Drug Tables

Drug (Brand)	Induction Dose^a	Infusion Dose	Onset (s)	Duration (min)	VD (L/kg)	Elimination t_1/2 (h)	Contraindications^c	Notes
Propofol (Diprivan)^{[12, 13, 35]}	1–2.5 mg/kg	GA: 100–200 mcg/kg/min Sedation: 25–75 mcg/kg/min	15–45	5–10	2–10	2–24	Absolute: Allergy to eggs, egg products, soybeans, or soy products Relative: Hypotension	Vial must be used within 12 h of opening (lipid emulsion supports bacterial growth)
Etomidate (Amidate)^{[12, 14, 36]}	0.2–0.3 mg/kg	GA: 10 mcg/kg/min	15–45	3–10	4–4.5	3–5	Relative: Adrenal insufficiency	Can cause adrenal suppression (esp. infusion)
Ketamine (Ketalar)^{[12, 15, 37]}	1–2 mg/kg	GA: 30–90 mcg/kg/min Adjunct: 0.1 mg/kg/h	30–60	5–10	2–3	2–4	Absolute: Patients for whom a significant BP elevation poses a serious hazard	Schedule III controlled substance
Methohexital (Brevital)^{[12, 19, 20, 38]}	1–2 mg/kg	GA: 50–150 mcg/kg/min	15–30	5–10	2–3	2–4	Absolute: Porphyria Relative: Status asthmaticus
Thiopental (Pentothal)^{[12, 20]}	3–5 mg/kg	GA: 30–70 mcg/kg/min	15–30	5–10	1.6–8	12	Absolute: Porphyria Relative: Status asthmaticus
Dexmedetomidine (Precedex)^{[12, 21, 39]}	1 mcg/kg^b	Sedation: 0.2–1.4 mcg/kg/h	—	—	1.6	2–3

^aConsider reducing dose by up to 50% for elderly, chronically/critically ill, hypovolemic, heavily premedicated patients.

^bGive over >10 min. Bolus doses can cause transient hypertension.

^cKnown hypersensitivity is an absolute contraindication to all drugs

Source: Adapted from Anders, MG. Chapter 2B. Intraveouns Anesthetics. In: Urman RD, Ehrenfeld JM, eds. Pocket Anesthesia. 4th ed. Philadelphia, PA: Wolters Kluwer; 2021:6.

Agent (Brand)	MAC 30-60 y (%)	MAC >65 y (%)	Partition Coefficients					Boiling Point (°C)	Vapor Pressure at 20° C (mmHg)
Agent (Brand)	MAC 30-60 y (%)	MAC >65 y (%)	Oil:Gas	Blood:Gas	Brain:Blood	Fat:Blood	Muscle:Blood	Boiling Point (°C)	Vapor Pressure at 20° C (mmHg)
Sevoflurane (Ultane)^{[76, 77]}	1.8	1.45	47	0.65	1.7	47.5	3.1	59	157
Isoflurane (Forane)^{[76, 78]}	1.17	1.0	91	1.46	1.6	44.9	2.9	49	238
Desflurane (Suprane)^{[76, 79]}	6.6	5.17	19	0.42	1.3	27.2	2.0	24	669
Halothane (Fluothane)^[76]	0.75	0.64	224	2.5	1.9	51.1	3.4	50	243
Nitrous Oxide^{[76, 80]}	104	—	1.4	0.46	1.1	2.3	1.2	-88	38,770

Source: Adapted from Barash PG, Cullen BF, Stoelting RK, Cahalan MK, Stock MC, Ortega R, Sharar SR, & Holt NF, eds. Clinical anesthesia. 8th ed. Philadelphia, PA: Wolters Kluwer; 2017:461.

