypotension, severe asthma	Risk of arrhythmias, extravasation injury; verify doses carefully; consult BNF for pregnancy
Esmolol	Short-acting selective Beta-1 blocker	500 micrograms/kg IV loading, then 50–300 micrograms/kg/min infusion	N/A	Aortic dissection (rate control), arrhythmias	Can precipitate heart failure, hypotension, bronchospasm; check BNF for pregnancy
Furosemide (Frusemide)	Loop diuretic inhibiting Na⁺/K⁺/2Cl⁻ in ascending loop	20–40 mg IV initially, reassess; can go up to 200 mg single dose if needed	N/A	Acute pulmonary oedema, fluid overload states	Hypovolaemia, electrolyte depletion, ototoxicity; check BNF for pregnancy
Labetalol	Combined alpha and beta blocker	Bolus: 20–80 mg IV every 10 min PRN; Infusion: 1–8 mg/min titrated	N/A	Hypertensive emergencies	Can precipitate heart failure, bradycardia, bronchospasm; check BNF for pregnancy
Magnesium Sulfate	Essential electrolyte, membrane stabiliser, reduces neuromuscular excitability	Eclampsia: 2–4 g IV load over ~5 min Torsades: 2 g IV push Asthma: 2 g IV over 15 min	N/A	Eclampsia, torsades de pointes, severe asthma	Hypotension if given rapidly, respiratory depression if overdosed; safe in pregnancy (commonly used for eclampsia)
Glyceryl Trinitrate (GTN, Nitroglycerin)	Venodilator, increases cGMP	5–200 micrograms/min IV, increase by 10 micrograms every 3–5 min until desired effect	N/A	Angina, CHF, acute pulmonary oedema	Hypotension, headache, rare methemoglobinaemia; check BNF for pregnancy
Sodium Nitroprusside	Direct vasodilator via NO release	Start at 0.3 micrograms/kg/min IV, titrate; max 10 micrograms/kg/min. If no control after 10 min at max, stop.	N/A	Hypertensive emergencies	Cyanide toxicity (prolonged infusion), methemoglobinaemia, hypotension; check BNF for pregnancy
Norepinephrine (Noradrenaline)	Potent alpha-1 > beta-1 agonist	1–30 micrograms/min IV infusion (titrate to BP)	N/A	Refractory hypotension (septic shock, other shock states)	Arrhythmias, extravasation injury (use central line); check BNF for pregnancy

Emergency Drugs - Cardiac

Check all doses with BNF or equivalent UK guidelines

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