Recognise & treat

**IM adrenaline 1:1000**, anterolateral thigh — repeat at 5 min

**Salbutamol 5 mg nebulised** (oxygen-driven) + oral prednisolone

**Controlled O₂ 88–92%**, nebulised salbutamol + ipratropium, **prednisolone 30 mg**

**Dexamethasone 150 micrograms/kg PO**, single dose

**Aspirin 300 mg PO** (chewed) + a second antiplatelet

**Furosemide 40 mg IV**; sit the patient up; high-flow oxygen

**IV 0.9% sodium chloride**, then fixed-rate IV insulin; continue long-acting insulin

**Calcium gluconate 10% IV** (if ECG changes) → insulin–glucose → salbutamol

Conscious → fast-acting oral carb; unconscious → **IM glucagon or IV glucose 10%**

**Benzodiazepine first-line** — IV lorazepam (buccal midazolam in the community)

Thrombolysis (alteplase/tenecteplase) if <4.5 h; then **aspirin 300 mg**

**IV broad-spectrum antibacterial within 1 hour** + fluid resuscitation

**Amoxicillin** (low severity); **co-amoxiclav + macrolide** (moderate–high)

Community + rash → **IM benzylpenicillin or ceftriaxone** before transfer; hospital → **IV ceftriaxone + dexamethasone**

**Acetylcysteine (NAC) IV** — guided by the nomogram and timing

**Naloxone IV**, titrated to respiratory rate — repeat as needed

**IM lorazepam alone**, OR **IM haloperidol + IM promethazine**

**Apixaban or rivaroxaban** (a DOAC) first-line

**Oral rehydration salts (ORS)**; IV 0.9% NaCl bolus if shocked

**Nitrofurantoin** (avoid at term), 7 days — **AVOID trimethoprim in the 1st trimester**

**Oral aciclovir** (or valaciclovir/famciclovir) within 72 h of rash onset

**Resuscitate (ABCDE, transfuse) → endoscopy**; variceal → terlipressin + antibiotics

**IV fluid resuscitation + treat the cause**

**NBM, IV fluids, analgesia + antiemetic**; antibiotics if peritonitic; urgent surgical review

**NSAID first-line** (lowest effective dose, shortest time)

**SABA or SAMA PRN → LABA + LAMA → triple (add ICS)**

**Lifestyle + metformin** first-line; add an **SGLT2 inhibitor** if CVD / HF / CKD

**Induce** (aminosalicylate / corticosteroid) → **maintain** (azathioprine / biologic)

**Levodopa** (co-careldopa / co-beneldopa) first-line if motor symptoms affect QoL

**AChE inhibitor** (donepezil / rivastigmine / galantamine); memantine in severe

**Supportive prescribing** — antiemetics, neutropenic-sepsis cover, tumour-lysis prophylaxis