Dosages Induction Meds Flashcards
What is the dose for Thiopental?
- 4mg/kg IV
What is the IV methohexital dose?
What if it needs to be given rectally?
- 1.5 mg/kg IV
- 20 - 30 mg/kg PR
For Propofol, what are the doses for:
1. Induction
2. Maintenance
3. Conscious sedation
- Induction = 1.5 - 2.5 mg/kg IV
- Maintenance = 100 - 300 μg/kg/min
- Conscious sedation = 25 - 100 μg/kg/min
What is the induction dose of propofol in adults?
Metabolism:
Excretion:
E1/2:
Diprivan/Propofol
Adults: 1.5-2.5 mg/kg IV
Metabolism: CYP
Excretion: Renal
E1/2: 0.5-1.5 hours
What is the conscious sedation dose of propofol?
- 25 - 100 μg/kg/min
What is the sub-hypnotic dosing for propofol?
- 10 - 15 mg IV, followed by 10 mcg/kg/min
What is the anti-pruritic dosing of propofol?
- 10 mg IV
What is the anti-convulsant dosing of propofol?
1mg/kg IV
What is the induction dose for etomidate?
Onset:
Metabolism:
Excretion:
E1/2:
Etomidate/Amidate
Dose: 0.3 mg/kg IV
Onset: 1 min
Metabolism: CYP, plasma esterase
Excretion: 85% urine, 13% bile
E1/2: 2-5 hours
What can be administered with etomidate to prevent involuntary myoclonic movements?
Fentanyl 1-2 μg/kg IV
What is the induction dose of ketamine IV?
Onset:
Duration:
Metabolism:
Excretion:
E1/2:
Ketamine/Ketalar
Dose: 0.5 - 1.5 mg/kg IV
Onset: 1 min
Duration: 10-20 min
Metabolism: CYP
Excretion: Renal
E1/2: 2-3 hours
What is the IM dose of ketamine?
4 - 8 mg/kg IM
What is the maintenance and subanesthetic/analgesic dose of ketamine?
- 0.2 - 0.5 mg/kg IV
What is the post-operative sedation and analgesia dosing for ketamine in pediatric cardiac surgery cases?
1-2 mg/kg/hour
What is the neuraxial epidural analgesia dosing of ketamine?
What about intrathecal route?
- 30mg epidural
- 5 - 50 mg via intrathecal/spinal/subarachnoid
What drug and dosing should be used to treat excessive salivary secretions from ketamine administration?
Glycopyrrolate: 0.2mg
At what dosing will the ICP increasing effects of ketamine plateau?
- 2mg/kg IV
What is the dosage of morphine?
Onset:
Peak:
Duration:
Metabolism:
E1/2:
- 1 - 10 mg IV
Onset: 10-20 min
Peak: 15 - 30 minutes
Duration: 4-5 hours
Metabolism: glucuronic conjugation
E1/2: 1.5-3.5 hours
What is the primary indication for meperidine?
What dose is used?
- Post-operative shivering
- 12.5mg IV
What is the analgesia dosage of fentanyl?
Induction dose?
Onset:
Duration:
Metabolism:
Clearance:
- Analgesia: 1 - 2 μg/kg IV
- Induction: 1.5 - 3 μg/kg IV
Onset: 30-60 seconds
Duration: 1-1.5 hours
Metabolism: CYP
Clearance: kidneys
What is the intrathecal dosage of fentanyl?
25 mcg
What is the adult oral dose of fentanyl?
Pediatric?
- Adult: 5 - 20 mcg/kg
- Peds: 15 - 20 mcg/kg
What is the transdermal dose of fentanyl?
- 75 - 100 μg (18 hours steady delivery)
What is the analgesia dose of sufentanil?
- Analgesia: 0.1 - 0.4 μg/kg IV
What is the induction dose of sufentanil?
18.9 mcg/kg IV
What is the alfentanil induction dose?
What about laryngoscopy dose?
What about maintenance?
