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Tell me use of all the medicines mentioned in the given picture

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Crash Cart Trolley Medicines - SMHRC/DBASI

This is an emergency crash cart stocked for resuscitation and life-threatening situations. Here is a breakdown of every medicine listed:

EMERGENCY CARDIAC / RESUSCITATION DRUGS

9. Inj. Atropine 1 ml

Class: Anticholinergic (muscarinic antagonist)
Uses: Treats symptomatic bradycardia (slow heart rate), heart block, and organophosphate/nerve agent poisoning. Also used to reduce secretions before surgery and as a pre-anesthetic agent.
Mechanism: Blocks vagal tone on the heart, increasing heart rate.

11. Inj. Adrenaline (Epinephrine)

Class: Sympathomimetic / Catecholamine
Uses: First-line drug in cardiac arrest (asystole, pulseless VT/VF), anaphylaxis (severe allergic reaction), severe asthma, and croup. Also used with local anesthetics to prolong their effect.
Mechanism: Stimulates alpha and beta-adrenergic receptors - increases heart rate, cardiac output, and causes vasoconstriction.

10. Inj. Hydrocortisone 100 mg

Class: Corticosteroid
Uses: Anaphylaxis (second-line after adrenaline), adrenal crisis, severe asthma, allergic reactions, and anti-inflammatory emergencies. Reduces the delayed phase of allergic reactions.
Mechanism: Suppresses inflammation and immune response; restores vascular tone.

17. Inj. Amiodarone 3 ml

Class: Class III antiarrhythmic
Uses: Life-threatening ventricular arrhythmias (VF, pulseless VT) - given during cardiac arrest after defibrillation attempts. Also used for atrial fibrillation and supraventricular tachycardia.
Mechanism: Prolongs cardiac action potential and refractory period; blocks sodium, potassium, and calcium channels.

16. Inj. Lignocaine HCl 2% 30 ml (Lidocaine)

Class: Class IB antiarrhythmic / Local anesthetic
Uses: Treatment of ventricular arrhythmias (VT, VF), especially post-myocardial infarction. Also used as a local and regional anesthetic for procedures.
Mechanism: Blocks sodium channels in cardiac and nerve tissue, stabilizing the membrane.

18. Inj. Magnesium Sulphate 2 ml

Class: Electrolyte / Anticonvulsant
Uses: Eclampsia and pre-eclampsia (seizure prevention in pregnancy), Torsades de Pointes (a type of VT), hypomagnesemia, severe asthma, and digitalis toxicity. Also in acute MI.
Mechanism: Acts as a physiological calcium antagonist; reduces neuromuscular excitability.

19. Inj. Calcium Gluconate 10 ml

Class: Calcium salt / Electrolyte
Uses: Hypocalcemia, hyperkalemia (cardiac membrane stabilization), calcium channel blocker overdose, magnesium toxicity, and fluoride poisoning. Treats tetany and cardiac resuscitation in specific scenarios.
Mechanism: Restores normal cardiac membrane potential; antagonizes the effects of elevated potassium.

20. Inj. Sodium Bicarbonate 25 ml

Class: Alkalinizing agent / Buffer
Uses: Metabolic acidosis (e.g., in cardiac arrest, diabetic ketoacidosis, renal failure), tricyclic antidepressant overdose, severe hyperkalemia, and salicylate toxicity.
Mechanism: Neutralizes excess acid (H⁺) in the blood; shifts pH toward normal.

32. Inj. Dopamine 5 ml

Class: Catecholamine / Vasopressor-Inotrope
Uses: Cardiogenic shock, severe hypotension, acute heart failure. Low doses increase renal blood flow; higher doses increase heart rate and cardiac output; very high doses cause vasoconstriction.
Mechanism: Stimulates dopamine, beta-1, and alpha-1 adrenergic receptors in a dose-dependent manner.

33. Inj. Dobutamine 5 ml

Class: Synthetic catecholamine / Inotrope
Uses: Acute heart failure, cardiogenic shock, low cardiac output states. Preferred over dopamine when elevated pulmonary vascular resistance is present.
Mechanism: Predominantly stimulates beta-1 receptors - increases myocardial contractility and cardiac output with less effect on heart rate than dopamine.