Drug (Brand)	Intubation Dose (mg/kg)^a	Infusion Dose^b	Onset (min)^c	Duration to Return		Major Routes of Metabolism/Elimination
Drug (Brand)	Intubation Dose (mg/kg)^a	Infusion Dose^b	Onset (min)^c	≥25% Twitch Height (min)	≥0.9 TOF Ratio (min)	Major Routes of Metabolism/Elimination
Depolarizing
Succinylcholine (Anectine, Quelicin)^{[12, 55]}	0.3–1; RSI: 1–1.2	2.5–5 mg/min^d	1–2	6–8	RSI: 10–12	Plasma cholinesterases
Non-Depolarizing
Rocuronium (Zemuron)^{[12, 56]}	0.6–1.2; RSI: 0.9–1.2	10–12 mcg/kg/min	1–2	30–40; RSI 50–70	55–80	Hepatic (>70%), Renal (10–25%)
Vecuronium (Norcuron)^{[12, 57]}	0.08–0.1	1 mcg/kg/min	2.5–3	35–45	50–80	Hepatic (50–60%), Renal (40–50%)
Pancuronium (Pavuton)^{[12, 58]}	0.1	—	2–3	80–120	130–220	Renal (85%), Hepatic (15%)
Atracurium (Tracrium)^{[12, 59]}	0.4–0.5	9–10 mcg/kg/min	2–2.5	30–45	55–80	Hofmann, nonspecific esterases
Cisatracurium (Nimbex)^{[12, 60]}	0.15–0.2	3 mcg/kg/min	2–3	45–60	60–90	Hofmann

^aCalculate based on ideal body weight.

^bListed infusion doses are recommended initial doses. Adjust subsequent dosing based on twitch monitoring.

^cFor all NMBDs, higher doses have shorter onset time.

^dLimit dose and duration when infusing.

Source: Adapted from Anders, MG. Chapter 2E. Neuromuscular Blocking Drugs and Reversal Agents. In: Urman RD, Ehrenfeld JM, eds. Pocket Anesthesia. 4th ed. Philadelphia, PA: Wolters Kluwer; 2021:28.

Drug (Brand)	Dose (mg/kg)	Peak Antagonism (min)	Duration of Antagonism (min)	Concurrent Anticholinergic Dose		Major Route of Metabolism
Drug (Brand)	Dose (mg/kg)	Peak Antagonism (min)	Duration of Antagonism (min)	Atropine (mcg/kg)	Glycopyrrolate (mcg/kg)	Major Route of Metabolism
Cholinesterase Inhibitors
Edrophonium (Tensilon)^{[12, 61]}	0.75	1–3	45–60	7–10	10^b	30% hepatic
Neostigmine (Prostigmin)^{[12, 62]}	0.03–0.07 (max 5 mg)	7–10	55–75	15–30	10–15	50% hepatic
Pyridostigmine (Mestinon)^{[12, 63]}	0.1–0.25	15–20	80–130	15–20	10	75% hepatic
Binding Agents
Sugammadex (Bridion)^{[12, 40]}	Routine, 2 TOF twitches: 2 Routine, 0 TOF, 1–2 PTC: 4 Immediate: 16	Rocuronium^: 2.1–4.3 Vecuronium^: 2.3–6.6	—	—	—	Not metabolized

^*Measured at a dose of 4 mg/kg

^aDuration of action is increased in renal failure.

^bAtropine is the preferred anticholinergic with edrophonium due to onset times. If using glycopyrrolate, administer several minutes in advance.

Source: Adapted from Anders, MG. Chapter 2E. Neuromuscular Blocking Drugs and Reversal Agents. In: Urman RD, Ehrenfeld JM, eds. Pocket Anesthesia. 4th ed. Philadelphia, PA: Wolters Kluwer; 2021:29.

