ADRENALINE
Concentration
1mg/ml
Pharmacology
- Alpha- and beta-adrenergic agonist agent
- Iris and bronchial smooth muscle relaxation
- Antagonizes effects of histamine
- Increases glycogenolysis
- Rapid IV administration – positive inotrope and chronotrope, and increased systolic blood pressure
- Slow IV administration – produces modest rise in systolic blood pressure and a decrease in diastolic
blood
pressure - Total peripheral resistance is decreased due to beta effects
Precautions and Side Effects
- Vomiting
- Tremor
- Excitability
- Hypertension
- Arrhythmia
- Necrosis at injection site
Indications
- Recurrence of hypotension after initial dose of adrenaline
Preparation
- Bolus doses – dilute 1 vial into 10ml saline to create 1:10 000 concentration
- Add 1 ampule (1mg) to 100ml saline to create a 10ug/ml solution
Dose Rates
- Loading dose: 0.01mg/kg IV
- Round up to the nearest 10 kg and administer 0.1ml/10kg of undiluted (1:1,000) adrenaline
- Or diluted 1:10,000 give 1ml per 10kg
Ongoing Continuous Rate Infusion:
- 0.05-0.15ug/kg/minute (titrate to effect)
- Note: If no access to CRI pumps the below can be easily done with a standard fluid pump. 1ml of
undiluted
(1:1,000) adrenaline added to 1 liter of Saline 0.9% or Hartmans mix well. Starting rate of
3ml/kg/hr then
titrate to effect.
| WEIGHT | 0.05ug/kg/min (ml/hr) | 0.1ug/kg/min (ml/hr) | 0.15ug/kg/min (ml/hr) |
|---|---|---|---|
| 1 | 0.3 | 0.6 | 0.9 |
| 2 | 0.6 | 1.2 | 1.8 |
| 3 | 0.9 | 1.8 | 2.7 |
| 4 | 1.2 | 2.4 | 3.6 |
| 5 | 1.5 | 3.0 | 4.5 |
| 6 | 1.8 | 3.6 | 5.4 |
| 7 | 2.1 | 4.2 | 6.3 |
| 8 | 2.4 | 4.8 | 7.2 |
| 9 | 2.7 | 5.4 | 8.1 |
| 10 | 3.0 | 6.0 | 9.0 |
| 11 | 3.3 | 6.6 | 9.9 |
| 12 | 3.6 | 7.2 | 10.8 |
| 13 | 3.9 | 7.8 | 11.7 |
| 14 | 4.2 | 8.4 | 12.6 |
| 15 | 4.5 | 9.0 | 13.5 |
| 16 | 4.8 | 9.6 | 14.4 |
| 17 | 5.1 | 10.2 | 15.3 |
| 18 | 5.4 | 10.8 | 16.2 |
| 19 | 5.7 | 11.4 | 17.1 |
| 20 | 6.0 | 12.0 | 18.0 |
| 21 | 6.3 | 12.6 | 18.9 |
| 22 | 6.6 | 13.2 | 19.8 |
| 23 | 6.9 | 13.8 | 20.7 |
| 24 | 7.2 | 14.4 | 21.6 |
| 25 | 7.5 | 15.0 | 22.5 |
| 26 | 7.8 | 15.6 | 23.4 |
| 27 | 8.1 | 16.2 | 24.3 |
| 28 | 8.4 | 16.8 | 25.2 |
| 29 | 8.7 | 17.4 | 26.1 |
| 30 | 9.0 | 18.0 | 27.0 |
| 31 | 9.3 | 18.6 | 27.9 |
| 32 | 9.6 | 19.2 | 28.8 |
| 33 | 9.9 | 19.8 | 29.7 |
| 34 | 10.2 | 20.4 | 30.6 |
| 35 | 10.5 | 21.0 | 31.5 |
| 40 | 12.0 | 24.0 | 36.0 |
| 45 | 13.5 | 27.0 | 40.5 |
| 50 | 15.0 | 30.0 | 45.0 |
| 55 | 16.5 | 33.0 | 49.5 |
| 60 | 18.0 | 36.0 | 54.0 |
| 65 | 19.5 | 39.0 | 58.5 |
| 70 | 21.0 | 42.0 | 63.0 |
ALFAXAN
Concentration
10 mg/ml
Pharmacology & Indications
- Short acting anaesthetic for light plane of anaesthesia during intubation or mechanical
ventilation - Of particular use in small dogs and cats that were requiring high doses of propofol, and avoids
the
potential
side effect of lipidemia that can be seen in these patients - Additional boluses may be required for mouth care or other stimulation
- Cats can be managed quiet well with low doses of midazolam CRI; dogs with medium to high dose
midazolam CRI
and
butorphanol CRI or IVF additive
Precautions and Side Effects
- Can still cause cardiorespiratory depression and hypotension
- Start at lowest dose and titrate up
- Patients at high risk of hypotension should not be administered high maintenance doses
Preparation
- Dilute 50:50 with 0.9% NaCl
- CRI
Concentration
of 5mg/ml
Dilution to 5mg/ml allows for more accurate titration of dose for small animals
Dose Rates
- Loading dose: 1-2.5mg/kg IV
- CRI Rate 2-6mg/kg/hr IV
| WEIGHT | LOADING DOSE (ml) | LOW DOSE (2mg/kg/hr) ml/hr | MEDIUM DOSE (4mg/kg/hr) ml/hr | HIGH DOSE (6mg/kg/hr) ml/hr |
|---|---|---|---|---|
| 1 | 0.2-0.5 | 0.4 | 0.8 | 1.2 |
| 2 | 0.4-1 | 0.8 | 1.6 | 2.4 |
| 3 | 0.6-1.5 | 1.2 | 2.4 | 3.6 |
| 4 | 0.8-2 | 1.6 | 3.2 | 4.8 |
| 5 | 1-2.5 | 2.0 | 4.0 | 6.0 |
| 6 | 1.2-3 | 2.4 | 4.8 | 7.2 |
| 7 | 1.4-3.5 | 2.8 | 5.6 | 8.4 |
| 8 | 1.6-4 | 3.2 | 6.4 | 9.6 |
| 9 | 1.8-4.5 | 3.6 | 7.2 | 10.8 |
| 10 | 2-5 | 4.0 | 8.0 | 12.0 |
| 11 | 2.2-5.5 | 4.4 | 8.8 | 13.2 |
| 12 | 2.4-6 | 4.8 | 9.6 | 14.4 |
| 13 | 2.6-6.5 | 5.2 | 10.4 | 15.6 |
| 14 | 2.8-7 | 5.6 | 11.2 | 16.8 |
| 15 | 3-7.5 | 6.0 | 12.0 | 18.0 |
| 16 | 3.2-8 | 6.4 | 12.8 | 19.2 |
| 17 | 3.4-8.5 | 6.8 | 13.6 | 20.4 |
| 18 | 3.6-9 | 7.2 | 14.4 | 21.6 |
| 19 | 3.8-9.5 | 7.6 | 15.2 | 22.8 |
| 20 | 4-10 | 8.0 | 16.0 | 24.0 |
| 21 | 4.2-10.5 | 8.4 | 16.8 | 25.2 |
| 22 | 4.4-11 | 8.8 | 17.6 | 26.4 |
| 23 | 4.6-11.5 | 9.2 | 18.4 | 27.6 |
| 24 | 4.8-12 | 9.6 | 19.2 | 28.8 |
| 25 | 5-12.5 | 10.0 | 20.0 | 30.0 |
| 26 | 5.2-13 | 10.4 | 20.8 | 31.2 |
| 27 | 5.4-13.5 | 10.8 | 21.6 | 32.4 |
| 28 | 5.6-14 | 11.2 | 22.4 | 33.6 |
| 29 | 5.8-14.5 | 11.6 | 23.2 | 34.8 |
| 30 | 6-15 | 12.0 | 24.0 | 36.0 |
| 31 | 6.2-15.5 | 12.4 | 24.8 | 37.2 |
| 32 | 6.4-16 | 12.8 | 25.6 | 38.4 |
| 33 | 6.6-16.5 | 13.2 | 26.4 | 39.6 |