41. Inj. Digoxine (Digoxin) 2 ml

Class: Cardiac glycoside
Uses: Atrial fibrillation/flutter (rate control), chronic heart failure (especially with AF). Also used in some supraventricular tachycardias.
Mechanism: Inhibits Na⁺/K⁺-ATPase pump, increasing intracellular calcium and thus myocardial contractility; slows conduction through the AV node.

ANTIEPILEPTIC / NEUROLOGICAL DRUGS

12. Inj. Phenytoin 2 ml

Class: Antiepileptic (hydantoin)
Uses: Status epilepticus (second-line after benzodiazepines), generalized tonic-clonic seizures, and prevention of seizures post-head injury.
Mechanism: Blocks voltage-gated sodium channels in the brain, stabilizing hyperexcitable neuronal membranes.

13. Inj. Diazepam 2 ml

Class: Benzodiazepine
Uses: Status epilepticus (first-line), acute anxiety, alcohol withdrawal seizures, muscle spasm, and sedation for procedures.
Mechanism: Enhances GABA-A receptor activity, increasing chloride ion influx and causing CNS depression/sedation.

BRONCHODILATORS

14. Inj. Aminophylline 10 ml

Class: Methylxanthine bronchodilator
Uses: Acute severe asthma and COPD exacerbations (when beta-2 agonists fail), neonatal apnea. IV aminophylline is the water-soluble form of theophylline used in emergencies.
Mechanism: Inhibits phosphodiesterase, increasing cAMP; relaxes bronchial smooth muscle and stimulates the respiratory center.

15. Inj. Theophylline & Etophylline 2 ml

Class: Methylxanthine combination bronchodilator
Uses: Bronchial asthma, COPD, bronchospasm. Etophylline is combined with theophylline to improve tolerability and reduce side effects.
Mechanism: Same as aminophylline - phosphodiesterase inhibition causing bronchodilation.

IV FLUIDS

21. Inj. DNS 500 ml (Dextrose Normal Saline)

Uses: Provides fluid, electrolytes (sodium, chloride), and calories (dextrose 5% + NaCl 0.9%). Used for rehydration, maintenance fluids, and as a vehicle for drug infusions.

22. Inj. NS 500 ml (Normal Saline - 0.9% NaCl)

Uses: Volume expansion, resuscitation in shock, hyponatremia correction, drug dilution. The most commonly used isotonic crystalloid.

23. Inj. Ringer Lactate 500 ml

Uses: Fluid resuscitation in trauma, surgery, burns, and sepsis. More physiologically balanced than NS - contains sodium, potassium, calcium, and lactate.

24. Inj. Dextrose 5% 500 ml

Uses: Hypoglycemia treatment, provides caloric support, vehicle for drug infusions, and rehydration (hypotonic after dextrose metabolism).

38. Inj. Dextrose 25% 100 ml

Uses: Acute hypoglycemia (low blood sugar emergencies), especially in diabetic patients. Higher concentration than D5% for rapid glucose correction.

ANALGESICS / PAIN RELIEF

25. Inj. Tramadol 2 ml

Class: Opioid analgesic (weak mu-agonist)
Uses: Moderate to severe pain management (post-operative, trauma, cancer pain). A centrally acting analgesic.
Mechanism: Binds opioid receptors AND inhibits serotonin/norepinephrine reuptake.

ANTI-ALLERGIC / ANTIHISTAMINE

26. Inj. Pheniramine (Avil) 2 ml

Class: H1 antihistamine (first-generation)
Uses: Allergic reactions, urticaria, anaphylaxis (adjunct), drug reactions, blood transfusion reactions, and motion sickness.
Mechanism: Blocks H1 histamine receptors, reducing allergic symptoms like itching, rash, and bronchoconstriction.

35. Inj. Phenergan (Promethazine)

Class: Phenothiazine antihistamine
Uses: Nausea and vomiting, allergic reactions, pre-operative sedation, motion sickness, and as an adjunct in anaphylaxis.
Mechanism: Blocks H1, dopamine (D2), and muscarinic receptors.

