Commonly used anesthetic drugs with DOSE(10 DRUGS)

Reading File

Finding Sources

Reading File

Finding Sources

Reading File

Finding Sources

Reading File

Finding Sources

I now have sufficient data from Miller's Anesthesia and Morgan & Mikhail's Clinical Anesthesiology to compile a comprehensive answer. Let me put together the full reference table.

10 Commonly Used Anesthetic Drugs with Doses

Below is a summary of 10 key anesthetic drugs drawn from Miller's Anesthesia (10th ed.) and Morgan & Mikhail's Clinical Anesthesiology (7th ed.), organized by drug class.

I. Intravenous Induction Agents

1. Propofol

Class: Alkylphenol IV hypnotic
Mechanism: GABA-A receptor potentiation
Induction: 1-2.5 mg/kg IV (healthy adult); reduce to 1-1.75 mg/kg in elderly (>60 years)
Maintenance: 100-200 mcg/kg/min IV infusion
Pediatric induction: 2-3 mg/kg IV (ED95)
Notes: Dose must be reduced in elderly/sick patients (ASA III-IV). Causes apnea on induction. Rapid recovery makes it ideal for TIVA and day surgery.
Miller's Anesthesia, p. 2484-2485

2. Thiopental (Sodium Thiopentone)

Class: Oxybarbiturate
Mechanism: GABA-A receptor potentiation; NMDA antagonism
Induction: 3-5 mg/kg IV (standard adult); usual dose 3-4 mg/kg
ED50: 2.2-2.7 mg/kg
Onset: 15-30 seconds
Notes: Dose halved in elderly, hypovolemia, or cardiac patients. Context-sensitive half-time increases significantly with repeated dosing. No analgesic properties.
Miller's Anesthesia, p. 2497-2511

3. Ketamine

Class: Phencyclidine derivative; dissociative anesthetic
Mechanism: NMDA receptor antagonist
Induction (IV): 1-2 mg/kg IV (general); up to 4.5 mg/kg IV in neonates/cardiovascular instability
Induction (IM): 6.5-13 mg/kg IM
Analgesic/sub-dissociative: 0.1-0.5 mg/kg IV
Maintenance infusion: 0.01-0.05 mg/kg/min IV
Notes: Produces "dissociative anesthesia" - eyes remain open with nystagmus. Preserves airway reflexes and cardiovascular tone. Associated with emergence delirium at higher doses.
Miller's Anesthesia; Katzung's Pharmacology 16th ed.

4. Etomidate

Class: Imidazole-derived hypnotic
Mechanism: GABA-A receptor potentiation
Induction: 0.2-0.3 mg/kg IV
Notes: Cardiovascular stability makes it preferred in hemodynamically unstable patients. Causes adrenocortical suppression (inhibits 11-beta hydroxylase) - avoid prolonged infusions. Pain on injection; myoclonus common.
Morgan & Mikhail's Clinical Anesthesiology 7th ed.

5. Midazolam

Class: Benzodiazepine
Mechanism: GABA-A receptor potentiation (at benzodiazepine binding site)
Premedication: 0.02-0.05 mg/kg IV (1-5 mg IV in adults)
Sedation: 0.5-2 mg IV titrated
Induction (adjunct/co-induction): 0.1-0.2 mg/kg IV (reduces propofol requirement by ~30%)
Notes: Produces anxiolysis, amnesia, and sedation. Not analgesic. Reversal agent: Flumazenil.
Miller's Anesthesia (co-induction data)

II. Opioid Analgesics

6. Fentanyl

Class: Synthetic opioid (phenylpiperidine)
Mechanism: Mu-opioid receptor agonist
Intraoperative analgesia: 1-2 mcg/kg IV bolus
Balanced anesthesia supplement: 2-20 mcg/kg IV
High-dose cardiac anesthesia: 50-100 mcg/kg IV
Maintenance infusion: 0.5-5 mcg/kg/hr
Notes: 100x more potent than morphine. Causes chest wall rigidity at large bolus doses. Minimal histamine release.
Morgan & Mikhail's Clinical Anesthesiology 7th ed., Table 10-3

