Dose entries

Clinical Pharmacology and Toxicology

Calculate the following dose entries:

  • Dose of aspirin for acute myocardial infaction
  • Dose of diazepam in patient having epileptic seivure (i.v.)
  • Dose of furosemide IV for initial treatment of pulmonary oedema
  • Treatment dose of enoxaparin once daily in pulmonary embolism daily in a 80kg man
  • Initial dose of diamorphine for acute pain in a patient with a suspected myocardial infarction

Dose of aspirin for acute myocardial infaction

Suspected MI / Acute coronary syndrome for exams the following drugs and doses can be used:
Aspirin 300mg PO
Oxygen high flow (e.g. 15/l min rebreathe mask)
Nitrate (e.g. 2 puffs GTN)
Clopirdogel 300mg PO
Diamorphine 2.5-5mg
LMWH S/c e.g. enoxaparin 1mg/kg

Dose of diazepam in patient having epileptic seivure (i.v.)

The equivalent dose of lorazepam is 2-4mg. Diazepam can be given IV or PR at the same dose. It has a short half life. Benzodiazepine effect can be reversed by flumazenil but extreme caution should be used because of the risk of seizure following administration.

Dose of furosemide IV for initial treatment of pulmonary oedema

IV furosemide is given at a dose of 40-100mg initially. It comes in 50mg vials. Therefore prefer to prescibe either 50 or 100mg IV. Higher doses are needed for renal failure. Caution in hypostensive patients (e.g. Systolic BP <100mmhg). Furosemide effect is not simply from diuresis it has effects on the pulmonary vascular bed.

Treatment dose of enoxaparin once daily in pulmonary embolism daily in a 80kg man

DVT and PE treatment doses of LMWH= 1.5mg/kg = 120mg once daily. Enoxaparin is a LMWH anticoagulant and at this dose will have a similar therapeutic effect to a warfarinised patinet with an INR of approximately 2-3.[Unstable angina\: enoxaparin dose is different- 1mg kg BD].

Initial dose of diamorphine for acute pain in a patient with a suspected myocardial infarction

For exam purposes for a typical patient not currently taking morphine: Acute pain relief with diamorphine for severe pain is 2.5-5mg initially.