Anesthetics

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Section 8 - MEDICATION GUIDELINES

8.03 ANESTHETICS

Pontocaine Ophthalmic / Local anesthetic

DESCRIPTION

  • Ophthalmic anesthetic.

INDICATIONS

  • Removal of foreign objects, tonometry.

CONTRAINDICATIONS

  • It should not be administered in the presence potential penetrating eye injury. Allergy or sensitivity to PABA.

PRECAUTIONS

  • Thorough history must be obtained to rule out penetrating injury.

DOSAGE

  • 1-2 gtts - adult and children. Instill in lower conjunctival cornix.


Ketamine / Anesthetic

DESCRIPTION

  • Dissociative anesthetic, Systemic. Schedule III controlled substance.

INDICATIONS

  • Sedation in the extremely agitated patient

CONTRAINDICATIONS

  • Hypersensitivity
  • Penetrating eye injury.
  • Pregnancy
  • Due to sympathomimetic effects, contraindicated in patients with known, severe CAD (for example, patients currently experiencing STEMI).

PRECAUTIONS

  • Have ventilatory support readily available
  • There is no known antidote or reversal agent for Ketamine
  • Emergence Reaction - Read "Special Note" at RxList - Ketamine


DOSAGE

  • Dose is 2 mg/kg SLOW IVP OR 4 mg/kg IM, 1 dose

Onset of action:

  • IM administration: 3 – 5 minutes
  • IV administration: 1- 2 minutes

Duration of action:

  • 20 – 40 minutes when dosed at 4mg/kg IM.
  • 12 – 20 minutes when dosed at 2mg/kg IV.

Side Effects:

  • Hypertension, emesis, laryngospasm, tachycardia, bronchodilation, increased salivation, emergence reaction (12%).