ActrapidA fast acting human insulin
product, which is used to reduce the high blood sugar level in patients with diabetes
mellitus. Actrapid® will start to lower your blood sugar approximately 30 minutes after
injection, and the effect will last for approximately 8 hours.
100 IU/ml: dilution is 50 IU (0.5 ml) in 50 ml Saline (Luer lock syringe), giving 1 IU/ml.
A typical dose is 0.3 - 1 IU/kg/day.
Shelf life: before opening - 30 months;
after opening - stored for a maximum of 6 weeks.
(Store at 2-8°C)
A hormone neurotransmitter of the sympathetic nervous system, secreted by the
medulla of the adrenal gland, in response to stimulation of the sympathetic
nervous system, causing vasoconstriction and increase in cardiac output.
- Promotes fight-or-flight response
- Relaxes smooth muscle in the airways (dilating bronchioles)
- Vasoconstriction of most arterioles - raising blood pressure
- Stimulates cardiac output, and increases heart rate
- Increases blood flow to the brain
- Causes the liver to release glycogen
Pharmacological Adrenaline (Epinephrine) is administered in cases of asthma,
anaphylactic shock, cardiac arrest, and collapse.
||1g in 10,000 ml
1 mg in 10 ml
|1g in 1,000 ml|
1 mg in 1 ml
|Dose||1 mg (10 ml)
||0.5 mg (0.5 ml)|
|If repeated:||Every 3-5 mins
||At 5 mins|
- Pulmonary oedema
AlfentanilIntra-operative opioid (quick
acting, 10-15 mins ½ life) with an onset which is 4 times faster than Fentanyl, a
¼ the potency, and about a 1/3 of the duration. Respiratory
depression may be a side-effect.
AmikacinA demi-synthetic aminoglycoside
antibiotic for treating hospital-acquired broad spectrum infections.
to reverse airway obstruction, and treatment for acute severe asthma. Brand name:
An anti-arrhythmic agent, which causes peripheral vasodilation. Hypotension
occurs when given I.V.
For shockable rhythms, an initial bolus of 5 mg/kg
should be given, after the third shock. If still in VF/VT, a repeat dose is to be
given after the fifth shock. If given peripherally, flush with normal saline.
ADH aka Vasopressin: Peptide hormone from the pituitary gland, causing
reabsorption of water in the renal tubules, with consequent reducion in urine
output. In larger doses, ADH also causes constriction (vasoconstriction) of plain
muscle, which increases peripheral vascular resistance, resulting in increased
arterial blood pressure.
AspirinA non steroidal anti-inflammatory agent,
which is used to treat fever, pain, and inflammation. Also, has an anti-platelet effect,
by stopping the binding of platelets, thus preventing the patching over damaged blood
AtracuriumShort/medium duration muscle
relaxation. Brand name: Tracrium.
(G.A. potentiates use, so can reduce dose)
> 2 years old:
0.3 - 0.6 mg/kg IV over 60 seconds, then 0.08 - 0.1 mg/kg 20-45 minutes, after initial
dose. To maintain neuromuscular block, repeat maintenance dose 15-25 min.
1 month - 2 years:
0.3 - 0.4 mg/kg IV.
Spontaneous recovery from full block takes approximately 35 minutes.
antagonist, which blocks the action of the Vagus nerve. An emergency antimuscarinic
and antispasmodic, used to counter bradycardia resulting from a reversal agent
(Neostigmine). It is no longer recommended for asystole or cardiac arrest.
A competitive antagonist of muscarinic cholinergic receptors (an
antimuscarinic drug which antagonises (blocks) the action of Acetylcholine at
receptors). It blocks the effect of the vagus nerve on both the sinoatrial (SA)
and atrioventricular (AV) nodes, which increases the sinus rate and, thereby,
the heart rate. Atropine ampoules should be stored away from light.
When used as premedication for anaesthesia, Atropine decreases bronchial and
salivary secretions, and blocks the bradycardia associated with some drugs, such
as Halothane, Suxamethonium, and Neostigmine.