| 34 | 6.8-17 | 13.6 | 27.2 | 40.8 |
| 35 | 7-17.5 | 14.0 | 28.0 | 42.0 |
| 40 | 8-20 | 16.0 | 32.0 | 48.0 |
| 45 | 9-22.5 | 18.0 | 36.0 | 54.0 |
| 50 | 10-25 | 20.0 | 40.0 | 60.0 |
| 55 | 11-27.5 | 22.0 | 44.0 | 66.0 |
| 60 | 12-30 | 24.0 | 48.0 | 72.0 |
| 65 | 13-32.5 | 26.0 | 52.0 | 78.0 |
| 70 | 14-35 | 28.0 | 56.0 | 84.0 |
BUTORPHANOL
Concentration
10 mg/ml
Pharmacology & Indications
- Mixed opioid agonist/antagonist
- Little or no respiratory depression
- Antitussive, sedation, reversal of pure mu opioids (methadone/fentanyl)
- Duration of effect is 30 min to 1 hr in dogs; and 1-3 hrs in cats
Precautions and SIde Effects
- Do not use with other opioids. Only provides mildly analgesic effects. Reduce dose in MDR1
affected dogs (Collies, Australian Shepherds)
Preparation
- Add 2.5ml (25mg) Butorphanol to 47.5ml 0.9% saline to make a CRI
Concentration
of
0.5mg/ml
Dose Rates
- Can give loading dose of 0.1-0.5mg/kg IV, SQ, IM if required
- 0.1-0.5mg/kg/hr IV in Dogs and Cats
| WEIGHT | LOADING DOSE (0.1-0.2mg/kg) | LOW DOSE (0.1mg/kg/hr) ml/hr | MEDIUM DOSE (0.3mg/kg/hr) ml/hr | HIGH DOSE (0.5mg/kg/hr) ml/hr |
|---|---|---|---|---|
| 1 | 0.2-0.4 | 0.2 | 0.6 | 1.0 |
| 2 | 0.4-0.8 | 0.4 | 1.2 | 2.0 |
| 3 | 0.6-1.2 | 0.6 | 1.8 | 3.0 |
| 4 | 0.8-1.6 | 0.8 | 2.4 | 4.0 |
| 5 | 1-2 | 1.0 | 3.0 | 5.0 |
| 6 | 1.2-2.4 | 1.2 | 3.6 | 6.0 |
| 7 | 1.4-2.8 | 1.4 | 4.2 | 7.0 |
| 8 | 1.6-3.2 | 1.6 | 4.8 | 8.0 |
| 9 | 1.8-3.6 | 1.8 | 5.4 | 9.0 |
| 10 | 2-4 | 2.0 | 6.0 | 10.0 |
| 11 | 2.2-4.4 | 2.2 | 6.6 | 11.0 |
| 12 | 2.4-4.8 | 2.4 | 7.2 | 12.0 |
| 13 | 2.6-5.2 | 2.6 | 7.8 | 13.0 |
| 14 | 2.8-5.6 | 2.8 | 8.4 | 14.0 |
| 15 | 3-6 | 3.0 | 9.0 | 15.0 |
| 16 | 3.2-6.4 | 3.2 | 9.6 | 16.0 |
| 17 | 3.4-6.8 | 3.4 | 10.2 | 17.0 |
| 18 | 3.6-7.2 | 3.6 | 10.8 | 18.0 |
| 19 | 3.8-7.6 | 3.8 | 11.4 | 19.0 |
| 20 | 4-8 | 4.0 | 12.0 | 20.0 |
| 21 | 4.2-8.4 | 4.2 | 12.6 | 21.0 |
| 22 | 4.4-8.8 | 4.4 | 13.2 | 22.0 |
| 23 | 4.6-9.2 | 4.6 | 13.8 | 23.0 |
| 24 | 4.8-9.6 | 4.8 | 14.4 | 24.0 |
| 25 | 5-10 | 5.0 | 15.0 | 25.0 |
| 26 | 5.2-10.4 | 5.2 | 15.6 | 26.0 |
| 27 | 5.4-10.8 | 5.4 | 16.2 | 27.0 |
| 28 | 5.6-11.2 | 5.6 | 16.8 | 28.0 |
| 29 | 5.8-11.6 | 5.8 | 17.4 | 29.0 |
| 30 | 6-12 | 6.0 | 18.0 | 30.0 |
| 31 | 6.2-12.4 | 6.2 | 18.6 | 31.0 |
| 32 | 6.4-12.8 | 6.4 | 19.2 | 32.0 |
| 33 | 6.6-13.2 | 6.6 | 19.8 | 33.0 |
| 34 | 6.8-13.6 | 6.8 | 20.4 | 34.0 |
| 35 | 7-14 | 7.0 | 21.0 | 35.0 |
| 40 | 8-16 | 8.0 | 24.0 | 40.0 |
| 45 | 9-18 | 9.0 | 27.0 | 45.0 |
| 50 | 10-20 | 10.0 | 30.0 | 50.0 |
| 55 | 11-22 | 11.0 | 33.0 | 55.0 |
| 60 | 12-24 | 12.0 | 36.0 | 60.0 |
| 65 | 13-26 | 13.0 | 39.0 | 65.0 |
| 70 | 14-28 | 14.0 | 42.0 | 70.0 |
DOBUTAMINE
Concentration
250mg in 20ml
Pharmacology & Indications
- Direct beta 1 adrenergic agonist (with mild beta 2- and alpha 1- adrenergic effects)
- Potent inotropic effects (increased cardiac contractility and output)
- Does not cause the release of norepinephrine (unlike dopamine)
- Relatively mild chronotropic, arrhythmogenic and vasodilatory effects
Precautions and SIde Effects
- High doses can cause tachycardia, arrhythmias
- High doses in cats can cause seizures
- DO NOT USE in cats with HCM
Preparation
- 250mg dobutamine in 500ml dextrose 5% or 0.9% NaCl
- Makes a CRI
Concentration
of 0.5mg/ml or 500mcg/ml
Do not make with plasmalyte
Dextrose maintains activity of drug
Dose Rates
- Dogs: 5-20ug/kg/minute IV CRI
- Cats: 2-5 ug/kg/minute IV – USE WITH CAUTION
| WEIGHT | 5ug/kg/min (ml/hr) | 10ug/kg/min (ml/hr) | 15ug/kg/min (ml/hr) | 20ug/kg/min (ml/hr) |
|---|---|---|---|---|
| 1 | 0.6 | 1.2 | 1.8 | 2.4 |
| 2 | 1.2 | 2.4 | 3.6 | 4.8 |
| 3 | 1.8 | 3.6 | 5.4 | 7.2 |
| 4 | 2.4 | 4.8 | 7.2 | 9.6 |
| 5 | 3.0 | 6.0 | 9.0 | 12.0 |
| 6 | 3.6 | 7.2 | 10.8 | 14.4 |
| 7 | 4.2 | 8.4 | 12.6 | 16.8 |
| 8 | 4.8 | 9.6 | 14.4 | 19.2 |
| 9 | 5.4 | 10.8 | 16.2 | 21.6 |
| 10 | 6.0 | 12.0 | 18.0 | 24.0 |
| 11 | 6.6 | 13.2 | 19.8 | 26.4 |
| 12 | 7.2 | 14.4 | 21.6 | 28.8 |
| 13 | 7.8 | 15.6 | 23.4 | 31.2 |
| 14 | 8.4 | 16.8 | 25.2 | 33.6 |
| 15 | 9.0 | 18.0 | 27.0 | 36.0 |
| 16 | 9.6 | 19.2 | 28.8 | 38.4 |
| 17 | 10.2 | 20.4 | 30.6 | 40.8 |
| 18 | 10.8 | 21.6 | 32.4 | 43.2 |
| 19 | 11.4 | 22.8 | 34.2 | 45.6 |
| 20 | 12.0 | 24.0 | 36.0 | 48.0 |
| 25 | 15.0 | 30.0 | 45.0 | 60.0 |
| 30 | 18.0 | 36.0 | 54.0 | 72.0 |
| 35 | 21.0 | 42.0 | 63.0 | 84.0 |
| 40 | 24.0 | 48.0 | 72.0 | 96.0 |
| 45 | 27.0 | 54.0 | 81.0 | 108.0 |
| 50 | 30.0 | 60.0 | 90.0 | 120.0 |
| 55 | 33.0 | 66.0 | 99.0 | 132.0 |
| 60 | 36.0 | 72.0 | 108.0 | 144.0 |
| 65 | 39.0 | 78.0 | 117.0 | 156.0 |
| 70 | 42.0 | 84.0 | 126.0 | 168.0 |
DOPAMINE
Concentration
200mg/5ml
Pharmacology & Indications
- Adrenergic/dopaminergic inotropic agent
- Used to increase blood pressure in hypotensive patients
- Low doses act at dopaminergic and Beta 1 receptors causing vasodilation and increased
