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 &nbsp &nbsp : mg/kg

    PHARMACOKINETICS

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

    DOSE IN RENAL IMPAIRMENT

    GFR (mL/MIN)

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

    DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

  • CAPD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp:Unlikely to be dialysed. Dose as in normal renal function

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

    –.