Page 263 - Critical Care Notes

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pancuronium, Pavulon: Neuromuscular blockade. Uses: Facilitation of endotra-
cheal intubation, skeletal muscle relaxation during mechanical intubation,
surgery or general anesthesia. Dosages: IV 0.04–0.1 mg/kg, then 0.01 mg/kg
1
every ⁄2–1hr.
phenylephrine, Neo-Synephrine: adrenergic, direct acting. Uses: Hypotension,
paroxysmal SVT, shock, maintain BP for spinal anesthesia. Dosages:
Hypotension: SC/IM 2–5 mg, may repeat every 10–15 min if needed, do not
exceed initial dose; IV 50–100 mcg, may repeat every 10–15 min if needed, do
not exceed initial dose. SVT: IV bolus 0.5–1 mg given rapidly, not to exceed
prior dose by >0.1 mg, total dose 1 mg. Shock: IV infusion 10 mg/500 mL
D5W given 100–180 mcg/min, then maintenance of 40–60 mcg/min.
procainamide, Pronestyl: Antidysrhythmic. Uses: Life-threatening ventricular
dysrhythmias. Dosages: Atrial fibrillation/PAT: PO 1–1.25 g; may give another
750 mg if needed; if no response, 500 mg–1 g every 2 hr until desired
response; maintenance 50 mg/kg in divided doses every 6 hr. Ventricular
tachycardia: PO 1 g; maintenance 50 mg/kg/day given in 3-hr intervals;
sustained release 500 mg–1.25 g every 6 hr. Other dysrhythmias: IV bolus
100 mg every 5 min, given 25–50 mg/min, not to exceed 500 mg; or
17 mg/kg total, then IV infusion 2–6 mg/min.
propofol, Diprivan: General anesthetic. Uses: Induction or maintenance of
anesthesia as part of balanced anesthetic technique; sedation in mechani-
cally ventilated patients. Dosages: Induction IV 2–2.5 mg/kg, approximately
40 mg every 10 sec until induction onset. Maintenance IV 0.1–0.2 mg/kg/min
(6–12 mg/kg/hr). ICU sedation: IV 5 mcg/kg/min over 5 min; may give
5–10 mcg/kg/min over 5–10 min until desired response.
rocuronium, Zemuron: Neuromuscular blocker (nondepolarizing). Uses:
Facilitation of endotracheal intubation, skeletal muscle relaxation during
mechanical ventilation, surgery or general anesthesia. Dosages: Intubation:
IV 0.6 mg/kg.
streptokinase, Streptase: Thrombolytic enzyme. Uses: DVT, PE, arterial throm-
bosis, arteriovenous cannula occlusion, lysis of coronary artery thrombi
after MI, acute evolving transmural MI. Dosages: Lysis of coronary artery
thrombi: IC 20,000 units, then 2,000 international units/min over 1 hr as
IV infusion. Arteriovenous cannula occlusion: IV infusion 250,000 interna-
tional units/2 mL solution into occluded limb of cannula run over ⁄2 hr;
1
clamp for 2 hr, aspirate contents; flush with NaCl solution and reconnect.
Thrombosis/embolism/DVT/pulmonary embolism: IV infusion 250,000
international units over 1/2 hr, then 100,000 international units/hr for 72 hr
for deep vein thrombosis; 100,000 international units/hr over 24–72 hr for
pulmonary embolism; 100,000 international units/hr for 24–72 hr for arterial
thrombosis or embolism. Acute evolving transmural MI: IV infusion
1,500,000 international units diluted to a volume of 45 mL; give within 1 hr;
intracoronary infusion 20,000 international units by bolus, then 2,000 inter-
national units/min for 1 hr, total dose 140,000 international units.
CC MEDS