Dosages NMBs, LAs, Pressors Flashcards
What is the dose of Succinylcholine?
Onset:
Duration:
Metabolism:
Succinylcholine (Anectine)
Dose: 1 mg/kg IV
Onset: 30-60 seconds
Duration: 3-5 minutes
Metabolism: pseudocholinesterase
Dantrolene
Dose:
Metabolism:
Dantrolene (Ryanodex)
Dose: 2mg/kg IV
Repeat doses until symptoms subside or 10mg/kg IV
Metabolism: Hepatic
What is the dose of SCh for MG patients?
1.5-2.0 mg/kg
(increased d/t resistance)
For a patient with burns needing intubation, how can we offset the resistance to non-depolarizing blockers the burn causes?
1.2 mg/kg dose of Rocuronium
Pancuronium
Dose:
Onset:
Duration:
Metabolism:
Pancuronium (Pavulon)
- Dose: 0.1mg/kg;
- Onset: 3-5 minutes;
- Duration: 60-90 minutes
Metabolism: Hepatic
Excretion: 80% unchanged in Urine
Vecuronium
Dose:
Onset:
Duration:
Metabolism:
Vecuronium (Norcuron)
- Intubating Dose: 0.1 mg/kg
- Onset: 3-5 minutes
- Duration: 20-35 minutes
Metabolism: 70% Hepatic
Excretion: 30% unchanged in Urine
Rocuronium
Normal Dose:
Onset:
Duration:
Metabolism:
Excretion:
Rocuronium (Zemuron)
* Dose: 0.6 mg/kg
* Onset: 3-5 minutes
* Duration: 20-35 minutes
Metabolism: Hepatic
Excretion: Bile, 10-30% Renal
Rocuronium
RSI Dose:
Onset:
Duration:
Metabolism:
Excretion:
Rocuronium (Zemuron)
- Dose: 1.2 mg/kg
- Onset: 1-2 minutes
- Duration: 60-90 minutes
Metabolism: Hepatic
Excretion: Bile, 10-30% Renal
Cisatracurium
Dose:
Onset:
Duration:
Metabolism:
Cisatracurium (Nimbex)
* Intubating Dose: 0.1 mg/kg;
* Onset: 3-5 minutes;
* Duration of action: 20-35 minutes
Metabolism: Hoffman elim & plasma cholinesterase
Mivacurium
Dose:
Onset:
Duration:
Metabolism:
Mivacurium (Mivacron)
* Intubating Dose: 0.15 mg/kg;
* Onset: 2-3 minutes (Conditions less desirable);
* Duration: 12-20 minutes
Metabolism: plasma cholinesterase
Neostigmine
Dose:
Max:
Onset:
Duration:
Neostigmine (prostigmine)
Dose: 40 - 70 mcg/kg
Max: 5mg
Onset: 5-10 min
Duration: 60 min
Edrophonium
Dose:
Onset:
Duration:
Edrophonium (Tensilon)
Dose: 0.5 - 1 mg/kg
Onset: 1-2 min
Duration: 5-15min
What is the dose of Atropine?
7 - 10 mcg/kg
What is the Sugammadex dose for a moderate block?
Onset:
Duration:
Elimination:
Sugammadex (Bridion)
2 mg/kg
Onset: 1-4 min
Duration: 1.5 - 3 hours
Elimination: Urine
What is the Sugammadex dose for a deep block?
4 mg/kg
What is the sugammadex dose for an extreme block?
8 - 16 mg/kg
What drug and dose would be a good choice for a recurarizing patient in the PACU?
Why might this be a good choice?
- Neostigmine 0.05 mg/kg IV (40-70mcg/kg)
- Longer duration of action (60min)
What is the dose and max for glycopyrrolate?
7 - 15 mcg/kg
1mg maximum
MAGA: What is the intra-op infusion dose of lidocaine?
1 mg/kg over an hour
What is the IV dose of Lidocaine? (bolus and drip)
- 1 to 2 mg/kg IV (initial bolus) over 2 - 4 min.
