CLINICAL USE

Induction and maintenance of general anaesthesiaSedation of ventilated patients for up to 3 days

DOSE IN NORMAL RENAL FUNCTION

Induction: 1.5–2.5 mg/kg at a rate of 20–40 mg every 10 secondsMaintenance: 25–50 mg repeated according to response or 4–12 mg/kg/hourSedation: 0.3–4 mg/kg/hour Sedation for surgical and diagnostic procedures: 0.5–1 mg/kg over 1–5 minutes then maintenance: 1.5–4.5 mg/kg/hour or

  • 10 to 20     : mg/kg

    PHARMACOKINETICS

  • Molecular weight                           :178.3
  • %Protein binding                           :>95
  • %Excreted unchanged in urine     : <0.3
  • Volume of distribution (L/kg)       :8–19
  • half-life – normal/ESRD (hrs)      :3–12/Unchanged

    DOSE IN RENAL IMPAIRMENT

    GFR (mL/MIN)

  • 20 to 50     : Dose as in normal renal function
  • 10 to 20     : Dose as in normal renal function
  • <10           : Dose as in normal renal function

    DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

  • CAPD                :Unlikely to be dialysed. Dose as in normal renal function
  • HD                     :Unlikely to be dialysed. Dose as in normal renal function
  • HDF/high flux   :Unlikely to be dialysed. Dose as in normal renal function
  • CAV/VVHD      :Unknown dialysability. Dose as in normal renal function

    IMPORTANT DRUG INTERACTIONS

    Potentially hazardous interactions with other drugsAdrenergic-neurone blockers: enhanced hypotensive effectAntihypertensives: enhanced hypotensive effect

  • Antidepressants: avoid MAOIs for 2 weeks before surgery; increased risk of arrhythmias and hypotension with tricyclics
  • Antipsychotics: enhanced hypotensive effectMuscle relaxants: increased risk of myocardial depression and bradycardia with suxamethonium

    ADMINISTRATION

    Reconstition

    –

    Route

    IV

    Rate of Administration

    See local protocols

    Comments

    –.

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