Вы находитесь на странице: 1из 9

OBAT ANESTESI 1. Safol 1 cc = 10 mg Dosage: Induction of general anesth Adult Titrate 40 mg every 10 sec until onset of anesth.

Adult <55 yr 1.5-2.5 mg/kg. Childn >8 yr 2.5 mg/kg slow IV until onset of anesth. Maintenance of general anesth Adult 4-12 mg/kg/hr or 25-50 mg repeated bolus inj. Childn >3 yr 9-15 mg/kg/hr. Sedation during intensive care 0.3-4 mg/kg/hr. 2. Ephedrine 1cc= 1 amp/aplus 4cc= 10mg Dosis: Oral Diabetic neuropathic oedema Adult: 30-60 mg tid. Child: Intravenous Reversal of spinal or epidural anaesthesia-induced hypotension Adult: 3-6 mg or up to 9 mg in a 3 mg/mL soln given as slow Inj repeated every 3-4 min, as needed. Max Dosage: 30 mg. 3. Fentanyl Premed 100 mcg IM 30-60 mins prior to surgery. Adjunct to regional anesth 50-100 mcg IM/slowly IV over 1-2 mins when additional analgesia is required. Post-op (recovery room) 50-100 mcg IM, may be repeated in 1-2 hr as needed. As analgesic supplement to general anesth Low dose: 2 mcg/kg. Moderate dose: 2-20 mcg/kg. High dose: 20-50 mcg/kg. As anesth agent 50-100 mcg/kg. 4. atropine Parenteral Premedication in balanced anaesthesia Adult: 300-600 mcg IM/SC 30-60 minutes before anaesthesia. Alternatively, 300-600 mcg IV immediately before induction of anaesthesia. Child: >20 kg: 300-600 mcg; 12-16 kg: 300 mcg; 7-9 kg: 200 mcg; >3 kg: 100 mcg. Doses to be given via IM/SC admin 30-60 minutes before anaesthesia. Parenteral Organophosphorus poisoning Adult: 2 mg IV/IM, every 10-30 minutes until muscarinic effects disappear or atropine toxicity appears. In severe cases, dose can be given as often as every 5 minutes. In moderate to severe poisoning, a state of atropinisation is maintained for at least 2 days and continued for as long as symptoms are present. Child: 20 mcg/kg given every 5-10 minutes. Parenteral

Poisoning or overdosage with compounds having muscarinic actions Adult: 0.6-1 mg IV/IM/SC, repeated every 2 hr. Intravenous Bradycardia Adult: 500 mcg every 3-5 minutes. Total: 3 mg. Max Dosage: 0.04 mg/kg body weight. Ophthalmic Inflammatory eye disorders Adult: Instill 1-2 drops of a 0.5-1% solution up to 4 times daily. Child: As sulfate: Instill 1-2 drops of a 0.5% soln (or 1 drop of a 1% solution) up to tid. Ophthalmic Eye refraction Adult: Instill 1 drop of a 1% solution bid for 1-2 days before the procedure, or on a single occasion 1 hr before the procedure. Child: As sulfate: Instill 1 or 2 drops of a 0.5% soln (or 1 drop of a 1% solution) bid for 1-3 days before the procedure, with a further dose given 1 hr before the procedure. Incompatibility: Incompatible with hydroxybenzoate preservatives. 5. Syntocinon Induction of labour IV infusion: 1 u/100 mL. Rate: 5-40 drop/min. 3rd stage of labour 510 iu IM or 5 iu slow IV Caesarian section 5 iu intramurally after delivery. 6. Methergin Active management of 3rd stage of labor 0.5-1 mL IM following delivery of the head or anterior shoulder or immediately after child delivery. Delivery under general anesth Recommended dose: 1 mL. Uterine atony/hemorrhage 1 mL IM or 0.5-1 mL IV. May be repeated at intervals of not <2 hr. Subinvolution, lochiometra, puerperal bleeding 0.125-0.25 mg orally or 0.5-1 mL IM, up to 3 times daily; in lactating women preferably for not >3 days. 7. Bucain Percutaneous infiltration anaesthesia Adult: 0.25% solution is typically used. For prolonged action: 9 mg (1.8 ml) of a 0.5% solution with adrenaline (1:200,000) can be admin, repeated once after 2-10 min if necessary. Max total: 90 mg/dental sitting. Max single dose: 150 mg with or without adrenaline, followed by 50 mg every 2 hr if needed. Injection Peripheral nerve block

