Drug Dosages: ANS

Question 1

Epinephrine

Answer 1

1-2 mcg/kg/min = Beta 2
4-5 mcg/kg/min= Beta 1
10-20 mcg/kg/min= Alpha and Beta

*at moderate doses: Increase SBP, Decrease DBP, Map same

Question 2

Dopamine

Answer 2

1-3 mcg/kg/min = D1
3-10 mcg/kg/min= B1
>10 mcg/kg/min= alpha

Question 3

Norepinephrine

Answer 3

4-16 mcg/min

*Increased preload, decreased CO and HR; increased SBP, DBP, MAP

Question 4

Dobutamine

Answer 4

2-10 mcg/kg/min
5 mcg/kg/min= weak Alpha 1
*coronary artery vasodilator

Question 5

Ephedrine

Answer 5

10-25 mg IV

10-50 mg IM

Question 6

Phenylephrine

Answer 6

50-200 mcg IV or infusion at 20-50 mcg/min

Question 7

Albuterol

Answer 7

100mcg per puff, 2 puffs q4-6hr, max 16-20 puffs

Nebulization for asthma: 15mg/hr for 2 hours

Question 8

Phentolamine

Answer 8

30-70 mcg/kg IV (onset 2 minutes; DOA 10-15 mins)

Local infiltration: 2.5-5.0 mg in 10 ml

Question 9

Propranolol

Answer 9

0.05 mg/kg IV or 1-10 mg (give slowly 1mg q 5 mins)

Question 10

Metoprolol

Answer 10

PO: 50 - 400mg
IV: 1-15 mg

Question 11

Esmolol

Answer 11

0.5 mg/kg IV (10-180mg IV)

DOA <15 mins

Question 12

Labetalol

Answer 12

0.1-0.5 mg/kg

5mg at a time for mild htn in OR

Question 13

Atropine

Answer 13

Onset: 1 minutes
DOA: 30-60 min
E1/2T: 2.3 hours
18% unchanged in urine

DOSE: 0.2-0.4 mg IV (preop)
0.4-1.0 mg IV (bradycardia)
2mg in 5ml NS via nebulizer (bronchodilate)

Question 14

Glycopyrrolate

Answer 14

Onset: 2-3 minutes
DOA: 30-60 minutes
E1/2T: 1.25 hours
80% unchanged in ruine

DOSE: 0.1 to 0.2 mg IV (preop and bradycardia)

Question 15

Scopolamine

Answer 15

1% unchanged in urine
DOSE: 0.3- 0.5 mg or 5mcg/kg IM preop
1.5 mg transdermal (5mcg/hr x 72 hours for nausea)

Question 16

Tx for Central Anticholinergic Syndrome

Answer 16

Likely with Scopolamine and Atropine
Physostigmine 15-60 mcg/kg IV PRN q1-2hrs.
SX: restlessness, hallucinations, somnolence, unconsciousness, delayed emergence.