Week 2 opiods

Question 1

Morphine intrathecal dosing (adult and peds)

Answer 1

adults 0.1-0.5mg
peds 0.01mg/kg

Question 2

Morphine epidural (bolus, infusing, and peds)

Answer 2

Bolus: 2-6 mg q8-24h
Infusing: 0.2-1mg/hr
Peds: 0.03-0.05mg/kg (MAX:0.1mg/kg or 5mg/24hrs)

Question 3

Hydromorphone (dilaudid) analgesia dose (adult and peds)

Answer 3

Adult: 0.4-2mg IV
Peds: 0.005-0.02mg/kg

Question 4

Hydromorphone PCA dose (adult and peds demand and basal)

Answer 4

Adult demand: 0.2-0.6mg q5-15min
Adult basal: 0-0.2mg/hr
Peds demand: 0.005-0.02mg/kg q6-20mins
Peds basal: 0-0.005mg/kg/hr

Question 5

Meperidine sedation/analgesia (adult, peds, post op shivering)

Answer 5

Adult: 50-150mg IV, IM q3-4h
Peds: 0.5-2mg/kg IV, IM
Adult post op shivering: 12.5-25mg IV

Question 6

Fentanyl intubation adjunct

Answer 6

1-3mcg/kg

Question 7

Fentanyl sedation/analgesia(load and maint)

Answer 7

0.5mcg/kg(load); 0.01-0.04mcg/kg/hr(maint)

Question 8

Fent GA adjunct(bolus and infusion)

Answer 8

2-20mcg/kg bolus; 2-10mcg/kg/hr infusion

Question 9

Fent high dose

Answer 9

20-50mcg/kg

Question 10

Fent cardiac surgery

Answer 10

up to 150mcg/kg as sole GA agent

Question 11

Fent postop

Answer 11

0.5-1.5mcg/kg

Question 12

Fent Intrathecal

Answer 12

10-25mcg

Question 13

Fent epidural

Answer 13

10-100mcg, or mixed in local anesthetic 2-10mcg/ml

Question 14

Fent PCA

Answer 14

10-20mcg q6-20min

Question 15

Remifentanil induction dose

Answer 15

1-3mcg/kg over 1 min

Question 16

Remifentanil GA adjunct(loading, bolus, maintenance)

Answer 16

Loading:0.5-2mcg/kg
Bolus:0.5-1mcg/kg
Maintenance:0.05-2mcg/kg/min

Question 17

Remifentanil sedation(load and maintenance)
Propofol warning*

Answer 17

Load: over 30-60seconds 0.5-1mcg/kg
Maintenance 0.025-0.2mcg/kg/min
* increased respiratory depression with propofol*

Question 18

Sufentanil GA(minor procedure)

Answer 18

1-2mcg/kg load then 10-50 mcg PRN

Question 19

Sufentanil GA (moderate procedure)

Answer 19

2-8mcg/kg load then 10-50mcg PRN, infusion 0.3-1.5mcg/kg/hr

Question 20

Sufentanil GA (major procedure)

Answer 20

8-30mcg/kg load then 10-50mcg PRN, infusion 0.5-2.5 mcg/kg/hr

Question 21

Sufentanil sedation (load and infusion)

Answer 21

Load: 0.1-0.5mcg/kg
Infusion: 0.005-0.01 mcg/kg/min

Question 22

Sufentanil epidural

Answer 22

10-15 mcg/10ml of 0.125 bupivacaine

Question 23

Methadone (PO, IV/IM/SC)

Answer 23

Adult: 2.5-10 MG PO
IV/IM/SC 2.5mg-5mg q8-12hrs
*titrate up q3-5 days

Question 24

Oxycodone(immediate and controlled release)

Answer 24

Adult IR- 5-15mg PO q4-6hrs
Adult ER- 10mg q8-q12
Titrate by 25-50% q1-2 days

Question 25

Hydrocodone

Answer 25

2.5-10mg q4hrs *Morphine 10mg=hydrocodone 5-10mg

Question 26

Codeine (antitussive and pain-adult and peds)

Answer 26

Antitussive: 15mg Pain adult:15-60mg PO q4-6h (max 120mg/d) peds pain- 1-1.5mg/kg/day divided by q4-6hr Age 2-6: 30mg/day max Age 6-12: 60mg/day max

Question 27

Buprenorphine (IV/IM)

Answer 27

0.3-0.4mg q6-8h (may repeat initial dose in 30-60mins x1) *Doses greater than 0.3mg/dose should ONLY be given IM

Question 28

Buprenorphine 2-12 years old

Answer 28

2-6mcg/kg IV/IM q4-6h (max 6mcg/kg/dose)

Question 29

Buprenorphine>13years old

Answer 29

0.3mg IV/IM q6-8h (max 300 mcg/dose)

Question 30

Buprenorphine epidural

Answer 30

0.3mg

Question 31

Buprenorphine intrathecal

Answer 31

0.15mg

Question 32

Naloxone (opiate OD)

Answer 32

0.2-0.4mg IV q2-3min PRN(MAX 10 10mg) then may infuse at 0.4mg/hr and titrate to effect

Question 33

Naloxone (reversal of opiate resp depression)

Answer 33

0.04-0.4mg doses IV titrated q2-3min Infusion load of 5 mcg/kg followed by 2.5-160 mcg/kg/hr

Question 34

Naloxone reversal of opiate-induced pruritis

Answer 34

0.25 mcg/kg/hr

Question 35

Naloxone birth-5years or less than 20 kg

Answer 35

0.1mg/kg IV q2-3min PRN

Question 36

Naloxone >5yrs or greater than 20 kg (opiod OD)

Answer 36

2mg/dose q2-3 PRN, infusion 0.4mg/hr and titrate to effect (same as adult)

Question 37

Naloxone >5yrs or greater than 20kg (reversal of opiate resp depression)

Answer 37

1-10mcg/kg IV titrated q2-3min up to 0.4mg

Question 38

Naloxone >5yrs or greater than 20kg (treatment of opiate-induced pruritis)

Answer 38

0.25mcg/kg/hr