Term
| Norepinephrine (Levophed) |
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Definition
•Start at 0.5 - 1.0 mcg/min
•Titrate to desired effect (SBP of 90 - 100 mmHg); up to 30 mcg/min
•Adult dosage commonly 2 - 12 mcg/min
•Mix 4 ml ampule (1 mg/ml) in 500 ml D5W or 0.9% NSS to make 8 mcg/ml |
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Term
| Phenylephrine (Neo-synephrine) |
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Definition
•Titrate 0.1 - 0.18 mg/min until BP stabilizes, then 0.04 - 0.06 mg/min for maintenance infusion.
•Dilute 10 mg in 500 ml D5W or 0.9% NSS to make 0.2 mg/ml concentration. |
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Term
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Definition
•Low dose: 2 - 5 mcg/kg/min
•Mid-range dose: 5 - 10 mcg/kg/min
•High dose: > 10 mcg/kg/min
•Titrate dosage to desired hemodynamic effect, using data from right heart catheterization as measure of effects.
•Dilute 400 mg in 250 ml D5W for concentration of 1600 mcg/ml. |
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Term
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Definition
•Start at 0.5 mcg/kg/min IV and titrate to desired effect
•Usual dose is 2 - 20 mcg/kg/min
•Insertion of Swan-Ganz catheter for continuous pressure monitoring
•Titrate upward so as not to increase heart rate by greater than 10% (unless for stress echocardiogram).
•Dilute 1000 mg in 250 ml of D5W or 0.9% NSS for a concentration of 4 mg/ml. |
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Term
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Definition
•Cardiac arrest: single bolus of 40 units IV; use epinephrine if no response in 10 - 20 minutes
•Currently acceptable via endotracheal route; no set dosage as of current ACLS guidelines
-Vasodilatory Shock: Initially, 0.04 unit/min. DO NOT TITRATE! |
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Term
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Definition
•Intravenously:
•Start at 10 - 20 mcg/min and titrate until desired effect (pain free) is noted or to a maximum of 500 mcg/min.
•Bolus with 12.5 - 25.0 mcg, then start infusion
•Best for patients with unstable angina or for continuous treatment for AMI
•Dilute 40 mg with 250 ml D5W or 0.9% NSS for a concentration of 160 mcg/ml.
•Transdermal ointment:
•For chronic therapy, not for acute treatment of chest pain
•1 - 2 inches of 2% paste applied to the chest wall |
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Term
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Definition
•Dosage varies with patient’s size, age, and renal function.
•Start with 2 - 10 mg slow IV over 3-5 minutes.
•Titrate in small increments (1 - 3 mg) to desired effect, while maintaining adequate respiratory status. |
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Term
| Sodium nitroprusside (Nipride) |
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Definition
•Start infusion at 0.5 mcg/kg/min and titrate every 5 - 10 minutes to desired effect (SBP < 150 mmHg and/or DBP < 60 - 90 mmHg).
•Normal range is 0.5 - 8.0 mcg/kg/min.
•Mix 50 mg with 2 - 3 ml of D5W in the vial, then add 250 ml of D5W for a concentration of 200 mcg/ml. |
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Term
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Definition
•Hypertension in adults:
•: 10 - 50 mg QID
•Intravenous: 5 - 40 mg slow IV push over 1 - 2 minutes, may repeat every 4 - 6 hours as needed
•Hypertension in geriatrics: start with 10 mg PO BID or TID and titrate as needed |
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Term
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Definition
•Loading dose: 0.75 mcg/kg over 2-5 minutes
•Infusion at 5 - 10 mcg/kg/min, titrated to desired effect
•Adjust frequently to achieve optimal effects at lowest possible dose
•Mix 20 ml ampule of 100 mg (5 mg/ml) with 0.9% NSS for 1 - 3 mg/ml concentration |
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Term
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Definition
•Initial loading dose: 50 mcg/kg slow IVP over 10 minutes
•Continuous infusion: 0.375 - 0.75 mcg/kg/min
•Titrate dosage to maximum clinical effects (patient improvement, increase in urinary output, improvement in right-heart hemodynamics)
•Drug is commonly used concomitantly with digitalis and diuretics.