7. Morphine

Class: Natural opioid alkaloid
Mechanism: Mu-opioid receptor agonist
Premedication: 0.05-0.1 mg/kg IM/IV
Intraoperative: 0.1-1 mg/kg IV (titrated)
Postoperative analgesia: 0.05-0.1 mg/kg IV q3-4h PRN
Notes: Histamine release with rapid IV bolus; avoid in asthma. Active metabolite (morphine-6-glucuronide) accumulates in renal failure.
Morgan & Mikhail's Clinical Anesthesiology 7th ed., Table 10-3

8. Remifentanil

Class: Ultra-short-acting opioid (esterase-metabolized)
Mechanism: Mu-opioid receptor agonist
Induction adjunct (loading): 0.5-1 mcg/kg IV over 30-60 seconds
Maintenance infusion: 0.05-2 mcg/kg/min
Postoperative analgesia: 0.025-0.2 mcg/kg/min (lower range)
Notes: Metabolized by non-specific plasma and tissue esterases; context-insensitive half-life ~3-5 min. Requires analgesia plan at emergence as effect disappears instantly.
Morgan & Mikhail's Clinical Anesthesiology 7th ed., Table 10-3

III. Neuromuscular Blocking Agents

9. Succinylcholine (Suxamethonium)

Class: Depolarizing neuromuscular blocker
Mechanism: Persistent nicotinic ACh receptor activation
Intubation dose: 1-1.5 mg/kg IV
Pediatric dose: 2 mg/kg IV
IM (when no IV access): 4 mg/kg (max 150 mg)
Onset: 45-60 seconds; Duration: 10-12 min (ultra-short)
Notes: Drug of choice for rapid-sequence intubation (RSI) and management of laryngospasm. Contraindicated in hyperkalemic states, burns (>24 hrs), crush injuries, malignant hyperthermia susceptibility.
Morgan & Mikhail's Clinical Anesthesiology 7th ed.

10. Rocuronium

Class: Non-depolarizing neuromuscular blocker (aminosteroid)
Mechanism: Competitive nicotinic ACh receptor antagonism
Standard intubation: 0.6 mg/kg IV (onset 60-90 sec)
RSI dose: 0.9-1.2 mg/kg IV (onset approaches succinylcholine at ~60 sec)
Maintenance: 0.1-0.2 mg/kg IV bolus PRN
Notes: Reversal with sugammadex (2-16 mg/kg depending on depth of block). At 1.2 mg/kg, recovery faster with sugammadex than spontaneous recovery from succinylcholine. No histamine release; no cardiac muscarinic effects.
Miller's Anesthesia 10th ed.; Morgan & Mikhail 7th ed.

Quick Reference Summary Table

#	Drug	Class	Route	Induction Dose	Key Note
1	Propofol	IV hypnotic	IV	1-2.5 mg/kg	Reduce in elderly
2	Thiopental	Barbiturate	IV	3-5 mg/kg	Onset 15-30 sec
3	Ketamine	Dissociative	IV/IM	1-2 mg/kg IV; 6.5-13 mg/kg IM	Preserves airway
4	Etomidate	Imidazole	IV	0.2-0.3 mg/kg	Best CV stability
5	Midazolam	Benzodiazepine	IV	0.02-0.1 mg/kg	Amnesic/co-induction
6	Fentanyl	Opioid	IV	1-2 mcg/kg (analgesia)	100x morphine potency
7	Morphine	Opioid	IV/IM	0.05-0.1 mg/kg	Histamine risk
8	Remifentanil	Ultra-short opioid	IV infusion	0.5-1 mcg/kg load	Context-insensitive
9	Succinylcholine	Depolarizing NMB	IV	1-1.5 mg/kg	RSI drug of choice
10	Rocuronium	Non-depolarizing NMB	IV	0.6-1.2 mg/kg	Reversible with sugammadex

Sources: Miller's Anesthesia, 10th Edition | Morgan & Mikhail's Clinical Anesthesiology, 7th Edition | Barash's Clinical Anesthesia, 9th Edition

Clinical note: All induction doses should be titrated based on patient age, weight, ASA status, premedication, and hemodynamic state. Elderly and hemodynamically compromised patients require significant dose reductions (often 50%).

