Clinical Drug Table PDF

Nurse Anesthesia Program – Anesthesia Pharmacology Essentials* ANXIOLYTICS Drug Name Dose Onset/ Peak/ MOA/ Metabolism/ Indications Contra-Consideration of Drug Effects Duration...

Nurse Anesthesia Program – Anesthesia Pharmacology Essentials* ANXIOLYTICS Drug Name Dose Onset/ Peak/ MOA/ Metabolism/ Indications Contra-Consideration of Drug Effects Duration Classification Elimination indication s Midazolam 1-2.5 mg IV O=30-60 Benzodiazepine Metabolized in Preprocedura Liver disease Antiepileptic Peds 0.25- seconds (IV) enhances the effect liver with an l sedation Elderly link Muscle relaxer (S 176-177 0.5 mg/kg ~30 minutes PO of the active and anxiolytic with POCD Antianxiety B 587) po (max 20 P=5 min neurotransmitter metabolite, Synergistic effects with opioids and mg) DOA=15-80min excreted renal other anesthetic meds GABA on the Caution in Obesity, respiratory disease GABAA receptors (↑ patients frequency of Cl− channel opening) RFUMS Dept of Nurse Anesthesia 2019  OPIOIDS + ANALGESICS Drug Name Dose Onset/ Peak/ MOA/ Metabolism/ Indications Contra- Consideration of Drug Effects Duration Classification Elimination indications Morphine 2.5-15 mg IV O=Within 1 Opioid agonist, Binds Metabolize IV acute pain Hypersensitivit Common opioid effects: min (IV) primarily to mu liver with management y PONV Standard 10 mg IM 15-30 min (IM) receptors (also, delta, active Oral chronic Can cause Respiratory depression comparison of P=15-30 kappa receptors) metabolite pain histamine Bradycardia opioids is to 10 0.01-0.2 Works supraspinal (morphine 6- management release Pruritus min(IV) mg IV morphine mg/kg (B (periaqueductal grey glucuronide) Dependence 45-90 min (IM) 473) matter) and spinal Excretion renal Tolerance (S 226) DOA=up to 4 (substantia Constipation hours (IM) gelatinosa) Urinary retention Miosis Cough suppressant Fentanyl 1-2 mcg/kg IV O=3 min Phenyl-piperidine Metabolized Blunt SNS Hypersensitivit Common opioid S/Es P=6 min synthetic opioid liver response to y 50-100x more Cardiac DOA=~30 min (Norfentanyl DL or surgical Chest wall rigidity with higher, rapid potent than induction 50 **infusion metabolite), stimulus dosing mcg/kg IV >sufentanil excretion renal morphine Acute pain after 2 Potentiates midazolam and propofol 100 mcg – 10 mg management effects MSO4 hours** (S 231/232) Seizure activity and increase ICP (modest) noted Sufentanil 0.1-1 mcg/kg O= 6 min Phenylpiperidine-- Metabolized Intraop and Hypersensitivit Common opioid side effects IV induction DOA = 20-45 Highly selective and liver, excreted postop y 5x10x more min potent mu receptor urine and analgesia Caution with obesity—prolong potent than GA Bolus 5-20 agonist feces Not elimination Fentanyl mcg or gtt recommended 1000x as MSO4 0.005-0.015 for neuro with Caution in patients with OSA, 10mcg=10mg mcg/kg/min need of pulmonary HTN MSO4 0.3-1 immediate RFUMS Dept of Nurse Anesthesia 2019 (S 235) postoperative assessment Remifentanil 0.5-1 mcg/kg O=55 Repeat doses inhibit platelet redose q6hrs min prostaglandin liver, excreted moderate to years old aggregation 30mg IV = 10 mg Peak 1 hour synthesis, COX renal severe pain Renal MSO4 Peds dose 0.5 DOA=4-6 hrs inhibitor management insufficiency mg/kg IV ASA allergy (S 271 Bleeding B 1485) disorders Caution with asthmatics Nalbuphine 5-10 mg IV O=2-3 min Opioid agonist- Liver Analgesia-- Hypersensitivit Equal potency to Morphine for (Nubain) DOA=3-6 antagonist. Partial metabolism Patients y to Morphine analgesia (Equal potency hours antagonist mu and unable to group as MSO4) agonist k receptors tolerate pure Withdraw potential with d/c opioid RAD—poorly agonist controlled (S 242-243 Ceiling B 489) effect— increasing RFUMS Dept of Nurse Anesthesia 2019  doses over 30 mg no further response or depression of ventilation INDUCTION AGENTS Drug Dose Onset/ Peak/ MOA/ Metabolism/ Indications Contra- Consideration of Drug Effects Name Duration Classification Elimination indications Thiopental 3-5 mg/kg O=