Running head: MEDICATION CHART
Medication Chart
Jason Anderson
Wolford College
MEDICATION CHART
Drug
Dose
Onset
Duratio
n
Half
Life
Eliminat
ion
Metabolis
m
Recepto
rs
Usage
Risk
Atracurium
ED95 dose: 0.25 mg/kg
Induction dose: 0.5
mg/kg IV maint. 0.1
-0.2 mg/kg IV
<3 min
20-35 min
20 min
Bile, Urine
10%
Hoffman
Elimination and
hydrolosys
ACh antagonism
NMB
MH hx, myopathy, major trauma,
muscular denervation, motor neuron
injury, pseudocholinesterase deficiency,
NMdz
Atropine Sulfate
Reverse Bradycardia:
Adults 0.4-1 mg IV, IM
Immediate
4-6 hr
2.5 hr
Urine; 30-50%
Hepatic
Muscarinic ACh
Bradycardia, Asystole
Obstructive uropathy; paralytic ileus,
asthma
Calcium Chloride
500-1000mg q 4-6hr
Immediate
0.5-2 hr
Unknown
Urine 20%,
feces 80%
Hepatic
Active
electrolyte
Hypocalcemia,
arrhythmias, CCB
overdose,
hypermagnesium
Dexamethasone
4-10 mg IV before
induction
15-30 min
36 - 54 hours
1.8-3.5 hr
Urine
Hepatic
glucocorticoid
PONV Prevention
Digoxin
2.4-3.6 mcg/kg IV qd;
8-12 mcg/kgTID 1st
dose 50%
5-30 min
3-4 d
1.5-2 d; 3.5-5
d (Anuria)
Urine 50-70%
Hepatic
K(D,1) &
K(D,2); Na/K
ATPase
CHF, Afib, PSVT
conversion
Diphenhydramine
25-50 mg
<30 min
4-8 hr
3.4-9.2 hr
Urine
Hepatic
H1
Sedation, EPS,
allergic rxns
hypophosphatemia, VF, hypercalcemia,
digitalis toxicity, nephrolithiasis,
dehydration, renal impairment, vitamin
D toxicity
Fungal infection, TB, measles,
varicella, HTN, CHF, MI, DM, PUD,
ulcerative colitis, diverticulitis,
intestinal anastomosis, GI performation
risk
VT, AMI, IHSS, Renal Impairment,
WPW syndrome, bradycardia, AVB,
myocarditis
pts<2yo, elderly, CNS depressants,
incr. IOP, HTN, COPD, asthma,
hyperthyroidism, PUD, GI obstruction,
prostatic hypertrophy
Droperidol
0.625-1.25 mg q3-4hr;
Max 2.5 mg
3-10 min
2-4 hr
134 min
Urine 75%,
feces 22%
Hepatic
D2 & alpha
N/V (periop)
prolonged QT interval, elderly,
HoTN, hepatic/renal impairment, CHF,
HR<50, cardiac dz, hypokalemia,
hypomagnesemia, Black Box Warning
Tardive Dyskinesia
Edrophonium
0.5 - 1.0 mg/kg TV;
Max 40 mg cumm.
Dose
1-2in
5-20 min
33-110 min
Urine
Hepatic
Cholinesterase
ND-NMB reversal
Urinary Obstruction, GI obstruction,
asthma, arrhythmias
Ephedrine
5-25 mg q5-10min;
then q3-4hr
5 min
2 hr
3-6 hr;
dependent on
pH 5-6.3
Urine
Minimally Hepatic
Beta
HoTN, bronchospasm
MAOI(14d), Breastfeeding,
hyperthyroidism, CAD, HTN
Epinephrine
1 mg (1:10,000) q35min; 2-10 mcg/min
1-2 min
5-10 min
1 min
Urine
Hepatic
Alpha & Beta
VT, Bradycardia, CO
maintenance
Coronary insuff., L&D, HTN,
arrhythmias, DM, Parkinson dz
Esmolol
50-200 mcg/kg/min;
Max 8hr
2-10 min
10-30 min
9 min; 4.5
min (<16yo)
Urine 71-88%
Extensively
Erythrocytes;
CYP450 (active
metabolite)
Beta-1
SVT, HTN or
Tachycardia
(intraop/postop),
Sinus brady, AVB, SSS, CGS, CHF,
PHTN, Pregnancy, renal impairment,
prinzmetal angina, HoTN,
hypovolemia, PVD
Etomidate
0.3 mg/kg; range 0.20.6 mg/kg
30-40 sec
3-10 min
75 min
Urine
Hepatic
Unknown
General anesthesia
induction
Elderly
MEDICATION CHART
Drug
Dose
Onset
Duratio
n
Half
Life
Eliminat
ion
Metabolis
m
Recepto
rs
Usage
Risk
Fentanyl
50-100 mcg,
preop®ional&pain;
2-50 mcg/kg
(anesthesia adjunct)