Create a quick reference PDF card with this dosing table for the OR

Reading File

Running Command

ls /home/daytona/workspace/ 2>/dev/null || echo "workspace empty or missing"

Writing File

~/anesthesia-card/generate_card.py

#!/usr/bin/env python3
"""
Anesthesia Quick Reference Card - PDF Generator
Uses reportlab for a clean, OR-ready card layout (A4 landscape)
"""

from reportlab.lib.pagesizes import A4, landscape
from reportlab.lib.units import mm, cm
from reportlab.lib import colors
from reportlab.lib.styles import getSampleStyleSheet, ParagraphStyle
from reportlab.platypus import (
    SimpleDocTemplate, Table, TableStyle, Paragraph,
    Spacer, HRFlowable
)
from reportlab.lib.enums import TA_CENTER, TA_LEFT
from reportlab.pdfbase import pdfmetrics
from reportlab.pdfbase.ttfonts import TTFont
import os

OUTPUT_PATH = "/home/daytona/workspace/anesthesia-card/Anesthesia_Drug_Reference_Card.pdf"
os.makedirs(os.path.dirname(OUTPUT_PATH), exist_ok=True)

# ── Colour palette ────────────────────────────────────────────────────────────
NAVY       = colors.HexColor("#0A2342")
TEAL       = colors.HexColor("#0D7377")
LIGHT_TEAL = colors.HexColor("#E8F7F7")
AMBER      = colors.HexColor("#F0A500")
RED_WARN   = colors.HexColor("#C0392B")
BLUE_MILD  = colors.HexColor("#D6EAF8")
GREEN_MLD  = colors.HexColor("#D5F5E3")
PURPLE_MLD = colors.HexColor("#E8DAEF")
WHITE      = colors.white
LIGHT_GRAY = colors.HexColor("#F4F6F6")
MID_GRAY   = colors.HexColor("#BDC3C7")
DARK_GRAY  = colors.HexColor("#2C3E50")

PAGE_W, PAGE_H = landscape(A4)  # 297 x 210 mm

doc = SimpleDocTemplate(
    OUTPUT_PATH,
    pagesize=landscape(A4),
    leftMargin=10*mm, rightMargin=10*mm,
    topMargin=8*mm, bottomMargin=8*mm,
)

# ── Styles ────────────────────────────────────────────────────────────────────
styles = getSampleStyleSheet()

title_style = ParagraphStyle(
    "CardTitle",
    fontName="Helvetica-Bold",
    fontSize=16,
    textColor=WHITE,
    alignment=TA_CENTER,
    spaceAfter=0,
)
subtitle_style = ParagraphStyle(
    "CardSubtitle",
    fontName="Helvetica",
    fontSize=8,
    textColor=colors.HexColor("#AED6F1"),
    alignment=TA_CENTER,
    spaceAfter=0,
)
section_style = ParagraphStyle(
    "Section",
    fontName="Helvetica-Bold",
    fontSize=8,
    textColor=WHITE,
    alignment=TA_CENTER,
)
cell_style = ParagraphStyle(
    "Cell",
    fontName="Helvetica",
    fontSize=7.2,
    textColor=DARK_GRAY,
    leading=9,
)
cell_bold = ParagraphStyle(
    "CellBold",
    fontName="Helvetica-Bold",
    fontSize=7.5,
    textColor=DARK_GRAY,
    leading=10,
)
warn_style = ParagraphStyle(
    "Warn",
    fontName="Helvetica-Oblique",
    fontSize=6.5,
    textColor=RED_WARN,
    leading=8,
)
note_style = ParagraphStyle(
    "Note",
    fontName="Helvetica",
    fontSize=6.2,
    textColor=colors.HexColor("#555555"),
    leading=8,
    alignment=TA_CENTER,
)

def P(text, style=cell_style):
    return Paragraph(text, style)

