|
| |
| Commonly used critical care
medications |
| NM blocker, analgesics, sedative |
| Drug |
Usual dose |
Onset of action |
Duration of action after single
dose |
| Succinylcholine |
1.0-1.5 mg/kg |
45-60 sec |
2-10 min |
| Pancuronium |
0.05-0.08 mg/kg |
2-4 min
|
40-60 min |
| Midazolam |
1-4 mg
Drip: 1-10 mg/hr |
1-5 min |
30-60 min |
| Morphine |
2-5 mg
Drip: 1-10 mg/hr |
2-10 min |
2-4 hr |
| Propofol |
0.25-1 mg/kg
Drip: 50-100 ug/kg/min |
15-60 sec
|
3-10 min |
| Antihypertensives |
| Labetolol |
20 to 80 mg every 10 min, drip 0.5-2mg/min |
| Vasotec |
1.25-2.5 mg iv q 6 hr |
| Nicardipine |
5mg/hr, increase by 1-2.5mg/hr, up to 15 mg/hr |
| Antiemetics |
 | Prochlorperazine (Compazine) 5 to 10 mg IV Q6h.
 | May cause hypotension and dystonic reactions. |
|
| Metoclopramide (Reglan): 5 to 10 mg or more (up to 30 mg) IV Q6h. May
cause dystonic reactions. |
| Droperidol (Inapsine): 1.25 to 2.5 mg IV. May be sedating. |
| Ondansetron (Zofran): 4 mg IV over 15 minutes (expensive).
| Does not cause dystonia. |
|
|
| DVT prophylaxis |
| High risk |
Moderate risk |
| Heparin 5000 u q8 |
| Fragmin 5000 iu qd |
| Lovenox 30 bid |
|
| Heparin 5000 u bid |
| Fragmin 2500 iu qd |
| Lovenox 30 mg qd |
|
| Miscellaneous |
| For Myxedema coma: Thyroxine T4 500 µg IV followed
by oral thyroxine 0.1 mg QD. (or T3 40 µg IV if available) |
| Diabetes insipidus: DDAVP 10 to 25 µg intranasally BID to
reduce polydipsia or polyuria. |
|
| Further |
|
|
| Treatment of adverse reaction from
neuro drug |
| Drug causing adverse effect |
Antidote & Usual adult dose |
| Anticholinergics |
| Physostigmine Sulfate: 0.5-2.0 mg IV (IM) over 2 min q30-60 min prn |
|
| Anticholinesterases |
| Atropine sulfate: 1-5 mg iv (IM,SC) q15 min prn to drying of secretions |
|
| Acute extrapyramidal reaction |
| Diphyhydramine: 25-50 mg IV (IM, PO) prn |
| Benztropine mesylate (Cogentin) 1-2 mg iv (IM, PO) prn |
|
| Opiods |
| Naloxone: 0.4-2 mg IV (IM), may repeated every
2 min as needed. May precipitate withdraw. |
|
| Warfarin |
| Vit K1. 10 mg IM, SC |
|
| Benzodiazepine |
| Flumazenil
| 0.2 mg is given over 30 seconds, followed by
0.3 and 0.5 mg at 1-minute intervals to a maximum dose of 3 mg. |
| For recurrent sedation, 0.2 mg flumazenil is
administered intravenously as required, to a total of 1 mg/h, or
is infused at 0.5 mg/h. |
| In coma due to multiple-drug
overdose, flumazenil reverses only the benzodiazepine component of
CNS depression |
| Risks of seizures, arrhythmias, and withdrawal
symptoms, it cannot be recommended for the patient with coma of
unknown origin and a possibly mixed toxic ingestion. |
|
|
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|