- At higher doses dopaminergic responses are overridden by alpha receptor activity,
resulting
force of contraction and heart rate resulting in increased cardiac output and organ
perfusion. Systemic vascular resistance remains unchanged
in increased SVR and reduced peripheral blood flow
Precautions and SIde Effects
- Tachycardia
- Increase urine production
- Arrhythmias, ectopic beats
- Nausea/vomiting
- Hypotension or hypertension (dose related)
- Dyspnoea
- ECG monitoring advised
Preparation
- Add 5ml Dopamine (200mg) into 500ml bag 0.9%NaCl to make CRI
Concentration
of
0.4mg/mlDiluted drug is stable for 24 hours
0.4mg/ml
Dose Rates
- Start on low dose of 5-15mcg/kg/min and titrate up to lowest dose required to maintain mean arterial
blood pressure
| WEIGHT | LOW DOSE 5ug/kg/min (ml/hr) | MEDIUM DOSE 10ug/kg/min (ml/hr) | HIGH DOSE 15ug/kg/min (ml/hr) |
|---|---|---|---|
| 1 | 0.8 | 1.5 | 2.3 |
| 2 | 1.5 | 3.0 | 4.5 |
| 3 | 2.3 | 4.5 | 6.8 |
| 4 | 3.0 | 6.0 | 9.0 |
| 5 | 3.8 | 7.5 | 11.3 |
| 6 | 4.5 | 9.0 | 13.5 |
| 7 | 5.3 | 10.5 | 15.8 |
| 8 | 6.0 | 12.0 | 18.0 |
| 9 | 6.8 | 13.5 | 20.3 |
| 10 | 7.5 | 15.0 | 22.5 |
| 11 | 8.3 | 16.5 | 24.8 |
| 12 | 9.0 | 18.0 | 27.0 |
| 13 | 9.8 | 19.5 | 29.3 |
| 14 | 10.5 | 21.0 | 31.5 |
| 15 | 11.3 | 22.5 | 33.8 |
| 16 | 12.0 | 24.0 | 36.0 |
| 17 | 12.8 | 25.5 | 38.3 |
| 18 | 13.5 | 27.0 | 40.5 |
| 19 | 14.3 | 28.5 | 42.8 |
| 20 | 15.0 | 30.0 | 45.0 |
| 21 | 15.8 | 31.5 | 47.3 |
| 22 | 16.5 | 33.0 | 49.5 |
| 23 | 17.3 | 34.5 | 51.8 |
| 24 | 18.0 | 36.0 | 54.0 |
| 25 | 18.8 | 37.5 | 56.3 |
| 26 | 19.5 | 39.0 | 58.5 |
| 27 | 20.3 | 40.5 | 60.8 |
| 28 | 21.0 | 42.0 | 63.0 |
| 29 | 21.8 | 43.5 | 65.3 |
| 30 | 22.5 | 45.0 | 67.5 |
| 31 | 23.3 | 46.5 | 69.8 |
| 32 | 24.0 | 48.0 | 72.0 |
| 33 | 24.8 | 49.5 | 74.3 |
| 34 | 25.5 | 51.0 | 76.5 |
| 35 | 26.3 | 52.5 | 78.8 |
| 40 | 30.0 | 60.0 | 90.0 |
| 45 | 33.8 | 67.5 | 101.3 |
| 50 | 37.5 | 75.0 | 112.5 |
| 55 | 41.3 | 82.5 | 123.8 |
| 60 | 45.0 | 90.0 | 135.0 |
| 65 | 48.8 | 97.5 | 146.3 |
| 70 | 52.5 | 105.0 | 157.5 |
FENTANYL
Concentration
500mcg/10ml
Pharmacology & Indications
- Short acting mu opioid agonist, potent analgesic
- Short onset of action of 5 minutes
Precautions and SIde Effects
- Dose related respiratory, CNS and circulatory depression
- Titrate to effect and adjust inhalant anaesthetic appropriately
Preparation
- Add 500mcg (10ml vial) to 40ml 0.9% NaCl
- To make CRI of 10ug/ml
Concentration
Dose Rates
- Initial bolus of 2-4 ug/kg IV, IM
- Then CRI of 2-10 ug/kg/hr IV
- Post-operative pain relief 2-6 ug/kg/hr IV
| WEIGHT | 2ug/kg/hr (ml/hr) | 4ug/kg/hr (ml/hr) | 6ug/kg/hr (ml/hr) | 8ug/kg/hr (ml/hr) | 10ug/kg/hr (ml/hr) |
|---|---|---|---|---|---|
| 1 | 0.2 | 0.4 | 0.6 | 0.8 | 1.0 |
| 2 | 0.4 | 0.8 | 1.2 | 1.6 | 2.0 |
| 3 | 0.6 | 1.2 | 1.8 | 2.4 | 3.0 |
| 4 | 0.8 | 1.6 | 2.4 | 3.2 | 4.0 |
| 5 | 1.0 | 2.0 | 3.0 | 4.0 | 5.0 |
| 6 | 1.2 | 2.4 | 3.6 | 4.8 | 6.0 |
| 7 | 1.4 | 2.8 | 4.2 | 5.6 | 7.0 |
| 8 | 1.6 | 3.2 | 4.8 | 6.4 | 8.0 |
| 9 | 1.8 | 3.6 | 5.4 | 7.2 | 9.0 |
| 10 | 2.0 | 4.0 | 6.0 | 8.0 | 10.0 |
| 11 | 2.2 | 4.4 | 6.6 | 8.8 | 11.0 |
| 12 | 2.4 | 4.8 | 7.2 | 9.6 | 12.0 |
| 13 | 2.6 | 5.2 | 7.8 | 10.4 | 13.0 |
| 14 | 2.8 | 5.6 | 8.4 | 11.2 | 14.0 |
| 15 | 3.0 | 6.0 | 9.0 | 12.0 | 15.0 |
| 16 | 3.2 | 6.4 | 9.6 | 12.8 | 16.0 |
| 17 | 3.4 | 6.8 | 10.2 | 13.6 | 17.0 |
| 18 | 3.6 | 7.2 | 10.8 | 14.4 | 18.0 |
| 19 | 3.8 | 7.6 | 11.4 | 15.2 | 19.0 |
| 20 | 4.0 | 8.0 | 12.0 | 16.0 | 20.0 |
| 21 | 4.2 | 8.4 | 12.6 | 16.8 | 21.0 |
| 22 | 4.4 | 8.8 | 13.2 | 17.6 | 22.0 |
| 23 | 4.6 | 9.2 | 13.8 | 18.4 | 23.0 |
| 24 | 4.8 | 9.6 | 14.4 | 19.2 | 24.0 |
| 25 | 5.0 | 10.0 | 15.0 | 20.0 | 25.0 |
| 26 | 5.2 | 10.4 | 15.6 | 20.8 | 26.0 |
| 27 | 5.4 | 10.8 | 16.2 | 21.6 | 27.0 |
| 28 | 5.6 | 11.2 | 16.8 | 22.4 | 28.0 |
| 29 | 5.8 | 11.6 | 17.4 | 23.2 | 29.0 |
| 30 | 6.0 | 12.0 | 18.0 | 24.0 | 30.0 |
| 31 | 6.2 | 12.4 | 18.6 | 24.8 | 31.0 |
| 32 | 6.4 | 12.8 | 19.2 | 25.6 | 32.0 |
| 33 | 6.6 | 13.2 | 19.8 | 26.4 | 33.0 |
| 34 | 6.8 | 13.6 | 20.4 | 27.2 | 34.0 |
| 35 | 7.0 | 14.0 | 21.0 | 28.0 | 35.0 |
| 40 | 8.0 | 16.0 | 24.0 | 32.0 | 40.0 |
| 45 | 9.0 | 18.0 | 27.0 | 36.0 | 45.0 |
| 50 | 10.0 | 20.0 | 30.0 | 40.0 | 50.0 |
| 55 | 11.0 | 22.0 | 33.0 | 44.0 | 55.0 |
| 60 | 12.0 | 24.0 | 36.0 | 48.0 | 60.0 |
| 65 | 13.0 | 26.0 | 39.0 | 52.0 | 65.0 |
| 70 | 14.0 | 28.0 | 42.0 | 56.0 | 70.0 |
FENTANYL, LIGNOCAINE & KETAMINE
Concentration
Ketamine 50mg/ml Lignocaine 20mg/ml F entanyl 500ug/10ml
Pharmacology & Indications
Ketamine
- Dissociative anaesthetic
- Antagonizes NMDA receptors
- Enhances opioid receptor sensitivity and reduces rebound hyperalgesia
- Failure to administer loading dose will result in an excessive delay in reaching
therapeutic levels
Fentanyl
- Pure mu opioid agonist
- Continuous infusion reduced peak and trough effect
