Glycopyrrolate
-other name
-mech of action
- used for
-mg/ mL
-Robinul
-anti muscarinic, does not cross BBB (no CNS effects)
-used to tx bradycardia and dry up airway secretions/ saliva
- 0.2 mg/ mL
Phenylephrine
-other name
-mech of action
- used for
-mg/ mL
-NeoSynephrine
- alpha-1 agonist
-used to tx hypotension, may cause reflex bradycardia
-100 mcg/mL
Ephedrine
-other name
-mech of action
- used for
-mg/ mL
- N/A
- stimulates NE release (alpha 1, alpha 2 beta 1 agonist
-tx hypotension, increase BP, HR and contractility - 5 mg/mL
Hypotension and requires medication? Rule of thumb
If HR <70, give ephedrine (no reflex brady).
If HR>90, give phenylephrine (reflex brady as side effect)
If HR 70-90, either will work
Rocuronium
-other name
-mech of action
- used for
-mg/ kg
-Zemuron
- Non-depol NM blocker (antagonist)
- paralytic, do not use in renal failure pt. Has no CV effect
-0.6 mg/kg intubation, 1.2 mg/kg for RSI
Sugammadex
-other name
-mech of action
- used for
-mg/ mL or typical dose
-Bridion
-Cyclodextrin encapsulates and binds Rocuronium or Vecuronium rendering it unable to bind to acetylcholine receptors at NMJ
- reversal agent for paralytics
- may reduce effects of BC
- typical dose 2mg/kg with max of 16 mg/kg
Succinylcholine
-other name
-mech of action
- used for
-mg/ mL or typical dose
-N/A
-depolarizing NM agent (agonist)
- paralytic/ breaking laryngospasms
- will trigger malignant hyperthermia. May cause bradycardia
- intubating dose 0.6-1 mg/kg
Propofol
-other name
-mech of action
- used for
-mg/ mL or typical dose
-Diprivan
- potentiates GABA activity
- sedative hypnotic, rapid in and rapid out
- profound depression of RR, TV, causes bronchodilation and vasodilation, decreases upper airway reflexes and tone
- 2-3 mg/kg for IV induction, 50-150 mcg/kg/min for TIVA
Ketamine
-other name
-mech of action
- used for
-mg/ mL or typical dose
- N/A
- NMDA receptor (glutamate) antagonist, dissociative anesthetic, dissociates thalamus from limbic system, may lead to hallucinations/ dysphoria
- works well in opioid tolerant pt
- closest to “complete” anesthetic (analgesia, amnesia and unconsciousness)
- SNS stimulator: increases BP, HR and CO as well as bronchodilator. Negative inotrope (decrease contractility). causes increased salavation
- Dart 4 mg/kg otherwise ?
Midazolam
-other name
-mech of action
- used for
- typical dose
- Versed
- Benzo, enhances GABA activity
- Anxiolytic, sedative, hypnotic, anti-convulsant, amnestic
- 0.01 - 0.1 mg/kg
Dexmedetomidine
-other name
-mech of action
- used for
-mg/ mL or typical dose
- Precedex
- Alpha 2 agonist
- hypnotic, analgesic
- no suppression of respiratory drive. Large blous can cause HTN. Side effects: bradycardia, hypotension, heart block and nausea
- loading dose 1 mcg/ kg over 10 min. TTE 0.2 - 1 mcg/kg/hr
Fentanyl
-other name
-mech of action
- used for
-mg/ mL or typical dose
- Sublamaze
- mu opoiod receptor agonist
- decrease RR and tV. Blunts SNS response
- 50-100 mcg for induction; 1-2 mcg/ kg adjunct
Remifentanyl
-other name
-mech of action
- used for
-mg/ mL or typical dose
- ## Ulitva-strong narcotic with very rapid off set
- 0.05- 2 mcg/ kg/ min for TIVA; 50 mcg/ mL
Toradol
-other name
-mech of action
- used for
-mg/ mL or typical dose
-Ketorolac
-NSAID
- good to give at end of surgery for simulating procedures. Only <65 yo (decreased clearance in elderly). Do not give to renal or liver pts. Increased risk of bleeding and decreased bone healing. When given IV, more analgesic than anti-inflammatory
- 30 mg/mL
Lidocaine
-other name
-mech of action
- used for
-mg/ mL or typical dose
- Xilocaine
-local anesthetic, anti-arrhythmic, Na+ channel blocker - can numb larynx if given in high dose (IV 1-2 mg/kg)
- 40 - 100 mg IV prior to Propofol
Hydralazine
-other name
-mech of action
- used for
-mg/ mL or typical dose
- N/A
- direct arteriolar vasodilation
- used for HTN
- dose 2-5 mg q15 min, TTE
Morphine
-other name
-mech of action
- used for/ side effects
-mg/ mL or typical dose
- N/A
- mu opioid receptor agonist
- pain/ watch for depressed respiratory effect
Hydromorphone
-other name
-mech of action
- used for
-mg/ mL or typical dose
- Dilaudid
- semi-synthetic opiod
- pain longer duration that Fentanyl
- 0.2-1 mg/ kg
Meperidine
-other name
-mech of action
- used for
-mg/ mL or typical dose
- Demerol
- synthetic opioid. Action at mu receptor (analgesia) and kappa receptor (shivering)
-used to combat post op shivering - 12.5 -25 mg dose IV
Esmolol
-other name
-mech of action
- used for
-mg/ mL or typical dose
- Brevibloc
- beta- blocker
- fast acting, short duration
- 10 mg/mL, TTE
Labetalol
-other name
-mech of action
- used for
-mg/ mL or typical dose
- N/A
- blocks alpha1, beta 1, beta 2
- used when pt has HTN and tachycardia. Avoid in pts with asthma
- 5 mg/mL
Metoprolol
-other name
-mech of action
- used for
-mg/ mL or typical dose
- Lopressor
- cardio selective beta 1 blocker
- lasts longer than esmolol
- 1 mg/mL,
Sevofluorane
-other name
-mech of action
- used for
-mg/ mL or typical dose
- Ultane
- enhance activity at GABA receptors and act as NMDA antagonists
- increase RR and decrease tV. Bronchodilator. Does not cause tachycardia
- all volatile agents cause some form of CV depression making dysrhythmias more noticeable and all will decrease SVR
- MAC is 2.1%
- Compound A causes toxicity
Desfluorane
-other name
-mech of action
- used for
-mg/ mL or typical dose
- Suprane
- enhance activity at GABA receptors and act as NMDA antagonists
- increase RR and decrease tV. Quick on/ off. Good for short cases and obese pts. CO2 is biproduct. Increased risk of bronchospasm in smokers on wake up. Turning on too quickly may cause tachycardia.
- MAC is 6%
- be ready to manage pt because when you turn off gas they are going to wake up quick
