Skip to Main Content
Home Books Internal Medicine: A Guide to Clinical Therapeutics

Intrathecal Injections

Colleen Barthol; Conrado Gamboa

  • Sections
  • Print
  • Get Citation

    Citation

    AMA Citation
    Barthol C, Gamboa C. Barthol C, Gamboa C Barthol, Colleen, and Conrado Gamboa.Intrathecal Injections. In: Attridge RL, Miller ML, Moote R, Ryan L. Attridge R.L., Miller M.L., Moote R, Ryan L Eds. Rebecca L. Attridge, et al.eds. Internal Medicine: A Guide to Clinical Therapeutics New York, NY: McGraw-Hill; 2013. http://accesspharmacy.mhmedical.com/content.aspx?bookid=565&sectionid=42003769. Accessed November 17, 2019.
    MLA Citation
    Barthol C, Gamboa C. Barthol C, Gamboa C Barthol, Colleen, and Conrado Gamboa.. "Intrathecal Injections." Internal Medicine: A Guide to Clinical Therapeutics Attridge RL, Miller ML, Moote R, Ryan L. Attridge R.L., Miller M.L., Moote R, Ryan L Eds. Rebecca L. Attridge, et al. New York, NY: McGraw-Hill, 2013, http://accesspharmacy.mhmedical.com/content.aspx?bookid=565&sectionid=42003769.

    Download citation file:

    RIS (Zotero)
    EndNote
    BibTex
    Medlars
    ProCite
    RefWorks
    Reference Manager
    Mendeley
    © Copyright
  • Tools
  • Search Book
  • Clip
Top
Table C-1 Adult Intrathecal Analgesic Injections*
View Table|Favorite Table|Download (.pdf)
Table C-1 Adult Intrathecal Analgesic Injections*

Class

Medication

Usual Dose

Onset

Duration

Concentration

Side Effects

Opioid Analgesics

Fentanyl

5–25mcg/dose

5–10min

1–4h

0.05mg/mL PF

Sedation, N/V, urinary retention, respiratory depression, constipation

Hydromorphone

50–100mcg/dose

†

†

10mg/mL PF

Sedation, N/V, pruritus, urinary retention, respiratory depression, constipation

Morphine

0.2–1mg/dose (APS recommends 0.1–0.3mg/dose)

45–75min

18–24h

0.5, 1, 10, 25mg/mL PF

Sedation, N/V, pruritus, urinary retention, respiratory depression, constipation

Sedatives

Midazolam

1–2mg/dose

5–10min

2–4h

1, 5mg/mL PF (diluted to max conc 1mg/mL)

Sedation, motor weakness, respiratory depression

Nonopioid Adjuvants

Baclofen

25–75mcg/dose

30–60min

4–8h

0.05, 0.5, 2mg/mL PF

Sedation, cognitive impairment, weakness, hypotension, constipation, urinary retention

Clonidine

25–75mcg

30–60min

6–8h

100, 500mcg/mL PF

Orthostatic hypotension, bradycardia, sedation

Table C-2 Adult Intrathecal Antimicrobial Injections*
View Table|Favorite Table|Download (.pdf)
Table C-2 Adult Intrathecal Antimicrobial Injections*

Medication

Usual Dose

Concentration

Route

Side Effects

Amikacin

5–20mg/d

4mg/mL PFNS

IT‡

Minor hearing loss

Amphotericin B

0.01–0.5mg/d

0.1mg/mL D5W

IT/IVT‡

Tinnitus, fever, chills, parkinsonism

Gentamicin

4–8mg/d

2mg/mL PFNS

IT/IVT‡

Transient hearing loss, seizures, aseptic meningitis

Tobramycin

4–8mg/d

2mg/mL PFNS

IT/IVT‡

Transient hearing loss, seizures, aseptic meningitis

Vancomycin

5–20mg/d

5mg/mL PFNS

IT/IVT‡

Sensorineural hearing loss

APS, American Pain Society; IT, intrathecal; IVT, intraventricular; N/V, nausea & vomiting; PFNS, preservative-free normal saline.

*Information provided as a medical resource but not intended to replace physician's judgment.

†Information not available.

‡Not FDA approved by this route.

References: Rathmell JP, Lair TR, Nauman B. The role of intrathecal drugs in the treatment of acute pain. Anesth Analg 2005;101: S30; Tunkel AR, et al. Practice guidelines for the management of bacterial meningitis. Clin Infect Dis 2004;39:1267; Ziai W, Lewin III JJ. Improving the role of intraventricular antimicrobial agents in the management of meningitis. Curr Opin Neurol 22:277.

Pop-up div Successfully Displayed

This div only appears when the trigger link is hovered over. Otherwise it is hidden from view.

This site uses cookies to provide, maintain and improve your experience. MHE Privacy Center Close