Pick 5 meds...

1: Food/Water, fentanyl
2: Albuterol/inatroprium
3: Benadryl
4: Cipro (lots of it)
5: Tylenol

That's minor pain, nausea, pain relief, antibiotics and potentially life-threatening asthma knocked out.
 
Rocketmedic40 said:
1: Food/Water, fentanyl
2: Albuterol/inatroprium
3: Benadryl
4: Cipro (lots of it)
5: Tylenol

That's minor pain, nausea, pain relief, antibiotics and potentially life-threatening asthma knocked out.
Click to expand...

Most importantly, I can use the benadryl to sleep, the fentanyl to party, the duo-neb as a sweet foglight, the cipro to cure myself of pesky local social diseases and the tylenol for hangovers.
 
Rocketmedic40 said:
Most importantly, I can use the benadryl to sleep, the fentanyl to party, the duo-neb as a sweet foglight, the cipro to cure myself of pesky local social diseases and the tylenol for hangovers.
Click to expand...

Just so you know, the cirpo doesn't work so well for that.
 
I am answering assuming the meds are for emergencies in an urban western environment. Some are not first line drugs for the uses but if i can only pick 5... ;-)

1. Oxygen: For Hypoxia or pt. could clinically benefit from it use.
2. Diphenhydramine: for anticholinergic, antitussive, antiemetic needs.(Note was also consider Phenergan for this choice)
3. ASA: for AMI's mainly but also pain, fever, and inflammation
4. Eppie: for cardiac arrest, but more so for... anaphylaxis, bronchospasm, asthma, bradycardia, and hypotension.
5.Morphine, because I am a nice guy.( note I was going to choose an antibiotic but I am assuming once immediate life threats are stable enough outside of the ED or EMS, ICU or primary care will have picked an antibiotic as one of their top 5 choices ;-)
 
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I think I will change my answer to fentanyl instead of morphine.

- Faster onset
- More potent action
- More cardiovascular stability
- Less histamine release
- Can be given intranasal (but so can morphine, in theory?)

Ideally for pain relief I'd like to have ketamine because it provides profound analgesia with extremely low haemostatic risk and is good for maintaining airway and can be used for sedation as well as analgesia however I think it would be overkill for a lot of simple things fentanyl could be used for, e.g. a broken finger or something small like that, gallstones or whatever.

Oh I can't wait until I am allowed ketamine! :D

Patients, I mean patience ....
 
schulz said:
I am answering assuming the meds are for emergencies in an urban western environment. Some are not first line drugs for the uses but if i can only pick 5... ;-)
Click to expand...

It was not limited to that.

The question that was posed to me was: "If you had to select 5 meds and could be called to work anywhere at any given time what would they be?"

It was a physician who asked and I was expected to answer in the span of the conversation without research.

My answers are based around being able to care for the most people. Emergently or not.
 
Without doing much research on common medical problems in "austere" environments, I'm going to aim for infection, dehydration, and injury being the biggest problems faced. So...

An NSAID for pain relief and anti-inflammatory properties - Ibuprofin
A broad spectrum antibiotic that can cover SSTI and infectious diarrhea - Ciprofloxacin
An anti-protozoan for giardia or amebiasis - Metronidazole
A fluid for dehydration - LR
An antihistamine for allergic reactions - diphenhydramine
 
Ok sorry in that case I choose.

1. Amoxicllin for broad spectrum antibiotic
2. Aspirin for pain, fever, inflammation and AMI
3. diphenhydramine for for anticholinergic, antitussive, antiemetic needs
4. Eppie anaphylaxis, bronchospasm, asthma, bradycardia, and hypotension
5. LR for fluids when needed
 
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ASA
ciprofloxacin or azithromycin ( I guess azithromycin have less serious secondary effects)
epinephrine 1:10000 IV
fentanyl
promethazine

And if its possible, normal saline/IV fluids and oxygen.
 
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I am surprised at how many answers do not specify the route of administration since that greatly changes the form and efficacy of the meds. Remember the "rights".
(drug, route, dose, frequency, urgency).
 
mycrofft said:
I am surprised at how many answers do not specify the route of administration since that greatly changes the form and efficacy of the meds. Remember the "rights".
(drug, route, dose, frequency, urgency).
Click to expand...
Patient, reason, etc

I think that the question was so limiting and vene did not state only one formulation, people took advantage of that loophole to gain some more flexibility. It would be nice to have abx, benedryl, etc in both PO and parenteral formulations.
 
1. Normal Saline
2. Ertapenem
3. Epi 1:1000 30ml multi-dose vial
4. Fentanyl
5. Phenergan
 
1. Epi 1:1000 - can use to tx anaphylaxis or asthma exacerbation refractory to salbutamol.
2. Either naproxen or ibuprofen. Not sure which one i'd take. For minor injuries.
3. Gravol (dimenhydrinate) injection - it is an antihistamine (salt of diphenhydramine). In theory you might be able to use it for allergies as well as n/v if there was no other option.
4. Ketamine - can be used for analgesia, sedation or general anesthesia depending on dose. Pts keep their airway reflexes intact.
5. A broad spectrum ABx for injection (iv), likely a fluroquinilone such as levofloxacin or moxifloxicin.

I would also add a few litres of saline and iv start gear. In canada, crystalloid iv solutions are otc and not legally considered drugs.
 
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