Drug Therapy Protocols v2.2

anaphylaxis or severe allergic reaction

Severe life threatening bronchospasam or silent chest pt must only be able to speak single words + or haemodynamic compromise + or ALOC

Bradycardia with poor perfusion unresponsive to atropine + or TCP

Cardiac arrest

Croup with stridor at rest

Shock unresponsive to adequate fluid resuscitation excluding haemorrhagic cause

ksar

hypovolaemic shock

hypertension

pt taking monoamine oxidase inhibitors (MAOI`s)

anxiety

hypertension

tachyarrhythmias / palpatations

pupil dilation

1mg / 1 ml amp  1:1000

1mg / 10 ml amp + mini jet  1:10 000

Neb

IM

IV

IO

• onset
• 30 secs IV , 60 secs IM

• Duration
• 5 - 10mins

• Halflife
• 2 mins

IM  500mcg repeated at 5 mins if no improvement as per ARC guide lines

5mg neb single dose only

may be given for minor face or tounge swelling thought to be allergic in origin. If stridor presemt IM adrenaline must be given.

IV / IO. 

20 - 50 mcg repeat at 1 min intervals

no maximum dose

IM  500mcg  repeated @ 5 mins if no improvement as per ARC guide lines

IV / IO  20mcg repeated @ 1 min intervals

no max dose

• IV / IO 20mcg repeate at 1 min intervals
• no max dose

• IV / IO  1mg repeat at 3-5 min intervals
• no max dose

• IV / IO 20 mcg repeat @ 1 mins intervals
• no max dose

IM  >6 yrs  300 mcg

     < 6 yrs 150 mcg

repeated at 5 mins if no improvement

Neb  5mg single does only.

may be given for minor face / tongue swelling thought to be allergic in origin. If stridor is present IM / IV adrenaline must be given

• IV / IO    2 mcg /kg
• repeated at 2 min intervals
• no max dose

IM   >6 yrs  300 mcg 

     < 6 yrs 150 mcg

  repeated at 5 mins if no improvement

IV / IO   2mcg/kg  single dose not to exceed 50mcg

• repeated @ 2min intervals
• no max dose

IO /  IV   10mcg/kg

• repeated every 3-5 mins
• no max dose

5mg neb 

single dose only

• IV / IO  2mcg/kg  
• single dose not to exceed 50 mcg

repeated @ 2 min  intervals

no max dose

sympathomimetic

1:1 000  s3 therapeutic poison

1:10 000  unscheduled

• a naturally occurring catecholamine acts on alpha and beta adrenergic receptors
• increase in heart rate b1
• increase contraction force b1
• increase irritability of ventricles b1
• bronchodilation b2
• peripheralvasoconstriction a1

• symapthetic nerve endings
• mitochondrial breakdown at synaptic level

cardiac arrest (refactory VF or pulseless VT )

nil in cardiac arrest

concomitant use of anti-arrythmic drugs that pro long QT interval

Thyroid disease

hypotension

bradycardia

nausea / vomiting

peripheral paraesthesia (pins n needles)

150 mg in a 3 ml amp

anti-arrhythmic

s4 restricted drug

• IV
• IO

300mg IV / IO slow push over 2 min (2 vials)

repeat once @ 150mg after 5 mins   (1 vial)

total max dose = 450mg

5mg/kg slow push over 2 mins

single dose only

prep : take a 20ml syringe , 150mg (3ml) with 12ml glucose 10% (total 15ml) = final solution of  10mg/ml

• prolongs duration of the action potential
• reduces conduction across all cardiac cells

suspected ACS

acute cardiogenic pulmonary oedema

KSAR to aspirin and other NSAIDs

chest pain associated with psych stimulant overdose

bleeding disorders

current GI bleed or peptic ulcers

pts <12 yrs

possible aortic aneurysm or other condition that may require surgery

pregnancy

Hx of GI bleed or peptic ulcers

concomitant anti coagulant therepy excluding clopidogrel

epigastric pain / discomfort

nausea / vomiting

gastritis

GI bleed

NSAID induced bronchospasm

300mg white tablet

300mg chewed with sip of water

pts >12 yrs only

if ? ACS or APO give even if pt is pain free

o= ? 10 mins

d= 1 week antiplatelet effect

h= 3.2 hrs

anti platelet

s2 therapeutic poison

• inhibits platelet aggregation irreversibly for the life of the platelet.
• prevents platelets from aggregating to exposed collagen fibers at site of vascular injury.