Adult: 12.5 mg (5 ml) of a 0.25% solution or 25 mg (5 ml) of a 0.5% solution. Max single dose: 150 mg with or without adrenaline, followed by 50 mg every 2 hr if needed. Injection Sympathetic nerve block Adult: 50-125 mg (20-50 ml) of a 0.25% solution. Injection Retrobulbar block Adult: 15-30 mg (2-4 ml) of a 0.75% solution. Injection Caudal block Adult: In surgery: 37.5-75 mg (15-30 ml) of a 0.25% solution or 75-150 mg (15-30 ml) of a 0.5% solution. With analgesia during labour: 25-50 mg (10-20 ml) of a 0.25% solution or 50-100 mg (10-20 ml) of a 0.5% solution. Injection Lumbar epidural block Adult: In surgery: 25-50 mg (10-20 ml) of a 0.25% solution or 50-100 mg (10-20 ml) of a 0.5% solution. With analgesia during labour: 15-30 mg (6-12 ml) of a 0.25% solution or 30-60 mg (6-12 ml) of a 0.5% solution. In non-obstetric surgery: 75-150 mg (10-20 ml) of a 0.75% solution. 8. Sotatic Oral Adult 10 mg or 1-2 tsp 3 times daily. Childn & adolescents Max dose: 0.5 mg/kg body wt/day in 3 divided doses. Childn <6 yr Max dose: 0.1 mg/kg body wt/day as a single dose. Post-chemotherapy antiemetic Adult 0.5 mg/kg body wt/day 4 times daily for 6 days, to be given 24 hr after chemotherapy. Inj Treatment of delayed gastric emptying Adult 10 mg by IV inj over 1-2 min. Childn 6-14 yr 2.5-5 mg by IV inj, 6 yr 0.1 mg/kg body wt by IV inj. Prevention of vomiting due to chemotherapy 1-2 mg/kg body wt IV over >15 min, to be given 30 min before chemotherapy. Prevention of vomiting before surgery 10-20 mg IM over 1-2 min, before the end of surgery. 9. Cedantron Oral Prevention of post-op nausea & vomiting Initially 1 tab 1 hr before anaesth, followed by 2 doses of 1 tab 8 hrly. Radiotherapy-induced nausea & vomiting 8 mg orally 8 hrly. 1st dose should be taken 1-2 hr before radiotherapy. Inj Treatment of postop nausea & vomiting 4 mg IM as single dose or slow IV inj. Highly emetogenic chemotherapy Initially 8 mg by slow IV inj or 15 min infusion immediately before chemotherapy, then continuous IV infusion of 1 mg/hr for up to 24 hr or by further 2