def header_block():
    """Blue banner header"""
    header_data = [[
        P("<b>🔵  ANESTHESIA QUICK REFERENCE CARD  🔵</b>", title_style),
    ]]
    t = Table(header_data, colWidths=[PAGE_W - 20*mm])
    t.setStyle(TableStyle([
        ("BACKGROUND",  (0,0), (-1,-1), NAVY),
        ("TOPPADDING",  (0,0), (-1,-1), 6),
        ("BOTTOMPADDING",(0,0),(-1,-1), 4),
        ("LEFTPADDING", (0,0), (-1,-1), 8),
        ("RIGHTPADDING",(0,0), (-1,-1), 8),
        ("ROUNDEDCORNERS", [4]),
    ]))
    return t

def sub_banner(text, bg=TEAL):
    row = [[P(f"<b>{text}</b>", section_style)]]
    t = Table(row, colWidths=[PAGE_W - 20*mm])
    t.setStyle(TableStyle([
        ("BACKGROUND",    (0,0),(-1,-1), bg),
        ("TOPPADDING",    (0,0),(-1,-1), 3),
        ("BOTTOMPADDING", (0,0),(-1,-1), 3),
        ("LEFTPADDING",   (0,0),(-1,-1), 6),
    ]))
    return t

# ── Main drug table ───────────────────────────────────────────────────────────

COL_DRUG    = 28*mm
COL_CLASS   = 32*mm
COL_ROUTE   = 14*mm
COL_IND     = 38*mm
COL_MAINT   = 42*mm
COL_ONSET   = 18*mm
COL_NOTES   = 72*mm   # fill remaining

TOTAL = COL_DRUG + COL_CLASS + COL_ROUTE + COL_IND + COL_MAINT + COL_ONSET + COL_NOTES
# should ≈ 244mm; PAGE_W - margins = 297-20 = 277mm; we can expand notes

COL_NOTES_ADJ = (PAGE_W - 20*mm) - (COL_DRUG + COL_CLASS + COL_ROUTE + COL_IND + COL_MAINT + COL_ONSET)

header_row = [
    P("<b>Drug</b>", cell_bold),
    P("<b>Class</b>", cell_bold),
    P("<b>Route</b>", cell_bold),
    P("<b>Induction / Bolus Dose</b>", cell_bold),
    P("<b>Maintenance Dose</b>", cell_bold),
    P("<b>Onset</b>", cell_bold),
    P("<b>Key Notes / Warnings</b>", cell_bold),
]

# Row data: [drug, class, route, induction_dose, maintenance, onset, notes]
# Colours: None=white, 'blue', 'green', 'purple', 'amber'