Drug (Name)	Dose	Onset (min)	Duration	VD (L/kg)	Elimination t_1/2	Potency^a
Fentanyl (Sublimaze)^{[12, 23]}	GA adjunct: 2–20 mcg/kg Intubation adjunct: 1–3 mcg/kg Premed/regional adjunct: 25–100 mcg Infusion: 2–10 mcg/kg/h	1–3	30–60 min	4	3–7 h	100
Remifentanil (Ultiva)^{[12, 24]}	Induction: 1 mcg/kg load over 30–60 s Sedation: Load: 0.5–1 mcg/kg over 30–60 s; Maint: 0.025–0.2 mcg/kg/min^b GA adjunct: Load: 1 mcg/kg; Bolus: 0.5–1 mcg/kg; Maint: 0.05–2 mcg/kg/min	0.5–1.5	4–6 min	0.3–0.4	12–30 min	80–100^c
Sufentanil (Sufenta)^{[12, 25]}	GA adjunct (minor proc): 1–2 mcg/kg load (induction/intubation), then 10–50 mcg boluses prn GA adjunct (moderate proc): 2–8 mcg/kg load, then 10–50 mcg boluses prn or 0.3–1.5 mcg/kg/h infusion GA adjunct (major proc): 8–30 mcg/kg load, then 10–50 mcg boluses prn or 0.5–2.5 mcg/kg/h infusion Sedation: Load: 0.1–0.5 mcg/kg; Infusion: 0.2–0.5 mcg/kg/h	1.5–3	20 min	2.5	2.5–3 h	500–4,000
Alfentanil (Alfenta)^{[12, 26]}	Incremental GA adjunct: 20–50 mcg/kg load (at induction), then 5–15 mcg/kg q5–20min prn (max 75 mcg/kg) Infusion GA adjunct (Spont. ventilation): 8–20 mcg/kg load, then 0.5–1 mcg/kg/min Infusion GA adjunct (Controlled ventilation): 50–75 mcg/kg load, then 0.5–3 mcg/kg/min^d	1.2–5	15 min	0.86	1.5–1.9 h	10–25
Morphine (Astramorph, Duramorph)^{[12, 27]}	Sedation/analgesia: 2–10 mg IV Analgesia: 2–20 mg q2–4h IV, IM, SC Infusion: 0.8–10 mg/h	5–20	2–3 h	3–4	1.5–2 h	1
Hydromorphone (Dilaudid)^{[12, 28]}	Analgesic dosing: 0.4–2 mg IV	15	2–4 h	3.7	2.3 h	5–7
Meperidine (Demerol)^{[12, 29]}	Sedation/analgesia: 50–150 mg IV/IM q3–4h Infusion: 0.3–1.5 mg/kg/h Postoperative shivering: 12.5–25 mg IV	15	2–3 h	3–4.5	2–5 h	0.1

^aRelative to morphine.

^bUse caution when titrating, risk of respiratory depression with propofol.

^cSlightly less potent than fentanyl in most studies.

^dReduce infusion rates by 30–50% for initial hour after induction.

Source: Adapted from Anders, MG. Chapter 2C. Analgesics. In: Urman RD, Ehrenfeld JM, eds. Pocket Anesthesia. 4th ed. Philadelphia, PA: Wolters Kluwer; 2021:11-13.

Drug (Name)	Dose	Max Daily Dose	Onset (min)	Duration (h)	VD (L/kg)	Elimination t_1/2 (h)
Acetaminophen (Tylenol)^{[12, 22]}	PO/PR: 325–650 mg q4–6h or 1,000 mg q6–8h IV (adults >50 kg): 650mg q4h or 1,000 mg q6h over 15 min IV (adults <50 kg): 12.5 mg/kg q4h or 15 mg/kg q6h	PO/PR: 4 g Adults >50 kg: 4 g Adults <50 kg: 3.75 g	PO/PR: 10 IV: 5	4–6	0.9	1.9–2.5
Ketorolac (Toradol)^{[12, 30]}	IV (adults >50 kg and <65 y.o.): 30 mg IV q6h IV (adults <50 kg and >65 y.o.): 15 mg IV q6h	Adults >50 kg and <65 y.o.: 120 mg Adults <50 kg and >65 y.o.: 60 mg	IV: 30	4–6	0.2	5–6
Ibuprofen (Advil, Motrin)^{[12, 31]}	PO: 200–800 mg q6h IV: 400–800 mg q6h	3,200 mg	PO: 15 IV: 30–60	4–6	0.1–0.2	1.9–2.2

Drug (Name)

Dose

Max Daily Dose

Onset (min)

Duration (h)

VD (L/kg)

Elimination t_1/2 (h)

Acetaminophen (Tylenol)^{[12, 22]}

PO/PR: 325–650 mg q4–6h or 1,000 mg q6–8h

IV (adults >50 kg): 650mg q4h or 1,000 mg q6h over 15 min

IV (adults <50 kg): 12.5 mg/kg q4h or 15 mg/kg q6h

PO/PR: 4 g

Adults >50 kg: 4 g

Adults <50 kg: 3.75 g

PO/PR: 10

IV: 5

4–6

0.9

1.9–2.5

Ketorolac (Toradol)^{[12, 30]}

IV (adults >50 kg and <65 y.o.): 30 mg IV q6h

IV (adults <50 kg and >65 y.o.): 15 mg IV q6h

Adults >50 kg and <65 y.o.: 120 mg

Adults <50 kg and >65 y.o.: 60 mg

IV: 30

4–6

0.2

5–6

Ibuprofen (Advil, Motrin)^{[12, 31]}

PO: 200–800 mg q6h

IV: 400–800 mg q6h

3,200 mg

PO: 15

IV: 30–60

4–6

0.1–0.2

1.9–2.2

Source: Adapted from Anders, MG. Chapter 2C. Analgesics. In: Urman RD, Ehrenfeld JM, eds. Pocket Anesthesia. 4th ed. Philadelphia, PA: Wolters Kluwer; 2021:17-19.

