Last Updated on May 30, 2022
| wdt_ID | Medication | Dose - IV | Onset | Duration | Class | Action | Advantages | Disadvantages | Adverse Effect | Antidote | Precaution |
|---|---|---|---|---|---|---|---|---|---|---|---|
| 1 | Propofol | Procedural sedation (adult) • 0.5 - 1 mg / kg (repeat every 1 - 2 minutes until desired effect) • Half dose if >65 yrs |
IV: 40 seconds | IV: 6 mins | • Rapid onset & recovery• Sedative & amnesic effetcs | • No analgesia properties | • C&S and respiratory depression, especially when used with opioids | • Contraindicated in soy / egg allergies | |||
| 2 | Midazolam | Procedural sedation (adult) • 0.1 mg / kg in divided doses Procedural sedation (paeds) • 0.05 mg / kg in divided doses (max 2 mg if |
IV: 2 - 5 mins | IV: 30 - 60 mins | Benzodiazepine | • Anxiolytic properties• Sedative & amnesic effects | • No analgesia properties | • C&S and respiratory depression, especially when used with opioids• Hypotension | Flumazenil | ||
| 3 | Ketamine | Procedural sedation (adult) • 1 - 2 mg/kg, followed by 0.25 - 0.5 mg/kg every 5 - 10 mins Procedural sedation (paeds) • 1 mg/kg slow bolus |
IV: 30 seconds | IV: 10 - 20 mins | • Bronchodilatation | • Fairly safe• Side effects rare• Sedative + analgesic properties• Dissociative amnesic• Useful in asthma patients (bronchodilator effect) | • Laryngospasm with large doses (uncommon) | • In paeds, use in conjunction with atropine to decrease secretions | |||
| 4 | Fentanyl | Procedural sedation (adult) • 0.5 - 1 µg/kg, then every 2 mins till appropriate level of analgesia (max 2 µg/kg) • Half dose in elderly • Usual dose: 50 µg stat Procedural sedation (paeds) • 0.5 µg/kg every 2 mins (max 2 µg/kg) |
IV: 2 - 3 mins | IV: 30 - 60 mins | Analgesia | • Rapid analgesic effect• Minimal histamine release (anaphylactoid reaction)• Short duration• No intermediate metabolites (therefore ideal analgesic for patients with chronic renal / liver disease) | • Respiratory depression with concurrent use of sedative• Chest wall rigidity with large doses• Hypotension (uncommon) | • For use in combination with propofol & midazolam, to give Fentanyl 15 mins before sedatives | |||
| 5 | Morphine | Procedural sedation (adult) • 0.1 - 0.2 mg/kg in divided doses • Half dose in elderly Procedural sedation (paeds) • 0.01 - 0.04 mg/kg in divided doses |
IV: >5 mins | 3 - 4 hours | Opioid analgesia | • Can be titrated | • Slow onset with prolonged action• Causes histamine release | • Respiratory & CNS depression• Vomiting | Naloxone | • For use in combination with propofol & midazolam, to give Fentanyl 15 mins before sedatives | |
| 6 | Naloxone | Adult • IV 0.2 mg over 15 seconds • If no response after 1 min, repeat with 0.3 mg • If no response after 1 min, repeat with 0.5 mg • Repeat till max cumulative dose of 5 mg/hr Paeds • IV 0.01 mg/kg every 1 hour |
IV: 1 min | IV: 45 mins | • Fairly safe | ||||||
| 7 | Flumazenil | Adult 100 µg every 2 - 3 mins till reversal Paeds 0.1 mg |
IV: 1 - 2 mins | IV: 10 - 15 mins | • Fairly safe | • Half life shorter than benzodiazepine half life | |||||
| 8 | Clotrimazole (Canesten) | Antifungal | |||||||||
| 9 | |||||||||||
| 10 | |||||||||||
| Medication | Onset | Duration | Class | Action | Advantages | Disadvantages | Adverse Effect | Antidote | Precaution |