Drugs

Drugs

Analgesia

Opioids

(mu receptors)

Fentanyl
0.5-5mcg/kg/dose or 0.5-5mcg/kg/hr gtt

O/P/D: <1min/5mins/30-60mins

Morphine
0.05-0.2mg/kg/dose or 0.05-0.4mg/kg/hr gtt
O/P/D: 5-10mins/20mins/4hrs

Dilaudid
0.008-0.01mg/kg/dose or 0.003-0.04mg/kg/hr gtt
O/P/D: 5-10mins/20mins/4hrs

Methadone

0.05-0.2mg/kg/dose q4-6h
O/P/D: 10-20mins/1-2hrs/4-8hrs

+Sedation

Ketamine

(NMDA receptor antagonist)
0.5-2mg/kg/dose or 2.5-20mcg/kg/min
O/P/D: 30secs/5mins/1-2hrs

Sedation/
Amnesia

Benzodiazepine

Lorazepam (Ativan)
0.05-0.2mg/kg/dose
O/P/D: 2-10mins/15mins/6-8hrs

Midazolam (Versed)
0.05-0.1mg/kg/dose or 0.05 to 0.3mg/kg/hr
O/P/D: 3-5mins/3-5mins/2hrs

+Analgesia

Dexmedetomidine
(Central Alpha-2 Agonist)
0.5-1mcg/kg/dose [20mins] or 0.2-1.5mcg/kg/hr gtt
O/P/D: 5mins/15-30mins/1-2hrs

Clonidine (PO)
(Central Alpha-2 Agonist)
1-5mcg/kg/dose PO/IV up to 300mcg
O/P/D: 30-60mins/1-3hrs/3-5hrs

Other

Chloral Hydrate
10-25mg/kg/dose q6h
O/P/D: 15-30mins/30-60mins/1-2hrs

GABA Agonism

Propofol
1-2mg/kg bolus or 50-250mcg/kg/min gtt (uptitrate w/ 1mg/kg bolus)
O/P/D: 30secs/1min/10mins

Barbiturates

Pentobarbital
(inc GABA duration)
1-2mg/kg/dose or 0.5-3mg/kg/hr
O/P/D: 3-5min/10mins/15-45mins

Muscle Relaxants

Non-Depolarizing

Rocuronium
1-1.2mg/kg/dose
O/P/D: 1min/1min/30-40mins

Cisatracurium
(plasmaesterases metabolism - Hoffman Degradation)
0.1-0.3mg/kg/hr gtt
O/P/D: 2-3mins/3-5mins/35-45mins

Depolarizing

Succinylcholine:
(depolarizing NMB, avoid: HyperK, burns, MH, myopathies)
1-3mg/kg (use higher dose for infants)
O/P/D: 30secs/2mins/5mins

o = onset
p = peak
d = duration

Helpful hints:

Noxious Procedures WITHOUT secure airway

Intubating WITHOUT IV access

  • Fentanyl (1mcg/kg) ± Ketamine (0.5-1mg/kg) ± Propofol (1-2mg/kg)
    OR
  • Fentanyl (1 mcg/kg) + Versed (0.05-01 mg/kg)
  • Ketamine IM (4-5mg/kg) + Roc IM (1-1.5mg/kg)

Opioid Reversal: Naloxone (SE pulm edema)

BZD Reversal: Flumazenil

Dex/Clonidine Reversal: Naloxone

Roc/Vec Reversal: Sugammadex

Cis Reversal: Neostigmine + Glyco