04 Sedation
ICU Sedation
analgesics (pain) vs anxiolytics (sedation)
IV push vs drip
RASS goal? Stay in 0, -1, -2
Anxiolytics
Push | Drip | Dosing | Indication | Caution | |
Propofol | xx | 0.5 mcg/kg/min 0-100mg | - drug of choice - fat soluble - short half life | -hypotension>bradycardia - propofol infusion syndrome - hyperlipidemia | |
Versed midazolam | xx | xx | 0.04 mg/kg/hr | - sedation - ETOH withdrawal on vent - seizures | - hypotension - delirium - accumulation in fatty tissues - liver renal dosing |
Ativan Lorazepam | xx | 0.04 mg/kg/hr 1-4mg IV Q3 PRN | - ETOH withdrawal - seizures - CIWA | - same as Versed - propylene glycol toxicity (no drip) | |
Halodol | xx | 5-10mg IV Q4-6 PRN | - delirium - agitation | - long QT - EPS | |
Precedex Dexmedotramidin | xx | 0-0.7 mcg/kg/hr | - delirium - agitation - weaning off vent | - bradycardia>hypotension - cost | |
Ketamine | xx | only status epilepticus |
Analgesics
Push | Drip | Dosing | Indication | Caution | |
Fentanyl | xx | xx | 25-100 IV PRN Q2 0.1-4 mcg/kg/hr | - drug of choice - short 1/2 life - BP neutral | safe short 1/2 life |
Dilaudid | xx | x | 0.5-4 mg Q3 | - opioid experienced - sickle cell | hypotension |
Morphine | xx | 5-10 mg IV Q3 | - rarely in ICU - terminal weaning - air hunger suppression | hypotension histamine release itching renal failure |
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