- Not recommended for use in cats
- Anti-arrhythmic and local anaesthetic
Lignocaine
| WEIGHT | LOW (0.5ml/kg/hr) ml/hr | MEDIUM (1ml/kg/hr) ml/hr | HIGH (2ml/kg/hr) ml/hr | LOW (0.5ml/kg/hr) ml/hr | HIGH (1ml/kg/hr) ml/hr |
|---|---|---|---|---|---|
| 1 | 0.5 | 1.0 | 2.0 | 0.5 | 1.0 |
| 2 | 1.0 | 2.0 | 4.0 | 1.0 | 2.0 |
| 3 | 1.5 | 3.0 | 6.0 | 1.5 | 3.0 |
| 4 | 2.0 | 4.0 | 8.0 | 2.0 | 4.0 |
| 5 | 2.5 | 5.0 | 10.0 | 2.5 | 5.0 |
| 6 | 3.0 | 6.0 | 12.0 | 3.0 | 6.0 |
| 7 | 3.5 | 7.0 | 14.0 | 3.5 | 7.0 |
| 8 | 4.0 | 8.0 | 16.0 | 4.0 | 8.0 |
| 9 | 4.5 | 9.0 | 18.0 | 4.5 | 9.0 |
| 10 | 5.0 | 10.0 | 20.0 | 5.0 | 10.0 |
| 11 | 5.5 | 11.0 | 22.0 | 5.5 | 11.0 |
| 12 | 6.0 | 12.0 | 24.0 | 6.0 | 12.0 |
| 13 | 6.5 | 13.0 | 26.0 | 6.5 | 13.0 |
| 14 | 7.0 | 14.0 | 28.0 | 7.0 | 14.0 |
| 15 | 7.5 | 15.0 | 30.0 | 7.5 | 15.0 |
| 16 | 8.0 | 16.0 | 32.0 | 8.0 | 16.0 |
| 17 | 8.5 | 17.0 | 34.0 | 8.5 | 17.0 |
| 18 | 9.0 | 18.0 | 36.0 | 9.0 | 18.0 |
| 19 | 9.5 | 19.0 | 38.0 | 9.5 | 19.0 |
| 20 | 10.0 | 20.0 | 40.0 | 10.0 | 20.0 |
| 21 | 10.5 | 21.0 | 42.0 | 10.5 | 21.0 |
| 22 | 11.0 | 22.0 | 44.0 | 11.0 | 22.0 |
| 23 | 11.5 | 23.0 | 46.0 | 11.5 | 23.0 |
| 24 | 12.0 | 24.0 | 48.0 | 12.0 | 24.0 |
| 25 | 12.5 | 25.0 | 50.0 | 12.5 | 25.0 |
| 26 | 13.0 | 26.0 | 52.0 | 13.0 | 26.0 |
| 27 | 13.5 | 27.0 | 54.0 | 13.5 | 27.0 |
| 28 | 14.0 | 28.0 | 56.0 | 14.0 | 28.0 |
| 29 | 14.5 | 29.0 | 58.0 | 14.5 | 29.0 |
| 30 | 15.0 | 30.0 | 60.0 | 15.0 | 30.0 |
| 31 | 15.5 | 31.0 | 62.0 | 15.5 | 31.0 |
| 32 | 16.0 | 32.0 | 64.0 | 16.0 | 32.0 |
| 33 | 16.5 | 33.0 | 66.0 | 16.5 | 33.0 |
| 34 | 17.0 | 34.0 | 68.0 | 17.0 | 34.0 |
| 35 | 17.5 | 35.0 | 70.0 | 17.5 | 35.0 |
| 40 | 20.0 | 40.0 | 80.0 | 20.0 | 40.0 |
| 45 | 22.5 | 45.0 | 90.0 | 22.5 | 45.0 |
| 50 | 25.0 | 50.0 | 100.0 | 25.0 | 50.0 |
| 55 | 27.5 | 55.0 | 110.0 | 27.5 | 55.0 |
| 60 | 30.0 | 60.0 | 120.0 | 30.0 | 60.0 |
| 65 | 32.5 | 65.0 | 130.0 | 32.5 | 65.0 |
| 70 | 35.0 | 70.0 | 140.0 | 35.0 | 70.0 |
FRUSEMIDE
Concentration
50mg/ml
Pharmacology & Indications
- Loop diuretic – most commonly used for congestive heart failure and pulmonary
oedema
Precautions and SIde Effects
- Fluid and electrolyte abnormalities
- Ototoxicity
- Dehydration
Preparation
- Dilute with 0.9% NaCl as required to administer small but accurate volumes
- Eg 1ml of frusemide into 24ml of saline -> 2mg/ml)
Dose Rates
- Bolus dose of 1-4mg/kg IV
- Dose for CRI 0.66-1mg/kg/hr IV
| WEIGHT | LOW DOSE 0.66mg/kg/hr (ml/hr) | MEDIUM DOSE 0.83mg/kg/hr (ml/hr) | HIGH DOSE 1mg/kg/hr (ml/hr) |
|---|---|---|---|
| 1 | 0.3 | 0.4 | 0.5 |
| 2 | 0.7 | 0.8 | 1.0 |
| 3 | 1.0 | 1.2 | 1.5 |
| 4 | 1.3 | 1.7 | 2.0 |
| 5 | 1.7 | 2.1 | 2.5 |
| 6 | 2.0 | 2.5 | 3.0 |
| 7 | 2.3 | 2.9 | 3.5 |
| 8 | 2.6 | 3.3 | 4.0 |
| 9 | 3.0 | 3.7 | 4.5 |
| 10 | 3.3 | 4.2 | 5.0 |
| 11 | 3.6 | 4.6 | 5.5 |
| 12 | 4.0 | 5.0 | 6.0 |
| 13 | 4.3 | 5.4 | 6.5 |
| 14 | 4.6 | 5.8 | 7.0 |
| 15 | 5.0 | 6.2 | 7.5 |
| 16 | 5.3 | 6.6 | 8.0 |
| 17 | 5.6 | 7.1 | 8.5 |
| 18 | 5.9 | 7.5 | 9.0 |
| 19 | 6.3 | 7.9 | 9.5 |
| 20 | 6.6 | 8.3 | 10.0 |
| 21 | 6.9 | 8.7 | 10.5 |
| 22 | 7.3 | 9.1 | 11.0 |
| 23 | 7.6 | 9.5 | 11.5 |
| 24 | 7.9 | 10.0 | 12.0 |
| 25 | 8.3 | 10.4 | 12.5 |
| 26 | 8.6 | 10.8 | 13.0 |
| 27 | 8.9 | 11.2 | 13.5 |
| 28 | 9.2 | 11.6 | 14.0 |
| 29 | 9.6 | 12.0 | 14.5 |
| 30 | 9.9 | 12.5 | 15.0 |
| 31 | 10.2 | 12.9 | 15.5 |
| 32 | 10.6 | 13.3 | 16.0 |
| 33 | 10.9 | 13.7 | 16.5 |
| 34 | 11.2 | 14.1 | 17.0 |
| 35 | 11.6 | 14.5 | 17.5 |
| 40 | 13.2 | 16.6 | 20.0 |
| 45 | 14.9 | 18.7 | 22.5 |
| 50 | 16.5 | 20.8 | 25.0 |
| 55 | 18.2 | 22.8 | 27.5 |
| 60 | 19.8 | 24.9 | 30.0 |
| 65 | 21.5 | 27.0 | 32.5 |
| 70 | 23.1 | 29.1 | 35.0 |
HYDROCORTISONE
Concentration
250mg/2ml (125mg/ml)\
Pharmacology & Indications
- \’95Hypoadrenocorticism (Addison’s Disease), Critical Illness Related
Corticosteroid - Insufficiency (CIRCI), Refractory hypotension unresponsive to fluids and
vasopressor
therapy
Precautions and SIde Effects
- Do not mix IV with Ampicillin, Heparin sodium, Phenobarbital sodium
Preparation
- Add 0.4ml (50mg) to 49.6ml of 0.9% saline or
- 0.8ml (100mg) to 99.2ml 0.9% saline
- Solu-Cortef once prepared to instruction is 1mg/ml
Dose Rates
- CRI rate of 0.25-0.5mg/kg/hr IV
| WEIGHT | LOW DOSE 0.5mg/kg/hr (ml/hr) | HIGH DOSE 1mg/kg/hr (ml/hr) |
|---|---|---|
| 1 | 0.5 | 1.0 |
| 2 | 1.0 | 2.0 |
| 3 | 1.5 | 3.0 |
| 4 | 2.0 | 4.0 |
| 5 | 2.5 | 5.0 |
| 6 | 3.0 | 6.0 |
| 7 | 3.5 | 7.0 |
| 8 | 4.0 | 8.0 |
| 9 | 4.5 | 9.0 |
| 10 | 5.0 | 10.0 |
| 11 | 5.5 | 11.0 |
| 12 | 6.0 | 12.0 |
| 13 | 6.5 | 13.0 |
| 14 | 7.0 | 14.0 |
| 15 | 7.5 | 15.0 |
| 16 | 8.0 | 16.0 |
| 17 | 8.5 | 17.0 |
| 18 | 9.0 | 18.0 |
| 19 | 9.5 | 19.0 |
| 20 | 10.0 | 20.0 |
| 21 | 10.5 | 21.0 |
| 22 | 11.0 | 22.0 |
| 23 | 11.5 | 23.0 |
| 24 | 12.0 | 24.0 |
| 25 | 12.5 | 25.0 |
| 26 | 13.0 | 26.0 |
| 27 | 13.5 | 27.0 |
| 28 | 14.0 | 28.0 |
