Inhalational

Inhalational anaesthetics (compiled from notes)

	Blood:gas	Oil:gas	MAC	MAC awake	MW	Boiling point	Vapour pressure
Halothane	2.54	224	0.75%	0.55 MAC	197	50.2C	244 mmHg
Enflurane	1.90		1.63%		184	56.5C	172 mmHg
Isoflurane	1.46	98	1.17%	0.38 MAC	184	48.5C	240 mmHg
Desflurane	0.42	19	6.60%	0.34 MAC	168	22.8C	669 mmHg
Sevoflurane	0.69	47	1.80%	0.34 MAC	200	58.5C	170 mmHg
N2O	0.46	1.4	104%	0.64 MAC	44	-88.5C	gas
Xenon	0.115		71%		131	-108C	gas
Comment			Hal = most potent N2O = least			Des = highest Sev = lowest

IV anaesthetic agents

IV anaesthetic agents (compiled from notes)

	Vd	PB	Clearance	Elimination halflife	CSHT (8 hrs)	pK	Acid/base	pH	Dose
Propofol	3.5 - 4.5 L/kg	98%	30 - 60 mL/kg/min	0.5 - 1 hours	<40min	11	Acid	7 - 8.5 (Diprivan) 4.5 - 6.4 (Generic)	1 - 2.5 mg/kg
Thiopentone	2.5 L/kg	80%	3.4 mL/kg/min	11.6 hours	3 hours	7.6	Acid	10.5	3 - 5 mg/kg
Methohexitone	2.2 L/kg		10.9 mL/kg/min	3.9 hours		higher than 7.6	Acid
Ketamine	2.5 - 3.5 L/kg	20-50%	16 - 18 mL/kg/min	2 - 3 hours		7.5		3.5 - 5.5	1 - 2 mg/kg IV
Etomidate	2.2 - 4.5 L/kg	76%	10 - 20 mL/kg/min	2 - 5 hours		4.2	Base	6.9 (Propylene glycol) 8.1 (	0.2 - 0.4 mg/kg
Midazolam	1 - 1.5 L/kg	96 - 98%	6 - 8 mL/kg/min	1 - 4 hours		6.15		3.5	0.1 - 0.2 mg/kg

NB:

• Ketamine dose
  * 1 - 2 mg/kg IV for induction
  * 4 - 8 mg/kg IM for induction
  * 0.2 - 0.5 mg/kg IV for analgesia

Local anaesthetics

Local anaesthetics (compiled from notes)

	Potency	pK	Nonionised fraction at pH 7.4	Lipid solubility	Relative lipid solubility	Protein-binding	Vd (L)	Speed of metabolism (1 is fastest)	Onset	Duration	Elimination T1/2	Clearance	Comment
Ester LA
Procaine	1	8.9	3%	0.6		6%	65 L	2	Slow	45 - 60 min	9 min
Chloroprocaine	4	8.7	5%				35 L	1	Rapid	30 - 35 min	7 min		Rapid onset despite high pK, due to the high concentration used (3%)
Amethocaine	16	8.5	7%	80		76%		3	Slow	60 - 180 min			High potency, slow metabolism Used topically on eyes
Benzocaine		3.5											Very low pK, almost entirely non-ionised at physiological pH
Cocaine		?8.5
Amide LA
Lignocaine	1	7.9	25%	2.9	1	70%	91 L	2	Rapid	60 - 120 min	1.6 hours	9 mL/kg/min
Etidocaine	4	7.7	33%	141	39	94%	133 L	3	Slow	240 - 480 min	2.6 hours
Prilocaine	1	7.9	24%	0.9		55%	191 L	1	Slow	60 - 120 min	1.6 hours
Pipecoloxylidide
Mepivacaine	1	7.6	39%	0.8		77%	84 L	2	Slow	90 - 180 min	1.9 hours
Bupivacaine	4	8.1	17%	27.5	10	95%	73 L	3	Slow	240 - 480 min	3.5 hours	7 mL/kg/min
Levobupivacaine	4	8.1	17%			>97%	55 L		Slow	240 - 480 min	2.6 hours
Ropivacaine	4	8.1	17%		2.9	94%	59 L	3	Slow	240 - 480 min	1.8 hours	11 mL/kg/min

• Relative lipid solubility is based on relative heptane:buffer partition coefficient

Opioid agonists

Opioids

	Potency (IV, appr)	Vd	PB	Lipid solubility	pKa	% non-ionised	HER	Clearance	T1/2	CSHT (4hr)	Equ'n time
Morphine	1	3-5 L/kg	35%	1	7.9	23%	0.6-0.8	15 - 30 mL/kg/min	1.7 - 3.3 hr
Pethidine	0.1	3-5 L/kg	70%	32	8.5	7%	0.5-0.7	8 - 18 mL/kg/min	3 - 5 hr
Fentanyl	100	3-5 L/kg	84%	955	8.4	8.5%	0.8-1.0	10 - 20 mL/kg/min	3.1 - 6.6 hr	260 min	6.8 min
Sufentanil	1000	2.5-3 L/kg	93%	1727	8.0	20%	0.7-0.9	10 - 15 mL/kg/min	2.2 - 4.6 hr	30 min	6.2 min
Alfentanil	10	0.4-1.0 L/kg	92%	129	6.5	89%	0.3-0.5	4 - 9 mL/kg/min	1.4 - 1.5 hr	60 min	1.4 min
Remifentanil	2000	0.2-0.3 L/kg	80%		7.3	58%		30 - 40 mL/kg/min	0.17 - 0.33 hr	4 min	1.1 min
Tramadol		2-3 L/kg	20%		9.41			6 - 9 mL/kg/min	5 - 7 hr 6 - 8 hr (M1)

NB:

• Potency table is a very rough estimation
• Fentanyl is 75-125 times as potent as morphine
• Sufentanil is about 10 times as potent as fentanyl
• Alfentanil is about 1/10 as potent as fentanil
• Remifentanil is 15-20 times as potent as fentanyl

=====

Still need to do tables for

• NMBD
• Anticholinesterase
• Anticholinergics
• Benzodiazepine (Diazepam, Midazolam, lorazepam, Flumazenil)