rows_data = [
    # ── IV INDUCTION AGENTS ──────────────────────────────────
    {
        "group_header": "IV INDUCTION AGENTS",
        "bg_header": TEAL,
    },
    {
        "drug": "Propofol",
        "class_": "Alkylphenol\nIV Hypnotic",
        "route": "IV",
        "induction": "1–2.5 mg/kg IV\nElderly: 1–1.75 mg/kg\nPeds (ED95): 2–3 mg/kg",
        "maint": "100–200 mcg/kg/min\ninfusion (TIVA)",
        "onset": "30–60 sec",
        "notes": "↓ dose in elderly/ASA III-IV. Causes apnoea on induction. Pain on injection. Anti-emetic at sub-hypnotic doses. Co-induction with midazolam reduces requirement by ~30%.",
        "row_bg": LIGHT_GRAY,
        "warn": "",
    },
    {
        "drug": "Thiopental\n(Thiopentone)",
        "class_": "Oxybarbiturate",
        "route": "IV",
        "induction": "3–5 mg/kg IV\n(ED50: 2.2–2.7 mg/kg)\nElderly: halve dose",
        "maint": "50–100 mcg/kg/min\n(not preferred)",
        "onset": "15–30 sec",
        "notes": "NO analgesic effect. Accumulates with repeat dosing. Preferred for ECT (with methohexital). Avoid in porphyria. ↓ ICP — use in neurosurgery.",
        "row_bg": WHITE,
        "warn": "⚠ Contraindicated in porphyria",
    },
    {
        "drug": "Ketamine",
        "class_": "Dissociative\nAnesthetic\n(NMDA Antag.)",
        "route": "IV / IM",
        "induction": "IV: 1–2 mg/kg\nIM: 6.5–13 mg/kg\nNeonates/CVS: 4–7 mg/kg IV",
        "maint": "0.01–0.05 mg/kg/min\nSub-dissoc: 0.1–0.5 mg/kg",
        "onset": "IV: 30–60 sec\nIM: 3–5 min",
        "notes": "Preserves airway reflexes & BP. Bronchodilator — ideal in asthma/haemodynamic instability. Causes emergence delirium (pre-treat with midazolam). ↑ secretions — give glycopyrrolate.",
        "row_bg": LIGHT_GRAY,
        "warn": "",
    },
    {
        "drug": "Etomidate",
        "class_": "Imidazole\nIV Hypnotic",
        "route": "IV",
        "induction": "0.2–0.3 mg/kg IV",
        "maint": "Not recommended\nfor infusion",
        "onset": "30–60 sec",
        "notes": "Best cardiovascular stability of all IV induction agents. Inhibits 11-β-hydroxylase → adrenocortical suppression. Causes myoclonus & pain on injection. Avoid prolonged infusion.",
        "row_bg": WHITE,
        "warn": "⚠ Single bolus only — adrenal suppression risk with infusion",
    },
    # ── BENZODIAZEPINES ──────────────────────────────────────
    {
        "group_header": "BENZODIAZEPINE",
        "bg_header": colors.HexColor("#1A5276"),
    },
    {
        "drug": "Midazolam",
        "class_": "Benzodiazepine\n(GABA-A agonist)",
        "route": "IV / IM\n/ PO",
        "induction": "Co-induction: 0.05–0.1 mg/kg IV\nPremed: 0.02–0.05 mg/kg IV\nSedation: 0.5–2 mg titrated",
        "maint": "0.02–0.1 mg/kg/hr\ninfusion (ICU)",
        "onset": "IV: 1–2 min\nIM: 5–10 min",
        "notes": "Anxiolytic, amnesic, anticonvulsant. NO analgesia. Reduces propofol induction dose by ~30%. Reversal: Flumazenil 0.2 mg IV (repeat q1 min, max 1 mg).",
        "row_bg": BLUE_MILD,
        "warn": "",
    },
    # ── OPIOIDS ──────────────────────────────────────────────
    {
        "group_header": "OPIOID ANALGESICS",
        "bg_header": colors.HexColor("#1E8449"),
    },
    {
        "drug": "Fentanyl",
        "class_": "Synthetic\nOpioid\n(μ-agonist)",
        "route": "IV",
        "induction": "Analgesia: 1–2 mcg/kg IV\nBalanced anaes: 2–20 mcg/kg\nCardiac: 50–100 mcg/kg",
        "maint": "0.5–5 mcg/kg/hr\ninfusion",
        "onset": "1–2 min",
        "notes": "100× more potent than morphine. Minimal histamine. Chest wall rigidity at large rapid bolus. Duration 30–60 min. Transdermal patch available for chronic pain.",
        "row_bg": GREEN_MLD,
        "warn": "",
    },
    {
        "drug": "Morphine",
        "class_": "Natural\nOpioid Alkaloid\n(μ-agonist)",
        "route": "IV / IM\n/ SC",
        "induction": "0.05–0.1 mg/kg IV\nPostop pain: 2–5 mg IV\nq3–4h PRN",
        "maint": "0.01–0.04 mg/kg/hr\ninfusion",
        "onset": "IV: 5–10 min\nIM: 15–30 min",
        "notes": "Histamine release — give slowly. Active metabolite (M6G) accumulates in renal failure. ↑ nausea. Reversal: Naloxone 0.04–0.4 mg IV titrated.",
        "row_bg": LIGHT_GRAY,
        "warn": "⚠ Reduce dose in renal failure (M6G accumulation)",
    },
    {
        "drug": "Remifentanil",
        "class_": "Ultra-short\nOpioid\n(esterase metab.)",
        "route": "IV infusion\nonly",
        "induction": "Loading: 0.5–1 mcg/kg\nover 30–60 sec",
        "maint": "0.05–2 mcg/kg/min\ninfusion",
        "onset": "< 1 min",
        "notes": "Context-insensitive t½ ~3–5 min. Metabolised by plasma esterases — safe in renal/hepatic failure. Plan multimodal analgesia BEFORE stopping — NO residual effect at extubation.",
        "row_bg": GREEN_MLD,
        "warn": "⚠ Plan post-op analgesia before emergence — effect disappears instantly",
    },
    # ── NMBAs ─────────────────────────────────────────────────
    {
        "group_header": "NEUROMUSCULAR BLOCKING AGENTS (NMBAs)",
        "bg_header": colors.HexColor("#6C3483"),
    },
    {
        "drug": "Succinylcholine\n(Suxamethonium)",
        "class_": "Depolarizing\nNMBA",
        "route": "IV / IM",
        "induction": "RSI: 1–1.5 mg/kg IV\nPeds: 2 mg/kg IV\nIM (no IV): 4 mg/kg (max 150 mg)",
        "maint": "NOT used for\nmaintenance",
        "onset": "45–60 sec",
        "notes": "Drug of choice for RSI & laryngospasm. Duration ~10–12 min. ↑ K⁺ risk in burns >24h, crush injury, denervation, myopathies. Triggers malignant hyperthermia in susceptible pts.",
        "row_bg": PURPLE_MLD,
        "warn": "⚠ Contraindicated: hyperkalaemia, burns >24h, MH susceptibility, myopathies",
    },
    {
        "drug": "Rocuronium",
        "class_": "Non-depolarizing\nNMBA\n(Aminosteroid)",
        "route": "IV",
        "induction": "Standard intubation: 0.6 mg/kg\nRSI dose: 0.9–1.2 mg/kg\n(onset ≈ suxamethonium)",
        "maint": "0.1–0.2 mg/kg IV\nbolus PRN",
        "onset": "0.6 mg/kg: ~90 sec\n1.2 mg/kg: ~60 sec",
        "notes": "No histamine release. No cardiac muscarinic effects. Fully reversible with Sugammadex: moderate block 2 mg/kg, deep block 4 mg/kg, immediate reversal 16 mg/kg IV.",
        "row_bg": LIGHT_GRAY,
        "warn": "",
    },
]

