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Drug
Comment
Dosage
Rectal
40 mg/kg
PO
1020 mg/kg
60 mg/kg
Rapid IV bolus
0.1 mg/kg
Repeat dose
0.2 mg/kg
Maximum dose
12 mg
Albuterol
Nebulized
1.252.5 mg in 2 mL
saline
Alfentanil
2025 g/kg
Maintenance infusion
13 g/kg/min
5 mg/kg
5 mg/kg
Infusion
510 g/kg/min
Maximum dose
20 mg/kg/day
56 mg/kg
0.50.9 mg/kg/h
Amoxicillin
PO
50 mg/kg
Ampicillin
IV
50 mg/kg
Ampicillin/sulbactam
IV
2550 mg/kg
Amrinone
Loading (IV)
0.751 mg/kg
Maintenance
510 g/kg/min
IV
0.010.02 mg/kg
IM
0.02 mg/kg
Minimum dose
0.1 mg
Premedication (PO)
0.030.05 mg/kg
Atracurium
Intubation (IV)
0.5 mg/kg
Bretylium
5 mg/kg
Caffeine
IV
10 mg/kg
Calcium chloride
IV (slowly)
520 mg/kg
Calcium gluconate
IV (slowly)
15100 mg/kg
Cardioversion
0.52 J/kg
Cefazolin
IV
25 mg/kg
Acetaminophen
Adenosine
Amiodarone
Aminophylline
Atropine
Cefotaxime
IV
2550 mg/kg
Cefotetan
IV
2040 mg/kg
Cefoxitin
IV
3040 mg/kg
Ceftazidime
IV
3050 mg/kg
Ceftriaxone
IV
2550 mg/kg
Cefuroxime
IV
25 mg/kg
Chloral hydrate
PO
25100 mg/kg
Rectal
50 mg/kg
Cimetidine
IV or PO
510 mg/kg
Cisatracurium
Intubation (IV)
0.15 mg/kg
Clindamycin
IV
20 mg/kg
Dantrolene
2.5 mg/kg
Maximum dose
10 mg/kg
First attempt
2 J/kg
Subsequent attempts
4 J/kg
Desmopressin
IV
0.20.4 g/kg
Dexamethasone
IV
0.10.5 mg/kg
Dextrose
0.51 g/kg
Diazepam
Sedation (IV)
0.10.2 mg/kg
Digoxin
1530 g/kg
Diltiazem
IV over 2 min
0.25 mg/kg
Diphenhydramine
IV, IM, or PO
1 mg/kg
Dobutamine
Infusion
220 g/kg/min
Dolasetron
IV
0.35 mg/kg
Dopamine
Infusion
220 g/kg/min
Droperidol
IV
5075 g/kg
Edrophonium
0.51 mg/kg
Ephedrine
IV
0.10.3 mg/kg
Epinephrine
IV bolus
0.01 mg/kg
Endotracheal dose
0.1 mg/kg
Infusion
0.11.0 g/kg/min
Nebulized
0.05 mL/kg in 3 mL
saline
Esmolol (bolus)
IV
0.10.5 mg/kg
Esmolol (infusion)
IV
25200 g/kg/min
Famotidine
IV
0.15 mg/kg
Defibrillation
Fentanyl
12 g/kg
2 g/kg
Premedication (Actiq)
1015 g/kg
15 g/kg
Maintenance infusion
24 g/kg/h
50100 g/kg
Flumazinil
IV
0.01 mg/kg
Fosphenytoin
IV
1520 mg/kg
Furosemide
IV
0.21 mg/kg
Gentamicin
IV
2 mg/kg
Glucose
IV
0.51 g/kg
Glucagon
IV
0.51 mg
Glycopyrrolate
IV
0.01 mg/kg
Granisetron
IV
0.04 mg/kg
Heparin
IV
100 U/kg
Hydrocortisone
IV
1 mg/kg
Hydromorphone
IV
1520 g/kg
Ibuprofen
PO
410 mg/kg
Imipenem
IV
1525 mg/kg
Insulin
Infusion
0.020.1 U/kg/h
Isoproterenol
Infusion
0.11 g/kg/min
Ketamine
Induction (IV)
12 mg/kg
Induction (IM)
610 mg/kg
10 mg/kg
Maintenance infusion
2575 g/kg/min
Premedication (PO)
610 mg/kg
Sedation (IV)
23 mg/kg
Sedation (IV)
0.51 mg/kg
Ketorolac
IV
0.50.75 mg/kg
Labetalol
IV
0.25 mg/kg
Lidocaine
Loading
1 mg/kg
Maintenance
2050 g/kg/min
IV (slowly)
2550 mg/kg
2g
Mannitol
IV
0.251 g/kg
Meperidine
0.20.5 mg/kg
Premedication (IM)
1 mg/kg
Magnesium
Methohexital
Induction (IV)
12 mg/kg
2530 mg/kg
Induction (IM)
10 mg/kg
Methylprednisolone
IV
24 mg/kg
Metoclopramide
IV
0.15 mg/kg
Metronidazole
IV
7.5 mg/kg
Midazolam
Premedication (PO)
