Page 56 - JSOM Summer 2022

APPENDIX 1 Dosing Details for Common Analgesics and Sedatives
ANALGESIA
Duration Duration of
Onset Peak Effect Serum Half-Life of Effect Intermittent Dose
Class Medication (minutes) (minutes) (hours) (hours) (hours)
Non-NSAID Acetaminophen (PO) 30–60 30–60 2–3 4–6 4–6
NSAID Ibuprofen (PO) 30 60 2–2.5 4–6 4–6
Ketorolac (Toradol) (IV) 30 120–180 5 4–6 6–8
Meloxicam (Mobic) (PO) 120 240+ 20 24 24
NMDA Receptor Ketamine (IV/IO) (single dose) 0.5 1–5 2–4 Variable (10–15 min)
Antagonist Ketamine (IM) (single dose) 3–4 15 2–4 Variable (15–30 min)
Opioid Fentanyl (IV/IO/IM) 1–2 2–5 7–12 0.5–1 0.5–1
Fentanyl (OTFC) 5–10 30 3–14 2–3 1–3
Morphine (IV) 1–2 5–15 2–3 4–5 4–5
Hydromorphone (Dilaudid) (IV) 1–2 8–20 2–3 3–4 4–5
Sufentanil (ODT) 6 60 2.5 3 1
Hydrocodone (PO) 30 60 3–4 4–8 4–6
Oxycodone (IR) (PO) 15 60–120 2–3 3–6 4–6
Tramadol (PO) 60 120+ 6–9 4–6 4–6
GABA Gabapentin (PO) Variable 120+++ 5–7 Variable 8
Muscle Relaxant Cyclobenzaprine (Flexeril) (PO) 60 240+++ 18–32 12–24 8
SEDATIVES
Duration Duration of
Onset Peak Effect Serum Half-Life of Effect Intermittent Dose
Class Medication (minutes) (minutes) (hours) (hours) (minutes)
NMDA Receptor Ketamine (IV/IO) Anesthetic (single dose) 0.5 1–5 2–4 (5–10 min) 10–15
Antagonist Ketamine (IM) Anesthetic (single dose) 3–4 15 2–4 (15–30 min) 15–30
Benzodiazepines Midazolam (IV) 2–5 3–5 3 <2 30+
Lorazepam (IV) 1–5 15–20 14 12–24 360+
Diazepam (IV) 2–5 1 33–45 Variable 20+
General Etomidate (IV) (single dose) <1 1 3 (2–5 min) Not recommended
Anesthetic Propofol (IV) (single dose) <1 1 (40 min) (3–10 min) 3–10
Central Alpha-2- Dexmedetomidine (Precedex) (IV) 5–10 15–30 Distribution 1–2 60–120
Agonist (single dose) (6 min) /
Terminal 3 hr
IM – intramuscular; IR = immediate release; IV – intravenous; PO = oral; ODT = oral dissolvable tablet; OTFC = oral transmucosal fentanyl
citrate.

54 | JSOM Volume 22, Edition 2 / Summer 2022