doses of 8 mg by slow IV inj or 15 min infusion 4 hr apart. Either regimen is then followed by 8 mg orally 12 hrly up to 5 days. Less emetogenic chemotherapy 8 mg by slow IV inj or 15 min infusion immediately before chemotherapy or 8 mg orally 1-2 hr before chemotherapy followed by 8 mg orally 8 hrly for up to 5 days. 10. pethidine Oral Moderate to severe acute pain Adult: As hydrochloride: 50-150 mg every 4 hr if needed. Child: As hydrochloride: Children 2 mth to 12 yr: 0.5-2 mg/kg; 12-18 yr: 50-100 mg. Repeat dose every 4-6 hr if necessary. Elderly: As hydrochloride: 50 mg every 4 hr. Renal impairment: Dose reductions may be necessary. Hepatic impairment: Dose reductions may be necessary. Parenteral Moderate to severe acute pain Adult: As hydrochloride: 25-100 mg IM/SC inj or 25-50 mg by slow IV inj repeated after 4 hr. IM/SC doses may be given every 2-3 hr if needed. Child: As hydrochloride: SC/IM: 2 mth to 12 yr: 0.5-2 mg/kg; 12-18 yr: 20-100 mg. Repeat dose every 4-6 hr if needed. IV inj: Neonates and children 12 yr: 0.5-1 mg/kg IV inj every 10-12 hr if needed in those up to 2 mth and every 4-6 hr if needed in older children. 12-18 yr: 25-50 mg every 4-6 hr if needed. Alternatively, 1 mth: Loading dose: 1 mg/kg by IV inj followed by 100-400 mcg/kg/hr via continuous IV infusion adjusted according to response. Elderly: 25 mg every 4 hr. Renal impairment: Dose reductions may be necessary. Hepatic impairment: Dose reductions may be necessary. Parenteral Obstetric analgesia Adult: As hydrochloride: 50-100 mg by IM/SC inj as soon as contractions occur at regular intervals; repeat after 1-3 hr if needed. Max: 400 mg in 24 hr. Renal impairment: Dose reductions may be necessary. Hepatic impairment: Dose reductions may be necessary. Intramuscular Preoperative medication Adult: As hydrochloride: 25-100 mg IM/SC given 1 hr before surgery. Child: As hydrochloride: 1-2 mg/kg given 1 hr before surgery. Renal impairment: Dose reductions may be necessary.

Hepatic impairment: Dose reductions may be necessary. Parenteral Postoperative pain Adult: As hydrochloride: 25-100 mg IM/SC inj every 2-3 hr if necessary. Renal impairment: Dose reductions may be necessary. Hepatic impairment: Dose reductions may be necessary. Intravenous Adjunct to anaesthesia Adult: As hydrochloride: 10-25 mg by slow IV inj. Renal impairment: Dose reductions may be necessary. Hepatic impairment: Dose reductions may be necessary. Reconstitution: IV infusion: Dilute with glucose 5% or sodium chloride 0.9% to required volume. IV inj: Dilute with water for inj to a concentration of 5-10 mg/ml. Incompatibility: Y-site incompatible with idarubicin, imipenem/cilastatin, minocycline, allopurinol, amphotericin B cholesteryl sulfate complex, cefepime, cefoperazone, doxorubicin liposome. Admixture incompatibility: Aminophylline, amobarbital, floxacillin, furosemide, heparin, morphine, phenobarbital, phenytoin, thiopental, pentobarbital. Syringe incompatibility: Pentobarbital, heparin, morphine. 11. ketamine Intravenous Induction of anaesthesia Adult: 1-4.5 mg/kg as IV inj. Surgical anaesthesia is produced within 30 sec of the end of inj. Usual dose to produce 5-10 minutes of anaesthesia: 2 mg/kg over 60 seconds. Alternatively, 1-2 mg/kg infused at 0.5 mg/kg/minute; may use with diazepam to prevent emergence reactions. Child: 1-4.5 mg/kg as IV Inj. Surgical anaesthesia is produced within 30 sec of the end of inj and lasts for 5-10 min if 2 mg/kg is given over 60 sec. Alternatively, 0.5-2 mg/kg as IV infusion. Maintenance: Achieve with 10-45 mcg/kg/min; titrate infusion rate according to response. Intramuscular Induction of anaesthesia Adult: 6.5-13 mg/kg. Usual dose to produce 12-25 minutes of anesthesia: 10 mg/kg. Incompatibility: May form precipitates with barbiturates; do not inject in the same syringe.