0.5 mg/kg
20 mg
Sedation (IM)
0.10.15 mg/kg
7.5 mg
Sedation (IV)
0.05 mg/kg
Loading (IV)
5070 g/kg
Maintenance
0.3750.75
g/kg/min
Intubation (IV)
0.20.3 mg/kg
Infusion
324 g/kg/min
0.0250.1 mg/kg
Premedication (IM)
0.1 mg/kg
Naloxone
IV
0.01 mg/kg
Neostigmine
0.040.07 mg/kg
Nitroglycerin
IV
0.53 g/kg/min
Nitroprusside
Infusion
0.58 g/kg/min
Norepinephrine
Infusion
0.12 g/kg/min
Ondansetron
IV
0.1 mg/kg
Oxacillin
IV
50 mg/kg
Pancuronium
IV
0.1 mg/kg
Penicillin G
IV
50,000 U/kg
Pentobarbital
Premedication (IM)
46 mg/kg
Phenobarbital
13 mg/kg
520 mg/kg
Phentolamine
IV
30 g/kg
Phenylephrine
IV
110 g/kg
Phenytoin
Slowly IV
520 mg/kg
Physostigmine
IV
0.010.03 mg/kg
Prednisone
PO
1 mg/kg
Protamine
IV
1 mg/100 U heparin
Procainamide
15 mg/kg
Milrinone
Mivacurium
Morphine
Propanolol
IV
1025 g/kg
Propofol
Induction (IV)
23 mg/kg
Maintenance infusion
60250 g/kg/min
Prostaglandin E1
Infusion
0.050.1 g/kg/min
Ranitidine
IV
0.251.0 mg/kg
Remifentanil (bolus)
IV
0.251 g/kg
Remifentanil (infusion)
IV
0.052 g/kg/min
Rocuronium
Intubation (IV)
0.61.2 mg/kg
Scopolamine
IV
0.01 mg/kg
Sodium bicarbonate
IV
1 mEq/kg
Succinylcholine
Intubation (IV)
23 mg/kg
Intubation (IM)
46 mg/kg
Premedication (Intranasal)
2 g/kg
0.51 g/kg
Maintenance infusion
0.52 g/kg/h
1015 g/kg
Induction (IV)
56 mg/kg
(per rectum)
2530 mg/kg
Sufentanil
Thipental
Trimethoprim/sulfamethoxazole IV
45 mg/kg
Vancomycin
IV
20 mg/kg
Vecuronium
IV
0.1 mg/kg
Verapamil
IV
0.10.3 mg/kg
Methohexita
13
<30
510
++
+
l
Propofol
1.52.5
1545
510
+
++
0
Midazolam
0.20.4
3090
1030
0
0
0
0/
Diazepam
0.30.6
4590
1530
0
+/+++
0
0/
Lorazepam 0.030.06 60120 60120
0
++
0
0/
Etomidate
0.20.3
1545
312
+++
+++
0
0
Ketamine
12
4560
1020
+
0
Table 19-4 Dosage for Fentanyl, Sufentanil, Alfentanil, and Remifentanil During Elective
Surgery in Adultsa
ANESTHETIC
PHASE
FENTANYL SUFENTANIL ALFENTANIL REMIFENTANIL
Premedication (g)
2550
25
250500
Induction
With hypnotic
1.55
0.11
1050
0.51.0
(g/kg)
and/or 0.250.5
g/kg/min
With 6070% N2O
823
1.32.8
(g/kg)
High-dose opioid
50
1030
120
25
(g/kg)
+/or 2 g/kg/min
Maintenance
Balanced anesthesia
Intermittent bolus
25100
520
250500
2550
(g)
Infusion
0.033
0.0050.015
0.51.5
0.250.05
(g/kg/min)
High dose opioid
0.5
2.510
1.03.0
(g/kg/min)
0.050.15
Transition to PACU
(g/kg/min)
Monitored Anesthesia Care
Intermittent bolus
12.550
2.510
125250
12.525
(g)
Infusion (g/kg/min)
0.010.2
PACU, postanesthesia care unit.
a
Doses are guidelines for hemodynamically stable adults. They should be adjusted downward for
elderly patients and those with cardiac dysfunction and hemodynamic instability.
Agent
Blood/Gas
Brain/Blood
Muscle/Blood
Fat/Blood
Nitrous oxide
0.47
1.1
1.2
2.3
Halothane
2.4
2.9
3.5
60
Isoflurane
1.4
2.6
4.0
45
Desflurane
0.42
1.3
2.0
27
Sevoflurane
0.65
1.7
3.1
48
These values are averages derived from multiple studies and should be used for comparison
purposes, not as exact numbers.