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 Formulary Chapter 22: Rarely Used or Urgent Access Drugs - Full Chapter
Notes:

Hospital only guidance

Drugs immediately available in the ED or areas where poisoned patients are initially treated

 Details...
22  Expand sub section  Drugs
Rarely Used or Urgent Access Drugs
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Formulary
Red Hospital
Drug Indication Presentation Recommended stock Availability
Acetylcysteine Paracetamol 200mg/ml, 10ml amps 20 amps ED or emergency drugs cupboard
Activated charcoal Many oral poisons 50g pack 7 packs ED or emergency drugs cupboard
Atropine Bradycardia 600mcg/ml, 1mp amp 10 amps ED or emergency drugs cupboard
Calcium Chloride calcium channel blockers 10ml amp 6 amps ED or emergency drugs cupboard
Calcium Gluconate gel Hydrofluoric acid 25 pack 1 pack ED or emergency drugs cupboard
Dicobalt Edetate Acetylcysteine 15mg/ml, 20ml amp 6 amps ED or emergency drugs cupboard
Hydroxocobolamin Acetylcysteine 5g pack (Cyanokit®) 2 packs ED or emergency drugs cupboard
Sodium Nitrite Acetylcysteine 3% (30mg/ml), 10ml amp 5 amps ED or emergency drugs cupboard
Sodium Thiosulphate Acetylcysteine 50% (500mg/ml), 10ml amp 5 amps ED or emergency drugs cupboard
Flumazenil Over sedation with benzodiazepines 100mcg/ml, 5ml amp 5 amps ED or emergency drugs cupboard
Glucagon Beta-blockers 1mg vial *STORE IN FRIDGE* 50 vials ED or emergency drugs cupboard
Intralipid 20% Severe systemic local anaesthetic toxicity 100ml or 250ml of 20% solution or 500ml of 20% solution 1.5 litres ED
Methylthioninium Chloride Methaemoglobinaemia 0.5%, 10ml amps 5 amps ED or emergency drugs cupboard
Naloxone Opioids 400mcg/ml, 1ml amps 30 amps ED or emergency drugs cupboard
Procyclidine injection Dystonic reactions 5mg/ml, 2ml amps 5 amps ED or emergency drugs cupboard
Sodium Bicarbonate 8.4% TCAs & class 1a & 1c antiarrhythmic drugs 200ml polyfusor 3 polyfusors ED or emergency drugs cupboard
Sodium Bicarbonate isotonic 1.26% or 1.4% Urinary Alkanisation 500ml polyfusor 12 polyfusors ED or emergency drugs cupboard
Vipera Tab European adder 10ml amps *STORE IN FRIDGE* 2 amps ED or emergency drugs cupboard
Calcium folinate Methotrexate 10mg/ml, 30ml amp 15 amps ED or emergency drugs cupboard
Cyproheptadine Serotonin syndrome 4mg tablet 30 tablets ED or emergency drugs cupboard
Dantrolene Neuroleptic malignant syndrome 20mg vial 48 amps ED or emergency drugs cupboard
Dantrolene Other drug-related hyperpyrexia 20mg vial 36 amps ED or emergency drugs cupboard
Desferrioxamine Iron 500mg vial 40 vials ED or emergency drugs cupboard
Digifab® Digoxin 40mg vial 10 vials ED or emergency drugs cupboard
Fomepizole Ethylene glycol 5mg/ml, 20ml amp 25 amps ED or emergency drugs cupboard
Ethanol Ethylene glycol 1g/ml, 1.5ml vial 4 vials ED or emergency drugs cupboard
Idarucizumab Dabigatran 2.5g/50ml vials 2 vials ED or emergency drugs cupboard
Cyproheptadine Gut decontamination 4 sachets 12 sachets ED or emergency drugs cupboard
Mesna Cyclophosphamide 400mg tablet, 1g/10ml amp Variable ED or emergency drugs cupboard
Octreotide Sulphonylureas 50mcg/ml, 1ml amp 5 amps ED or emergency drugs cupboard
Phentolamine Digital ischaemia related to epinephrine 10mg/ml, 1ml amp 5 amps ED or emergency drugs cupboard
Phytomenadione Vitamin K anticoagulants 10mg tablet or 10mg/ml, 1ml amp 2 tablets, 10 amps ED or emergency drugs cupboard
Protamine sulphate Heparin 10mg/ml, 5ml amp 10 amps ED or emergency drugs cupboard
Pyridoxine Isoniazid Isoniazid 100 amps ED or emergency drugs
 
Link  Antidotes and rarely used medicines
   
 ....
Key
note Notes
Section Title Section Title (top level)
Section Title Section Title (sub level)
First Choice Item First Choice item
Non Formulary Item Non Formulary section
Restricted Drug
Restricted Drug
Unlicensed Drug
Unlicensed
Track Changes
Display tracking information
click to search medicines.org.uk
Link to adult BNF
click to search medicines.org.uk
Link to children's BNF
click to search medicines.org.uk
Link to SPCs
SMC
Scottish Medicines Consortium
Cytotoxic Drug
Cytotoxic Drug
CD
Controlled Drug
High Cost Medicine
High Cost Medicine
Cancer Drugs Fund
Cancer Drugs Fund
NHSE
NHS England
Homecare
Homecare
CCG
CCG

Traffic Light Status Information

Status Description

Blue

For routine prescribing in primary and secondary care.   

Green

Initiated (if clinically urgent) or advised (if non-urgent) by specialist in secondary care, prescribing can be continued in primary care.   

Amber

Shared care  

Red Hospital

Hospital only  

Double Red

There should be no prescribing of these drugs  

Mixed

The traffic light of the drug is dependant on the indication. Please see individual drug entry for details  

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