Indications & Dose: INDUCTION OF ANESTHESIA IV Adult 50-75mg at intervals of 20-40sec based on response. Additional 25-50 mg may be given as necessary when patient movements indicate lightening of anesthesia Child Initially up to 2mg/kg as inj in neonates, then 1mg/kg repeated as necessary, max total dose 4mg/kg, 1 month-18 yr: Initially up to 4 mg/kg, then 1mg/kg repeated as necessary, max total dose 7mg/kg | MAINTENANCE OF ANESTHESIA IV Adult In individuals undergoing short (15min) surgical procedures, intermittent inj/ continuous inf of 0.2/0.4% of solution may be usedAs a sole drug | STATUS EPILEPTICUS IV Adult Loading dose 5mg/kg, followed in 30min by continuous inf (administered as 1-3mg/kg/h for at least 12h) after seizures abate Child Neonate: Initially up to 2mg/kg by slow inj, then up to 8mg/kg/h by continuous inf, adjusted according to response, 1 month-18 yr: Initially up to 4mg/kg by slow inj, then up to 8mg/kg/h by continuous inf adjusted according to response

Precautions: Asthma/COPD, respiratory disease, addison’s disease, severe anemia, unstable aneurysms, myasthenia gravis, myxedema, history of drug abuse, hepatic/renal impairment, abrupt withdrawal

ADR: Serious: bradycardia, hypotension, syncope, SJS, respiratory depression, anaphylaxis, agranulocytosis, thrombocytopenia, megaloblastic anemia, immune hemolytic anemia, laryngospasm, thrombophlebitis, Others: drowsiness, lethargy, CNS depression, impaired judgment, confusion, somnolence, hyperkinesia, nervousness, hallucinations, nightmares, exfoliative dermatitis, cough, anxiety, insomnia, hypoventilation

DDI: Serious Pethidine effects are reduced, Antipsychotics efficacy is enhanced, MAOIs increases BP & bradycardia, Metoclopramide/Aspirin/Probenecid increases drug level, TCAs increases duration of anesthesia, Cocaine leads to cardiac arrhythmias, Epirubicin/Doxorubicin prolongs QT interval, Alcohol reduces drug level

Monitor: Respiratory rate,HR,BP