Contraindicated in glaucoma.
Bradycardia dose (I.V.):
Ampoule: 0.6 mg in 1 ml. Adult: 0.3 - 0.6 mg.
Paediatric (1 yr+): 0.01 - 0.03 mg/kg (max 100 mcg).
Augmentin (Co-amoxiclav)A broad spectrum
penicillin antibiotic, composed of Amoxicillin and Clavulanate Potassium, used in
the treatment (and propholaxysis) of infections of the ear, urinary tract, skin,
and bacterial infections such as bronchitis, sinusitis, pneumonia. Augment is often
used for treating infections caused by bacteria which are resistant to Amoxicillin.
Augmentin should be used with caution in patients with:
- Kidney disfunction
- Liver disfunction
- Glandular fever
- Lymphoid Leukaemia
agents, such as: Diazepam, Lorazepam, Midazolam, and Temazepam, which are
antagonised by Flumazenil.
I.M.: 1.6-2 ml WFI or 0.9% Saline
I.V.: 4-10 ml WFI or 0.9% Saline
Aka Marcaine: An analgesic and peripheral nerve block, for patients over
12 years old. Longer lasting effect (2-6 hours) than Lignocaine. The addition of
Adrenaline causes vasoconstriction, resulting in reduced blood loss.
Maximum safe doses...
Without Adrenaline (epinephrine): 2 mg/kg (equivalent to 0.8 ml/kg of 0.25% solution)
For maximum volume, dilute with Saline to 1.25 ml/kg
With Adrenaline: 2.5 mg/kg
BuscopanAka Scopolamine Butylbromide:
An anticholinergic, containing the active ingredient Hyoscine Butylbromide, used
as an antispasmodic to relieve colicky abdominal pain caused by painful spasms in
the muscles of the gastro-intestinal or genito-urinary tract.
Hyoscine works by
relaxing smoothe (involuntary ) muscle in the walls of the stomach, intestines, bowel,
bile duct, and urinary tract, whose contractions are caused by acetylcholine (neurotransmitter).
Hyoscine stops the spasms in the smooth muscle by preventing acetylcholine from acting on
the muscle, through the blocking of the receptors on the muscle cells which acetylcholine
would normally act upon.
CalciumIncreases myocardial excitability, contractility,
and peripheral resistance. Used in severe hyperkalaemia, and severe hypocalcaemia.
Calcium Chloride is the response to hyperkalaemia.
antibiotic against Gram positive & negative bacteria. Brand name: Zinacef.
ChlorphenamineAn antihistamine to treat
allergies, urticaria, and anaphylaxis.
ClarithromycinA macrolide antibiotic used
to treat pharyngitis, tonsillitis, acute maxillary sinusitis, acute bacterial
exacerbation of chronic bronchitis, pneumonia (especially atypical pneumonias
associated with Chlamydophila pneumoniae), skin and skin structure infections. It
is also sometimes used to treat legionellosis.
ClindamycinAntibacterial against Gram
positive cocci, Penicillin resistant staphylococcal, and bone/joint infection.
Clonadine, CatapresLowers blood pressure by decreasing
the levels of certain chemicals in the blood, which allows the blood vessels to relax,
and the heart to beat more slowly and easily.
ClopidogrelAn antiplatelet agent, to lower the risk
of blood clot formation. Clopidogrel may be given to patients who have had:
- A heart attack
- A stroke
- Acute coronary syndrome (minor heart attack or unstable angina)
- A coronary stent (device to open up a blocked artery to the heart)
Clopidogrel may also be given to patients who are at risk or heart attack or
stroke, and are allergic to Aspirin. For example, patients who:
- Have high cholesterol
- Have high blood pressure
- Have diabetes
CocaineA topical local analgesic and
vasoconstrictor, which readily penetrates mucous membranes.
Co-codamolAs a non-proprietary name used
to denote a particular compound analgesic - codeine phosphate and paracetamol.
