non-IV anesthetics Flashcards
What are the induction doses of propofol for adults, children, and the elderly/sicker pts?
Adults: 1.5-2.5 mg/kg
Children (3-12): 2.5-3 mg/kg
Elderly/sicker pts: 1-1.5 mg/kg
What is the onset, duration of effects, and elimination time for propofol?
Onset: 15-45 sec
Duration of effects: 5-10 min (4.5 min after induction)
Elimination time: 50 min
What is the clearance rate of propofol? Describe the clearance mechanism of propofol.
Clearance rate: 30-60 ml/kg/min (10x faster than hepatic blood flow!)
Mainly metabolized by the liver and excreted by the kidneys (inactive metabolites, water solube)
Negative feedback mech: can decrease its own clearance by decreasing hepatic blood flow.
Evidence for extra-hepatic clearance (~60% cleared y lungs)
What class of drugs is thiopental?
It is a thiobarbuturate (contains a sulfur atom)
What is the dose, onset, and duration of thiopental?
Dose: 3-6 mg/kg
Onset: 10-15 sec w/ peak plasma lvls in 30 sec
Duration of effects: 5-10 min
What is the clearance rate and mechanism of thiopental?
Clearance rate: 1.6-4.3 ml/kg/min
Metabolized by liver at 10-14%/hr (1st order kinetics), excreted by kidney
What class of drugs is methohexital?
Oxybarbiturate
What is the onset and duration of methoehexital? Clearance rate in relation to thiopental?
Onset: 10-30 sec
Duration of effects: 5-10 min
Clearance rate: 3x faster than thiopental
What are the general properties of etomidate?
- Unstable in aquous solution
- Dissolved in propylene glycol
- Causes more pain on injection than propofol
What’s the dose, onset, and elimination rate of etomidate?
Dose: 0.1-0.4 mg/kg
Onset: 10-15 sec
Duration: 3-5 min
Elimination rate: 70-270 min
What is the clearance rate of etomidate compared to thiopental? What is its mechanism of metabolism?
- Cleared ~5x faster than thiopental
- Metabolized in liver, inactive metabolites