| 29 | 14.5 | 29.0 |
| 30 | 15.0 | 30.0 |
| 31 | 15.5 | 31.0 |
| 32 | 16.0 | 32.0 |
| 33 | 16.5 | 33.0 |
| 34 | 17.0 | 34.0 |
| 35 | 17.5 | 35.0 |
| 40 | 20.0 | 40.0 |
| 45 | 22.5 | 45.0 |
| 50 | 25.0 | 50.0 |
| 55 | 27.5 | 55.0 |
| 60 | 30.0 | 60.0 |
| 65 | 32.5 | 65.0 |
| 70 | 35.0 | 70.0 |
INSULIN (ACTRAPID)
Concentration
100 units/ml
Pharmacology & Indications
- Facilitates uptake of glucose by cells
- Stimulates lipogenesis, increases protein synthesis, inhibits lipolysis
and
free fatty acid release - Intracellular shift of potassium and magnesium
from adipose tissues
Precautions and SIde Effects
- Hypokalaemia (monitor blood gas closely and supplement IVF)
- Hypoglycaemia (over dose)
Preparation
- Add 25iu of Actrapid into 500ml 0.9% NaCl (or 0.45% NaCl + 2.5% glucose)
’96 mix well - Protect from light
Dose Rates
- 1ml/kg/hr IV in conjunction with IVF (ie separate from IVF)
- Once blood glucose <12mmol /L - half insulin rate and make up IVF to 2.5% glucose
- Adjust insulin rate to maintain BG between 8-14mmol/L
- Monitor BG q 2hrs; blood gas at least q 6hrs
KETAMINE
Concentration
50mg/ml
Pharmacology & Indications
- NMDA receptor antagonist useful for adjunctive pain relief and
prevention of ‘wind up’
Precautions and SIde Effects
- HCM, Congestive Heart Failure and shock (increased myocardial
demand) - Cats\’92 eyes remain open when given Ketamine – require regular eye
care. - Corneal desiccation can occur – corneal protection required
- Can cause elevated sympathetic tone so to caution with HCM,
Hyperthyroid
patients,
pheochromocytomas
Preparation
- Add 0.5ml (50mg) to 49.5ml 0.9% NaCl, D5W or Water for injection
- To make a CRI
Concentration
of 1mg/ml
Dose Rates
- Loading dose 0.1-0.2 mg/kg IV followed by CRI of 0.1 – 0.6mg/kg/hr
IV
| WEIGHT | 0.1mg/kg/hr (ml/hr) | 0.2mg/kg/hr (ml/hr) | 0.3mg/kg/hr (ml/hr) | 0.4mg/kg/hr (ml/hr) | 0.5mg/kg/hr (ml/hr) |
|---|---|---|---|---|---|
| 1 | 0.1 | 0.2 | 0.3 | 0.4 | 0.5 |
| 2 | 0.2 | 0.4 | 0.6 | 0.8 | 1.0 |
| 3 | 0.3 | 0.6 | 0.9 | 1.2 | 1.5 |
| 4 | 0.4 | 0.8 | 1.2 | 1.6 | 2.0 |
| 5 | 0.5 | 1.0 | 1.5 | 2.0 | 2.5 |
| 6 | 0.6 | 1.2 | 1.8 | 2.4 | 3.0 |
| 7 | 0.7 | 1.4 | 2.1 | 2.8 | 3.5 |
| 8 | 0.8 | 1.6 | 2.4 | 3.2 | 4.0 |
| 9 | 0.9 | 1.8 | 2.7 | 3.6 | 4.5 |
| 10 | 1.0 | 2.0 | 3.0 | 4.0 | 5.0 |
| 11 | 1.1 | 2.2 | 3.3 | 4.4 | 5.5 |
| 12 | 1.2 | 2.4 | 3.6 | 4.8 | 6.0 |
| 13 | 1.3 | 2.6 | 3.9 | 5.2 | 6.5 |
| 14 | 1.4 | 2.8 | 4.2 | 5.6 | 7.0 |
| 15 | 1.5 | 3.0 | 4.5 | 6.0 | 7.5 |
| 16 | 1.6 | 3.2 | 4.8 | 6.4 | 8.0 |
| 17 | 1.7 | 3.4 | 5.1 | 6.8 | 8.5 |
| 18 | 1.8 | 3.6 | 5.4 | 7.2 | 9.0 |
| 19 | 1.9 | 3.8 | 5.7 | 7.6 | 9.5 |
| 20 | 2.0 | 4.0 | 6.0 | 8.0 | 10.0 |
| 21 | 2.1 | 4.2 | 6.3 | 8.4 | 10.5 |
| 22 | 2.2 | 4.4 | 6.6 | 8.8 | 11.0 |
| 23 | 2.3 | 4.6 | 6.9 | 9.2 | 11.5 |
| 24 | 2.4 | 4.8 | 7.2 | 9.6 | 12.0 |
| 25 | 2.5 | 5.0 | 7.5 | 10.0 | 12.5 |
| 26 | 2.6 | 5.2 | 7.8 | 10.4 | 13.0 |
| 27 | 2.7 | 5.4 | 8.1 | 10.8 | 13.5 |
| 28 | 2.8 | 5.6 | 8.4 | 11.2 | 14.0 |
| 29 | 2.9 | 5.8 | 8.7 | 11.6 | 14.5 |
| 30 | 3.0 | 6.0 | 9.0 | 12.0 | 15.0 |
| 31 | 3.1 | 6.2 | 9.3 | 12.4 | 15.5 |
| 32 | 3.2 | 6.4 | 9.6 | 12.8 | 16.0 |
| 33 | 3.3 | 6.6 | 9.9 | 13.2 | 16.5 |
| 34 | 3.4 | 6.8 | 10.2 | 13.6 | 17.0 |
| 35 | 3.5 | 7.0 | 10.5 | 14.0 | 17.5 |
| 40 | 4.0 | 8.0 | 12.0 | 16.0 | 20.0 |
| 45 | 4.5 | 9.0 | 13.5 | 18.0 | 22.5 |
| 50 | 5.0 | 10.0 | 15.0 | 20.0 | 25.0 |
| 55 | 5.5 | 11.0 | 16.5 | 22.0 | 27.5 |
| 60 | 6.0 | 12.0 | 18.0 | 24.0 | 30.0 |
| 65 | 6.5 | 13.0 | 19.5 | 26.0 | 32.5 |
| 70 | 7.0 | 14.0 | 21.0 | 28.0 | 35.0 |
LIGNOCAINE
Concentration
20mg/ml
Pharmacology & Indications
- On its own its own is used for anti-arrhythmic effects
- Can be combined with opioid and ketamine for pain relief
- Promotes gastric motility
- Reduces requirements for injectable and inhalant anaesthetics
- Low dose CRI useful in hyperalgesia and neuropathic pain
Precautions and SIde Effects
- Decreased mentation/depression
- Muscle tremors, seizures (high dose)
- Nausea/vomiting
- Cats have lower threshold to toxicity, and use with caution –
should not exceed
25 ug/kg/min IV
Preparation
- Use as 20mg/ml solution
Dose Rates
-
ANTIARRHYTHMIC:
- Loading dose 1-2 mg/kg slow IV bolus over 30secs (repeated up to
8 mg/kg, each bolus 5mins - Followed by CRI of 20-80 mcg/kg/min IV
apart until it converts to normal rhythm)
| WEIGHT | 20ug/kg/min (ml/hr) | 40ug/kg/min (ml/hr) | 60ug/kg/min (ml/hr) | 80ug/kg/min (ml/hr) |
|---|---|---|---|---|
| 1 | 0.06 | 0.12 | 0.18 | 0.24 |
| 2 | 0.12 | 0.24 | 0.36 | 0.48 |
| 3 | 0.18 | 0.36 | 0.54 | 0.72 |
| 4 | 0.24 | 0.48 | 0.72 | 0.96 |
| 5 | 0.30 | 0.60 | 0.90 | 1.20 |
| 6 | 0.36 | 0.72 | 1.08 | 1.44 |
| 7 | 0.42 | 0.84 | 1.26 | 1.68 |
| 8 | 0.48 | 0.96 | 1.44 | 1.92 |
| 9 | 0.54 | 1.08 | 1.62 | 2.16 |
| 10 | 0.60 | 1.20 | 1.80 | 2.40 |
| 11 | 0.66 | 1.32 | 1.98 | 2.64 |