DIURETICS

27. Inj. Furosemide (Lasix) 2 ml

Class: Loop diuretic
Uses: Acute pulmonary edema (emergency), heart failure, hypertensive crisis, hypercalcemia, and fluid overload/edema states.
Mechanism: Inhibits Na⁺-K⁺-2Cl⁻ cotransporter in the ascending loop of Henle, causing marked sodium and water excretion.

37. Inj. Mannitol 20% 100 ml

Class: Osmotic diuretic
Uses: Raised intracranial pressure (head injury, stroke, brain tumor), acute glaucoma, prevention of acute renal failure, cerebral edema.
Mechanism: Creates osmotic gradient drawing water from brain and other tissues into the blood; excreted by kidneys pulling water with it.

STEROIDS (ANTI-INFLAMMATORY)

28. Inj. Dexamethasone 2 ml

Class: Potent corticosteroid (glucocorticoid)
Uses: Cerebral edema, severe allergic reactions, asthma exacerbations, croup, anaphylaxis (adjunct), meningitis, COVID-19 (severe), and anti-nausea (post-op).
Mechanism: Potent anti-inflammatory and immunosuppressive effects; reduces vascular permeability and edema.

ANTI-ULCER / GI DRUGS

29. Inj. Rantidine 2 ml (Ranitidine)

Class: H2 receptor antagonist
Uses: Peptic ulcer disease, GERD, stress ulcer prophylaxis, and as pre-medication before anesthesia to reduce gastric acid secretion.
Mechanism: Blocks H2 receptors on gastric parietal cells, reducing acid secretion.

30. Inj. Ondansetron (Emset) 2 ml

Class: 5-HT3 serotonin antagonist / Antiemetic
Uses: Nausea and vomiting - post-operative, chemotherapy-induced, and radiation-induced. One of the most effective antiemetics available.
Mechanism: Blocks 5-HT3 receptors in the gut and vomiting center (chemoreceptor trigger zone).

31. Inj. Metoclopramide

Class: Dopamine antagonist / Prokinetic antiemetic
Uses: Nausea and vomiting, gastroparesis (delayed gastric emptying), GERD, and gastric stasis. Also used in migraines.
Mechanism: Blocks D2 receptors in the chemoreceptor trigger zone; also has prokinetic effects by enhancing gastric motility.

ELECTROLYTES

34. Inj. Potassium Chloride 10 ml

Uses: Treatment of hypokalemia (low potassium), always given diluted in IV fluid. Used in arrhythmias due to low K⁺, and to maintain electrolyte balance.
Warning: Must never be given undiluted or as IV push - can cause fatal cardiac arrest.

HEMOSTATICS / ANTI-BLEEDING

39. Inj. Pause / Tranexamic Acid 5 ml

Class: Antifibrinolytic
Uses: Major bleeding - post-partum hemorrhage, trauma hemorrhage, surgical bleeding, heavy menstrual bleeding, and bleeding from fibrinolysis.
Mechanism: Inhibits plasminogen activation, preventing clot breakdown (fibrinolysis) and thus reducing bleeding.

36. Inj. Vitamin K 1 ml

Uses: Bleeding due to Vitamin K deficiency, reversal of warfarin (anticoagulant) overdose, prophylaxis in newborns (hemorrhagic disease of newborn), and liver disease coagulopathy.
Mechanism: Essential co-factor for synthesis of clotting factors II, VII, IX, and X in the liver.

LOCAL ANESTHETIC WITH VASOCONSTRICTOR

40. Inj. Lidocaine & Adrenaline 2% 5 ml

Uses: Local/regional anesthesia for minor surgical procedures, dental procedures, wound suturing. Adrenaline prolongs the anesthetic effect and reduces bleeding by causing local vasoconstriction.