Co-codamol tablets are used for the relief of mild to moderate pain when
paracetamol or NSAIDS, such as ibuprofen, aspirin or naproxen alone do not
sufficiently relieve a patient's symptoms.
Codeine PhosphateOpioid analgesic, for
mild to moderate pain, or coughing. Also, antitussive (relieves coughs) and
Controlled drugAny substance or product
specified in Part I, II, or III of Schedule 2 of the Misuse of Drugs Act,1971.
CyclizineAntihistamine and broad spectrum
treatment for PONV and
vertigo. Brand name: Valoid.
of Malignant Hyperthermia. Brand name: Dantrium.
Ampoule: 20 mg; dilute with 60 ml
WFI. Dose: 2-3 mg/kg. Repeat doses of 1 mg/kg, until tachycardia and pyrexis reduced,
and CO2 stabilised.
DesfluraneInhalational volatile liquid
anaesthetic which is quick acting and, because of it's low solubility, allows
rapid recovery. A maintenance agent, which is a respiratory irritant, so unsuitable
DexamethasoneA corticosteroid which suppresses
the release of substances which cause inflammation. Also used to treat allergy, cerebral
oedema, croup, nausea, and vomiting.
peptic ulcer, diabetes, infectious diseases.
DiamorphineOpioid analgesic, which causes
less hypotension and nausea than Morphine.
A Benzodiazepine, containing an injectable form of Diazepam.
DiclofenacNon steroidal anti-inflammatory
agent for treating rheaumatic disease, and post operative pain. Brand names include:
DigoxinA cardiac glycoside drug which increases the force
of heart muscle contractions, and reduces conductivity in the Atrio-Ventricular
Node. Often used to treat Atrial Fibrillation. Brand name: Lanoxin.
DobutamineA sympathomimetic which
stimulates the β-1 receptors of the sympathetic nervous system, having a
positive inotropic effect. Used in the treatment of heart failure.
DoxapramStimulates the respiratory centre in
the brain, to counter respiratory failure and postoperative respiratory depression.
Brand name is Dopram.
EphedrineA sympathomimetic amine, routinely used to
treat hypotension associated with anaesthesia. Works by constricting peripheral blood
vessels. Also used as a bronchodilator.
Ampoule: 30 mg in 1 ml; dilute to
3 mg/ml (add 9 ml NaCl). Dose: 6 mg bolus every few minutes.
ischaemic heart disease, hyperthyroidism, hypertension.
ErgometrineA type of medicine called an ergot alkaloid, used to
help prevent and control bleeding after childbirth. Ergometrine acts on three different
types of receptor in the walls of the blood vessels and in the uterus. When these
receptors are stimulated by Ergometrine (500 mcg), they cause the blood vessels to
constrict, and the uterus to contract. The contractions help the placenta to be pushed out.
ErythromycinA macrolide antibiotic with an antimicrobial spectrum,
similar to that of penicillin, often used for patients who are allergic to penicillins.
EtomidateInduction agent, with rapid action and recovery,
without hangover effects. No analgesic properties. The hypotension associated with
induction is less severe than which occurs with Propofol or Thiopentone. Extraneous
muscle movement can be minimised by administration of a pre-induction opioid, or short
acting benzodiazepine (Loprazolam, Temazepam). Should not be used as a maintenance agent.
Reduces intracranial pressure. 0.3 mg/kg.
FentanylSynthetic opioid for intra-operative
analgesia and enhancement of anaesthesia, with short duration (½ life: 20-30
Strength: 50 mcg/ml. Induction dose: 2mcg/kg.
FlumazenilReversal agent for sedative affects
of Benzodiazepines. Has shorter half-life and duration than Diazepam or Midazolam,
so may need several doses.
FragminUsed with aspirin to prevent blood vessel
complications in people with certain types of angina, or heart attack.
Also used to prevent a type of blood clot (deep vein thrombosis), which can lead to blood
clots in the lungs (pulmonary embolism). A DVT can occur after certain types of surgery,
or in people who are bed-ridden due to a prolonged illness.
