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| Alpha2-adrenergic agonist sedative.
INDICATIONS AND USAGE
For Adult Intensive Care Unit Sedation: Generally initiate at one mcg/kg over 10 minutes, followed by a maintenance infusion of 0.2 to 0.7 mcg/kg/hour.
For Adult Procedural Sedation: Generally initiate at one mcg/kg over 10 minutes, followed by a maintenance infusion initiated at 0.6 mcg/kg/hour and titrated to achieve desired clinical effect with doses ranging from 0.2 to 1 mcg/kg/hour.
Alternative Doses: Recommended for patients over 65 years of age and awake fiberoptic intubation patients.
Dosage reductions may need to be considered for adult patients with hepatic impairment, and geriatric patients [see package insert]
WARNINGS AND PRECAUTIONS:
USE IN SPECIFIC POPULATIONS:
DOSAGE FORMS AND STRENGTHS:
| Ultrashort-acting nonbarbiturate hypnotic.
Anesthesia: Initial: 0.2 to 0.6 mg/kg IV over 30-60 seconds for induction of anesthesia; maintenance: 5-20 mcg/kg/minute. Produces rapid induction of anesthesia with minimal cardiovascular effects.
Procedural sedation (usual): 0.1 to 0.2 mg/kg IV over 30-60 seconds
DOSAGE AND ADMINISTRATION (package insert)
Smaller increments of intravenous etomidate may be administered to adult patients during short operative procedures to supplement subpotent anesthetic agents, such as nitrous oxide. The dosage employed under these circumstances, although usually smaller than the original induction dose, must be individualized. There are insufficient data to support this use of etomidate for longer adult procedures or for any procedures in pediatric patients; therefore, such use is not recommended. The use of intravenous fentanyl and other neuroactive drugs employed during the conduct of anesthesia may alter the etomidate dosage requirements. Consult the prescribing information for all other such drugs before using.
Supplied: 2 mg/ml (10 ml, 20 ml) injection.
| fospropofol disodium -LUSEDRA™ Injection CIV
Mechanism of Action:
Fospropofol disodium is a prodrug of propofol. Following intravenous injection, fospropofol is metabolized by alkaline phosphatases. For every millimole of fospropofol disodium administered, one millimole of propofol is produced (1.86 mg of fospropofol disodium is the molar equivalent of 1 mg propofol).
INDICATIONS AND USAGE:
USE IN SPECIFIC POPULATIONS
DOSAGE AND ADMINISTRATION:
Standard dosing regimen: initial intravenous bolus dose of 6.5 mg/kg followed by supplemental doses of 1.6 mg/kg as needed. No initial dose should exceed 16.5 mL; no supplemental dose should exceed 4 mL.
Modified dosing regimen [for patients who are ≥65 years of age or who have severe systemic disease (ASA P3 or P4)]: 75% of the standard dosing regimen.
AAdminister supplemental doses only when patients can demonstrate purposeful movement in response to verbal or light tactile stimulation and no more frequently than every 4 minutes.
Adults who weigh >90 kg should be dosed as if they are 90 kg; adults who weigh <60 kg should be dosed as if they are 60 kg.
Intended for single-use administration only.
DOSAGE FORMS AND STRENGTHS::
WARNINGS AND PRECAUTIONS
To report SUSPECTED ADVERSE REACTIONS, contact Eisai Inc. at 1-888-422-4743 or FDA at 1-800-FDA-1088 or www.fda.gov/medwatch.
| Ketalar is a rapid-acting general anesthetic producing an anesthetic state characterized by profound analgesia, normal pharyngeal-laryngeal reflexes, normal or slightly enhanced skeletal muscle tone, cardiovascular and respiratory stimulation, and occasionally a transient and minimal respiratory depression.
Dosing(adults): Anesthesia (sedation, analgesia): IM: 3-8 mg/kg. IV: Range: 1-4.5 mg/kg; usual induction dosage: 1-2 mg/kg.
Maintenance: Supplemental doses of 1/3 to 1/2 of initial dose.
Supplied: Injection, solution: 50 mg/ml (10 ml); 100 mg/ml (5 ml). Ketalar®: 10 mg/ml (20 ml); 50 mg/ml (10 ml); 100 mg/ml (5 ml).
| Ultra short-acting IV barbiturate anesthetic.
Dosing (adults): Anesthesia: IV: Induction: 50-120 mg to start; 20-40 mg every 4-7 minutes. (doses must be titrated to effect).
Supplied: 500 mg, 2.5 g, 5 gram (powder for reconstitution)
| Short-acting barbiturate with sedative, hypnotic, and anticonvulsant properties.
Dosing (adults): Hypnotic: IM: 150-200 mg. IV: Initial: 100 mg, may repeat every 1-3 minutes up to 200-500 mg total dose. Preoperative sedation: IM: 150-200 mg.
Barbiturate coma in head injury patients or status epilepticus: IV: Loading dose: 5-10 mg/kg given slowly over 1-2 hours; monitor blood pressure and respiratory rate; maintenance infusion: initial: 1 mg/kg/hour; may increase to 2-3 mg/kg/hour; maintain burst suppression on EEG. Status epilepticus: IV: Loading dose: 2-15 mg/kg given slowly over 1-2 hours; maintenance infusion: 0.5-3 mg/kg/hour.
| Dosing (adults):
Induction: General anesthesia: ASA I or II, <55 years: 2-2.5 mg/kg IV (~40 mg every 10 seconds until onset of induction). Cardiac anesthesia: 0.5-1.5 mg/kg IV (~20 mg every 10 seconds until onset of induction). Neurosurgical patients: 1-2 mg/kg IV (~20 mg every 10 seconds until onset of induction).
Maintenance: ASA I or II, <55 years: IV infusion: Initial: 150-200 mcg/kg/minute for 10-15 minutes; decrease by 30% to 50% during first 30 minutes of maintenance; usual infusion rate: 100-200 mcg/kg/minute (6-12 mg/kg/hour). IV intermittent bolus: 20-50 mg increments as needed.
ICU sedation in intubated mechanically-ventilated patients: Avoid rapid bolus injection; individualize dose and titrate to response. Continuous infusion: Initial: 0.3 mg/kg/hour (5 mcg/kg/min); increase by 0.3-0.6 mg/kg/hour (5-10 mcg/kg/min) every 5-10 minutes until desired sedation level is achieved; usual maintenance: 0.3-4.8 mg/kg/hour (5-80 mcg/kg/min) or higher.
Supplied: Injection: 10 mg/ml (20 ml, 50 ml, 100 ml).
| Dosing (adults):
Anesthesia: IV: Induction: 3-5 mg/kg.
Maintenance: 25-100 mg as needed. Increased intracranial pressure: IV: Children and Adults: 1.5-5 mg/kg/dose; repeat as needed to control intracranial pressure.
Seizures: I.V.: 75 to 250 mg/dose, repeat as needed.
Renal dosing: crcl <10 ml/minute: Administer 75% of normal dose.
Supplied: Powder for reconstitution: 250 mg, 400 mg, 500 mg, 1 g.
National Institutes of Health, U.S. National Library of Medicine, DailyMed Database.
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