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Sample Drug 5

Sedative

Analgesic

Dissociative anesthetic

PCP: Analgesia

ACP: Analgesia

ACP: Induction of sedation prior to intubation

ACP: Procedural sedation

ACP: Severe agitation or excited delirium syndrome

Hypersensitivity or allergy to ketAMINE

Unable to manage the adverse effects of ketAMINE

Conditions where elevated blood pressure may be harmful

Age < 6 months

PCP: Analgesia

Requires additional training and endorsement

  • Intransal: 0.75 mg/kg
    • May repeat 0.5 mg/kg after 20 minutes
  • Contact CliniCall for additional dosing instructions
  • See Procedure Pxx for intranasal drug administration guidelines

 

ACP: Analgesia

  • Intravenous/Intraosseous: 0.3 mg/kg slow push
    • May repeat 0.15 mg/kg after 5 minutes
    • Maximum total dose 0.6 mg/kg in 45 minutes
  • Intramuscular: 0.5 mg/kg
    • May repeat 0.3 mg/kg after 45 minutes

 

ACP: Procedural Sedation

  • Intravenous/Intraosseous: 0.1-0.5 mg/kg slow push every 60 seconds to effect
    • Consider starting at 0.5 mg/kg; use subsequent doses of 0.25 mg/kg or less as needed
    • Titrate to effect

 

ACP: Anesthesia Induction

  • Intravenous/Intraosseous: 2 mg/kg if shock index < 1
  • Intravenous/Intraosseous: 1 mg/kg if shock index ≥ 1

 

ACP: Maintenance of Anesthesia

  • ½ of required induction dose every 10-15 minutes as required

 

ACP: Excited Delirium

  • Intramuscular: 4-5 mg/kg bolus
    • Maximum volume of administration:
      • Deltoid: 2 mL
      • Lateral thigh: 4-5 mL
      • Gluteal: 5 mL

Avoid in infants (< 6 months of age)

PCP: Not authorized

ACP: Analgesia

  • Intravenous/Intraosseous: 0.3 mg/kg slow push
    • Maximum single dose 20 mg
    • Repeat every 2-3 minutes to total maximum of 0.6 mg/kg
  • Intramuscular: 0.5 mg/kg
    • May repeat 0.3 mg/kg after 45 minutes
  • Intranasal: 1.5 mg/kg
    • May repeat 1 mg/kg at 20 minutes
    • Maximum dose of 50 mg
    • See Procedure Pxx for intransal drug administration guidelines

 

ACP: Procedural Sedation

  • See adult dosing guidelines

 

ACP: Excited Delirium

  • CliniCall consult required for any patient under 12 years of age
  • See adult dosing guidelines

Onset:

Intravenous/Intraosseous: anesthetic effects within 30 seconds

Intramuscular: anesthetic effects within 3-4 minutes

Intranasal: analgesic effects within 5-10 minutes

 

Duration:

Intravenous/Intraosseous: 5-10 minutes, recovery 1-2 hours

Intramuscular: 12-15 minutes, recovery 3-4 hours

Intranasal: up to 60 minutes of analgesic effects

Emergence phenomenon: confusion, delirium, excitement, hallucinations

Tachycardia and hypertension (> 10%)

Laryngospasm (< 1%)

Bradycardia and hypotension (1-10%)

Anaphylaxis (< 1%)

Hypersalivation (< 1%)

Extreme muscle rigidity or tone (< 1%)

Nystagmus, increased intraocular pressure

Apnea and respiratory depression (rare; transient reaction with rapid IV bolus dose)

Erythema, morbiliform rash, rash at injection site

Severe hypertension (systolic BP > 180 mmHg)

Subarachnoid hemorrhage or epidural hematoma with severe hypertension

Myocardial ischemia or cardiac arrhythmias

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