- 1 to 2 mg/kg/hour (drip)
What is Lidocaine’s max infiltration dose? (with and without Epi)
- 300 mg plain
- 500 mg with Epi
What is the max dose of prilocaine?
600 mgs
What is the treatment and dose for methemoglobinemia secondary to prilocaine overdose?
Methylene Blue
- 1 to 2 mg/kg IV over 5 mins (initial dose)
- Total dose not to exceed 8 mg/kg
Benzocaine
Onset:
Duration:
Dose:
onset: rapid
duration: 30-60 min
Dose: 200-300 mg = 20% spray
Lidocaine max single dose
Infiltration:
Topical:
Epidural:
Spinal:
PNB:
- Infiltration: 300mg or 500mg with Epi
- Topical: 300 mg
- Epidural: 300mg or 500mg with Epi
- Spinal: 100mg
- PNB: 300mg or 500mg with Epi
Prilocaine Recommended Max Single Dose for infiltration/IVRA/PNB/Epidural?
600 mg
Bupivacaine Recommended Max Single Dose
Bupivacaine Recommended Max Single Dose with/Epi
Bupivacaine Recommended Max Single Dose for Spinal
175 mg
225 mg w/ Epi
Spinal max: 20 mg
Eutectic Mixture of LA (EMLA) contains what two local anesthetics?
Dose:
Onset:
Lidocaine 2.5% + Prilocaine 2.5% = 5% LA
Dose: 1 to 2 g/ 10 cm² area
Onset: 45 mins
What is the dose of bupivacaine for the scenario below?
5 ft tall patient = _____mL of ____% Bupivacaine
+ ______ mL for every inch above…. 2 cc total ( 1½ hours to 2 hours)
1 mL of 0.75% Bupivacaine
0.1 mL
For someone who is 5’5”, you will give 1.5 mL of 0.75% bupivacaine for a SAB.
What makes up the tumescent solution?
- Diluted Lidocaine (0.05% to 0.1%)
- Epinephrine 1:100,000
What is the dose for Regional Anesthesia Lidocaine with Epi?
7 mg/kg
Highly diluted Lidocaine with Epi Tumescent dose.
35 to 55 mg/kg
What is the bolus dose of Lipid Emulsion?
1.5 mL/kg of 20% lipid emulsion
What is the infusion dose of lipid emulsion?
How long should it be given?
0.25 mL/kg/minute for at least 10 minutes
What is the max total dose for lipid emulsion that should be given?
8 mL/kg
If cardiac arrest occurs with LAST syndrome, how should our epinephrine dosing change?
Small doses (10mcg - 100mcg boluses) are preferred with LAST ACLS.
What is the treatment for methemoglobinemia? What is the max dosage?
Methylene blue 1mg/kg over 5min
max: 8 mg/kg
What is the dose for Atenolol?
5mg q10min IV
What is the dose of metoprolol?
1mg q5min (Given in 5mg “blocks”)
What is the initial dose for esmolol?
20-30mg IV
What is the normal dosing of phenylephrine?
50-100mcg IV push
What is the dose for labetalol? How long would it take to see max effect from IV dose?
2.5 - 5mg IV; 10mg max
IV max effect 5-10 min
What is the IV push dose of epinephrine?
How long does it last?
- 2-8mcg IVpush
- 1-5 min
What is the infusion dose of epinephrine for β2 effects?
1-2 mcg/min
What is the infusion dose of epinephrine for β1 effects?
4 mcg/min
What is the infusion dose of epinephrine for predominantly α effects?
10-20 mcg/min
Which SNS agonist can be given IM? What dose?
Why would this be done?
- Ephedrine IM 50mg
- Long lasting increase in BP for OB patients.
What is the dose of Nitroprusside?
Initial: 0.3 mcg/kg/min
Tritrate slowly to 2 mcg/kg/min
What is the nitroglycerin dose?
Initial: 5 - 10 mcg/min
What is the initial dose of hydralazine?
2.5mg IV
What is the dose of nicardipine?
5mg/hr (↑2.5mg x4hr)
max 15mg/hr
What is the single IV push dose for ephedrine?
5-10mg IV
What is the single IV dose for vasopressin?
1-2 units IV