suspected meningococcal septicaemia  (with non blanching petechial + / or purple rash

< 1 month old

KSAR to cephalosporin  = <class of β-lactam antibiotics>

KSAR / anaphylaxis to penicillin based drugs (minor rash from penicillin does not contraindicate use of ceftriaxone)

nil

pain @ IM site

nausea / vomiting

1g glass vial

2g glass vial

antibiotic

s4

Pharm: 3rd generation cephalosporin antibiotic with a bactericidal action

IM

IV

4g IM  deep IM injection

prep: 2x2g vials with 2.4ml water = 4g/4ml  =(1g/1ml)

4g IV  slow push 3-5 mins

prep: 2x2g vials with 8.4ml water = 4g/10ml <= 400mg/ml>

•  IM:  100mg/kg  (>1month old)
• prep:2g with 3.6ml water = 2g/4ml, <5oomg/ml)

• IV:  100mg/kg slowly over 3-5 mins
• prep: 2g with 9.6water = 2g/10ml (200mg/ml)

significant pain

sedtion of maintanance of an established ETT

KSAR or hypersensitivity to fentanyl

GCS under 14

nasal admin : # nose, nasal obstruction

elderly

hypotension

resp tract burns

resp depression /failure

known addiction to narcotics

pts taking monoamine oxidase inhibitors (MAOIs) = <are one of the oldest classes of antidepressants and are typically used when other antidepressants have not been effective>

drowsyness

bradycardia

hypotension

nausea/vomiting

pin point pupils

resp depression

muscular rigidity  (resp muscles)

600mcg / 2ml  amp for IN

100mcg/2ml amp for IV / IM

1.5mcg/kg intranasal

repeat once at 1mcg/kg after 10 mins

• IM  25-100mcg repeat up to 50mcg every 10 min
• no max

IV/IO 25-50mcg repeat up to 50mcg every 10 min.  no max

IV / IO 25mcg

consider use with midazolam

prn

no max dose

NASAL  pt must be 1yr or over

1.5mcg/kg  repeat once @ 1mcg/kg @ 10 mins

total max dose 100mcg

narcotic analgesic

s8 controlled drug

hypoglycaemic with inability to self admin oral glucose

KSAR

nil

nil

1mg powder vial with water

1mg IM single dose only

> 25kg  1mg IM

<25kg 500mcg  IM

single dose only

hyperglycaemic

s3

as a vechicle for drug delivery during iv drug infusion

nil

hyperglycaemia

nil

500ml soft infusion pack

iv infusion max dose 1000ml

hypoglycaemia unable to self admin oral glucose

nil

extravasation may cause tissue/vascular necrosis

nil

500ml soft infusion pack

IV / IO

150ml IV / IO  repeat @ 100ml boluses every 5 mins until BSL > 4

IV / IO   2.5ml / kg  repeat @ 1ml/kg every 5 until BSL >4

hypoglycaemic pt who can swallow

KSAR

unconscious

pts with swallowing difficulty

pts < 2yrs

nil

nausea 

d+v

15g tube

adult + paedi   over 2 yrs old

15g repeat once @ 15 mins if BSL <4

max dose 30g

ACS

APO cardiogenic

autonomic dysreflexia with bp 160 or over

irukandji syndrome with bp 160 or over

KSAR

heart rate <50 or >150

bp <100

CVA

head trauma

erectil dysfunctiom drugs in last 24 hrs

inferior AMI

cerebral vascular disease

risk of hypotension / syncopy

intoxication

erectile drugs in last 4 days

dizzyness

hypotension

syncopy

tachycardia

headaches

600mcg tablet

O= < 2min

D= 20-30 mins

H= 5.5 mins

300 - 600mcg repeat every 5 mins

no max dose

vasodilator

s3

• ia a potent vasodilator that decreases preload and after load 
• causes venous pooling of blood
• vasodilation of coronary arteries helps with blood flow to the heart

modorate or severe asthma

exacerbation of COAD with evidence of rep distress

anaphylaxis or severe allergic reaction requiring adrenaline

symptomatic adrenal insuffciency with hx of addison disease,congenital adrenal hyperplasis,pan-hypopituitarisim or long term steroid administration

