Induction agents
| | Good | Bad
| Dose | | Ketamine | Less hypotension than thiopental and propofol
Good for kids
Good for repeated dosing
| Recovery is relatively slow
High incidence of extraneous muscle movements
Hallucinations, nightmares, etc
| 6.5–13 mg/kg IM
1–4.5 mg/kg IV
Maintenance: 10–45 micrograms/kg/minute IVI
| | Propofol | Rapid recovery
Less hangover effect | Pain on IV injection
Extraneous muscle movements
Bradycardia
Convulsions
| 1.5–2.5 mg/kg at a rate of 20–40 mg every 10 seconds
Maintenance: 4–12 mg/kg/hour | | Thiopentone | Smooth and rapid induction
| Dose-related cardiovascular and respiratory depression
Slow metabolism
No analgesic properties
| Initially 100–150 mg; Repeat if necessary
| | Etomidate | Rapid recovery without a hangover effect
Less hypotension than thiopental and propofol
| High incidence of extraneous muscle movements
Pain on injection
Suppresses adrenocortical function | 150–300 micrograms/kg |
Muscle relaxants| | Onset (secs)
| Duration (mins)
| Notes
| Dose
| | Atracurium | 120
| 25 - 30
| Degraded by Hofmann elimination
Insignificant placental transfer
Cardiovascular effects
| 0.3-0.6 mg/kg | | Rocuronium | 60
| 30 - 40
| Minimal cardio/resp effects | 0.6 mg/kg | | Vercuronium | 150
| 15 - 30
| | 0.1 mg/kg | | Suxamethonium | 30 - 60
| 5 - 10
| NB Pseudocholinesterase deficiency
=> Bradycardia, Hyperkalaemia
Risk of malignant hyperthermia
| 1 - 2 mg/kg |
Analgesics | | Dose | | Morphine | 10 mg
| | Diamorphine | 5 mg
| | Fentanil | 50–100 micrograms | | Alfentanil | Up to 500 micrograms | | Remifentanil | 0.25–1 micrograms/kg | | Midazolam | 2–2.5 mg |
Local anaesthetics| | Strength
| Max. dose | Notes
| Lidocaine
(Lignocaine)
| 1 %
| 3 mg/kg
7 mg/kg with adrenaline
| Local
| | Levobupivacaine | 0.75 %
| 150 mg
| Local / Epidural / Intrathecal / Blocks
Fewer adverse effects than bupivacaine
|
Antiemetics| | Notes | Dose | | Cyclizine | | 50 mg PO/IV
| | Metoclopramide | | 10 mg PO/IV
| | Prochlorperazine | | 12.5 mg IM
| | Ondansetron | Immediate onset - Give before waking
| 8 mg PO/IV
| | Dexamethasone | Delayed onset - Give at induction
| 0.4 - 20 mg IV
|
Antimuscarinics| | Notes | Dose
| | Atropine | Vagotonic
Not generally used as pre-med
| 300–600 micrograms | Glycopyrronium bromide
| Reduces salivary secretions
Produces less tachycardia than atropine | 200–400 micrograms | Hyoscine hydrobromide
| Reduces secretions
Amnesia, sedation, anti-emesis
May produce bradycardia rather than
tachycardia
Possibility of central anticholinergic syndrome | 200–600 micrograms |
Cardiac| | MOA
| | | | | Noradrenaline | | | | | | Metaraminol | Alpha-selective adrenergic agonist
| | | | | GTN |
| | | | | Labetalol | | | | | | Dopexamine | | | | | | Ephedrine | Mixed alpha/beta adrenergic agonist
| | | | | Adrenaline |
| | | | | Phenylephrine | | | | | | Milrinone | PDE3 inhibitor
Increases contractility
Also vasodilation => Reduced afterload | | | |
Antibiotics| | | | | | | Amoxicillin | | | | | | Clindamycin | | | | | | Flucloxacillin | | | | | | Erythromycin | | | | | | Gentamicin | | | | | | Benzyl-penicillin | | | | | | Cefurozime | | | | | | Vancomycin | | | | |
General| | | | | | | | Frusemide | | | | | | | Doxapram | | | | | | | Hydrocortisone | | | | | | | Heparin | | | | | | | Ranitidine | | | | | | | Dexamethasone | | | | | | | Naloxone | | | | | | | Tranexamic acid | | | | | | | Diclofenac | | | | | |
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