Immediate
1 min
0.5-1 hr
Urine
Hepatic
Opioid
Analgesia
Elderly, renal/hepatic impairment, head
injury, incr. ICP, pulm. Impairment, CV
fxn, GI obstruction, CNS depressant,
resp. depressant, HoTN
Flumazenil
0.2 mg IV qmin x15 doses max of 1
mg
2 min
30-60 min
54 min
Urine 90-95%,
feces 5-10%
Hepatic
benzodiazepine
Benzo sedation
Reversal
Furosemide
20-80 mg q1hr
5 min
2 hr
30-60 min
Urine 88%;
Bile/feces 12%
Hepatic
Na-K-2Cl
symporter
Pulm. Edema, HTN,
FVO
Glycopyrrolate
0.1-0.2 mg q2-3min;
0.8 mg/day
Immediate
1-7 hr
50 min
Urine 85%,
Bile
Hepatic
Ach
NMB reversal
Herparin
5000 units q8-12hrs; 18
units/kg/h; start: 80
units/kg, then 1000
units/h, 333 units/kg sc
then 250 unitskg sc
q12hr
20-60 min
(SQ);
8-12 hr (SQ);
2-6 hr (IV)
1.5 hr
Urine
Reticuloendothelia
l system; CYP450
Antithrombin III
Thromboembolism,
PCI, STEMI,
NSTEMI
Hypersens. To pork/corn/sulfites,
thrombocytopenia, HIT, hemorrhage,
active bleeding, pregnancy, severe
HTN, hepatic/renal dz
Hydralazine
10-20 mg q2-4hr
10-20 min
3-6 hr
3-7 hr
Urine 52-90%,
feces 10%
Hepatic
Alpha-1
Hypertensive Crisis
CAD, RHD, hypertrophic CM, HoTN,
Renal impairment
Ketorolac
30 mg (<65), 15mg
(>65)
10 min (IV);
45-60min
(IM)
Up to 4 hr
5.3 hr
Urine 91%,
feces 6%
Hepatic
opioid
Pain management
Aspirin triad, GI bleeding, CV
hemorrhage, active bleed, CABG sx
Labetalol
20-80 mg q10min; Max
300 mg
2-5 min
2-4 hr
5-8 hr
Urine 50%,
feces 50%
Hepatic
Alpha-1 & Beta1&2
HTN, HTN
emergency
AVB, CGS, CHF, SSS, asthma, PVD,
DM, thyroid disorder, WPW,
Hepatic/renal impairment,
pheochromocytoma
0.5-0.75 mg/kg q510min (VF, VT);
Various dosing, Max
300 mg (local
anesthesia)
3-20 mg/min 5-48 hr;
start 2-6g; 1-2g
IV
Antiarrytmic
effecs - 45-90
sec Epidural
5-15 Minutes
10-20 min;
Epidural 1-3 hr
1.5-2 hr
Urine
Hepatic
Na channel
VT, VF, Local
Anesthesia
Adams-Stokes syndrome, WPWs,
AVB, elderly, renal/hepatic
impairment, CHF, bradycardia,
hypovolemia, shock
Immediate
3-4 hr
Unknown
Urine
Hepatic
Electrolyte
VT, VF, TdP, Seizures
myocardial damage, diabetic coma,
heart block
Metoclopramide
5-10 mg
<30 min
1-2 hr
5-6 hr
Urine 85%,
feces 5%
Hepatic
D2
GERD, diabetic
gastroparesis, N/V
prevention
pheochromocytoma, seizures, GI bleed,
GI obstruction, Parkinson dz,
depression, HTN, CHF
Midazolam
1 mg q2-3min; Max
2.5mg(procedural)
30-60 sec
30-60 min
2.5 hr
Urine
Hepatic
benzodiazepine,
GABA
Sedation
Nalbuphine
10 mg q3-6hr (pain);
0.25-0.5 mg/kg
(anesthesia adjunct)
2-3 min
2-3 hr
5 hr
Urine, bile,
feces
Hepatic
Opioid
Pain management
Naloxone
0.4-2 mg q2-3min
<1 min
30-45 min
1.07-1.28 hr
Urine
Hepatic
opioid
Opioid reversal
Lidocaine
Magnesium Sulfate
TCA overdose, seizure risk,
alchoholism, hepatic impairment,
psychiatric disorder
Anuria, hepatic coma, e'lyte imbalance,
DM, AMI, DM, arrhythmias, hearing
impairment, SLE
Obstructive uropathy; paralytic ileus,
asthma
Pulm. Impairment, sleep apnea, CHF,
CNS depression, alcohol use, seizure
hx, renal/hepatic impairment, elderly
Head injury, pulm. Impairment, biliary
sx renal impairment, elderly pts,
pregnancy, L&D
renal/hepatic impairment, CVdz, opioid
addiction
MEDICATION CHART
4
Half
Life