•In patients with renal impairment, the maximum dose is 1.13 mg/kg/day. |
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Term
| Digitalis (Digoxin, Lanoxin) |
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Definition
•Loading dose: 10 - 15 mcg/kg
•IV effects in 5 - 30 minutes and peaks in 1.5 - 3.0 hours
•Maintenance dosing dependent on body size and renal function (monitor creatinine clearance)
•Normal therapeutic range is 0.5 - 2.0 ng/ml.
•Also available in oral preparations (0.125, 0.25, and 0.50 mg tablets) |
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Term
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Definition
•Intravenous: 20 - 80 mg IV, usually in increments of 20 mg
•Oral: 20 - 40 mg initially, titrated for effect |
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Term
| Dosages for Sodium Heparin (Anticoagulant) |
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Definition
•50 u/kg
•For acute myocardial infarction (AMI) 5000u loading and 1000 u/hr |
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Term
Dosages for ReoPro (Abciximab)
(Antiplatelet)
(Glycoprotein (GP) IIb/IIIa inhibitor) |
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Definition
•.25 mg/kg bolus
•Then .125 mcg/kg/min for MI
•For PCI post, 10 mcg/kg/min for 12 hours |
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Term
Dosages for Tirofiban HCL
(Aggrastat)
(Antiplatelet) |
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Definition
•Initial dose of 0.4 mcg/kg/min for 30 minutes
•Followed by 0.1 mcg/kg/min for 48 to 108 hours or 12 – 24 hours after coronary intervention |
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Term
Dosages for Bivalirudin (Angiomax)
•Antithrombotic |
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Definition
•Initially, 1 mg/kg IV bolus just before PCI
•Infusion at 2.5 mg/kg/hr for 4 hours
•Administer another IV infusion at 0.2 mg/kg/hr for up to 30 hours as needed
•Store prepared solution for up to 24 hours at 36 to 46 degrees Fahrenheit
•Give with 325 mg of aspirin |
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Term
Dosages for Argatroban (Acova)
•Thrombin inhibitor |
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Definition
•Begin infusion of 25 mcg/kg/min and administer bolus dose of 350 mcg/kg (over 3 to 5 minutes)
•ACT should be checked 5 to 10 minutes after bolus
•Proceed with procedure if ACT is > 300 seconds
•ACT < 300 seconds: give an additional 150 mcg/kg bolus and increase infusion rate to 30 mcg/kg/min (recheck ACT in 5 to 10 minutes)
•ACT > 450 seconds: decrease infusion rate to 15 mcg/kg/min (recheck ACT in 5 to 10 minutes)
•Once at therapeutic ACT (300 to 450 seconds), infusion should be continued at this dose for the duration of the procedure
•Reduce dosage to 0.5 mcg/kg/min in hepatic impairment
•Impending abrupt closure, thrombus formation during PCI, or inability to achieve ACT > 300 seconds: an additional bolus of 150 mcg/kg, followed by an increase in infusion rate to 40 mcg/kg/min may be administered |
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Term
Dosages for Aspirin
•Analgesic
•Antiplatelet |
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Definition
•Analgesic/antipyretic: 325 - 650 mg PO q 4 hours as needed
•Acute MI: 325 mg (or 4 x 81 mg chewable tablets to facilitate sublingual absorption and to expedite antiplatelet activity)
•Thromboembolic disorders: 325 - 650 mg PO QD or BID
•MI prophylaxis: 81 - 325 mg PO QD |
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Term
Dosages for Clopidogrel (Plavix)
•Antiplatelet
•Anticoagulant |
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Definition
•75 mg PO QD is recommended
•For ACS with or without PCI, load with 300 mg and then continue with 75 mg daily |
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Term
Dosages for Enalapril (Vasotec)
•Antihypertensive |
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Definition
•Hypertension
•PO: 5 mg/day; may increase to 10 to 40 mg/day in 1-2 divided doses
•IV: 1.25 mg slow IV push over 5 minutes every 6 hours; may give up to 5 mg every 6 hours in hypertensive emergencies
•CHF: 2.5 mg PO QD or BID; may increase up to 5 to 20 mg/day in 1 to 2 divided doses (max of 40 mg/day |
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