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Midazolam 2mg
- Hepatic metabolism -> renal excretion
- onset: 60 s
- duration: 10-30 mins
- induction dose: 0.05-0.15
- sedation dose: 0.5-1 mg
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Propofol 150 mg
- hepatic glucuronidation -> renal excretion
- onset: 30 s
- duration: 5-10 mins
- induction dose: 1.5-2.5 mg/kg
- sedation dose: 25-75 mg
- -medium ideal for bacteria - discard after 6h
- -venous irritation
- -reduces PONV - anti-emetic
- -allergies are rare - egg allergy?
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Ketamine IV
- NMDA receptor antagonist
- hepatic cyp3a4 -> renal excretion
- onset - 45-60s
- duration - 10-20 mins
- induction dose: 0.5-2.0 mg/kg
- sedation dose: 0.2-0.8 mg/kg (same for analgesia)
- eyes open, increased muscle tone, myoclonus, analgesic, increased secretions, restlessness, agitation, nightmares for weeks
- CI: ischemic HD, valvular disease, uncontrolled HTN, pre-eclampsia,
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Sevoflurane
- MAC 2.0
- Blood solubility 0.68
- 5% absorbed
- pleasant odor, respiratory depression, bronchodilation, decreased BP, dec contractility, increase CBF (vasodilation)
- metabolized by liver into compound A & B - compound A may cause renal toxicity (in mice)
- dose-related proteinuria, glycosuria and enzymuria in humans
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Desflurane
- MAC 6.0
- Blood solubility 0.42
- not metabolized
- can be used for inhalation induction
- airway irritability, breath holding, laryngospasm, salivation
- increased levels release catecholamines increasing HR and BP
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Fentanyl
- synthetic opioid agonist
- 100x more potent than morphine
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Ephedrine
- Indirectly releases endogenous catecholamines -> a & b activation -> inc HR, BP, CO
- 5-10 mg boluses
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