CARDIAC / ANTI-ANGINAL TABLETS

42. Cap. Depin 5 mg (Nifedipine)

Class: Calcium channel blocker (dihydropyridine)
Uses: Hypertensive emergencies (bitten/chewed for rapid effect), angina pectoris, Raynaud's phenomenon, and preterm labor. The capsule is bitten for sublingual-like rapid onset.
Mechanism: Blocks L-type calcium channels in vascular smooth muscle, causing vasodilation and blood pressure reduction.

43. Tab. Sorbitrate 5 mg (Isosorbide Dinitrate)

Class: Nitrate / Vasodilator
Uses: Angina pectoris (chest pain), acute coronary syndrome, heart failure. Sublingual for rapid relief of angina attacks.
Mechanism: Converted to nitric oxide (NO), which causes venous and arterial dilation, reducing preload and myocardial oxygen demand.

44. Tab. Aspirin 75 mg

Class: NSAID / Antiplatelet
Uses: Acute MI (given immediately to prevent further clot formation), unstable angina, stroke prevention, TIA, and chronic antiplatelet therapy in cardiovascular disease.
Mechanism: Irreversibly inhibits COX-1 and COX-2 enzymes; prevents thromboxane A2 synthesis, reducing platelet aggregation.

Summary Table

#	Medicine	Primary Emergency Use
9	Atropine	Bradycardia, cardiac arrest
10	Hydrocortisone	Anaphylaxis, adrenal crisis
11	Adrenaline	Cardiac arrest, anaphylaxis
12	Phenytoin	Status epilepticus
13	Diazepam	Status epilepticus (first-line)
14	Aminophylline	Severe asthma
15	Theophylline+Etophylline	Asthma, COPD
16	Lignocaine	Ventricular arrhythmias, local anesthesia
17	Amiodarone	VF/VT cardiac arrest
18	Magnesium Sulphate	Eclampsia, Torsades de Pointes
19	Calcium Gluconate	Hypocalcemia, hyperkalemia
20	Sodium Bicarbonate	Metabolic acidosis
25	Tramadol	Pain relief
26	Pheniramine (Avil)	Allergic reactions
27	Furosemide (Lasix)	Acute pulmonary edema
28	Dexamethasone	Cerebral edema, allergic reactions
29	Ranitidine	Acid suppression/ulcer prophylaxis
30	Ondansetron (Emset)	Nausea and vomiting
31	Metoclopramide	Nausea, gastroparesis
32	Dopamine	Cardiogenic shock, hypotension
33	Dobutamine	Acute heart failure, cardiogenic shock
34	Potassium Chloride	Hypokalemia
35	Phenergan	Nausea, allergic reactions
36	Vitamin K	Bleeding, warfarin reversal
37	Mannitol 20%	Raised intracranial pressure
38	Dextrose 25%	Acute hypoglycemia
39	Tranexamic Acid	Major hemorrhage
40	Lidocaine + Adrenaline	Local anesthesia
41	Digoxin	Atrial fibrillation, heart failure
42	Cap. Depin (Nifedipine)	Hypertensive emergency
43	Tab. Sorbitrate	Angina
44	Tab. Aspirin 75 mg	Acute MI, antiplatelet

This crash cart is well-stocked to handle cardiac arrest, arrhythmias, anaphylaxis, seizures, respiratory emergencies, shock, bleeding, and raised intracranial pressure - covering the full spectrum of life-threatening hospital emergencies.

Make a summary table of med, their emergency use and absolute contraindications

Here is the complete summary table of all crash cart medicines with their emergency uses and absolute contraindications:

Crash Cart Medicines - Emergency Use & Absolute Contraindications

#	Medicine	Emergency Use	Absolute Contraindications
1	Atropine	Symptomatic bradycardia, cardiac arrest (asystole), organophosphate poisoning	Glaucoma (narrow-angle), obstructive uropathy, myasthenia gravis, tachycardia
2	Adrenaline (Epinephrine)	Cardiac arrest (VF/VT/asystole/PEA), anaphylaxis, severe asthma	No absolute contraindication in cardiac arrest; in anaphylaxis - none absolute; avoid in cocaine-induced arrhythmias
3	Hydrocortisone 100 mg	Anaphylaxis (adjunct), adrenal crisis, severe asthma	Active untreated systemic fungal infection; live virus vaccines (concurrent)
4	Phenytoin 2 ml	Status epilepticus (2nd line), seizure prophylaxis post head injury	Sinus bradycardia, sinoatrial block, 2nd/3rd degree AV block, Adams-Stokes syndrome, hypersensitivity to hydantoins
5	Diazepam 2 ml	Status epilepticus (1st line), alcohol withdrawal seizures	Acute narrow-angle glaucoma, severe respiratory depression, myasthenia gravis, sleep apnea
6	Aminophylline 10 ml	Acute severe asthma, COPD exacerbation	Active peptic ulcer, uncontrolled seizure disorder, hypersensitivity to ethylenediamine; caution in arrhythmias
7	Theophylline + Etophylline 2 ml	Bronchospasm, asthma, COPD	Active peptic ulcer, hypersensitivity to xanthines, uncontrolled cardiac arrhythmias
8	Lignocaine HCl 2% (Lidocaine)	Ventricular tachycardia/fibrillation, local/regional anesthesia	Stokes-Adams syndrome, Wolff-Parkinson-White syndrome, severe sinoatrial/AV/intraventricular block (without pacemaker), known hypersensitivity to amide local anesthetics
9	Amiodarone 3 ml	Pulseless VT/VF during cardiac arrest, hemodynamically unstable VT	Severe sinus bradycardia, sinoatrial block, 2nd/3rd degree AV block (without pacemaker), cardiogenic shock, iodine hypersensitivity, thyroid disorders (relative)
10	Magnesium Sulphate 2 ml	Eclampsia/pre-eclampsia seizures, Torsades de Pointes, severe asthma	Heart block, myocardial damage, severe renal failure (GFR <20 ml/min), hypersensitivity
11	Calcium Gluconate 10 ml	Hypocalcemia, hyperkalemia (cardiac stabilization), Ca²⁺-channel blocker overdose, magnesium toxicity	Hypercalcemia, digoxin toxicity (risk of fatal arrhythmia), sarcoidosis
12	Sodium Bicarbonate 25 ml	Metabolic acidosis, cardiac arrest with confirmed acidosis, TCA overdose, hyperkalemia	Metabolic/respiratory alkalosis, hypocalcemia (if given with calcium), hypochloremic alkalosis
13	DNS 500 ml (Dextrose Normal Saline)	Rehydration, maintenance fluids, drug vehicle	Hypernatremia, hyperglycemia, heart failure (volume overload risk)
14	NS 500 ml (Normal Saline 0.9%)	Fluid resuscitation, hypovolemic shock, drug dilution	Hypernatremia, hyperchloremic acidosis (large volumes), fluid overload states
15	Ringer Lactate 500 ml	Trauma/burn/surgical resuscitation, sepsis volume replacement	Severe hepatic failure (cannot metabolize lactate), lactic acidosis, hyperkalemia
16	Dextrose 5% 500 ml	Hypoglycemia (mild), caloric support, drug vehicle	Hyperglycemia, diabetic ketoacidosis, hypertonic states
17	Tramadol 2 ml	Moderate-to-severe acute pain	Hypersensitivity, concurrent MAO inhibitor use (within 14 days), uncontrolled epilepsy, severe respiratory depression, acute intoxication with CNS depressants
18	Pheniramine (Avil) 2 ml	Anaphylaxis (adjunct), severe allergic reaction, transfusion reaction	Hypersensitivity to antihistamines, neonates/premature infants, narrow-angle glaucoma (relative)
19	Furosemide (Lasix) 2 ml	Acute pulmonary edema, hypertensive emergency, fluid overload	Anuria, hypersensitivity to sulfonamides, severe hypovolemia/dehydration, hepatic coma (with electrolyte depletion)
20	Dexamethasone 2 ml	Cerebral edema, severe anaphylaxis (adjunct), severe asthma, meningitis, croup	Active untreated systemic infection (septicemia), live vaccines; no absolute contraindication in life-threatening emergencies
