Pharmacology
Drug quick reference
The drugs you’ll draw up, hear about, and get pimped on — with typical adult ranges, onset and duration.
Induction agents
Benzodiazepines
Opioids
Neuromuscular blockers
NMB reversal
Vasopressors
Phenylephrine
α1 agonist · Neo-Synephrine, Biorphen50–100 mcg IV (label 40–100 mcg; max 200 mcg single dose)
Ephedrine
Mixed α/β agonist5–10 mg IV, repeat (label total 50 mg)
Epinephrine
α/β agonist · Adrenalin0.5 mg IM (1 mg/mL), anterolateral thigh
Norepinephrine
α1 > β1 agonist · Levophed≈0.02–0.3 mcg/kg/min, titrated
Vasopressin
V1 agonist · Vasostrict0.5–1 unit IV
Antihypertensives
Anticholinergics
Antiemetics
Analgesic adjuncts
Local anesthetics
Antibiotics
Inhaled anesthetics
| Concentration | Typical adult dose | Onset | Duration | ||
|---|---|---|---|---|---|
| Propofol | IV hypnotic | 10 mg/mL (1% lipid emulsion) | Induction (healthy adult < 55 y): 1.5–2.5 mg/kg IV (label 2–2.5) | 30–45 s | 5–10 min |
| Etomidate | IV hypnotic | 2 mg/mL | Induction: 0.2–0.3 mg/kg IV (label 0.2–0.6) | 30–60 s | 3–5 min |
| Ketamine | Dissociative anesthetic | 10 mg/mL; 50 mg/mL; 100 mg/mL | Induction: 1–2 mg/kg IV (label 1–4.5) | 30–60 s | 5–10 min |
| Midazolam | Benzodiazepine | 1 mg/mL; 5 mg/mL | Pre-op anxiolysis / sedation: 0.5–2 mg IV titrated (≈0.01–0.05 mg/kg); less in elderly or with opioids | 1–3 min (peak 3–5) | 30–60 min |
| Fentanyl | Opioid analgesic | 50 mcg/mL | Analgesia: 0.5–1 mcg/kg increments (commonly 25–100 mcg) | 1–2 min (peak 3–5) | 30–60 min |
| Hydromorphone | Opioid analgesic | 1 mg/mL (common); 2, 4, 10 mg/mL (high-potency) | PACU / end-of-case analgesia: 0.2–0.5 mg IV every 5–10 min, titrated | ≈5 min (peak 10–20) | 2–4 h |
| Succinylcholine | Depolarizing NMB | 20 mg/mL | Rapid sequence intubation: 1–1.5 mg/kg IV | 30–60 s | ≈5–10 min (label 4–6) |
| Rocuronium | Nondepolarizing NMB | 10 mg/mL | Intubation: 0.6 mg/kg IV | ≈1.5–2 min | ≈30–40 min (clinical) |
| Cisatracurium (and vecuronium) | Nondepolarizing NMB | Cisatracurium 2 mg/mL; Vecuronium powder (reconstituted) | Cisatracurium intubation: 0.15–0.2 mg/kg IV | 2–3 min | ≈45–60 min |
| Sugammadex | Selective relaxant binding agent | 100 mg/mL | TOF count ≥ 2 (moderate): 2 mg/kg IV (actual body weight) | ≈2–3 min | — |
| Neostigmine + glycopyrrolate | Acetylcholinesterase inhibitor | Neostigmine 1 mg/mL; Glycopyrrolate 0.2 mg/mL | Neostigmine: 0.03–0.07 mg/kg IV (max 0.07 mg/kg or 5 mg) | Peak ≈10 min | — |
| Phenylephrine | α1 agonist | 100 mcg/mL (prepared — confirm local) | Bolus: 50–100 mcg IV (label 40–100 mcg; max 200 mcg single dose) | Immediate | ≈10–20 min |
| Ephedrine | Mixed α/β agonist | 5 mg/mL (diluted or prefilled) | Bolus: 5–10 mg IV, repeat (label total 50 mg) | ≈1 min | ≈10–15 min |
| Epinephrine | α/β agonist | 1 mg/mL (IM); 0.1 mg/mL (code syringe); 10 mcg/mL push-dose (locally prepared) | Anaphylaxis (IM): 0.5 mg IM (1 mg/mL), anterolateral thigh | — | — |
| Norepinephrine | α1 > β1 agonist | Infusion per pharmacy | Infusion: ≈0.02–0.3 mcg/kg/min, titrated | Immediate | — |
| Vasopressin | V1 agonist | 20 units/mL (diluted) | OR bolus (off-label, local practice): 0.5–1 unit IV | — | — |
| Labetalol | α1 + β blocker | 5 mg/mL | Intra-op hypertension: 5–10 mg IV increments (label: 20 mg for severe HTN, then 40–80 mg every 10 min) | 2–5 min | 2–4 h |
| Esmolol | β1 blocker (ultra-short) | 10 mg/mL | Bolus: 0.5 mg/kg IV (or 10–20 mg increments) | 1–2 min | ≈10 min |
| Hydralazine | Arteriolar vasodilator | 20 mg/mL | Hypertension: 5–10 mg IV | 10–20 min | 2–4 h |
| Atropine | Anticholinergic | 0.4 mg/mL; 0.1 mg/mL (syringe) | Bradycardia: 0.5–1 mg IV every 3–5 min, max 3 mg (ACLS: 1 mg) | ≈1 min | — |
| Glycopyrrolate | Anticholinergic | 0.2 mg/mL | With neostigmine: 0.2 mg per 1 mg neostigmine | — | — |
| Ondansetron | 5-HT3 antagonist | 2 mg/mL | PONV prophylaxis: 4 mg IV at end of surgery | — | — |
| Dexamethasone | Corticosteroid | 4 mg/mL (also 10 mg/mL) | PONV prophylaxis: 4–5 mg IV after induction (8 mg also used) | — | — |
| Scopolamine patch | Anticholinergic antiemetic | 1 mg over 72 h (1.5 mg patch) | PONV prophylaxis: 1 patch behind the ear the evening before or ≥ 2 h pre-op | — | — |
| Acetaminophen IV | Analgesic / antipyretic | 10 mg/mL | Analgesia (≥ 50 kg): 1 g IV every 6 h; max 4 g/day (lower with liver disease or alcohol use) | — | — |
| Ketorolac | NSAID | 15 mg/mL, 30 mg/mL | Analgesia: 15–30 mg IV (15 mg if ≥ 65 y, < 50 kg, or renal impairment); max 5 days | — | — |
| Lidocaine | Amide local anesthetic | 1% = 10 mg/mL; 2% = 20 mg/mL | IV before propofol / blunting laryngoscopy: 1–1.5 mg/kg IV (commonly 40–100 mg) | — | — |
| Bupivacaine | Amide local anesthetic | 0.25% (2.5 mg/mL); 0.5% (5 mg/mL) | Label maximum (healthy adult): 175 mg plain; 225 mg with epinephrine (≈2.5 mg/kg teaching figure) | — | — |
| Cefazolin | 1st-gen cephalosporin | 1 g / 2 g vials (reconstituted) | Surgical prophylaxis: 2 g IV (3 g if ≥ 120 kg) within 60 min before incision | — | — |
| Sevoflurane | Volatile anesthetic | MAC ≈ 2.0% (age ≈ 40) | Maintenance: Titrated to ≈ 0.7–1 MAC with adjuncts (team decides) | — | — |