KSAR

hypertension

nil

100mg vial

IM

IV

O=1-2 hrs

D= 6-12 hrs

H= 6-8 hrs

200mg IM or IV 

single dose only

100mg IM / IV  single dose only

5mg/kg IV / IM

single dose only

not to exceed 100mg

cortico steriod

s4

an adrenocortical steroid that produces anti-inflammatory response

inhibits inflammatory cells gathering inflammation sites

prevents and suppresses cell mediated immune reactions

severe asthma or silent chest : pt only able to speak single word + or have haemodynamic compromise + or an ALOC

KSAR to anticholineergis

pt`s under 2yrs

glaucoma

prostatic hypertrophy

dry mouth

dilated puplis

palpitations

250mcg/1ml nebule

O=1-3mins peaks in 1-2hrs

D=4-6 hrs

H= 2 hrs

neb

500mcg neb    (2 vials)

single dose only

250 mcg neb  ( 1 vial)

single dose only

pt must be over 2 yrs

anticholinergic

s4

antimuscarinic agent that promotes broncodilation by inhibiting broncomotor tone

pain

KSAR

pts under 5 yrs

pre eclampsia

concurrent use of tetracyline antibiotics


Hx severe liver or renal disease

Hx malignant hyperthermia

ALOC

intoxicated or drug effected pt

3ml bottle

ALOC

cough

renal failure -following high dose exposure

3ml  repeat @10 mins

max dose 6ml

pt`s over 5 yrs

3ml

single dose only

nausea / vomiting

Hx nausea vomting with narcotic use or motion sickness

spinal injury

air med evac

KSAR

pt`s under 12

Hx of dystonic reactions

Gi haemorrhage

bowel obstruction or perforation

not to be given with in 6 hrs of phenothiazines eg stemitil

undiagnosed abdo pain

drowsiness

dry mouth

dystonic reaction

oculogyric crisis

10 mg in a 2ml amp

O=1-3 IV, 10- 15 IM

D= 1-2 hrs

H= 2-5 hrs

10mg  IM / IV 

single dose only

anti emetic

s4

sezures / convultions

sedation for :

matainence of established ETT

severely agitated pt -not due to pain

agitated head injury

proceducres TCP / cardioversion

ketamine -agitated emergence

KSAR to benzodiazepines

pt`s restrained in prone position

pt`s that are elderly or chronic renal failure ,CCF or shock may require lower doses

COAD -may cause sevsere resp depression

multiple sclerosis

myasthenia gravis  <neuromuscular disease>

respiratory depression  -esp with intox or narcotic

hypotension

5mg / 1ml amp

O=1-3 min IV , 5-15 IM

D=variable

H= 2.5 hrs

• IN
• IM
• IV
• IO

IN:  5mg prn @ 2min  max dose 10mg

IM:  5mg prn @ 2min max dose 20mg

IV:  2.5mg prn @ 5min  no max dose

IO 4 ICP:  1-2.5mg prn @ 5min no max dose

IV / IO  1 - 2.5mg 

consider with morph /fentanyl

repeat prn

max dose 20mg

IV / IO  up to 2.5mg prn @ 5 mins 

max 20mg

1mg prn @ 2min

max 20mg

IM up to 5mg prn @ 10 mins max 20mg

IV  up to 2.5mg prn @ 5mins max 20mg

up to 2.5mg IV  

max dose 5mg

NAS :  5mg prn @ 2mins, max dose 10mg

IM :  200mcg/kg (single dose not above       5mg) repeat @ half initial dose (max 2.5mg) @ 10 mins -- no max dose

IV / IO : 100mcg/kg  single dose not to exceed 2.5mg. repeat @ 5min intervals--- no max dose

IV / IO  50mcg/kg

single dose not exceed 2.5mg

repeat after 5mins

total max  5mg

IV / IO   up to 100mcg/kg

• single dose not above 2.5mg
• consider with morphine

• repeated after 5mins
• no max dose

consult needed

 IM / IV / IO    100mcg/kg

single dose not over 2.5mg

• repeat after 5mins
• total max 5mg

class: benzodiazepine

sched:  s4 restricted drug

pres: 5mg / 1ml amp

• a short acting CNS depressant that induces
• amnesia, anesthesia,hypnosis and sedation by enchaaning the action of GABA. Depresent effects all levels of the CNS

metabolised by the liver and excreted by the kidneys

O: 5-15 min IM and 1-3 mins  IV

D: variable

H : 2.5 hours

significant pain

autonomic dysreflexia with b/p 160 or over

sedation for maintenance of an ETT

KSAR

elderly pt`s

hypotension

resp depression / failure

resp tract burns

known addiction to narcotics

pt`s on MAOIs

bradycardia

drowsiness

hypotension

nausea / vomiting

rep depression

pin point pupils

IM : up to 10mg  repeated up to 5 mg @ 10 mins  max dose 20mg

IV :  up to 5 mg repeat up to 5mg every 5mins tritating to pt responce  no max dose

