Category Archives: drugs

Esmolol dosing

Beta1 adrenoreceptor antagonist.

Rapid onset & offset.

For SVT or sinus tachy.

 

Dosing

Infusion +/- loading dose

Loading doses

  • Immediate control: 1mg/kg over 30 sec
  • Gradual control: 500mcg/kg over 1 min

Without a loading dose steady state is achieved after 30min

Infusion

50-200mcg/kg/min (step-wise change every 4 min)

 

 

Clonidine

pre-synaptic alpha-2 adrenoreceptor agonist

Uses:

  • prolonging duration of LA for nerve blocks/ epidural
  • sedation and analgesia in ICU
  • opiate and alcohol withdrawal
  • chronic pain, regional pain syndromes
  • hypertension
  • diagnosis of phaeochromocytoma

Caution:

  • Bradycardia
  • Hypotension
  • Sensitivity
  • Porphyria
  • May cause initial hypertension

Dose

  • IV: 1-5mcg/kg bolus (adult), 1-2mcg/kg bolus (paeds)
  • Epidural: 1mcg/kg (up to 150mcg)

Asthma

Salbutamol IV

Bolus:
Dilute 1mg into 10ml = 100mcg/ml
Give 250 – 500mcg bolus over 10min
(Paeds 15mcg/kg over 10min)

Infusion:
Conc. 10mcg/ml @ 30-120ml/hr
or 200mcg/ml @ 1.5 – 6ml/hr (paeds: 0.3-0.6 ml/kg/hr. max. 1.5ml/kg/hr)

(Paeds 5mcg/kg/min **???

(INCOMPLETE)

Magnesium IV

1.2 – 2g over 20min (BTS guidelines) *
(Paeds 40mg/kg over 20min)

*in other uses has ben given @ 1g/min.
Attenuates tachycardia of salbutamol. May cause tingling, warmth, flushing, hypotension.

Aminophyline IV

(If not already on it!)

Bolus:
250-500 mg (5mg/kg) over 20min

Infusion:
500-1000mcg/kg/hr

Drugs
Ketamine
Propofol
Sevo
Vec>Roc>atracurim/sux

Ventilation.
Low rate.
Long expiratory pause. (high insp flow rate, low Vt)
Permissive hypercapnia.
(Minimise air trapping/breath stacking)
Consider forced expiration

Remifentanil recipe II – mcg/kg/min

PHASE CONTINUOUS IV
INFUSION OF ULTIVA (REMIFENTANIL)
(MCG/KG/MIN)
INFUSION DOSE
RANGE OF ULTIVA (REMIFENTANIL)
(MCG/KG/MIN)
SUPPLEMENTAL IV
BOLUS DOSE OF
ULTIVA (REMIFENTANIL) (MCG/KG)
Induction of Anesthesia (through intubation) 0.5 – 1*
Maintenance of anesthesia with:
  Nitrous oxide (66%) 0.4 0.1 – 2 1
  Isoflurane (0.4 to 1.5 MAC) 0.25 0.05 – 2 1
  Propofol (100 to 200 mcg/kg/min) 0.25 0.05 – 2 1
Continuation as an analgesic into the immediate postoperativeperiod 0.1 0.025 – 0.2 not recommended
*An initial dose of 1 mcg/kg may be administered over 30 to 60 seconds.

Anesthesia, Maintenance

0.25-0.5 mcg/kg/min IV; may bolus with 0.5-1 mcg/kg q2-5min in response to light anesthesia or transient episodes of intense surgical stress

Conscious Analgesia

1 mcg/kg IV bolus, followed by 0.05-0.2 mcg/kg/min IV

Analgesia, Immediate Post-Op Period

0.025-0.2 mcg/kg/min IV