All dosages are for adults unless otherwise specified. For details on pediatric dosages, please refer to Chapter 167.
|Glycopyrrolate (Robinul) (does not cross BBB)||++||++||0||+++|
Anticoagulants and Reversal
|Argatroban||Direct thrombin inhibitor||2 μg/kg/min infusion up to 10 μg/kg/min (HIT), 350 μg/kg IV over 2–5 min with 25 μg/kg/min infusion (PCI in patients with HIT)|
|Antithrombin III (ATIII, Thrombate III)||Binds coagulation factors, preventing formation of clot||Determine preinfusion (baseline) antithrombin III concentration and calculate initial (loading) dosage using following formula:|
|Administer dose to increase antithrombin III concentration to a suggested level of 120% of normal using formula|
|Enoxaparin (Lovenox)||Accelerates activity of antithrombin III||30–40 mg SC bid (DVT prophylaxis), 1 mg/kg SC q12 h or 1.5 mg/kg SC q day (Tx of DVT), 1.5 mg/kg/dose SC q12 h (ACS)|
|Protamine||Combines with heparin (strong acid) to form a stable complex (salt)||1 mg protamine per mg of active heparin|
|Warfarin (Coumadin)||Inhibits factors 2, 7, 9, 10 and proteins C and S||5 mg PO, and then maintenance of 2–10 mg PO for goal INR of 2–3|
|Drug||Dose (IV)||Mechanism||Anesthetic considerations|
|Ondansetron (Zofran)||4 mg (adults), 0.1 mg/kg (pediatrics) up to 4 mg||5-HT3 receptor antagonist|
- Prolongs QT interval
- Hepatic clearance
|Granisetron (Kytril)||1 mg (adults), 10 μg/kg (pediatrics)||5-HT3 receptor antagonist|
|Dolasetron (Anzemet)||12.5 mg (adults), 0.35 mg/kg||5-HT3 receptor antagonist|
|Droperidol (Inapsine)||1–2 μg/kg (adults), 0.1 mg/kg (pediatrics)||DA antagonist, blocks release of NE, 5-HT, GABA||Prolongs QT interval (black box warning), hypotension, extrapyramidal effects, avoid in pheochromocytoma, avoid in patients receiving L-dopa therapy|
|Dexamethasone (Decadron)||4–12 mg||Antiemetic mechanism unclear|
- Administer with caution in patients with DM
- Useful if airway trauma during repeated intubations
- Useful as antiemetic (4 mg)
|Metoclopramide (Reglan)||0.25 mg/kg||DA antagonist centrally, peripheral cholinomimetic|
- Avoid in patients with pheochromocytoma
- Can cause extrapyramidal side effects, neuroleptic malignant syndrome
- Does not affect gastric pH
|Promethazine (Phenergan)||12.5–25 mg|
- H1 receptor antagonist
- DA blocker
- Partial alpha-blocker
- Respiratory depression
- CNS depression
- Rare neuroleptic malignant syndrome
|Drug||Dosage||Mechanism of action|
|Aminocaproic acid (Amicar)|
- Acute bleeding: 4–5 g during the first hour, followed by 1 g/h for 8 h or until bleeding controlled (maximum daily dose: 30 g)
- Thrombocytopenia: 0.1 g/kg over 30–60 min
|Blocks activation of plasminogen ...|
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