Supply:5mg/ml 1ml,3ml/Amp(DORMICUMR), 7.5mg/F.C.Tab(DORMICUMR)
Use:Midazolam is effective for anesthesia induction, as a preanesthetic medication, a hypnotic prior to short surgical procedures and in the treatment of insomnia.
Place in therapy: Midazolam produces a more rapid onset and less venous irritation of anesthesia induction than diazepam. It also can be considered as an alternative to thiopental although it has a slower onset of action. Midazolam appears to offer no advantage over triazolam as a hypnotics for insomnia.
Contraindication:Hypersensitivity to midazolam or other benzodiazepines. Patients with narrow angle glancoma.
Adverse effect:Respiratory depression, apnea, injection site pain and phlebitis(less than diazepam).
Usual dosage:For anesthesia: 0.15 to 0.3 mg/kg IV; doses of 0.1 mg/kg IM have been effective for anesthetic premedication. For conscious sedation: 0.05-0.1 mg/kg IV, maintenance of sedation in increament of 25% of initial dose may be given by slow titration; 1 mg/ml is recommended for titration, no more than 2.5 mg should be given over at least 2 minutes. DO NOT ADMINISTER AS A BOLUS DOSE. Maximal dose: some cases showed 0.3-0.85 mg/kg (20-55 mg/hr) without respiratory depression or hypnotic. Benzodiazepines equivalent: 3-4 times as potent per milligram as diazepam. For mild to moderate renal failure, no dose adjustments are required; for severe renal failure ( CrCl<10 ml/min) the dose should be decrease by 50%.
BUPIVACAINE C
Supply:0.5% 20ml, 4ml(MARCAINER)
Use:Peripheral nerve block, infiltration, sympathetic block, caudal or epidural block.
Contraindication:Hypersensitivity to marcaine.
Adverse effect:During prolonged epidural block, venous stasis and pressure sores may develop. Foetal bradycardia has been reported following paracervical block during labor and may require the administration of atropine sulfate intravenously.
Usual dosage:
1. Local infiltration: 0.25% solution .
2. Epidural block: 0.25% 0r 0.5% solution.
3. Caudal block: 0.25% or 0.5% solution
4. Peripheral nerve block: 0.25% or 0.5% solution.
5. Sympathetic block: 0.25% solution .
The maximum dose is 2mg/kg in any 4 hours period equivalent to 25-30ml of 0.5% solution.
Special precautions:Resuscitative equipment & drugs should be immediately available when local anaesth is used; do not administer if presence of blood is noted in attempting lumbar puncture.
ISOFLURANE C
Supply:250ml/Bot(FORANER)
Use:Inhalation on anesthesia.
Contraindication:Known sensitivity to forane or history of malignant hyperpyrexia.
Adverse effect:Arrhythmias, elevation of the white blood cell count, hypotension, respiratory depression.
Usual dosage:Vaporisers specially calibrated for forane should be used so that the concentration of anesthetic delivered can be accurately controlled. MAC values for forane diminish with age, falling from an average in oxygen of 1.28% in the mid-twenties to 1.15% in the mid-forties, to 1.05% in the mid-sixties age group.
Special precautions:Uterine curettage. Patients with increased intracranial pressure
LIDOCAINE C
Supply:1) Local anesthesics (Local use) : Inj 2% 20 ml/Vial,
2% with epinephrine (1:80,000) 20ml/Vial
2) Antiarrythmics (Inj for IV): 2% 5ml, 10% 10ml.
Use:Local anesthesia, acute management of cardiac arrhythmia.
Contraindication:Hypersensitivity to local anesthetics of the amide type, Adam's-stokes syndrome, sinoatrial, atrioventricular or intraventricular heart block, hypovolemia.
Adverse effect:Less tolerant to local anesthetics, excitation of the CNS, arrhythmias and cardiac arrest may occur.
Usual dosage:1. Direct IV, adults : 50-100mg, rate 25-50mg/min, repeat if necessary, in one hour period 200-300mg. 2. IV infusion, adults : 20-50mg/kg/min, ECG monitoring. 3. Usual initial adult dose: without epinephrine not exceed 300mg, with epinephrine not exceed 500mg 4. Child, use of 0.5 or 1% solution.
Special precautions:Traumatised mucosa & sepsis
PROPOFOL B
Supply:10mg/ml 20ml/Amp(RECOFOLR)
Use:Inducing and/or maintaining general anesthesia, either in combination with other anesthetics or as the sole hypnotic agent.
Contraindication:Hypersensitivity to propofol or its inactive ingredients: soy-bean oil and egg phosphatide, should not receive this drug.
Adverse effect:Pain on injection, apnea, dose-related hypotension, headache, dizziness, twiching, bucking, jerking, throshing, seizure, heart block, temporary reduction in serum cortisol, porphyria, urine discoloration (green urine).
Usual dosage:Initial: 2-2.5mg/kg anesthesia, maintenance: 9-12 mg/kg/hr.
SEVOFLURANE B
Supply:250ml/Bot(ULTANER)
Use:Induction & maintenance of general anesthetics.
Contraindication:Known or suspected genetic susceptibility to malignant hyperthermia
Adverse effect:Dose-dependent cardio-resp depression, nausea, vomiting, hypotension.
Usual dosage:Induction: Individualized dosage
Special precautions:Coronary artery disease; renal or hepatic impairment; patients at risk for ICP elevations. Pregnancy, lactation.
THIAMYLIL
Supply:300mg/Amp(CITOSOLR)
Use:Anaesth for diagnostic & surgical procedures; induction of anaesth or to supplement low potency agent
Contraindication:Liver disease
Adverse effect:Induced-asthma
Usual dosage:Individualised dosage
Special precautions:Shock condition
THIOPENTAL SOD. C
Supply:2.5mg/Vial(PENTOTHALR)
Use:Anesthetic agent for brief surgical procedures, induction of anesthesia, control of convulsive states.
Contraindication:Complete absence of suitable veins for IV administration, hypersensitive to barbiturates, status asthmaticus, latent or manifest porphyria.
Adverse effect:Coughing, sneezing, hypersensitivity, respiratory depression, cardiac arrhythmia.
Usual dosage:Induction anesthesia, usual dose: IV 50-75mg (2-3ml of a 2.5% solution) at intervals of 20-40 seconds depending on the reaction of the patient. Use in convulsive states: IV 75-125mg (3-5ml of a 2.5% solution) should be given as soon as possible after the convulsion begins.
Special precautions:Moderate hypertension; excessive premed, hepatic dysfunction, increased blood urea, severe anemia; severe CV diseases, raised intracranial pressure, asthma, myasthenia gravis, severe uremia. Elderly.
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