IO :  2.5  - 5mg repeat up to 5mg every 5mins titrate to pt responce no max dose

IV / IO  :  2.5mg consider with midazolam  repeat prn

no max dose

IM  over 1 yr old : 100--200mcg/kg single max dose 5mg -total max dose 200mcg/kg

IV IO over 1 yr old : 100mcg/kg  single max dose 2.5mg repeat 50mcg/kg max 2.5mg @ 10 min intervals   no max dose.

• IV  IO : over 1yr , 100mcg/kg
• single dose not above 2.5mg consider with midazolam,   no max dose

class: narcotic analgesic

sched: s8 controlled drug

Pres: 10mg / 1ml amp

• narcotic analgesic acts on the CNS by binding to opioid receptors altering the pain perception and emotional response to pain 
• causes resp depression
• decrease in gag reflex
• decrease in av node conduction
• vasodialation
• meabolised by liver,kidney and lungs.

respiratory depression secondary to narcotics use

KSAR

pt`s with pre existing cardiac disease

• combativeness
• vomiting
• sweating
• tachycardia
• hypertension
• convulsions
• pulmonary
• oedema

IV

IM

IO

IM  :  800mcg (2 amps) prn tritating to pt and airway  max dose 4mg

• IV IO : 50mcg prn tritating to pt and airway
•              no max dose

IM :  20mcg/kg single dose only not to exceed 800mcg

• IV  IO : 20mcg/kg tritating to pt`s responce
•                              no max dose

class : opioid antagonist

sched: s4 restricted drug

metab: hepatic

pres: 400mcg/1ml amp

nausea / vomiting

prophylactic use for pt`s  who previously experienced nausea/vomiting with narcotics

spinal injury

aero med evacuations

pts under 3 yrs

KSAR

hepatic liver impairment

intestinal obstruction

headache

constipation

dysrrythmias

skin flushing / sense of warmth

extrapyramidal effects  (slow movement /tremours/stiffness/ repetative movements )

4mg wafer

orally disintegrating tablet -place directly on top of tongue will dissolve in seconds water not nessesary

adult:  4mg single dose only

paedi:  over 3 yrs  2mg single dose only

class : anti emetic

sched: s4 restricted drug

metab: liver excreted by kidneys

minor pain and fever

KSAR

pt`s under 25kg       (6yr old)

hepatic or renal dysfunction

pt`s on anticoagulant medications

nausea

0.5g -- 1gram

repeated every 4 hrs

total max dose 4 gram in 24hrs

25kg or over (6yrs)

20mg/kg

single dose only

must not be given within  4 hrs of previous paracetamol

class : analgesic

pharm: p-aminophenol derivative that produces analgesic and antipyretic effects -it does not possess significant anti-inflammatory activity

metab: hepatic excreted by kidneys

sched: s4 restricted drug

bronchospasm

hyperkalaemia with widening QRS and or AV dissociation

KSAR

pt`s under 2yrs

APO

ischaemic heart disease

anxiety

tachy arrhythmia's

tremors

hypokalaemia + metabolic acidosis

bronchospasm:  5mg neb prn no max dose

hypokalaemia ; 10mg neb  repeated once only

PAEDI asthma only : >2ys 5mg neb prn no max dose

class:  beta-adrenalic agonist

met : hepatic excreted by kidneys

sched : s4 restricted drug

is a direct acting sympathomimetic mainly effects beta 2 adrenoceptors. primarly acts as a bronchodilator but also has inotropic and chronotropic actions.lowers serum potassium levels thru direct stimulation of of sodium/potassium pump drawing potassium into cells

significant injury with potential for crush injury

cardiac arrest : > 15mins duration

TCA OD : (tricyclic anti depressant) with prolonged QRS.QT interval or seizures

? hyperkalaemia: (widening QRS / or AV discossiation)