Drug (Brand)	Induction Dose^a	Infusion Dose	Onset (min)	Duration (min)	VD (L/kg)	Elimination t_1/2 (h)
Midazolam (Versed)^{[12, 32]}	PO^b IV (premed) IV (induction)	0.25 mg/kg (max 20 mg) 1–2 mg 0.2–0.4 mg/kg	15–30 1–3 0.5–1.5	20–50 3–5 3–5	1–3	1.8–6.4 (active metabolites)
Lorazepam (Ativan)^{[12, 33]}	PO IM IV	1–4 mg 1–4 mg 1–4 mg	30–60 15–30 1–5	60–360 90–120 15–20	1.3	11–22
Diazepam (Valium)^{[12, 34]}	PO IM IV	2–10 mg 2–10 mg 2–10 mg	20–40 10–20 1–5	60–120 30–90 15–30	0.8–1	20–50+ (active metabolites)

Drug (Brand)

Induction Dose^a

Infusion Dose

Onset (min)

Duration (min)

VD (L/kg)

Elimination t_1/2 (h)

Midazolam (Versed)^{[12, 32]}

PO^b

IV (premed)

IV (induction)

0.25 mg/kg (max 20 mg)

1–2 mg

0.2–0.4 mg/kg

15–30

1–3

0.5–1.5

20–50

3–5

1–3

1.8–6.4 (active metabolites)

Lorazepam (Ativan)^{[12, 33]}

1–4 mg

30–60

15–30

1–5

60–360

90–120

15–20

1.3

11–22

Diazepam (Valium)^{[12, 34]}

2–10 mg

20–40

10–20

1–5

60–120

30–90

15–30

0.8–1

20–50+ (active metabolites)

^aFor all IV benzodiazepines, incremental dosing with titration to effect is recommended.

^bTypically used for premedication in pediatrics (0.5 mg/kg). The IV formulation can be added to juice.

Source: Adapted from Anders, MG. Chapter 2B. Intraveouns Anesthetics. In: Urman RD, Ehrenfeld JM, eds. Pocket Anesthesia. 4th ed. Philadelphia, PA: Wolters Kluwer; 2021:9.

Drug (Brand)	Dose (IV)	Infusion Duration (min)	Elimination t_1/2	Redosing Interval (h)^a
Antibacterials
Ampicillin-sulbactam (Unasyn)^{[12, 73]}	3 g (ampicillin 2 g/sulbactam 1 g)	30	0.8–1.3	2
Ampicillin (Principen)^{[12, 73]}	2 g	30	1–1.9	2
Aztreonam (Azactam)^{[12, 73]}	2 g	30	1.3–2.4	4
Cefazolin (Ancef)^{[12, 73]}	<60 kg: 1 g >60 kg: 2 g >120 kg: 3 g	3–5	1.2–2.2	4
Cefuroxime (Ceftin)^{[12, 73]}	1.5 g	3–5	1–2	4
Cefotaxime (Claforan)^{[12, 73]}	1 g^b	3–5	0.9–1.7	3
Cefoxitin (Mefoxin)^{[12, 73]}	2 g	3–5	0.7–1.1	2
Cefotetan (Cefotan)^{[12, 73]}	1–2 g	3–5	2.8–4.6	6
Ceftriaxone (Rocephin)^{[12, 73]}	2 g	3–5	5.4–10.9	10
Ciprofloxacin (Cipro)^{[12, 73]}	400 mg	60	3–7	6–8
Clindamycin (Cleocin)^{[12, 73]}	900 mg	10–60 (<30 mg/min)	2–4	6
Ertapenem (Invanz)^{[12, 73]}	1 g	30	3–5	24
Gentamicin (Cidomycin)^{[12, 73]}	5 mg/kg^c	30–60	2–3	N/A^*
Levofloxacin (Levaquin)^{[12, 73]}	500 mg	60	6–8	14
Metronidazole (Flagyl)^{[12, 73]}	500 mg	30–60	6–8	6–8
Moxifloxacin (Avelox)^{[12, 73]}	400 mg	60	8–15	24
Piperacillin-tazobactam (Zosyn)^{[12, 73]}	3.375 g	30	0.7–1.2	2
Vancomycin (Vancocin)^{[12, 73]}	15 mg/kg	120 min if given via PIV, 60 min if given via central line	4–8	6–12
Antifungals
Fluconazole (Diflucan)^{[12, 73]}	400 mg	≤200 mg/h	30	N/A^*
Micafungin (Mycamine)^{[12, 73]}	100 mg	60	12	N/A^*

^*Generally does NOT require redosing.