| 12 | 0.72 | 1.44 | 2.16 | 2.88 |
| 13 | 0.78 | 1.56 | 2.34 | 3.12 |
| 14 | 0.84 | 1.68 | 2.52 | 3.36 |
| 15 | 0.90 | 1.80 | 2.70 | 3.60 |
| 16 | 0.96 | 1.92 | 2.88 | 3.84 |
| 17 | 1.02 | 2.04 | 3.06 | 4.08 |
| 18 | 1.08 | 2.16 | 3.24 | 4.32 |
| 19 | 1.14 | 2.28 | 3.42 | 4.56 |
| 20 | 1.20 | 2.40 | 3.60 | 4.80 |
| 25 | 1.50 | 3.00 | 4.50 | 6.00 |
| 30 | 1.80 | 3.60 | 5.40 | 7.20 |
| 35 | 2.10 | 4.20 | 6.30 | 8.40 |
| 40 | 2.40 | 4.80 | 7.20 | 9.60 |
| 45 | 2.70 | 5.40 | 8.10 | 10.80 |
| 50 | 3.00 | 6.00 | 9.00 | 12.00 |
| 55 | 3.30 | 6.60 | 9.90 | 13.20 |
| 60 | 3.60 | 7.20 | 10.80 | 14.40 |
| 65 | 3.90 | 7.80 | 11.70 | 15.60 |
| 70 | 4.20 | 8.40 | 12.60 | 16.80 |
MEDETOMIDINE
Concentration
1mg/ml
Pharmacology & Indications
- Alpha-2 agonist
- Sedative/analgesic
Precautions and SIde Effects
- Alpha-2 agonists depress insulin production
- Do not use in cardiovascular unstable patients
- Interactions with atropine / glycopyrrolate
- Dose reductions may be required with opiods and propofol if
used concurrently
Preparation
- Add 0.5ml (0.5mg) Medetomidine to 49.5ml of 0.95 NaCl
- To make CRI
Concentration
of 0.01mg/ml (10mcg/ml)
Dose Rates
- 1-3 mcg/kg/hr IV
| WEIGHT | LOW DOSE 1ug/kg/hr (ml/hr) | MEDIUM DOSE 2ug/kg/hr (ml/hr) | HIGH DOSE 3ug/kg/hr (ml/hr) |
|---|---|---|---|
| 1 | 0.1 | 0.2 | 0.3 |
| 2 | 0.2 | 0.4 | 0.6 |
| 3 | 0.3 | 0.6 | 0.9 |
| 4 | 0.4 | 0.8 | 1.2 |
| 5 | 0.5 | 1.0 | 1.5 |
| 6 | 0.6 | 1.2 | 1.8 |
| 7 | 0.7 | 1.4 | 2.1 |
| 8 | 0.8 | 1.6 | 2.4 |
| 9 | 0.9 | 1.8 | 2.7 |
| 10 | 1.0 | 2.0 | 3.0 |
| 11 | 1.1 | 2.2 | 3.3 |
| 12 | 1.2 | 2.4 | 3.6 |
| 13 | 1.3 | 2.6 | 3.9 |
| 14 | 1.4 | 2.8 | 4.2 |
| 15 | 1.5 | 3.0 | 4.5 |
| 16 | 1.6 | 3.2 | 4.8 |
| 17 | 1.7 | 3.4 | 5.1 |
| 18 | 1.8 | 3.6 | 5.4 |
| 19 | 1.9 | 3.8 | 5.7 |
| 20 | 2.0 | 4.0 | 6.0 |
| 21 | 2.1 | 4.2 | 6.3 |
| 22 | 2.2 | 4.4 | 6.6 |
| 23 | 2.3 | 4.6 | 6.9 |
| 24 | 2.4 | 4.8 | 7.2 |
| 25 | 2.5 | 5.0 | 7.5 |
| 26 | 2.6 | 5.2 | 7.8 |
| 27 | 2.7 | 5.4 | 8.1 |
| 28 | 2.8 | 5.6 | 8.4 |
| 29 | 2.9 | 5.8 | 8.7 |
| 30 | 3.0 | 6.0 | 9.0 |
| 31 | 3.1 | 6.2 | 9.3 |
| 32 | 3.2 | 6.4 | 9.6 |
| 33 | 3.3 | 6.6 | 9.9 |
| 34 | 3.4 | 6.8 | 10.2 |
| 35 | 3.5 | 7.0 | 10.5 |
| 40 | 4.0 | 8.0 | 12.0 |
| 45 | 4.5 | 9.0 | 13.5 |
| 50 | 5.0 | 10.0 | 15.0 |
| 55 | 5.5 | 11.0 | 16.5 |
| 60 | 6.0 | 12.0 | 18.0 |
| 65 | 6.5 | 13.0 | 19.5 |
| 70 | 7.0 | 14.0 | 21.0 |
METHADONE
Concentration
10mg/ml
Pharmacology & Indications
- Pure mu opioid agonist
- Less sedation and vomiting than morphine
Precautions and SIde Effects
- Respiratory depression
- Can cause constipation
Preparation
- Dilute 3ml (30mg) in 97ml 0.9% NaCl
- To make CRI of 0.3mg/ml
- Dog 0.1-0.2mg/kg IV
- Cat 0.05/0.2mg/kg IV
- 0.05-0.1mg/kg/hr
DOSE RATES Loading dose:
CRI dose
| WEIGHT | LOW DOSE 0.05mg/kg/hr (ml/hr) | MEDIUM DOSE 0.08mg/kg/hr (ml/hr) | HIGH DOSE 0.1mg/kg/hr (ml/hr) |
|---|---|---|---|
| 1 | 0.2 | 0.3 | 0.3 |
| 2 | 0.3 | 0.5 | 0.7 |
| 3 | 0.5 | 0.8 | 1.0 |
| 4 | 0.7 | 1.1 | 1.3 |
| 5 | 0.8 | 1.3 | 1.7 |
| 6 | 1.0 | 1.6 | 2.0 |
| 7 | 1.2 | 1.9 | 2.3 |
| 8 | 1.3 | 2.1 | 2.7 |
| 9 | 1.5 | 2.4 | 3.0 |
| 10 | 1.7 | 2.7 | 3.3 |
| 11 | 1.8 | 2.9 | 3.7 |
| 12 | 2.0 | 3.2 | 4.0 |
| 13 | 2.2 | 3.5 | 4.3 |
| 14 | 2.3 | 3.7 | 4.7 |
| 15 | 2.5 | 4.0 | 5.0 |
| 16 | 2.7 | 4.3 | 5.3 |
| 17 | 2.8 | 4.5 | 5.7 |
| 18 | 3.0 | 4.8 | 6.0 |
| 19 | 3.2 | 5.1 | 6.3 |
| 20 | 3.3 | 5.3 | 6.7 |
| 21 | 3.5 | 5.6 | 7.0 |
| 22 | 3.7 | 5.9 | 7.3 |
| 23 | 3.8 | 6.1 | 7.7 |
| 24 | 4.0 | 6.4 | 8.0 |
| 25 | 4.2 | 6.7 | 8.3 |
| 26 | 4.3 | 6.9 | 8.7 |
| 27 | 4.5 | 7.2 | 9.0 |
| 28 | 4.7 | 7.5 | 9.3 |
| 29 | 4.8 | 7.7 | 9.7 |
| 30 | 5.0 | 8.0 | 10.0 |
| 31 | 5.2 | 8.3 | 10.3 |
| 32 | 5.3 | 8.5 | 10.7 |
| 33 | 5.5 | 8.8 | 11.0 |
| 34 | 5.7 | 9.1 | 11.3 |
| 35 | 5.8 | 9.3 | 11.7 |
| 40 | 6.7 | 10.7 | 13.3 |
| 45 | 7.5 | 12.0 | 15.0 |
| 50 | 8.3 | 13.3 | 16.7 |
| 55 | 9.2 | 14.7 | 18.3 |
| 60 | 10.0 | 16.0 | 20.0 |
| 65 | 10.8 | 17.3 | 21.7 |
| 70 | 11.7 | 18.7 | 23.3 |
MIDAZOLAM
Concentration
5mg/ml ampoules
Pharmacology & Indications
- Benzodiazepine
- Short acting anticonvulsant and sedative
Precautions and SIde Effects
- Combined with butorphanol during isoflurane
anaesthesia decreased blood pressure, heart - Acute narrow-angle glaucoma
- Also contraindicated in encephalopathic patients
rate and enhanced respiratory depression may occur
Preparation
- Dilute 10mls of 5mg/ml (total of 50mg) into 40ml of
saline - CRI
Concentration
1mg/ml
Dose Rates
Loading dose:
- 0.1-0.2mg/kg IV CRI dose
- 0.1 – 0.5 mg/kg/hr IV
| WEIGHT | LOADING DOSE (ml) | LOW (0.1mg/kg/hr) ml/hr | MEDIUM (0.3mg/kg/hr) ml/hr | HIGH (0.5mg/kg/hr) ml/hr |
|---|---|---|---|---|
| 1 | 0.1 | 0.1 | 0.3 | 0.5 |
| 2 | 0.2 | 0.2 | 0.6 | 1.0 |
| 3 | 0.3 | 0.3 | 0.9 | 1.5 |
| 4 | 0.4 | 0.4 | 1.2 | 2.0 |
| 5 | 0.5 | 0.5 | 1.5 | 2.5 |
| 6 | 0.6 | 0.6 | 1.8 | 3.0 |
| 7 | 0.7 | 0.7 | 2.1 | 3.5 |
