Pharm/Phys II

Etomidate brand name

Amidate

Etomidate class

Nonbarbiturate hypnotic, anesthesia induction agent

Etomidate Mechanism of Action

Ultra-short-acting hypnotic that produces rapid sedation with minimal cardiovascular or respiratory depression

Etomidate indications

Premedication for medication-facilitated intubation and procedural sedation

Etomidate Contraindications

Known hypersensitivity, Septic shock

Etomidate Adverse Rxn/Side effects

Transient apnea, Respiratory depression, hypoventilation, Nystagmus

Etomidate dosage for Adult RSI

0.3 mg/kg IVP/IOP

Etomidate Dosage for Synchronized Cardioversion

10 mg IVP/IOP

Etomidate Dosage for Pediatric RSI

0.3 mg/kg IVP/IOP

Fentanyl Brand name

Sublimaze

Fentanyl Class

Synthetic opioid analgesic. Schedule II

Fentanyl Mechanism of action

Binds to opioid receptors producing analgesia and sedation

Fentanyl Indications

Pain management, anesthesia adjunct

Fentanyl contraindications

Known hypersensitivity

Fentanyl Adverse rxns/side effects

CNS depression, sedation, respiratory depression, apnea, Nausea/vomiting, wooden chest syndrome

Fentanyl Adult pain control dose

1 mcg/kg IVP/IOP/IN; Commonly 50-100 mcg

Fentanyl Adult RSI/DSI

100 to 200 mcg IVP/IOP

Fentanyl Pediatric pain control dose

2 mcg/kg IVP/IOP; Commonly 25-50 mcg

Fentanyl pediatric RSI/DSI dose

50 to 100 mcg IVP/IOP

Ketamine brand name

Ketalar

Ketamine class

Dissociative anesthetic, Schedule III

Ketamine Mechanism of action

NMDA receptor blocker. Blocks pain receptors and minimizes spinal cord activity, affecting the brain’s association pathway between the thalamus and the limbic system.

Ketamine indications

Procedural sedation, management of agitated or violent behavior, pain control

Ketamine Contraindications

Known hypersensitivity, Infants < 3 months

Ketamine Adverse Rxns/Side effects

Hypertension, Hallucinations, Bronchodilation, hypersalivation, laryngospasm, tachycardia, transient apnea, nausea/vomiting

Ketamine Adult procedural sedation dose

1 to 2 mg/kg IVP/IOP; Follow with benzodiazepine

Ketamine adult pain control dose

0.25 mg/kg IVP/IOP; Pre-medicate with 25-50 mcg Fentanyl

Ketamine adult chemical restraint dose

2 mg/kg IVP/IOP or 4 mg/kg IM; Follow with benzodiazepine

Ketamine pediatric dosages

Same as adult

Midazolam brand name

Versed

Midazolam Class

Benzodiazepine; Schedule IV

Midazolam mechanism of action

Increases the affinity of GABA to receptors in the CNS causing sedative, anxiolytic, amnesic, and hypnotic effects.

Midazolam indications

Seizure, chemical restraint, sedation for chemical procedures

Midazolam contraindications

Known hypersensitivity, shock, depressed vital signs, respiratory depression

Midazolam side effects

Headache, somnolence, respiratory depression, hypotension

Midazolam Adult sedation/seizure dose

2.5 to 5 mg IVP/IOP/IM/IN Repeat as needed until maximum dose of 0.1 mg/kg

Midazolam Adult eclampsia dose

10 mg IM

Midazolam pediatric sedation and seizure dose

0.1 mg/kg IVP/IOP/IM, 0.2 mg/kg IN; Maximum single dose of 5 mg