21	Ranitidine 2 ml	Stress ulcer prophylaxis, pre-anesthetic acid reduction, acute GI bleed	Hypersensitivity to H2 blockers; use with caution in porphyria
22	Ondansetron (Emset) 2 ml	Post-op nausea/vomiting, chemotherapy-induced vomiting	Hypersensitivity, congenital long QT syndrome, concurrent apomorphine use (risk of severe hypotension)
23	Metoclopramide	Nausea/vomiting, gastroparesis, GI stasis pre-procedure	Phaeochromocytoma, epilepsy, Parkinson's disease, GI obstruction/perforation/hemorrhage, history of tardive dyskinesia
24	Dopamine 5 ml	Cardiogenic shock, severe hypotension, acute heart failure	Uncorrected tachyarrhythmias, ventricular fibrillation, phaeochromocytoma, hypersensitivity to bisulfites
25	Dobutamine 5 ml	Acute heart failure, cardiogenic shock, low cardiac output	Idiopathic hypertrophic subaortic stenosis (IHSS/HOCM), hypersensitivity, uncorrected hypovolemia
26	Potassium Chloride 10 ml	Hypokalemia (especially with arrhythmias), electrolyte replacement	Hyperkalemia, severe renal impairment (risk of fatal hyperkalemia), Addison's disease; NEVER give undiluted IV push
27	Phenergan (Promethazine)	Nausea/vomiting, allergic emergencies, sedation	Children under 2 years (risk of fatal respiratory depression), comatose states, CNS depression, hypersensitivity to phenothiazines
28	Vitamin K 1 ml	Warfarin reversal, Vitamin K deficiency bleeding, hemorrhagic disease of newborn	Hypersensitivity; IV route associated with anaphylaxis risk - avoid rapid IV bolus
29	Mannitol 20% 100 ml	Raised intracranial pressure, cerebral edema, acute glaucoma	Severe pulmonary congestion/edema, anuria (established renal failure), intracranial bleeding (active), severe dehydration, severe heart failure
30	Dextrose 25% 100 ml	Acute severe hypoglycemia	Hyperglycemia, diabetic ketoacidosis, known hypersensitivity to corn products
31	Tranexamic Acid (Pause) 5 ml	Major hemorrhage - trauma, post-partum hemorrhage, surgical bleeding	Active thromboembolic disease (DVT, PE, MI, stroke), subarachnoid hemorrhage, hypersensitivity, acquired color vision defects
32	Lidocaine + Adrenaline 2% 5 ml	Local/regional anesthesia for emergency procedures, wound repair	End-arterial regions (fingers, toes, nose, ear, penis) - adrenaline component causes ischemia; hypersensitivity to amide anesthetics
33	Digoxin 2 ml	Atrial fibrillation/flutter (rate control), acute decompensated heart failure	Ventricular fibrillation, hypertrophic obstructive cardiomyopathy (HOCM), Wolff-Parkinson-White syndrome with AF, digitalis toxicity/hypersensitivity
34	Cap. Depin 5 mg (Nifedipine)	Hypertensive emergency (bitten/sublingual), angina	Cardiogenic shock, significant aortic stenosis, acute MI within 1 month, hypersensitivity to dihydropyridines; sublingual use now discouraged in many guidelines due to uncontrolled hypotension
35	Tab. Sorbitrate 5 mg (ISDN)	Acute angina, acute coronary syndrome, hypertensive urgency	Hypotension (SBP <90 mmHg), severe anemia, raised intracranial pressure, concurrent PDE-5 inhibitors (sildenafil/tadalafil - fatal hypotension), hypovolemia
36	Tab. Aspirin 75 mg	Acute MI (immediate antiplatelet loading), acute ischemic stroke, ACS	Active GI bleeding/peptic ulcer, hypersensitivity/aspirin-induced asthma (Samter's triad), hemophilia and bleeding disorders, children <16 years (Reye's syndrome)

Note: In true life-threatening emergencies (cardiac arrest, anaphylaxis), most relative contraindications are overridden by the need to save life. Absolute contraindications listed above apply to non-arrest clinical scenarios. Always reassess the clinical context before administration.

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