Fragmin is also used, long-term, to treat venous thromboembolism (blood clot) in people
FurosemideLoop diuretic having peak effect
within 30 minutes, and 6 hour total duration.
Glycopyrronium: An antimuscarinic, typically given to counter bradycardia
resulting when Neostigmine is given to reverse non-depolarising muscle block.
For intra-operative bradycardia: 4-5 mcg/kg (iv). Ampoule: 600 mcg in 3 ml.
Glyceryl Trinitrate (GTN)A nitrate, used in
the short term treatment of angina (chest pain, caused by a lack of oxygen reaching the
heart), and left ventricular failure. The two effects are:
(1) Vasodilation of arteries leading to the heart, and
(2) Relaxation the veins which return blood to the heart.
Together these actions allow more oxygen to reach the heart muscle, and reduce
the work of the heart.
HaloperidolThe preferred anti-emetic for
opioid induced nausea, or nausea resulting from hypercalcaemia.
maintenance of anaesthesia.
HeparinAnti-coagulant treatment and
prophylaxis for blood clotting. Brand names: Calciparine, Monoparin.
HydrocortisoneShock; anaphylactic shock.
Brand names: Efcortesol, Solu-Cortef.
Hyoscineaka Scopolamine: An
antimuscarinic which is used to dry secretions, treat motion sickness, nausea, and
IsofluraneVolatile anaesthetic for induction & maintenance.
contractility, and heart rate, in bradycardic episodes where temporary electronic
pacing is inappropraite.
KetamineIntravenous phenycyclidine induction agent, with
good analgesic properties, amd less hypotension than Propofol or Thiopentone. Mainly used
in paediatric anaesthesia. Raises BP and heart rate, but maintains ventolation and laryngeal
reflexes. Recovery is slow, and side-effects include hallucinations and extraneous muscle
movements. Causes bronchodilation (infusions possible for those with severe asthma).
Contra-indicated for patients with head injury or intra-cranial pressure. Side-effects:
respiratory depression, nausea, laryngospasm, tachy/bradycardia, hypo/hypertension.
Ampoule: 500 mg in 10 ml. Dose: 1-4 mg/kg.
for hypertension in myocardial infarction, and to control blood pressure during
anaesthesia. Brand name: Trandate.
Lignocaineaka Lidocaine: A sodium channel
blocker, used as a local anaesthetic, and as treatment for arrhythmia following
myocardial infarction. As a local anaesthetic, Lignocaine is supplied in 1% (10 mg/ml)
and 2% solutions. The addition of Adrenaline to Lignocaine causes vasoconstriction,
resulting in reduced blood loss. Brand/other names are: Lidocaine, Instillagel,
Also available with Adrenaline (1:100,000), which causes local vasoconstriction
and limits local spread of the drug, thereby allowing a larger dose to be
infiltrated without causing systemic toxicity.
Duration=1 hour. The maximum dose of 1% lidocaine with epinephrine is 7 mg/kg.
LorazepamA benzodiazepine anxiolytic, with
slow onset (90 minutes), but longer lasting than Temazepam.
MagnesiumReduces Acetylcholine release from nerve terminals; Used as
a bronchodilator and antiarrhythmic agent. It also tends to lower the BP.
Trade name for Bupivacaine
MetaraminolVasoconstrictor sympathomimetic; To treat
Ampoule: 10 mg in 1 ml. Dilution: 10 mg in 20 ml NaCl
(add 19 ml). Dose: 0.5 mg bolus, to effect.
MetoclopramideAntiemetic treatment of severe
PONV in adults. Brand name: Maxolon.
MetronidazoleA first line antibiotic, used against
anaerobic bacteria, and protozoa, and Clostridium Difficile. Metronidazole
is used in places where bacteria do not need oxygen
to thrive, such as the pelvic cavity, gut, gums, and bones.
proves ineffective, Vancomycin may be used as a second line therapy.
