A usual regimen is a loading dose of 4–6 g intravenously over 15–30 minutes followed by a maintenance infusion of 1–2 g per hour on a pump, always as a secondary line so that it can be stopped independently. Read the bag in your hand and enter what it says.
The signs appear in a fixed order, and knowing that order is what prevents an arrest. Put the response to toxicity into order below.
The antidote is calcium gluconate 1 g — 10 mL of a 10 per cent solution — intravenously over about 3 minutes. Work out why 1 g is 10 mL rather than memorising it.
Prophylaxis for a higher-risk patient is enoxaparin 40 mg subcutaneously daily. Therapeutic dosing is calculated as 1 mg/kg subcutaneously every 12 hours.
An RhD-negative person who gives birth to an RhD-positive infant and is not already alloimmunised receives Rho(D) immune globulin 300 mcg intramuscularly within 72 hours of birth. The standard 300 mcg dose neutralises about 15 mL of fetal red cells, which is 30 mL of fetal whole blood.