外科加護病房常用藥

Anticonvlsants

Diazepam;Valium® (10mg/2ml/amp)
Lorazepam;Ativan® (2mg/1ml/amp)
Midazolam;Dormicum® (5mg/1ml/amp)
Phenobarbital (130mg/1ml/amp)
Phenytoin;Dilantin®;Aleviatin®(250mg/5ml/amp)
Propofol;Pofol® (200mg/20ml/amp)
Valproic acid;Depakine® (400mg/vial)


Diazepam;Valium® (10mg/2ml/amp)

劑量:IM or IV push
administration ≦ 5mg/min TO AVOID APNEA, VENOUS THROMBOSIS, PHLEBITIS AND HYPOTENSION
Status epilepticus: IV: 5-10 mg every 10-20 minutes, up to 30 mg in an 8-hour period; may repeat in 2-4 hours if necessary
作用:Benzodiazepine
監測項目:BP, heart rate, respiratory and cardiovascular status, symptoms of anxiety


Lorazepam;Ativan® (2mg/1ml/amp) 須冷藏保存

劑量:1-2mg up to 0.06mg/kg
(1) 1 amp direct IM
(2) 1amp + N/S or D5W 1ml IV push (rate < 2mg/min)
作用:Benzodiazepine
監測項目:BP, heart rate, respiratory and cardiovascular status, symptoms of anxiety



Midazolam;Dormicum® (5mg/1ml/amp)

劑量:loading dose: 0.2mg/kg slow IV push
maintenance dose: 0.75-10mcg/kg/min IV infusion
作用:Benzodiazepine
監測項目:BP, renal and hepatic parameter


Phenobarbital (130mg/1ml/amp)

泡製&劑量:IM; SC
IV infusion: administration ≦100 mg/min
10 amps + N/S or D5W 500 ml,10-20mg/kg/day
1 amps + N/S or D5W 100 ml drip 20min
作用:Barbiturate
監測項目:Phenobarbital serum concentrations, mental status, CBC, LFTs, seizure activity


Phenytoin;Dilantin®;Aleviatin® (250mg/5ml/amp)

劑量:IV infusion: administration ≦ 50 mg/min
loading dose: 10-20mg/kg/day ; add in N/S 100 ml drip 30-60min
maintenance dose: 100mg q6-8h (100mg + N/S 100 ml drip 30min)
作用:Anticonvulsant
監測項目:Blood pressure, vital signs, plasma phenytoin level, CBC, liver function tests


Propofol;Pofol® (200mg/20ml/amp)

劑量:start with 5ml/hr and increase as needed
usual rate: 5-20 ml/hr
(<5mg/kg/hr 以避免propofol infusion syndrome)
Propofol infusion syndrome 是指高劑量給予propofol之後造成心臟衰竭、代謝性中毒、橫紋肌溶解、高脂血症及高血鉀等症狀
作用:General Anesthetic
監測項目:BP, heart rate, TG


Valproic acid;Depakine® (400mg/vial)

劑量:
loading dose: 15mg/kg
maintenance: 1-2mg/kg/hr
IV infusion: administration ≦ 20 mg/min
1amp + add in N/S or D5W 100 ml drip 60min
作用:Anticonvulsant
監測項目:CBC with platelets, liver function tests
保存:配製好的溶液可維持24小時


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