Eliminat
ion
Metabolis
m
Dose
Neostigmine
0.03-0.07 mg/kg IV x1;
Max 5mg
1-5 min
30-60 min
24-113 min
Urine; 50%
Hepatic
Nitroprusside
3-4mcg/kg/min
Rapid
Short
2 min; 3 d
(thiocynate)
Urine
Pentothal
3-5 mg/k
30-120 sec
4 min
3-11.5 hr
Pheylephrine
100-500 mcg q1015min; Max 500mcg
<1 min
15-20 min
2-3 hr
30-40sec
3-10 min
3-12 hr;
Elimination
occurs during
distribution
phases, 2-4
min & 30-64
min
Urine
30 sec
2 hr
unknown
1-2 min
22-67 min
2-10 min
30-60 min
Propofol
Protamine
Rocuronium
2-2.25 mg/kg, 40mg
q10sec until onset; 100200 mcg/kg/min
1-1.5 mg per 100 units
heparin; Max 50 mg
06 mg/kg (endotracheal
intubation); 0.6-1.2
mg/kg (rapid sequence
intubtion)
Sodium
Bicarbonate
2-5 mEq/kg x1
Succinylcholine
0.3-1.1 mg/kg
(induction); 0.04-0.07
mg/kg q5-10min
(maintenance); 1-2
mg/kg (rapid sequence
intubation)
Vecuronium
80-100 mcg/kg
(induction); 10-15
mcg/kg q12-15min, 2545 after induction
(maintenance)
Verapamil
2.5-10 mg q15-30min;
Max 20 mg
Onset
Duratio
n
Drug
30-60 sec
3-5 min
1-5 min
3-5 min
Recepto
rs
Usage
Risk
Cholinesterase
ND-NMB reversal
Urinary Obstruction, GI obstruction,
asthma, arrhythmias
Erythrocytes,
Hepatic
NMDA
Hypertensive
emergency, CHF,
Controlled HoTN
aortic coarctation, AV shunt,
inadequate cerebral cirulation, optic
atrophy, (high output) CHF,
renal/hepatic impairment, CVdz
Urine
Hepatic
GABA
Sedation, Induction
Urine 86%
Hepatic
Alpha-1
HoTN
Hepatic
GABA
General anesthesia
induction
Other
Hepatic
Heparin
Heparin reversal
1.4-2.4 hr
Bile, Urine
Hepatic
ACh
NMB
Unknown
Urine
Hepatic
HCl
Metabolic acidosis,
urinary alkalinization
Unknown
Urine
3-5 min
65-75 min
Bile 25-50%,
Urine 3-35%
30-60 min
2-5 hr; 14-16
hr (hepatic
insufficiency)
Urine 70%,
feces 9-16%
Hepatic
ACh
porphyia, acute asthma atack, cardiac
disease
VT, asthma, bradycardiac, AVB, DM,
CV dz
hypersens. To egg, soy, glycerol; L&D,
elderly, ASA-PS III-IV, hyperlipidemia,
hypertriglyceridemia, seizure disorder,
incr. ICP, impaired cerebral circulation
hypersens. to fish, vasectomy, severe
LV dysfxn, abnl pulm. hemodynamics
Elderly, NMdz, cerebral palsy, MG,
Eaton-Lambert syndrome, pulm. Dz,
pulm. Dz, valvular heart dz,
dehydration, impaired circulation
hypochloremia, alkalosis, CHF, sodium
restriction, hypervolemia,
hypocalcemia, hypokalemia,
hypernatremia
NMB
MH hx, myopathy, major trauma,
muscular denervation, motor neuron
injury, pseudocholinesterase deficiency,
NMdz
Hepatic
ACh
NMB
NMdz, MG, eaton-lambert syndrome,
pulm. Dz, dehydration, CVdz,
anephric, impaired circulation, cerebral
palsy, hemiparesis
Hepatic
Glycine receptor
on L-type
calcium channel
blocker
PSVT, Afib
LV dysfxn, AVB, Afib, SSS, HoTN,
CGS, CHF, bradycardia, IHSS,
hepatic/renal impairment, GERD
MEDICATION CHART
5
Reference
Butterworth, J., Mackey, D., Wasnick, J., Morgan, G. & Mikhail, M. (2013). Morgan & Mikhail's clinical anesthesiology. New
York: McGraw-Hill.
Chu, L. & Fuller, A. (2012). Manual of clinical anesthesiology. Philadelphia: Wolters Kluwer Health/Lippincott Williams &
Wilkins.
Ouellette, R. & Joyce, J. (2011). Pharmacology for nurse anesthesiology. Sudbury, MA: Jones & Bartlett Learning.