12. Dormicum respiratory function, the dosage should be determined with caution, the special factors relating to each patient being taken into consideration. IV injections must be given slowly (approximately 2.5 mg in 10 sec for induction of anesthesia and 1 mg in 30 sec for basal sedation). The drug takes effect about 2 min after the injection is started. Premedication Before an Operation: IV: For Sedation in Diagnostic or Surgical Interventions Carried Out Under Local Anesthesia: The initial dose is 2.5 mg 5-10 min before the beginning of the operation. Further, doses of 1 mg may be given as necessary. In cases of severe illness, particularly if the patient is in poor general oral condition or of advanced age, the initial dose must be reduced to 1-1.5 mg. IM: Patients Suffering From Pain Before an Intervention: Administration alone or in combination with anticholinergics and possibly analgesics. Adults: 0.07-0.1 mg/kg IM standard dosage about 5 mg, according to age and general condition of the patient. Induction of Anesthesia: IV: As an induction agent in inhalation anesthesia or a sleepinducing component in combined anesthesia. The dose is 10-15 mg IV. A sufficiently deep level of sleep is generally achieved after 23 min. Maintenance of Anesthesia: IV: For maintenance of the desired level of unconsciousness, further small doses should be injected IV. The dose and the intervals between doses vary according to the individual reaction of the patient. When Dormicum is given with potent analgesics, the latter should be administered first so that the sedative effects of Dormicum can be safely titrated on top of any sedation caused by the analgesic. 13. Fortanest Sedation 2 mg by IV inj over 30 sec followed after 2 min by increments of 0.5-1 mg if sedation not adequate. Usual range: 2.5-7.5 mg. Premed 70-100 mcg/kg IM 30-60 min before surgery. Usual dose: 5 mg. Induction 200-300 mcg/kg by slow IV. Childn >7 yr 150 mcg/kg. Sedation of patients in ICU Initially 30-300 mcg/kg by IV infusion over 5 min, then 30-200 mcg/kg/hr. 14. Roculax

Endotracheal intubation 0.6-1.2 mg/kg body wt as IV bolus. Maintenance: 0.1-0.2 mg/kg body wt as intermittent IV inj. Childn Initially 0.6 mg/kg body wt. Maintenance: 0.0750.125 mg/kg body wt. 15. Notrixum Adult IV 0.3-0.6 mg/kg. Endotracheal intubation 0.5-0.6 mg/kg. Full block prolongation 0.10.2 mg/kg. Infusion After an initial 0.3-0.6 mg/kg bolus dose, neuromuscular block may be maintained by administration of 0.3-0.6 mg/kg/hr as a continuous infusion. ICU patients Maintenance of neuromuscular block: 11-13 mcg/kg/min. 16. Esmeron As with other neuromuscular-blocking agents, the dosage of Esmeron should be individualized in each patient. The method of anesthesia, the expected duration of surgery, the method of sedation and the expected duration of mechanical ventilation, the possible interaction with other drugs that are administered concomitantly, and the condition of the patient should be taken into account when determining the dose. The use of an appropriate neuromuscular monitoring technique is recommended for the evaluation of neuromuscular block and recovery. Inhalational anesthetics do potentiate the neuromuscular-blocking effects of Esmeron. This potentiation however, becomes clinically relevant in the course of anesthesia, when the volatile agents have reached the tissue concentrations required for this interaction. Consequently, adjustments with Esmeron should be made by administering smaller maintenance doses at less frequent intervals or by using lower infusion rates of Esmeron during long lasting procedures (>1 hr) under inhalational anesthesia (see Interactions). In adult patients, the following dosage recommendations may serve as a general guideline for tracheal intubation and short to long lasting muscle relaxation. Tracheal Intubation: The standard intubation dose during routine anesthesia is 0.6 mg/kg body weight, after which adequate intubation conditions are established within 60 sec in nearly all patients. A dose of 1 mg/kg body weight is recommended for facilitating tracheal intubation during rapid sequence induction of anesthesia, after which adequate intubation conditions are also established with 60 sec in nearly all patients. If a dose of 0.6 mg/kg body weight is used for rapid sequence induction of anesthesia, it is recommended to intubate the patient 90 sec after administration of rocuronium bromide. In patients undergoing cesarean section, it is recommended to only use a dose of 0.6 mg/kg body weight, since a 1 mg/kg dose has not been investigated in this patient group. Maintenance Dosing: The recommended maintenance dose is 0.15 mg/kg body weight; in the case of long-term inhalational anesthesia this should be reduced to 0.075-0.1 mg/kg body weight. The maintenance doses should best be given when twitch height has recovered to

