Beta1 adrenoreceptor antagonist.
Rapid onset & offset.
For SVT or sinus tachy.
Infusion +/- loading dose
- Immediate control: 1mg/kg over 30 sec
- Gradual control: 500mcg/kg over 1 min
Without a loading dose steady state is achieved after 30min
50-200mcg/kg/min (step-wise change every 4 min)
pre-synaptic alpha-2 adrenoreceptor agonist
- prolonging duration of LA for nerve blocks/ epidural
- sedation and analgesia in ICU
- opiate and alcohol withdrawal
- chronic pain, regional pain syndromes
- diagnosis of phaeochromocytoma
- May cause initial hypertension
- IV: 1-5mcg/kg bolus (adult), 1-2mcg/kg bolus (paeds)
- Epidural: 1mcg/kg (up to 150mcg)
Emergency treatment of refractory status asthmaticus with enoximone.
Case series of 8 patients.
100mg (50-200mg) stat +/- 8mg/hr infusion
NB COI: Author did receive payments from drug companies.
Wake up to remifentanil @
Use labetalol bolus prn. 5mg/ml. 20-40mg boluses.
Dilute 1mg into 10ml = 100mcg/ml
Give 250 – 500mcg bolus over 10min
(Paeds 15mcg/kg over 10min)
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 **???
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.
(If not already on it!)
250-500 mg (5mg/kg) over 20min
Long expiratory pause. (high insp flow rate, low Vt)
(Minimise air trapping/breath stacking)
Consider forced expiration
0.2mg/kg = 1ml per 10kg of 2mg/ml
Sedation for AFOI
Minto/plasma target: 0.3-0.5 ng/ml
Without midazolam: Up to 1.5ng/ml
NB Anaesthesia, May 2011: Remi as sole agent (no LA), minto model, effect site concentration of 6-8 ng/ml.
Use Procyclidine as treatment for dyskinetic side-effect of cyclizine
To avoid sympathetic stimulation
Rule of 24:
Conc x flow should <= 24
e.g. 4×6, 6×4, 8×3, 12×2
Insp Conc <=9, preferably <=8