Drug doses

15 mg/kg IV (>3/12 old, max 60 mg/kg/day)Max. 500 mg if <50kg
Max daily dose if <3/12 old, 60 mg/kg/day
For term neonates (>38/40 – 3/12 old), IV dose 10 mg/kg TDSIbuprofen400 mg tdsOver 1 year: 10 mg/kg tds
Under 1 year: 5 mg/kg qdsNot to be used if <1 month or <5kgDiclofenacMax 150 mg/24hr25 mg/mL75 mg one off IV1 mg/kg tdsNot to be used if < 6 monthsNaloxone200–400 mcg400 mcg4–10 mcg/kgFor opiate reversal; may need repeat doses




Local anaesthetics


Calculating concentrations:




1% = 10 mg/ml



0.5% = 5 mg/ml



0.25% = 2.5 mg/ml



0.125% = 1.25 mg/ml



Table 27.5 Local anaesthetics



















































Drug Maximum dose Maximum dose with adrenaline Maximum dose for 70 kg patient Notes
Lidocaine 3 mg/kg 6–7 mg/kg 210 mg/420 mg (with adrenaline) 1% or 2% concentration Onset 5–10 min
Bupivacaine 2 mg/kg 2.5 mg/kg 140 mg/175 mg (with adrenaline) 0.125% (usually in epidural infusion); 0.25% or 0.5% concentration LSCS spinal dose: 2.2–2.7 ml 0.5% heavy bupivacaine
Levobupivacaine 2.5–3 mg/kg 2.5–3 mg/kg 210 mg S-enantiomer of bupivacaine; less cardiotoxic
Ropivacaine 3 mg/kg 4 mg/kg 210/280 mg (with adrenaline)
Prilocaine 6 mg/kg 9 mg/kg 420 mg/630 mg (with adrenaline) 0.5%, 1% or 2% concentration Onset 5–10 min
Cocaine 3 mg/kg N/A 210 mg Generally reserved for ENT


Intralipid 20%: 1.5 ml/kg bolus; start IV infusion 15 ml/kg/h. Give up to 2 repeat boluses, increase infusion to 30 ml/kg/h up to maximum 12 ml/kg


For 70 kg patient: give 100 ml bolus, start IV infusion at 1000 ml/h. Give up to 2 further doses of 100 ml, then double rate to 2000 ml/h up to a maximum of 840 ml



Emergency drugs



Table 27.6 Emergency drugs

























































Drug Concentration Average dose 70 kg Paeds/Other Notes
Adrenaline 100 mcg/ml (in minijet 1:10 000) 50–100 mcg boluses = 0.5–1 ml 1:10 000 10 mcg/kg (0.1 ml/kg) in paediatric cardiac arrest IV infusion 2–20 mcg/min (dilute in 5% dextrose)
Atropine 600 mcg/ml 300–600 mcg 20 mcg/kg
Ephedrine 3 mg/ml 3–60 mg Dilute 30 mg in 9 ml 0.9% NaCl
Glycopyrrolate 200 mcg/ml 200–600 mcg 4–10 mcg/kg
Metaraminol 0.5 mg/ml 0.5–1 mg bolus prn 10 mcg/kg Dilute 10 mg in 19 ml 0.9% NaCl
Noradrenaline 80 mcg/ml (4 mg/50 ml) Dilute in 5% dextrose Starting rate IV infusion = 0.025 mcg/kg/min
Phenylephrine 10 mg/ml 50–100 mcg bolus Obs: boluses, or run IV infusion (50 mcg/ml) at 30–40 ml/h 10 mg in 100 ml 0.9% NaCl = 100 mcg/ml Use 10–20 ml in syringes as required

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Feb 7, 2017 | Posted by in ANESTHESIA | Comments Off on Drug doses

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