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Common Anesthesia Drug Dosages

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Fentanyl

pre-op dose
analgesia, pre-op
[50-100 mcg IV/IM]
Info: given 30-60 min prior to surgery
Fentanyl

adjunct anesthesia dose
anesthesia, adjunct
[2-50 mcg/kg IV x1]
Info: 2 mcg/kg for low dose, 2-20 mcg/kg for mod dose, 20-50 mcg/kg for high dose
Fentanyl

Regional anesthesia dose
[50-100 mcg IV]
Info: give over 1-2 minutes
Fentanyl

Post-op pain dose
post-op pain
[50-100 mcg IV q1-2h prn]
Alt: 0.5-1.5 mcg/kg/h IV infusion
Alfentanil

Anesthesia dose, induction
anesthesia, induction
[130-245 mcg/kg IV x1]
Info: for ventilated pts only; use w/neuromuscular blocker; decr. rate and inhalation anesthetics by 30-50% in 1st hour after induction
Alfentanil

anesthesia dose, maintenance
anesthesia, maintenance
[0.5-1.5 mcg/kg/min IV]
Max: 4 mcg/kg/min; Info: for ventilated pts only; use w/neuromuscular blocker; incr. infusion or give 7 mcg/kg/min IV for lightening or stress; decr. rate and inhalation anesthetics by 30-50% in 1st hour after induction; D/C 10-15min before surgery end
Alfentanil

anesthesia dose, analgesia adjunct
[incremental dosing]
anesthesia, analgesia adjunct
[incremental dosing]
Dose: 5-15 mcg/kg IV q5-20min for maintenance; Start: 20-50 mcg/kg IV x1; Max: total = 75 mcg/kg; Info: to attenuate response to laryngoscopy, intubation
sufentanil

anesthesia dose, general
anesthesia, general
[10-50 mcg/kg IV]
Start: 1-30 mcg/kg; Info: titrate to anesthetic effect
remifentanil

anesthesia dose, induction
anesthesia, induction
[0.5-1 mcg/kg/min IV]
Start: may give initial 1 mcg/kg over 30-60sec; Info: give with muscle relaxant to avoid chest wall rigidity
remifentanil

anesthesia, maintenance
anesthesia, maintenance
[0.05-2 mcg/kg/min IV]
Info: may give supplemental bolus 1 mcg/kg; not recommended as sole agent
remifentanil

analgesia, post-op
analgesia, post-op
[0.025-0.2 mcg/kg/min IV]
Info: for continuation of analgesia into the immediate post-op period

Other Info: onset <1min, peak 1-5min, duration 5-10min
Meperidine

pain, mod-severe
pain, mod-severe
[50-150 mg PO/SC/IM q3-4h]
Info: IM preferred over SC or IV; for IV use lower dose, use diluted solution and administer slowly; use lower dose in elderly; decr. dose 50% with concurrent phenothiazine
Meperidine

preoperative sedation
preoperative sedation
[50-100 mg SC/IM x1]
Info: give 30-60min before anesthesia; use lower dose in elderly
meperidine

analgesia, obstetric
analgesia, obstetric
[50-100 mg SC/IM q1-3h]
meperidine

renal dosing
[adjust dose amount]
renal dosing
[adjust dose amount]

CrCl 10-50: decr. dose by 25%; CrCl <10: decr. dose by 50%; ESRD/HD: avoid use
morphine

pain, oral route
pain, moderate to severe
[oral route]
Dose: 10-30 mg PO q3-4h prn; Alt: 15-30 mg SR PO q8-12h for chronic pain; Info: <50 kg or elderly may need lower dose, longer interval; 200 mg SR for opioid tolerant pts only; do not cut/crush/chew SR
morphine

pain, parenteral route
[parenteral route]
Dose: 2.5-10 mg SC/IM/IV q2-6h prn; Alt: 0.05-0.1 mg/kg IV load, then 0.8-10 mg/h IV; Info: <50 kg or elderly may need lower dose, longer interval
morphine

pain, epidural route
[epidural route]
Dose: 3-5 mg EPID x1 then 0.1-0.7 mg/h; Max: 10 mg/24h; Info: <50 kg or elderly may need lower dose, longer interval
morphine

pain, rectal route
[rectal route]
Dose: 10-20 mg PR q4h prn; Info: <50 kg or elderly may need lower dose, longer interval
morphine

pulmonary edema, adjuvant
*pulmonary edema, adjuvant
[1-3 mg IV q5min]
morphine

*MI, acute/unstable angina
*MI, acute/unstable angina
[2-5 mg IV q5-30min]
Info: some pts require maint. dose 4-8 mg IV q4-6h
morphine

renal dosing
[adjust dose amount]
renal dosing
[adjust dose amount]
CrCl 10-50: decr. dose 25%; CrCl <10: decr. dose 50%
hydromorphone

pain, mod-severe
[oral route]
pain, mod-severe
[oral route]
Dose: 2-8 mg PO q3-4h; Start: 2-4 mg PO q3-4h in opiate-naive pts
hydromorphone

pain, mod-severe
[parenteral route]
pain, mod-severe

[parenteral route]
Dose: 1-4 mg SC/IM/IV q4-6h; Start: 0.2-0.6 mg IV q2-3h or 0.8-1 mg SC/IM q4-6h in opiate-naive pts; Info: reduce dose when switching from PO
hydromorphone

pain, mod-severe
[rectal route]
[rectal route]
Dose: 3 mg PR q6-8h
alfentanil

anesthesia, analgesia adjunct
[continuous infusion]
[continuous infusion]
Dose: 0.5-3 mcg/kg/min IV for maintenance; Start: 50-75 mcg/kg IV x1; Info: to attenuate response to laryngoscopy, intubation, incision
alfentanil

anesthesia, analgesia adjunct
[monitored anesthesia care]
[monitored anesthesia care]
Dose: 3-5 mcg/kg IV q5-20min or 0.25-1 mcg/kg/min IV for maintenance; Start: 3-8 mcg/kg IV x1; Info: for sedated, responsive, spontaneously breathing pts; usual total dose = 3-40 mcg/kg

Deck Info

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