# ── Build table rows ──────────────────────────────────────────────────────────

col_widths = [COL_DRUG, COL_CLASS, COL_ROUTE, COL_IND, COL_MAINT, COL_ONSET, COL_NOTES_ADJ]

table_rows = [header_row]
table_style_cmds = [
    # Header row
    ("BACKGROUND",    (0, 0), (-1, 0), NAVY),
    ("TEXTCOLOR",     (0, 0), (-1, 0), WHITE),
    ("FONTNAME",      (0, 0), (-1, 0), "Helvetica-Bold"),
    ("FONTSIZE",      (0, 0), (-1, 0), 8),
    ("ALIGN",         (0, 0), (-1, 0), "CENTER"),
    ("VALIGN",        (0, 0), (-1,-1), "MIDDLE"),
    ("ROWBACKGROUND", (0, 0), (-1, 0), NAVY),
    ("GRID",          (0, 0), (-1,-1), 0.4, MID_GRAY),
    ("TOPPADDING",    (0, 0), (-1,-1), 3),
    ("BOTTOMPADDING", (0, 0), (-1,-1), 3),
    ("LEFTPADDING",   (0, 0), (-1,-1), 4),
    ("RIGHTPADDING",  (0, 0), (-1,-1), 4),
]

row_idx = 1  # 0 = header

for item in rows_data:
    if "group_header" in item:
        # Section separator row (spans all columns)
        table_rows.append([
            P(f"<b>  ▶  {item['group_header']}</b>", section_style),
            "", "", "", "", "", ""
        ])
        table_style_cmds += [
            ("SPAN",       (0, row_idx), (-1, row_idx)),
            ("BACKGROUND", (0, row_idx), (-1, row_idx), item["bg_header"]),
            ("TOPPADDING", (0, row_idx), (-1, row_idx), 4),
            ("BOTTOMPADDING", (0, row_idx), (-1, row_idx), 4),
        ]
        row_idx += 1
        continue

    warn_text = item.get("warn", "")
    notes_content = item["notes"]
    if warn_text:
        notes_para = [P(notes_content, cell_style), P(warn_text, warn_style)]
    else:
        notes_para = P(notes_content, cell_style)