MidazolamA short acting (wears off quickly)
benzodiazepine anxiolytic, with rapid onset; produces sedation with amnesia. Also
used as premedication, induction support, muscle relaxation, and as an anti-convulsant.
Milirinone (Primicor)Increases contractility, and dilates vessels;
used to combat the decreased contractility of cardiomyocytes (heart cells).
MivacuriumThe shortest acting non-depolarising
neuromuscular blocking agent. The advantage over Suxamethonium are that it does
not cause muscle pains after administration. It can be used for short procedures
which require full muscle relaxation for airway manipulation, but not for cases
which require rapid sequence induction, because onset time is slow, just as with
other non-depolarising muscle relaxants. Mivacurium is metabolised by plasma cholinesterase.
A reversal agent, such as Neostigmine (anticholinesterase), increases the concentration
of acetylcholine at the neuromuscular junction, thereby reversing the blockade. If a
patient has low levels of plasma cholinesterase (inherited or acquired), the duration
of action of Mivacurium is increased - similar to Suxamethonium apnoea.
MorphineAnalgesic with slow onset and long duration of action.
NaloxoneA narcotic antagonist:
reversal agent for respiratory depression caused by opiates. Brand name is Narcan.
NeostigmineAn anticholinesterase which reverses the effect
of competitive non-depolarising neuromuscular blocking agents (relaxant antagonist),
such as Atracurium, and is used in the treatment of myasthenia gravis, and urinary
retention. Also prolongs the effects of Suxamethonium. Brand name is Robinul.
Neuromuscular blocking agentsMuscle relaxants: Block
neuromuscular transmission at the neuromuscular junction, acting postsynaptically at
the Acetylcholine (ACh) receptors of the motor nerve end-plate, causing paralysis of
the affected muscles. NM blocking agents relax the diaphragm, abdomen, and vocal chords,
therefore the patient will require assisted ventilation during anaesthesia.
Constitute the majority of the clinically relevant
NM blocking agents. They act by competitively blocking the binding of
Acetylcholine to nicotinic receptors, preventing depolarisation of muscle
membrane. In some cases, they also directly block the ionotropic activity of the
Acetylcholine receptors. Can be reversed with anticholinesterases, such as
Principally, Suxamethonium: Acts by depolarizing the
plasma membrane of the skeletal muscle fiber. This persistent depolarization
makes the muscle fiber resistant to further stimulation by Acetylcholine.
Nitrous OxideA chemical compound (N2O), of Nitrogen and
Oxygen, which provides analgesia and anaesthesia. N2O increases cerebral blood
flow, so is unsuitable for patients with raised intracranial pressure. Additionally, it is
unsuitable in cases of bowel obstruction, pneumothorax, sinus and middle ear problems.
Its high MAC value (greater then 100) means it is not readily dissolved in the blood.
Because nitrous oxide is not soluble in blood, its rapid absorption from alveoli causes an
abrupt rise in the alveolar concentration of the other inhalation anesthetic. This means
that, if the gas is in equilibrium, the concentration in blood will be 1.4 times higher than
the concentration in the alveoli.
Vasoconstrictor sympathomimetic hormone and neurotransmitter of the sympathetic
nervous system, which increases vascular muscle tone.
- Increases heart rate
- Increases blood pressure (vasoconstriction)
- Causes release of glucose
- Increases brain's oxygen supply
- Restores peripheral vascular resistance
NSAIDNon steroidal anti-inflammatory drug,
PONV. Brand name is Zofran.
Opiates - IVAnalgesics
given at induction (Fentanyl, Alfentanil etc).
- Respiratory depression
- Cardiovascular depression
OpioidA chemical which works by binding to opioid
receptors, found principally in the central and peripheral nervous system and the
GI tract, with good analgesic properties.
OxytocinA human hormone, produced in the
hypothalamus, which causes the uterus to contract.
