Skip to Main Content

++

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

++

++
Table Graphic Jump Location
Favorite Table | Download (.pdf) | Print
Anticholinergics
TachycardiaBronchodilationSedationAntisialagogue
Atropine++++++++
Scopolamine+++++++
Glycopyrrolate (Robinul) (does not cross BBB)++++0+++
++

See following table.

++
Table Graphic Jump Location
Favorite Table | Download (.pdf) | Print
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:
Image not available.
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
++
Table Graphic Jump Location
Favorite Table | Download (.pdf) | Print
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
++
Table Graphic Jump Location
Favorite Table | Download (.pdf) | Print
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 ...

Want remote access to your institution's subscription?

Sign in to your MyAccess profile while you are actively authenticated on this site via your institution (you will be able to verify this by looking at the top right corner of the screen - if you see your institution's name, you are authenticated). Once logged in to your MyAccess profile, you will be able to access your institution's subscription for 90 days from any location. You must be logged in while authenticated at least once every 90 days to maintain this remote access.

Ok

Create a Free MyAccess Profile

* Required Fields

Note: If you have registered for a MyAccess profile on any of the Access sites, you can use the same MyAccess login credentials across all sites.

Passwords must be between 6 and 40 characters long (no whitespace), cannot contain characters #, &, and must contain:
  • at least one lowercase letter
  • at least one uppercase letter
  • at least one digit

Benefits of a MyAccess Profile:

  • Remote access to the site off-campus on any device
  • Notification of new content via custom alerts
  • Bookmark your favorite content such as chapters, figures, tables, videos, cases and more
  • Save and download images to PowerPoint
  • Self-Assessment quizzes saved for quick review
  • Custom Curriculum access for both instructors and learners

Subscription Options

AccessAnesthesiology Full Site: One-Year Subscription

Connect to the full suite of AccessAnesthesiology content and resources including procedural videos, interactive self-assessment, real-life cases, 20+ textbooks, and more

$995 USD
Buy Now

Pay Per View: Timed Access to all of AccessAnesthesiology

24 Hour Subscription $34.95

Buy Now

48 Hour Subscription $54.95

Buy Now

Pop-up div Successfully Displayed

This div only appears when the trigger link is hovered over. Otherwise it is hidden from view.