| 8 | 0.8 | 0.8 | 2.4 | 4.0 |
| 9 | 0.9 | 0.9 | 2.7 | 4.5 |
| 10 | 1.0 | 1.0 | 3.0 | 5.0 |
| 11 | 1.1 | 1.1 | 3.3 | 5.5 |
| 12 | 1.2 | 1.2 | 3.6 | 6.0 |
| 13 | 1.3 | 1.3 | 3.9 | 6.5 |
| 14 | 1.4 | 1.4 | 4.2 | 7.0 |
| 15 | 1.5 | 1.5 | 4.5 | 7.5 |
| 16 | 1.6 | 1.6 | 4.8 | 8.0 |
| 17 | 1.7 | 1.7 | 5.1 | 8.5 |
| 18 | 1.8 | 1.8 | 5.4 | 9.0 |
| 19 | 1.9 | 1.9 | 5.7 | 9.5 |
| 20 | 2.0 | 2.0 | 6.0 | 10.0 |
| 21 | 2.1 | 2.1 | 6.3 | 10.5 |
| 22 | 2.2 | 2.2 | 6.6 | 11.0 |
| 23 | 2.3 | 2.3 | 6.9 | 11.5 |
| 24 | 2.4 | 2.4 | 7.2 | 12.0 |
| 25 | 2.5 | 2.5 | 7.5 | 12.5 |
| 26 | 2.6 | 2.6 | 7.8 | 13.0 |
| 27 | 2.7 | 2.7 | 8.1 | 13.5 |
| 28 | 2.8 | 2.8 | 8.4 | 14.0 |
| 29 | 2.9 | 2.9 | 8.7 | 14.5 |
| 30 | 3.0 | 3.0 | 9.0 | 15.0 |
| 31 | 3.1 | 3.1 | 9.3 | 15.5 |
| 32 | 3.2 | 3.2 | 9.6 | 16.0 |
| 33 | 3.3 | 3.3 | 9.9 | 16.5 |
| 34 | 3.4 | 3.4 | 10.2 | 17.0 |
| 35 | 3.5 | 3.5 | 10.5 | 17.5 |
| 40 | 4.0 | 4.0 | 12.0 | 20.0 |
| 45 | 4.5 | 4.5 | 13.5 | 22.5 |
| 50 | 5.0 | 5.0 | 15.0 | 25.0 |
| 55 | 5.5 | 5.5 | 16.5 | 27.5 |
| 60 | 6.0 | 6.0 | 18.0 | 30.0 |
| 65 | 6.5 | 6.5 | 19.5 | 32.5 |
| 70 | 7.0 | 7.0 | 21.0 | 35.0 |
MORPHINE
Concentration
Available as 5, 10, 15, 30 mg/ml ampoules
Pharmacology & Indications
- Pure mu opioid agonist
- Continuous infusion reduced peak and trough effect
Precautions and Side Effects
- Respiratory depression
- Not to be used with any systemic histamine release conditions, asthma or mast cell tumours
- Vomiting/nausea
- Constipation
Preparation
- Add 30mg morphine to 59ml 0.9% NaCl
- (multiple strengths of morphine available)
- To make CRI of 0.5mg/ml
Dose Rates
- Dogs: 0.1-0.3mg/kg/hr IV
| WEIGHT | LOW DOSE 0.1mg/kg/hr (ml/hr) | MEDIUM DOSE 0.2mg/kg/hr (ml/hr) | HIGH DOSE 0.3mg/kg/hr (ml/hr) |
|---|---|---|---|
| 1 | 0.2 | 0.4 | 0.6 |
| 2 | 0.4 | 0.8 | 1.2 |
| 3 | 0.6 | 1.2 | 1.8 |
| 4 | 0.8 | 1.6 | 2.4 |
| 5 | 1.0 | 2.0 | 3.0 |
| 6 | 1.2 | 2.4 | 3.6 |
| 7 | 1.4 | 2.8 | 4.2 |
| 8 | 1.6 | 3.2 | 4.8 |
| 9 | 1.8 | 3.6 | 5.4 |
| 10 | 2.0 | 4.0 | 6.0 |
| 11 | 2.2 | 4.4 | 6.6 |
| 12 | 2.4 | 4.8 | 7.2 |
| 13 | 2.6 | 5.2 | 7.8 |
| 14 | 2.8 | 5.6 | 8.4 |
| 15 | 3.0 | 6.0 | 9.0 |
| 16 | 3.2 | 6.4 | 9.6 |
| 17 | 3.4 | 6.8 | 10.2 |
| 18 | 3.6 | 7.2 | 10.8 |
| 19 | 3.8 | 7.6 | 11.4 |
| 20 | 4.0 | 8.0 | 12.0 |
| 21 | 4.2 | 8.4 | 12.6 |
| 22 | 4.4 | 8.8 | 13.2 |
| 23 | 4.6 | 9.2 | 13.8 |
| 24 | 4.8 | 9.6 | 14.4 |
| 25 | 5.0 | 10.0 | 15.0 |
| 26 | 5.2 | 10.4 | 15.6 |
| 27 | 5.4 | 10.8 | 16.2 |
| 28 | 5.6 | 11.2 | 16.8 |
| 29 | 5.8 | 11.6 | 17.4 |
| 30 | 6.0 | 12.0 | 18.0 |
| 31 | 6.2 | 12.4 | 18.6 |
| 32 | 6.4 | 12.8 | 19.2 |
| 33 | 6.6 | 13.2 | 19.8 |
| 34 | 6.8 | 13.6 | 20.4 |
| 35 | 7.0 | 14.0 | 21.0 |
| 40 | 8.0 | 16.0 | 24.0 |
| 45 | 9.0 | 18.0 | 27.0 |
| 50 | 10.0 | 20.0 | 30.0 |
| 55 | 11.0 | 22.0 | 33.0 |
| 60 | 12.0 | 24.0 | 36.0 |
| 65 | 13.0 | 26.0 | 39.0 |
| 70 | 14.0 | 28.0 | 42.0 |
MORPHINE, KETAMINE & LIGNOCAINE
Concentration
Ketamine 50mg/ml Lignocaine
20mg/ml Morphine 10/30mg/ml vials
20mg/ml Morphine 10/30mg/ml vials
Pharmacology & Indications
Ketamine
- Dissociative anaesthetic
- Antagonizes NMDA receptors
- Enhances opioid receptor sensitivity and reduces rebound hyperalgesia
- Failure to administer loading dose will result in an excessive delay in reaching therapeutic levels
Morphine
- Pure mu opioid agonist
- Continuous infusion reduced peak and trough effect
Lignocaine
- Not recommended for use in cats
- Anti-arrhythmic and local anaesthetic
- Low dose CRI useful in hyperalgesia and neuropathic pain
Precautions and Side Effects
Ketamine
- Hypersalivation, respiratory depression, hyperthermia, emesis, erratic and prolonged recovery, muscle tremors/rigidity, hyperaesthesia (reduced noise stimulation)
Morphine
- Respiratory depression, CNS depression, hyperthermia (cats), hypothermia (dogs), nausea and reduced GI motility
Lignocaine
- Depression, muscle tremors, seizures (high dose), nausea/vomiting
Preparation
- Using a 500ml NaCl 0.9% bag – remove 41ml
- Ketamine 60mg (1.2ml of 50mg/ml)
- Morphine 60mg (2ml of 30mg/ml)
- Lignocaine 750mg (37.5ml of 20mg/ml)
- Protect from light
Concentration
Ketamine 50mg/ml Lignocaine
20mg/ml
Morphine 10/30mg/ml vials
CRI
20mg/ml
Morphine 10/30mg/ml vials
CRI
Concentration
| Drug | Concentration | Loading Dose | CRI Rate |
|---|---|---|---|
| Ketamine | 0.12mg/ml | 0.1-0.2mg/kg IV bolus | 2-24 ug/kg/min IV |
| Morphine | 0.12mg/ml | 0.1-0.3mg/kg IV bolus | 2-4 ug/kg/min IV |
| Lignocaine | 1.5mg/ml | 0.5 mg/kg slow IV bolus | 25-50 ug/kg/min IV |
NORADRENALIN
Concentration
- 4mg/4ml ampoules
- 1mg/ml ampoules
Pharmacology & Indications
- Vasopressor and inotrope
- Affinity for alpha1, alpha 2 and beta1 receptors
- Alpha stimulation causes peripheral, renal, splanchnic, and pulmonary vasoconstriction (more prominent at higher doses)