ParacetamolAnalgesic for mild/moderate pain,
which works by affecting prostaglandins (chemicals). Prostaglandins are substances
released in response to illness or injury. Paracetamol blocks the production of
prostaglandins, making the body less aware of the pain or injury. Paracetamol also
reduces temperature, by acting on the area of the brain responsible for controlling
The onset of analgesia is approximately 11 minutes after oral
administration of Paracetamol, with half-life of 1–4 hours. Though Paracetamol is used
to treat inflammatory pain, it is not generally classified as an NSAID because it
exhibits only weak anti-inflammatory activity.
Contraindications: severe renal or
Dose: 15 mg/kg
ParacoxibNon-opioid analgesic, used for short
term management of post operative pain.
PhentolamineA vasodilator, to treat hypertension in cardiac patients.
treatment for hypotension.
Infiltration anaesthetic. Brand name: Citanest.
ProchlorperazineA Phenothiazine for severe cases
of PONV or vertigo. Brand
PropofolA short acting (a few minutes) phenol IV
administered hypnotic agent, used for the induction and maintenance of general
anesthesia, and sedation for mechanically ventilated adults. Propofol has largely
replaced Thiopentone (Sodium Thiopental) for induction of anesthesia, because
recovery is more rapid, and does not seem to cause nausea. Propofol is also used
for sedation, for example, prior to endoscopic procedures, and has less prolonged
sedation and faster recovery time than Midazolam.
Strength: 10 mg/ml. Induction dose: 1-2mg/kg.
- Pain on injection
- Transient apnea
- Hypotension (due to vasodilation)
- Extraneous muscle movement
A Heparin antagonist, which reverses the anticoagulant effects of Heparin, by
binding to it. Used in cardiopulmonary bypass surgery to:
- Reverse the anti-clotting effects of Heparin
- Increase pulmonary artery pressure
- Decrease peripheral blood pressure
- Decrease myocardial oxygen consumption
- Decrease cardiac output
- Decrease heart rate
histamine H2 receptor antagonist, used to inhibit gastric acid secretion, in the
treatment of gastric and duodenal ulcer, gastroesophageal reflux disease, and
conditions which cause gastric hypersecretion. Dilute with 20 ml saline.
RemifentanilRemifentanil Hydrochloride is
an agonist of opioid μ-receptors, providing a very short acting (1 minute) analgesic,
and is 3-4 times faster acting than Fentanyl.
½ life is ≅5 minutes, 5-10 minutes of effect, and a quick recovery.
Given intra-operatively by continuous I.V. Common side effects are nausea, vomiting,
and headaches. These effects can be lessened if Midazolam is also administered, but
this dual use increases the risk of respiratory depression. A typical dose is
1 microgram/kg/minute. Infusion dilution: 1 mg in 20 ml saline. Brand name: Ultiva.
Reversal agentsDrugs which antagonise or
otherwise modify the effects of other drugs, such as opiates, muscle relaxants,
RocuroniumMuscle relaxation with intermediate duration. Brand
name is Esmeron.
Strength: 10 mg/ml. Induction dose: 600 mcg/kg.
SalbutamolMyometrial relaxant, bronchodilator; for asthma,
bronchospasm, airway obstruction, and premature labour.
SevofluraneInduction and maintenance of general anaesthesia.
Sodium bicarbonateA systemic alkalising agent, used in severe metabolic
acidosis, hyperkalaemia, and prolonged arrests.
Sodium CitrateReduces gastric acidity - typically
given prior to rapid sequence induction.
Sugammadex (Tradename Bridion) is an agent for
reversal of Rocuronium (neuromuscular) blockade, in general anaesthesia. It is the
first selective relaxant binding agent (SRBA).
Succinylcholine: Depolarising short acting muscle relaxant, with quick
onset. The main use in anaesthesia is to allow intubation of the trachea.
Similar structure to Acetylcholine, so non-competitively binds to cholinergic
receptors at the neuromuscular junction, preventing Acetylcholine from binding.
Action within 60 seconds, with 3-6 minute duration.
Can cause cardiac problems in patients with muscle disease or severe burns.