^aIn general, redosing should occur at intervals of 1-2 times the half life of the antibiotic. Adjust for renal function prn.

^bSome experts recommend 2 g for obese patients (BMI >30).

^cIf actual body weight >120% of ideal body weight (IBW), use dosing weight (DW): DW = IBW + [0.4 x (actual body weight - IBW)]

Source: Adapted from Bratzler, D. W., Dellinger, E. P., Olsen, K. M. et al., American Society of Health-System Pharmacists, Infectious Disease Society of America, Surgical Infection Society, & Society for Healthcare Epidemiology of America (2013). Clinical practice guidelines for antimicrobial prophylaxis in surgery. American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists, 70(3), 195–283.

Drug (Name)	pKa	Potency^a	Clinical Use	Concentration (%)	Onset	Duration (h)	Max Recommended Dose^b
Amides
Bupivacaine (Marcaine)^{[12, 46, 47]}	8.1	4	Infiltration Epidural Spinal Periph. Block	0.25 0.25–0.75 0.5–0.75 0.25–0.5	Fast Moderate Fast Slow	2–8 2–5 1–4 4–12	2.5 mg/kg (max 175 mg); 3 mg/kg w/ epi (max 225 mg) 150 mg 20 mg 150 mg
Lidocaine (Xylocaine)^{[12, 48, 49]}	7.9	1	Infiltration Topical Epidural Spinal Periph. Block IV regional	0.5–1 4 1.5–2 1.5–5 1–1.5 0.25–0.5	Fast	1–4 0.5–1 1–2 0.5–1 1–3 0.5–1	4.5 mg/kg (max 300 mg); 7 mg/kg w/ epi (max 500 mg) 300 mg 300 mg; 500 mg w/ epi 100 mg 300 mg; 500 mg w/ epi 300 mg
Mepivacaine (Carbocaine)^{[12, 50, 51]}	7.6	1.4	Infiltration Epidural Spinal Periph. Block	0.5–1 1.5–2 2–4 1–1.5	Fast	1–4 1–3 1–2 2–4	400 mg; 500 mg w/ epi 400 mg; 500 mg w/ epi 100 mg 400 mg; 500 mg w/ epi
Prilocaine (Citanest)^{[12, 54]}	7.9	1.2	Infiltration Epidural Periph. Block	0.5–1 2–3 1.5–2	Fast	1–2 1–3 1.5–3	600 mg
Ropivacaine (Naropin)^{[12, 52]}	8.1	2.9	Infiltration Epidural Periph. Block	0.2–0.5 0.05–0.1 0.5–1	Fast Moderate Slow	2–6 2–6 5–8	200 mg 200 mg 250 mg
Esters
Chlorprocaine (Nesacaine)^{[12, 41, 42]}	8.7	0.3	Infiltration Epidural Periph. Block	1 2–3 2	Fast	0.5–1	800 mg; 1,000 mg w/ epi
Cocaine^{[12, 43]}	8.6	N/A	Topical	2–12	Fast	0.5–1	150 mg
Procaine (Novocaine)^{[12, 44]}	8.9	0.3	Spinal	10	Fast	0.5–1	7 mg/kg; 10 mg/kg w/ epi (1,000 mg max)
Tetracaine (Pontocaine)^{[12, 45]}	8.5	2.0	Topical Spinal	2 0.5	Fast	0.5–1 2–6	20 mg

^aRelative to lidocaine. Indicative of CNS toxicity.

^bConsider reduction with extremes of age, pregnancy, hepatic/renal function, cardiac dysfunction.

Source: Adapted from Anders, MG. Chapter 2D. Local Anesthetics. In: Urman RD, Ehrenfeld JM, eds. Pocket Anesthesia. 4th ed. Philadelphia, PA: Wolters Kluwer; 2021:22-23.

Drug Tables

Intravenous Anesthetics

Volatile Anesthetics

Neuromuscular Blocking Drugs

Neuromuscular Blockade Reversal

Opioid Analgesics

NSAIDs

Benzodiazepines

Antibiotics

Local Anesthetics