- Beta 1 stimulation increases myocardial contractility, with less tachycardia produced than with adrenaline
- Indicated for profound hypotension, esp. septic shock, post cardiac hypotension
- Peripheral vasoconstrictor, inotrope, and coronary artery vasodilator
Precautions and SIde Effects
- Blood pressure must be continuously monitored, preferably directly, to avoid hypertension
- Avoid abrupt withdrawal of therapy
- Necrosis can occur at IV site if extravasation occurs
- Should be given through a central line if possible
Preparation
- Animals <10kg: Add 4mg in 100ml 5% dextrose in water or 5% dextrose in saline making a CRI
Concentration
Animals >10kg
- of 40ug/ml
- Animals >10kg
- Add 4mg in 50ml 5% dextrose in water or 5% dextrose in saline making a CRI
- of 80ug/ml
- Dextrose is recommended to preserve activity of adrenaline
- Light sensitive and should be protected from light
Dose Rates
- 0.1-2ug/kg/min IV
| WEIGHT | LOW RATE 0.1ug/kg/min (ml/hr) | 0.5ug/kg/min (ml/hr) | MEDIUM RATE 1ug/kg/min (ml/hr) | 1.5ug/kg/min (ml/hr) | HIGH RATE 2ug/kg/min (ml/hr) |
|---|---|---|---|---|---|
| 1 | 0.2 | 0.8 | 1.5 | 2.3 | 3.0 |
| 2 | 0.3 | 1.5 | 3.0 | 4.5 | 6.0 |
| 3 | 0.5 | 2.3 | 4.5 | 6.8 | 9.0 |
| 4 | 0.6 | 3.0 | 6.0 | 9.0 | 12.0 |
| 5 | 0.8 | 3.8 | 7.5 | 11.3 | 15.0 |
| 6 | 0.9 | 4.5 | 9.0 | 13.5 | 18.0 |
| 7 | 1.1 | 5.3 | 10.5 | 15.8 | 21.0 |
| 8 | 1.2 | 6.0 | 12.0 | 18.0 | 24.0 |
| 9 | 1.4 | 6.8 | 13.5 | 20.3 | 27.0 |
| 10 | 1.5 | 7.5 | 15.0 | 22.5 | 30.0 |
| 11 | 0.8 | 4.1 | 8.3 | 12.4 | 16.5 |
| 12 | 0.9 | 4.5 | 9.0 | 13.5 | 18.0 |
| 13 | 1.0 | 4.9 | 9.8 | 14.6 | 19.5 |
| 14 | 1.1 | 5.3 | 10.5 | 15.8 | 21.0 |
| 15 | 1.1 | 5.6 | 11.3 | 16.9 | 22.5 |
| WEIGHT | LOW RATE 0.1ug/kg/min (ml/hr) | 0.5ug/kg/min (ml/hr) | MEDIUM RATE 1ug/kg/min (ml/hr) | 1.5ug/kg/min (ml/hr) | HIGH RATE 2ug/kg/min (ml/hr) |
|---|---|---|---|---|---|
| 16 | 1.2 | 6.0 | 12.0 | 18.0 | 24.0 |
| 17 | 1.3 | 6.4 | 12.8 | 19.1 | 25.5 |
| 18 | 1.4 | 6.8 | 13.5 | 20.3 | 27.0 |
| 19 | 1.4 | 7.1 | 14.3 | 21.4 | 28.5 |
| 20 | 1.5 | 7.5 | 15.0 | 22.5 | 30.0 |
| 25 | 1.9 | 9.4 | 18.8 | 28.1 | 37.5 |
| 30 | 2.3 | 11.3 | 22.5 | 33.8 | 45.0 |
| 35 | 2.6 | 13.1 | 26.3 | 39.4 | 52.5 |
| 40 | 3.0 | 15.0 | 30.0 | 45.0 | 60.0 |
| 45 | 3.4 | 16.9 | 33.8 | 50.6 | 67.5 |
| 50 | 3.8 | 18.8 | 37.5 | 56.3 | 75.0 |
| 55 | 4.1 | 20.6 | 41.3 | 61.9 | 82.5 |
| 60 | 4.5 | 22.5 | 45.0 | 67.5 | 90.0 |
| 65 | 4.9 | 24.4 | 48.8 | 73.1 | 97.5 |
| 70 | 5.3 | 26.3 | 52.5 | 78.8 | 105.0 |
PROPOFOL
Concentration
10 mg/ml
Pharmacology & Indications
- Short acting hypnotic
- Useful for mechanical ventilation, seizure control, status epilepticus
- Low to maintenance dose recommended if also on additional anaesthetics or sedatives
Precautions and Side Effects
- High doses may lead to cardiorespiratory depression (respiratory depression common)
- Patients at high risk of hypotension should not be administered high maintenance.
- Prolonged CRI in cats can cause Heinz body production
Preparation
- No dilution required – use at 10mg/ml
Dose Rates
Loading dose
- 2-5mg/kg IV
CRI Rate
- 0.1 – 0.6mg/kg/min IV
| WEIGHT | LOADING DOSE (ml) | LOW (0.1mg/kg/min) ml/hr | MEDIUM (0.3mg/kg/min) ml/hr | HIGH (0.6mg/kg/min) ml/hr |
|---|---|---|---|---|
| 1 | 0.2 – 0.5 | 0.6 | 1.8 | 3.6 |
| 2 | 0.4 – 1 | 1.2 | 3.6 | 7.2 |
| 3 | 0.6 – 1.5 | 1.8 | 5.4 | 10.8 |
| 4 | 0.8 – 2 | 2.4 | 7.2 | 14.4 |
| 5 | 1 – 2.5 | 3.0 | 9.0 | 18.0 |
| 6 | 1.2 – 3 | 3.6 | 10.8 | 21.6 |
| 7 | 1.4 – 3.5 | 4.2 | 12.6 | 25.2 |
| 8 | 1.6 – 4 | 4.8 | 14.4 | 28.8 |
| 9 | 1.8 – 4.5 | 5.4 | 16.2 | 32.4 |
| 10 | 2 – 5 | 6.0 | 18.0 | 36.0 |
| 11 | 2.2 – 5.5 | 6.6 | 19.8 | 39.6 |
| 12 | 2.4 – 6 | 7.2 | 21.6 | 43.2 |
| 13 | 2.6 – 6.5 | 7.8 | 23.4 | 46.8 |
| 14 | 2.8 – 7 | 8.4 | 25.2 | 50.4 |
| 15 | 3 – 7.5 | 9.0 | 27.0 | 54.0 |
| 16 | 3.2 – 8 | 9.6 | 28.8 | 57.6 |
| 17 | 3.4 – 8.5 | 10.2 | 30.6 | 61.2 |
| 18 | 3.6 – 9 | 10.8 | 32.4 | 64.8 |
| 19 | 3.8 – 9.5 | 11.4 | 34.2 | 68.4 |
| 20 | 4 – 10 | 12.0 | 36.0 | 72.0 |
| 21 | 4.2 – 10.5 | 12.6 | 37.8 | 75.6 |
| 22 | 4.4 – 11 | 13.2 | 39.6 | 79.2 |
| 23 | 4.6 – 11.5 | 13.8 | 41.4 | 82.8 |
| 24 | 4.8 – 12 | 14.4 | 43.2 | 86.4 |
| 25 | 5 – 12.5 | 15.0 | 45.0 | 90.0 |
| 26 | 5.2 – 13 | 15.6 | 46.8 | 93.6 |
| 27 | 5.4 – 13.5 | 16.2 | 48.6 | 97.2 |
| 28 | 5.6 – 14 | 16.8 | 50.4 | 100.8 |
| 29 | 5.8 – 14.5 | 17.4 | 52.2 | 104.4 |
| 30 | 6 – 15 | 18.0 | 54.0 | 108.0 |
| 31 | 6.2 – 15.5 | 18.6 | 55.8 | 111.6 |
| 32 | 6.4 – 16 | 19.2 | 57.6 | 115.2 |
| 33 | 6.6 – 16.5 | 19.8 | 59.4 | 118.8 |
| 34 | 6.8 – 17 | 20.4 | 61.2 | 122.4 |
| 35 | 7 – 17.5 | 21.0 | 63.0 | 126.0 |
| 40 | 8 – 20 | 24.0 | 72.0 | 144.0 |
| 45 | 9 – 22.5 | 27.0 | 81.0 | 162.0 |
| 50 | 10 – 25 | 30.0 | 90.0 | 180.0 |
| 55 | 11 – 27.5 | 33.0 | 99.0 | 198.0 |
| 60 | 12 – 30 | 36.0 | 108.0 | 216.0 |
| 65 | 13 – 32.5 | 39.0 | 117.0 | 234.0 |
| 70 | 14 – 35 | 42.0 | 126.0 | 252.0 |
