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Metabolic Emergency Drugs (Hypokalaemia (ECG features ((Flattened /…
Metabolic Emergency Drugs
Hyperkalaemia
ECG Features
Flattened P waves
↑ PR interval
Widened QRS
Sine-wave pattern → VF
Peaked T waves
TX
Salbutamol 5mg nebulizer
Calcium resonium 15g PO or 30g PR
Haemofiltration (usually needed if anuric)
50ml 50% glucose + 10u insulin (Actrapid)
Hypokalaemia
ECG features
Flattened / inverted T waves
Prominent U waves (after T waves)
ST depression
Long PR interval
Long QT interval
Result from delayed ventricular repolarisation
Mild K over 2.5
give oral K supplements, 80 mmol/day
severe K <2.5 and/or dangerous symptoms
IV K cautiously
10mmol/h (Max 20mmol/h)
Best to give centrally (burning sensation)
Max central conc: 60mM
Max peripheral conc: 40mM
Acute poisoning
Benzodiazepine
Flumazenil
β-B
Atropine, glucagon
Cyanide
Dicobalt edentate
CO
Hyperbaric O2
Digoxin
Digibind
Ethylene Glycol
Ethanol
Heparin
Protamine
Iron
Desferrioxamine
Lead
Sodium calcium edentate
Methanol
Ethanol
Opiates
Naloxone
Organophosphates
Atropine + pralidoxime
Paracetamol
NAC
TCA
NaHCO3 + O2
Warfarin: major bleed
PCC + Vit K IV
Aspirin
Alkalinise urine: NaHCO3 + KCl
Hypercalcaemia
Rehydrate
1L 0.9% NS / 4h
Monitor pts. hydration state
Frusemide
Bisphosphonates
E.g. Pamidronate, Zoledronate (IV)