Table 2 Emergency drug dosing in obese patients. Adapted from Cataldo et al. [72]
Drugs | Loading dose | Maintenance dose |
|---|---|---|
Neuromuscular blockers and antagonists | ||
 Succynilcholine | TBW | – |
 Vecuronium | IBW | IBW |
 Atracurium | LBW | LBW |
 Rocuronium | LBW | LBW |
 Sugammadex | TBW | – |
 Neostigmine | ABW | – |
Sedative hypnotics | ||
 Benzodiazepine | IBW | IBW |
 Propofol | LBW | ABW |
 Thiopental | LBW | IBW |
 Phenobarbital | TBW | IBW |
 Ketamine | TBW | IBW |
 Etomidate | TBW | – |
 Dexmedetomidine | – | LBW |
Analgesics | ||
 Morphine | LBW | – |
 Remifentanil | LBW | – |
 Fentanil | LBW | – |
 Sufentanil | LBW | – |
 Alfentanil | ABW | – |
 Paracetamol | LBW | – |
Corticosteroids | ||
 Methylprednisolone | IBW | IBW |
Anti-epileptics | ||
 Phenytoin | IBW + [1.33 × (TBW − IBW)] | IBW |
 Valproic acid | – | IBW |
 Carbamazepine | – | IBW |
Beta-blockers | ||
 Propranolol | IBW | IBW |
 Labetalol | IBW | IBW |
 Metoprolol | IBW | IBW |
 Esmolol | IBW | IBW |
Calcium channel blockers | ||
 Verapamil | TBW | IBW |
 Diltiazem | TBW | Titration |
Antiarrhythmics | ||
 Lidocaine | ABW | ABW |
 Procainamide | IBW | IBW |
 Amiodarone | IBW | IBW |
 Digoxin | IBW | IBW |
 Adenosine | IBW | IBW |
Catecholamines | ||
 Dobutamine  Dopamine  Epinephrine  Norepinephrine  Phenylephrine  Vasopressin  Milrinone |  | There are no clinical studies in obese patients. According to the literature, ABW or IBW could be used to avoid overdoses, titrating the dose as a function of the clinical target. ABW in patients ≤120 kg |