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
13
Neurosurgery
Dose = 20mg/kg 8-hrly
Weight = 85kg
Total dose= 20mg/kg 8-hrly x 85kg
= 1.7g 8-hrly
Drug concentration = 5mg/mL
Minimum volume required
= 1700mg/(5mg/mL) = 340mL
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QuestionQAAnswer
340
mL
A 75-year-old man who was admitted for a severe chest infection developed cellulitis on his third day of admission. He is to be treated with vancomycin 20mg/kg IV 8-hrly. Weight 85kg.

Prior to administration, vancomycin needs to be diluted with sodium chloride 0.9% to a concentration not exceeding 5mg/mL.

What is the minimum volume (mL) to which each dose of vancomycin should be diluted?