Drug Database
Anesthetic agents, paralytics, opioids, pressors, locals, reversals, and antiemetics — with doses, kinetics, contraindications, and pearls.
27 of 27 drugs
Induction
Propofol
Diprivan
GABA-A receptor agonist; potentiates chloride conductance.
Onset
~30 seconds
Duration
5–10 min (single bolus)
Induction
Etomidate
Amidate
GABA-A modulator with minimal cardiovascular effects.
Onset
30–60 seconds
Duration
5–10 min
Induction
Ketamine
Ketalar
Non-competitive NMDA receptor antagonist; produces dissociative anesthesia.
Onset
30–60 sec IV; 3–5 min IM
Duration
10–20 min (IV)
Benzodiazepine
Midazolam
Versed
GABA-A potentiation via benzodiazepine binding site.
Onset
1–3 min IV; 15 min PO
Duration
30–60 min
Induction
Dexmedetomidine
Precedex
Highly selective α2-adrenoceptor agonist — sedation, analgesia, sympatholysis.
Onset
5–10 min
Duration
60–120 min after infusion stop
Neuromuscular Blocker
Succinylcholine
Anectine, Quelicin
ACh receptor agonist → sustained depolarization → flaccid paralysis.
Onset
30–60 sec
Duration
5–10 min
Neuromuscular Blocker
Rocuronium
Zemuron
Competitive ACh receptor antagonist at neuromuscular junction.
Onset
60–90 sec (RSI dose) / 2–3 min (standard)
Duration
30–60 min (longer with high dose)
Neuromuscular Blocker
Vecuronium
Norcuron
Competitive nicotinic ACh receptor antagonist.
Onset
3–5 min
Duration
25–40 min
Neuromuscular Blocker
Cisatracurium
Nimbex
Competitive nicotinic ACh antagonist.
Onset
2–3 min
Duration
30–60 min
Opioid
Fentanyl
Sublimaze
μ-opioid receptor agonist; 75–125× more potent than morphine.
Onset
1–2 min
Duration
30–60 min (single dose); context-sensitive half-time grows with infusion.
Opioid
Remifentanil
Ultiva
μ-opioid agonist; metabolized by non-specific plasma esterases.
Onset
1–2 min
Duration
3–10 min regardless of infusion duration
Opioid
Sufentanil
Sufenta
μ-opioid receptor agonist; 5–10× more potent than fentanyl.
Onset
1–3 min
Duration
30–60 min
Opioid
Morphine
μ-opioid receptor agonist.
Onset
5–10 min IV
Duration
3–4 h IV; up to 24 h intrathecal
Opioid
Hydromorphone
Dilaudid
μ-opioid receptor agonist; ~5–7× more potent than morphine.
Onset
5–10 min IV
Duration
3–4 h
Vasopressor / Inotrope
Phenylephrine
Selective α1 vasoconstriction; reflex bradycardia possible.
Onset
<1 min
Duration
5–20 min (bolus)
Vasopressor / Inotrope
Ephedrine
Releases endogenous NE; direct α and β effects.
Onset
1 min
Duration
10–60 min
Vasopressor / Inotrope
Norepinephrine
Levophed
α1 vasoconstriction with mild β1 inotropy.
Onset
<1 min
Duration
1–2 min
Vasopressor / Inotrope
Epinephrine
Low dose: β-predominant (inotropy, vasodilation). High dose: α-predominant.
Onset
<1 min IV
Duration
5–10 min
Vasopressor / Inotrope
Vasopressin
V1 receptor agonism → vasoconstriction independent of adrenergic system.
Onset
1–3 min
Duration
10–20 min
Local Anesthetic
Lidocaine
Xylocaine
Blocks voltage-gated Na+ channels.
Onset
Rapid (1–5 min infiltration)
Duration
1–2 h (4 h with epi)
Local Anesthetic
Bupivacaine
Marcaine, Sensorcaine
Blocks voltage-gated Na+ channels with high cardiac affinity.
Onset
5–10 min (infiltration); 5–8 min (epidural)
Duration
4–8 h
Local Anesthetic
Ropivacaine
Naropin
Na+ channel blockade; preferential sensory > motor block.
Onset
10–20 min
Duration
3–6 h
Reversal Agent
Sugammadex
Bridion
Encapsulates rocuronium/vecuronium 1:1, removing them from NMJ.
Onset
1–3 min
Duration
Pharmacologic effect ~24 h
Reversal Agent
Neostigmine
Inhibits AChE → ↑ACh at NMJ; outcompetes non-depolarizers.
Onset
5–10 min
Duration
60 min
Reversal Agent
Naloxone
Narcan
Competitive μ-opioid receptor antagonist.
Onset
1–2 min
Duration
30–60 min (less than most opioids — re-narcotization risk)
Antiemetic
Ondansetron
Zofran
Blocks 5-HT3 receptors in CTZ and vagal afferents.
Onset
5–15 min
Duration
4–8 h
Antiemetic
Dexamethasone
Decadron
Unclear antiemetic mechanism; anti-inflammatory.
Onset
Hours (analgesic effect ~1 h)
Duration
24+ h