ROUTINE MEDICATIONS:

CCF GENERAL ANESTHESIA

 

EMERGENCY DRUGS FOR HEMODYNAMICS:

Drug  How Supplied:  Preparation:  Dose (  /kg)  70kg pt: Dose  Contraindications
Atropine  1 mg in 1 mL vial  draw up 1 cc (in 3 cc syringe)  0.005-0.01 mg/kg  0.4  - 0.7 mg   
Ephedrine  50 mg in 1 mL vial  dilute with 9cc NS (in 10 cc syringe): 5 mg/mL
----- 
 5 - 10 mg  IHSS, patients who cannot tolerate tachycardia,patients on MAOI inhibitors
Phenylephrine
NB: "Double Dilution"
10 mg in 1 mL vial inject 10mg into a 10 cc bottle of NS; draw up 1 cc from the bottle and dilute with 9cc NS (in 10 cc syringe): 100mcg/mL
  ----- 
50 - 100 mcg patients who cannot tolerate increased afterload (ie severe CHF)
 Nitroglycerin 400 mcg/mL (in 10 cc bottle) draw up 2 cc (800 mcg) and dilute with 8 cc NS (in 10 cc syringe): 80 mcg/mL
   -----
 40 - 80 mcg  
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HYPNOTICS AND OPIOIDS:

Drug  How Supplied:  Preparation: Dose (  /kg)  70kg pt: Dose  Contraindications
Sodium Thiopental  500 mg powder  draw up in 20 cc NS: 25 mg/mL  3 - 5 mg/ kg  210 - 350 mg  severe hypovolemia, severe myocardial dysfunction, porphyria
Propofol  10 mg/mL  STERILE TECHNIQUE  int: 1.5- 2.5 mg/kg
maint:
75-150mcg/kg/min
  100 - 200 mg

   30 - 60 cc/ hr 

 
Etomidate 2 mg/mL (in 10 cc bottle)   draw up in 10 cc syringe: 2 mg/mL 0.1 - 0.3 mg/ kg  7 - 21 mg  
Fentanyl  50 mcg/mL  draw up in 5 cc syringe: 50 mcg/mL   1 - 2 mcg/ kg  50 - 150 mcg   
Morphine  15 mg in 1 mL  dilute with 9 cc NS (in 10 cc syringe): 1.5 mg/mL  0.05 - 0.1 mg/kg  3 - 8 mg  
 
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MUSCLE RELAXANTS:

Drug  How Supplied:  Preparation:  Dose (  /kg)  70kg pt: Dose  Contraindications
Succinylcholine  20 mg/ml (in 10 cc bottle)  draw up in 10 cc syringe: 20 mg/mL  1 - 2 mg/kg  70 - 140 mg  MH, burns, muscle dystrophy, CNS denervation (eg spinal cord injury), pseudocholinesterase deficiency
d-Tubocurarine  3 mg/ml  draw up in 3 cc syringe: 3 mg/mL  -----  3 - 4.5 mg  
Pancuronium  2 mg/mL (in 5 cc bottle)  draw up in 5 cc syringe: 2 mg/mL  int: 0.08 mg/kg
maint: 0.02 mg/kg
 6 mg
1-2 mg
renal failure, surgery < 90 minutes, patients who cannot tolerate tachycardia
Rocuronium  10 mg/mL (in 5 cc bottle)  draw up in 5 cc syringe:10 mg/mL  int: 0.5 - 0.8mg/kg
maint: 0.15 mg/kg
 35 - 60 mg
10 mg 
 
Atracurium  10 mg/mL (in 10 cc bottle)  draw up in 5 cc syringe:10 mg/mL int: 0.4 mg/kg
maint: 0.1 mg/kg
 25-30 mg
5 - 10 mg 
 

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REVERSAL AGENTS:

 Drug  How Supplied:  Preparation: Dose (  /kg)   70kg pt: Dose  Contraindications
Neostigmine  0.5 mg/mL (in 10 cc bottle) add to glycopyrrolate, at the time of reversal of NDMR   0.04 - 0.07 mg/kg 2.8 - 4.9 mg   
Glycopyrrolate  0.2 mg/mL with neostigmine (1/5 the weight of neostigmine)  0.5 - 1.0 mg   

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