Metabolised in plasma by Pseudocholinesterase. An anticholinesterase, such as
Neostigmine, will prolong the action of Suxamethonium, by inhibiting
Pseudocholinesterase, and so should not be given with Suxamethonium.
- Muscle fasciculations
- Intra-cranial pressure
- Intra-abdominal pressure
- Post-operative muscle pain
Suxamethonium should be stored in a refrigerator at 4°.
Ampoule: 100 mg/2 ml. Dose: 1-2 mg/kg (0.02 - 0.04 ml/kg)
SympathomimeticAgents which produce effects
similar to those caused by stimulation of the sympathetic nervous system. There
are inotropic and vasoconstrictor sympathomimetics.
Inotropic: Dobutamine, Dopamine, Dopexamine.
Vasoconstrictor: Metaraminol, Ephedrine, Noradrenaline, Phenylepherine.
SyntocinonThe synthetic form of Oxytocin. Syntocinon
induces or stimulates labour, prevents postpartum haemorrhage, and stimulates contractions
which help push out the placenta, after delivery.
TemazepamA long lasting (up to 12 hours) benzodiazepine
anxiolytic, given 30 - 120 minutes before surgery.
TerbutalineTo treat asthma and bronchospasm, by
relaxing the muscles in the passages of the lungs.
A smooth and rapidly acting barbiturate, mainly used for induction of anaesthesia,
by slow (IV) injection. Has no analgesic properties.
Thiopentone is prepared by dissolving a yellowish powder in sterile water, to
provide a 2.5% solution (25 mg/ml, 500 mg/20 ml). The solution should be kept cool,
and used within 24 hours of preparation. The solution has a pH greater than 10
(alkaline), and can be irritating and painful if accidentally injected into
tissues. Because of the alkalinity, Thiopentone should not be mixed in the same
syringe as other drugs.
Thiopentone crosses the placenta, but is considered safe for induction in
obstetric anaesthesia. IV injection causes loss of consciousness within 15 to 30
seconds, and lasts for 5 to 10 minutes. A short period of breath holding can
Metabolism of Thiopentone is quite slow, and rapid recovery is due to initial
redistribution into muscle and skin, followed by redistribution into body fat.
Metabolised in the liver, less than 1% of the drug is unchanged in the urine.
Return of consciousness from a moderate does is rapid, with prompt return of
airway protective reflexes. Metabolising Thiopentone is slow, so there may be
residual sedative effects for up to 24 hours.
Dose: 3-5 mg/kg.
- Depression of the heart's contractile force
- Cardiorespiratory depression
- Allergic reactions
- Inflammation at injection site
Tranexamic acidAn antifibrinolytic (inhibits
fibrinolysis), which promotes blood clotting. The acid stops the breakdown of clots,
by halting the breakdown of fibrin. In obstetric cases, tranexamic acid is used after
delivery, to reduce bleeding. Tranexamic acid competitively inhibits the activation of
plasminogen to plasmin, by binding to specific sites of both plasminogen and plasmin, a
molecule responsible for the degradation of fibrin, a protein that forms the framework
of blood clots. Used to control heavy menstrual bleeding.
VancomycinAn antibiotic against
Gram-positive bacteria, typically used as a last line treatment, because other agents
have been ineffective, given as an infusion (not bolus).
Adult infusion: Thrombophlebitis may be induced, as well as
flushing and a transient rash over the neck and shoulders.
usual dose is 1 - 1.5 g every 12 hours.
Vasoconstrictor sympathomimeticAn agent which
raises blood pressure by vasoconstricion.
VecuroniumMuscle relaxant with intermediate duration. Brand
name is Norcuron.
Supply: 10 mg powder. Strength: 5 mg/ 5 ml WFI.
Draw up: 10
mg + 5 ml WFI. Induction dose: 100 mcg/kg.
WarfarinAn anticoagulant; used as a prophylactic
for venous thrombolism. Usage should be stopped 2-4 days before surgery. Reversal,
after 3-6 hours, is possible with vitamin K.