- Induction: 150 - 300 μg/kg IV
- Laryngoscopy: 15 - 30 μg/kg IV
- Maintenance: 25 - 150 μg/kg/hr IV with inhaled anesthetics
What is the induction dose of remifentanil?
Onset:
Duration:
Metabolism:
- 0.5 - 1 μg/kg IV over 1 min
Onset: 30-60 seconds
Duration: 6-8 min
Metabolism: tissue and plasma esterase
What is the maintenance dosing of remifentanil?
- 0.005 - 2 μg/kg/min IV
Hydromorphone
Potency:
Dose:
Onset:
Duration:
- 5x more potent than morphine
- 0.5mg IV q4 → 1-4 mg total
Onset: 5-15 min
Duration: 2-4 hours
What is the dose of codeine for cough suppression?
Analgesia?
- Cough: 15mg
- Analgesia: 60mg (= about 5mg morphine)
What is the sufentanil intraop dose?
What is the infusion dose?
intraop: 0.3 - 1μg/kg IV
infusion: 0.5 - 1μg/kg/hr IV
What is the chronic pain dose of Pentazocine?
What dose and route would be equivalent to morphine 10mg?
- 10 - 30mg IV or 50 mg PO
- 20-30mg IM = 10mg morphine
What is the naloxone IV push dose?
Continuous infusion?
Duration:
Metabolism:
E1/2:
Push Dose:1-4 mcg/kg IV
Infusion: 5 mcg/kg/hr IV infusion
Duration: 30-45 min
Metabolism: Hepatic
E1/2: 60-90 min
What dose of naloxone is use for shock?
- > 1mg/kg IV
How does nalmefene’s potency compare to naloxone?
What is it’s dose and max?
- equipotent to naloxone
- 15 - 25 mcg IV q2-5min (max of 1 mcg/kg)
What is the dosage for Celebrex?
Peak:
200 to 400 mg PO QD
Peak: 3 hours
What is the duration & dose of Ondansetron? (pediatric?)
Duration/plasma half life: 4 hours
Dose: Adults: 4 - 8 mg IV
Dose: Pediatrics: 0.1 mg/kg IV
What is the dose for Dexamethasone (Decadron)?
What is the MOA of Dexamethasone (Decadron)?
4 - 8 mg IV
MOA: Anti-inflammatory; inhibition of phospholipase and cytokines and stabilization of cellular membrane.
According to the TXWES medication guide, what are the doses for Acetaminophen (Ofirmev), Ketorlac (Toradol), & Ibuprofen (Caldor).
Slide 62
What is the IV bolus and infusion dose of lidocaine?
When should the infusion be terminated?
- 1 to 2 mg/kg IV bolus over 2-4 min.
- 1 to 2 mg/kg/hr infusion
- Terminated within 12-72 hours.
What is the PO dose of preemptive Gabapentin?
When should we give it?
What is it’s MOA?
300-1200mg PO
1-2 hrs prior to OR
GABA analogue
For Ofirmev, what is the Dose, Peak effect time (PO/IV), and duration?
For Ketorolac, what is the:
- MOA
- Peak
- Dosing
MOA: Inhibits PG synthesis by inhibiting COX 1 and COX 2
Peak: 45 to 60 minutes IV
Dose: 15 to 30mg q6h (1/2 dose in elderly)
Max Dose: 60-120mg QD
What is Mg⁺⁺ dosing for the following two situations?
Preop:
Intraop:
- Preop: 50 mg/kg IV
- Intraop: 8 mg/kg/hr IV
Ibuprofen:
- MOA
- Dose
- Peak
- Excretion
- Contraindications
- COX 1 & 2 Inhibition = ↓ PG synthesis
- 200 - 800 mg q6h (max:3200mg QD)
- 1-2 hours
- Urine & Bile
-C/I: Nephropathy, CABG, bleeding disorders, wound healing
Using multimodal anesthesia, what 2 meds might we give in preop to better control pain later?
Acetaminophen 1000 mg PO, Gabapentin 300 mg PO