    row = [
        P(f"<b>{item['drug']}</b>", cell_bold),
        P(item["class_"], cell_style),
        P(item["route"], cell_style),
        P(item["induction"], cell_style),
        P(item["maint"], cell_style),
        P(item["onset"], cell_style),
        notes_para if isinstance(notes_para, Paragraph) else notes_para,
    ]
    table_rows.append(row)
    bg = item.get("row_bg", WHITE)
    table_style_cmds.append(("BACKGROUND", (0, row_idx), (-1, row_idx), bg))
    row_idx += 1

# Fix notes column: if it's a list, use a nested table
# Actually reportlab supports lists of flowables in a cell via KeepInFrame — 
# instead we just make the warns inline
# Re-build rows with combined notes text
table_rows2 = [header_row]
row_idx = 1
for item in rows_data:
    if "group_header" in item:
        table_rows2.append(table_rows[row_idx])
        row_idx += 1
        continue
    warn_text = item.get("warn", "")
    if warn_text:
        combined = f"{item['notes']}<br/><font color='#C0392B' size='6.5'><i>{warn_text}</i></font>"
    else:
        combined = item["notes"]
    row = [
        P(f"<b>{item['drug']}</b>", cell_bold),
        P(item["class_"].replace("\n", "<br/>"), cell_style),
        P(item["route"].replace("\n", "<br/>"), cell_style),
        P(item["induction"].replace("\n", "<br/>"), cell_style),
        P(item["maint"].replace("\n", "<br/>"), cell_style),
        P(item["onset"].replace("\n", "<br/>"), cell_style),
        P(combined, cell_style),
    ]
    table_rows2.append(row)
    row_idx += 1

drug_table = Table(table_rows2, colWidths=col_widths, repeatRows=1)
drug_table.setStyle(TableStyle(table_style_cmds))

# ── Footer note ───────────────────────────────────────────────────────────────
footer_text = (
    "<b>Sources:</b> Miller's Anesthesia 10e | Morgan & Mikhail's Clinical Anesthesiology 7e | Barash's Clinical Anesthesia 9e  ·  "
    "<b>Doses are for healthy adults unless stated.</b>  Always titrate to effect. Reduce dose in elderly, ASA III-IV, and haemodynamically compromised patients.  ·  "
    "For emergency reversal: Sugammadex (rocuronium/vecuronium) | Flumazenil (benzodiazepines) | Naloxone (opioids)."
)

# ── Assemble ──────────────────────────────────────────────────────────────────
elements = [
    header_block(),
    Spacer(1, 2*mm),
    drug_table,
    Spacer(1, 2*mm),
    HRFlowable(width="100%", thickness=0.5, color=TEAL),
    Spacer(1, 1*mm),
    Paragraph(footer_text, note_style),
]

doc.build(elements)
print(f"PDF saved to: {OUTPUT_PATH}")

Running Command

cd /home/daytona/workspace/anesthesia-card && python generate_card.py 2>&1

Running Command

ls -lh /home/daytona/workspace/anesthesia-card/

Your OR quick reference card is ready. Here's what's included:

Anesthesia Drug Reference Card

PDF Document · PDF

What's on the card (A4 landscape, print-ready):

The PDF is organized into 4 color-coded drug sections across a single landscape page:

Section	Color	Drugs Covered
IV Induction Agents	Teal header	Propofol, Thiopental, Ketamine, Etomidate
Benzodiazepine	Dark blue	Midazolam
Opioid Analgesics	Green	Fentanyl, Morphine, Remifentanil
NMBAs	Purple	Succinylcholine, Rocuronium

Each drug row includes:

Drug name + drug class
Route of administration
Induction / bolus dose (with pediatric & elderly adjustments where applicable)
Maintenance dose / infusion rates
Onset of action
Key clinical notes + red-text contraindication warnings

Footer: Emergency reversal agents (Sugammadex, Flumazenil, Naloxone) and source references (Miller's 10e, Morgan & Mikhail 7e, Barash 9e).

This is a shared conversation. Sign in to Orris to start your own chat.