QuestionQA
Concept
Chapter
#### Monitoring

The BNF advises to monitor lung function (in patients with a history of obstructive airway disease).

#### Overdoses

Overdosages with beta-blockers may cause cardiac effects such as bradycardia, hypotension, syncope, conduction abnormalities, and heart failure. Bradycardia is the most common arrhythmia, but some beta-blockers may induce ventricular tachyarrhythmias secondary to prolongation of QT interval (e.g. sotalol) or QRS duration (e.g. propranolol).
Non-cardiovascular effects include central nervous system effects (including drowsiness, confusion, convulsions, hallucinations, and in severe cases coma), respiratory depression, and bronchospasm.

Management
 - Airway protection 
 - Activated charcoal within 1 hour
 - IV Fluids
 
IV glucagon is the first-line management.
 
For symptomatic bradycardia, IV atropine may be used.

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Drug Calculations
Topic
91
Paediatrics
Dose = 0.1units/kg/hr
Weight = 20kg
Total insulin needed/hour
= 0.1units/kg/hr x20kg = 2units/hr
Total insulin needed for a day
= 2units/hr x 24hrs = 48 units
= 48units require 48mL of 0.9% sodium chloride.
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QuestionQAAnswer
48
mL
A 5-year-old boy is admitted to Emergency Department with Kussmaul breathing and ketotic breath following 3 days of polyuria and polydipsia. He was diagnosed with DKA and was started on the appropriate treatment. Fluids was prescribed and fixed rate Actrapid infusion was initiated at a rate of 0.1units/kg/hr. Weight 20kg.


For intravenous infusion of Actrapid, give continuously in Sodium Chloride 0.9% @ 1units in 1mL of 0.9% sodium chloride solution.

What is the volume (mL) of 0.9% sodium chloride solution needed for a fixed rate 24 hour Actrapid infusion?