nil

sodium bicarbonate 8.4% in paedi resus may worsen respiratory acidosis

cerebral oedema

congested heart failure

100ml bottle

class: alkalising agent

metabolised to Co2 + water

sched: unscheduled

IV / IO : 100ml single dose only

nb: injury with potential for crush for para 1

all other indications para 3 only

IV / IO : 1ml/kg

single dose only

• hypotonic alkalizing solution helps combating acidosis.
• bicarbonate ion combine with hydrogen ion to form carbonic acid,which dissociates to carbon dioxide and water.
• during administration the hydrogen ion levels in plasma falls ,further hydrogen comes out of the cells. To persevere electrical neutrality potassium moves into the cells thus reducing hyperkalaemia.
• h+hco3 <-----> h2oco2 <---> co2 + h2o

hypovolaemic shock :

cardiogenic shock :inadequate tissue perfusion

burns : deep / full / >15%

flush:

dissolve / dilute drugs : IM / IV / IO

nil

pt`s with hx /acute heart failure

renal failure

uncontrolled bleed : unless associated with severe head injury

isotonic crystalloid, electrolyte replenisher for maintenance or replacement of fluid deficits

uncontrolled haemorrhage use to maintain a radial pulse

traumatic brain injury use to maintain systolic bp of 100-120/p in adult

reassess every 250--500ml

bradycardia: with poor perfusion pre adrenaline

envenomation: with increased parasympathetic activity

organophospahate toxicity: with cardiac or resp compromise

hypersalivation : with ketamine use

KSAR

atrial flutter

atrial fibrillation

AMI

glucoma

agitation

hallucinations

dilated pupils

dry mouth /skin 

reduced broncho + gastric secretions

tachycardia

600mcg/1ml amp

antichlinergic  (antimuscarinic)

• inhibits the action of the parasympathetic nervous system.
• blocks the action of vagus nerve of the heart
• increase rate of SA node
• increases conduction thru AV node
• blocks exocrine gland acitvity

IV / IO :  600mcg repeated once @ 2min

max dose 1.2mg

IM  IV  IO :   1.2mg  (2 amps)

repeat at 5 min intervals 

no max dose

IV  IO :   600mcg 

single dose only

IV  IO : 20mcg/kg single dose not above 600mcg ( 2 amps)

repeat once

total max dose 40mcg/kg

IM  IO  IV :

20mcg/kg

repeat @ 5min intervals

no max dose

IV  IO :  20mcg/kg

single dose only - not to exceed 600mcg ( 2 amps)

O: 1-2 min peaks 15-20min

D:  up to 5 hrs

H: 3-4 hrs

class: electrolyte

pres: 0.953gram / 10ml amp

sched: unscheduled

met: renal glomeruli reabsorbs most of it,remained excreted by faeces

hyperkalaemic cardiac arrest:

severe hyperkalaemia: with haemodynamic compromise + or cardiac rhythm disturbance

calcium channel blocker toxicity:

hypotension assoc with magnesium infusion: that fails to respoond to IV fluids

KSAR

digoxin OD

respiratory acidosis

cardiac arrest : nil

• all other indications :
• syncope

hypotenision

bradycardia

cardia dysrrhythmias

cardiac arrest

IV  IO:   10ml slow push over 2mins

repeat once @ 10mins

IV  IO: 

0.2ml/kg

slow push over 2mins

repeat once @ 10min

• electrolyte that plays role in muscular and neural systems.
• involved in skeletal muscle contractions,excites coupling in cardiac and smooth muscle
• intracellular 2nd messenger
• these effects combine to exert a positive inotropic effect in cardiac arrest pt`s
• has a role in cardiac membrane stabilisation in hyperkalaemia

loop diuretic inhibits sodium and chloride absorption in the ascending loop of henle. (proxmial and distal tubes)

Congestive Cardiac Failure

fluid overload

oliguria: after correction of hypotension and hypovolaemia

KSAR

pt`s under 12yrs

hypotension

can lead to hypotension

potassium loss may cause dysrrhythmias

20mg / 2ml amp

O: 3-5mins peals in 30 min

D: 2hrs

H: 100 mins

Sched:  s4

IV :  40mg (2 amps) consider repeat @ 5min

max total 80mg (4 amps)

pain : servere burns following morphine 

•        : multipal or significant #`s (requiring         extraction) post morphine up to 0.3mg/kg
•        
•        :# reduction / splinting (post morphine)