25% of control twitch height, or when 2-3 response to train of four (TOF) stimulation are present. Continuous Infusion: If Esmeron is administered by continuous infusion, it is recommended to give a loading dose of 0.6 mg/kg body weight and when neuromuscular block starts to recover, start administration by infusion. The infusion rate should be adjusted to maintain twitch response at 10% of control twitch height or to maintain 1-2 sequences to TOF stimulation. In adults under IV anesthesia, the infusion rate required to maintain neuromuscular block at this level ranges from 0.3-0.6 mg/kg/hr, and under inhalational anesthesia, the infusion rate ranges from 0.3-0.4 mg/kg/hr. Continuous monitoring of neuromuscular block is recommended since infusion rate requirements vary from patient to patient and with the anesthetic method used. Children: Children (1-14 years) and infants (1-12 months) under halothane anesthesia manifest similar sensitivity to Esmeron as adults. Onset of action is faster in infants and children than in adults. Clinical duration is shorter in children than in adults. There are no data to support recommendations for the use of Esmeron in neonates (0-1 month). Elderly Patients and Patients with Hepatic and/or Biliary Tract Disease and/or Renal Failure: The standard intubation dose for geriatric patients and patients with hepatic and/or biliary tract disease and/or renal failure during routine anesthesia is 0.6 mg/kg body weight. A dose of 0.6 mg/kg body weight should be considered for rapid sequence induction of anesthesia in patients in which a prolonged duration is expected. Regardless of the anesthetic technique used, the recommended maintenance dose for these patients is 0.075-0.1 mg/kg body weight, and the recommended infusion rate is 0.3-0.4 mg/kg/hr (see also Continuous Infusion). Overweight and Obese Patients: When used in overweight or obese patients (defined as patients with a body weight of 30% above ideal body weight), doses should be reduced taking into account a lean body mass. Dosing to Facilitate Mechanical Ventilation: The use of an initial loading dose of 0.6 mg/kg body weight is recommended, followed by a continuous infusion as soon as twitch height recovers to 10% or upon reappearance of 1-2 twitches to TOF stimulation. Dosage should always be titrated to effect in the individual patient. The recommended initial infusion rate for the maintenance of a neuromuscular block of 80-90% (1-2 twitches of TOF stimulation) in adult patients is 0.3-0.6 mg/kg/hr during the 1st hr of administration, which will need to be decreased during the following 6-12 hrs, according to the individual response. Thereafter, individual dose requirements remain relatively constant. A large between-patient variability in hourly infusion rates has been found in controlled clinical studies, with mean hourly infusion rates ranging from 0.2-0.5 mg/kg/hr depending on nature and extent of organ failure(s), concomitant medication and individual patient characteristics. To provide optimal individual patient control, monitoring of neuromuscular transmission is strongly recommended. Administration up to 7 days has been investigated.

There are no data to support dose recommendations for the facilitation of mechanical ventilation in pediatric and geriatric patients. Administration: Esmeron is administered IV either as a bolus injection or as a continuous infusion (see Instructions for Handling under Cautions for Usage). 17. Farelax Maintenance of neuromuscular block 0.1-0.6 mg/kg/hr as continuous infusion. 18. Ecron Intubation & subsequent surgical procedures Initially 80-100 mcg/kg body wt IV. Incremental doses: 30-50 mcg/kg body wt IV.