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All dosages are for adults unless otherwise specified. For details on pediatric dosages, please refer to Chapter 167.

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Anticholinergics
TachycardiaBronchodilationSedationAntisialagogue
Atropine++++++++
Scopolamine+++++++
Glycopyrrolate (Robinul) (does not cross BBB)++++0+++
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See following table.

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Anticoagulants and Reversal
Drug
ArgatrobanDirect thrombin inhibitor2 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 clotDetermine preinfusion (baseline) antithrombin III concentration and calculate initial (loading) dosage using following formula:
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Administer dose to increase antithrombin III concentration to a suggested level of 120% of normal using formula
Enoxaparin (Lovenox)Accelerates activity of antithrombin III30–40 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)
ProtamineCombines 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 S5 mg PO, and then maintenance of 2–10 mg PO for goal INR of 2–3
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Antiemetics
DrugDose (IV)MechanismAnesthetic considerations
Ondansetron (Zofran)4 mg (adults), 0.1 mg/kg (pediatrics) up to 4 mg5-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/kg5-HT3 receptor antagonist
Droperidol (Inapsine)1–2 μg/kg (adults), 0.1 mg/kg (pediatrics)DA antagonist, blocks release of NE, 5-HT, GABAProlongs QT interval (black box warning), hypotension, extrapyramidal effects, avoid in pheochromocytoma, avoid in patients receiving L-dopa therapy
Dexamethasone (Decadron)4–12 mgAntiemetic 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/kgDA 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
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Antifibrinolytics
DrugDosageMechanism 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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