KSAR

Pt`s under 5yrs

GCS 12 or under

ACS

hypertension: sbp of 180 or over or dbp of 110 or over 

known hydrocephalus or raised intra-ocular pressure

pt`s over 65yrs

pt`s had midazolam or other CNS depressents

hypovolaemia : exaggerated effects n delayed onset

globe injury: eye

complex face injury / #s

impaired resp fuction

psychotic symptoms in pt`s

dissociation / trance like state

nystagmus

disinhibition

emergance: 10% more in adults

hypertension

tachycardia

decrease GCS

hypersalivation

nausea/vomting

laryngospasm

resp depression:rare

200mg / 2ml vial

IV  IO :  10-20mg repeated every 2-3 mins

total max dose 1mg/kg

prep:  mix 1 vial (200mg/2ml) with 18ml saline in 20ml syringe = 10mg/ml

IV IO: 1yr or above  100mcg/kg (0.1mg/kg)

repeat every 2-3 mins

total max dose 1mg/kg

• prep: mix 1 vial (200mg/2ml) with 18ml saline in 20ml syringe =10mg/ml
• expel 18ml then dilute with another 18ml saline = 1mg/ml

anesthetic

analgesic

hepatic ~ 90% excreted in urine as metabolites

• anaesthetic agent acts as NMDAreceptor antagonist.
• at low doses =significant analgesia preserves resp drive + airway reflexes
• minimal haemodynamic compromise as acts as sympathomimetic agent
• may result transient hypertension + tachycardia
• pt may have issues with perception/dis-inhibition or emergence reaction

Conscious VT : with out haemodynamic compromise

To reduce pain with ezyIO drug/fluid administration: when pt not in cardiac arrest

local anaesthesia:

KSAR

bradicardia

current heart failure

heart block or conduction defects

Torsades de Pointes

hypotension + poor pefusion in conscious VT

convulsions

hypotension

nausea

tinnitus

100mg / 5ml amp

• IV
• IO
• subcut

IV :  1-1.5mg/kg slow push over 2 mins

repeat once at half inital dose @ 10 min

total max dose 300mg

IO : 60mg   - (40mg then rapid 10ml flush,followed by another 20mg)

total max 60mg

IO:   1mg/kg single dose only

max dose 20mg

anti-arrhythmic

local analesthetic

• sodium channel blocker
• stabilises all excitable membranes and prevents the transmission of nerve impulses
• decreases cardiac muscle + conduction velocity thru AV node.

also a local anaesthetic

metabolisim: 80% by the liver remainder by kidneys

O: 1-2 mins

D: 20-30 mins

H: 1-2 hrs

Sced: s4 restricted drug

box jelly fish sting: unresponsive to viniger,ice,narcotics

Eclampisa:

Life threatening asthma: only in py`s requirng IM/IV adrenaline

Torsades de Pointes:

Irukandji sting: bp>160 pain unrekieved with narcotics

KSAR

Heart block

Renal failure

renal impairment

pain @ IV site

magnesium toxicity: = hypotension,resp depression/loss of tendon reflexes

10mmol (2.47g) in 5ml ampoule

IV  IO:   10mmol slow push over 10min

single dose only

IV  IO:   10mmol slow push over 10min

repeat once @ 10mins

total max dose 20mmol

IV  IO:  20mmol slow push over 10mins

repeat once if indicated at 10mins

IV  IO: 20mmol slow push over 10mins

single dose only

IV  IO:  0.1mmol/kg

• round up to nearest .05mmol
• slow push over 10mins

single dose only not to exceed 5mmol

IV IO:  0.1mmol/kg

• round up to nearest 0.5mmol
• slow push over 10mins

• single dose not to exceed 5mmol
• repeat once @ 10mins

total max dose 10mmol

• IV IO:    0.1mmol/kg
•  round up to nearest 0.5mmol

slow push over 10mins

single dose not to exceed 5mmol

repeat once @ 10mins

total max dose 10mmol

Class:  electrolyte

Met:  excreted mostly in urine small amounts in faeces and saliva

causes vasodilation / bronchodilation thu inhibition of smooth muscle contraction

also has anticonvulsant and anit-dysrrhythmic properties

age x 3 + 7   =kg