| Common Intravenous Infusions for Adults | |||||||||||||||
| The following are commonly used intravenous infusions used in the hospital setting, and their usual dosage assuming for a 70kg patient using a standard infusion preparation | |||||||||||||||
| Drug | Standard Dose | Standard Infusion Preparation | Concentration | Comments | Stability | ||||||||||
| Abciximab (Reopro) | Bolus: 0.25mg/kg | 9mg / 250ml D5W | 36mcg / ml | Use with inline 0.22 micron filter. Do not use in patients with severe HTN, active internal bleeding, or CVA | 24 hours | ||||||||||
| Main: 10mcg/min for 12 hours | |||||||||||||||
| Aminocaproic Acid (Amicar) | Bolus: 5g/100ml over 1 hour | 5g / 250ml D5W or NSS | 20mg / ml | Maximum dose is 24g/24 hours. Rapid infusion of undiluted drug is not recommended. Do not use in DIC. | 18 hours | ||||||||||
| Main: 1g/hr for 5 or more hours | |||||||||||||||
| Amiodarone (Cordarone) | Bolus: 150mg/100ml over 10 minutes | 900mg / 500ml D5W | 1.8mg / ml | Monitor for hypotension which can be related to rate of infusion. Incompatiable with heparin, cefazolin, sodium bicarbonate. May potentiate warfarin, digoxin, quinidine, procainamide. Store at room temperature. | 7 days | ||||||||||
| Main: 1mg/min for 6 hours, then 0.5mg/min for next 18 hours | |||||||||||||||
| Amrinone (Inocor) | Bolus: 0.75mg/kg over 2-3 minutes | 500mg / 200ml NSS | 2.5mg / ml | Incompatible with IV furosemide, sodium bicarbonate. May cause thrombocytopenia and hepatotoxicity. Contains sulfites, which may cause allergic reactions. | 24 hours | ||||||||||
| Main: 5-10mcg/kg/min | |||||||||||||||
| Atracurium (Tracrium) | Bolus: 0.4-0.5mg/kg IVP | 1g / 250ml D5W or NSS | 4mg / ml | Aminoglycosides may potentiate neuroblockade. Utilize peripheral nerve stimulation to assess degree of blockade. Monitor for hypokalemia. | |||||||||||
| Main: 11-13mcg/kg/min | |||||||||||||||
| Bretylium (Bretylol) | Bolus 5mg/kg over 1 minute, may repeat q15-30 minutes | 2g / 500ml D5W or NSS | 4mg / ml | Monitor for low BP. Causes as increased response to catecholamines. Maximum dose 30mg/kg/day | 24 hours | ||||||||||
| Main: 1-2mg/min | |||||||||||||||
| Diltiazem (Cardizem) | Bolus: 0.25mg/kg over 2 minutes | 125mg / 125ml D5W or NSS | 1mg / ml | May cause 2nd - 3rd degree heart block. Should not be administered with IV B-Blockers or within close proximity of each other. | 24 hours | ||||||||||
| Main: 5-15mg/hour | |||||||||||||||
| Dobutamine (Dobutrex) | 2.5-10mcg/kg/min | 250mg / 500ml D5W or NSS | 500mcg / ml | Incompatible with alkaline solutions such as sodium bicarbonate. Maximum dose 40mcg/kg/min. Higher doses cause tachycardia and arrhythmias. Contains sulfites, which may cause an allergic reaction. | 48 hours | ||||||||||
| 500mg / 500ml D5W or NSS (fluid restricted patients) | |||||||||||||||
| 1000mcg / ml | |||||||||||||||
| Dopamine (Inotropin) | 2-20mcg/kg/min | 400mg / 500ml D5W or NSS | 800mcg / ml | Incompatible with alkaline solutions (see above). Treat tissue necrosis by infiltrating area with 5-10mg of phentolamine (Regitine) mixed in 10ml normal saline. | 7 days | ||||||||||
| 800mg / 500ml D5W or NSS (fluid restricted patients) | |||||||||||||||
| 1600mcg / ml | |||||||||||||||
| Epinephrine (Adrenalin) | Bolus: 0.5-1mg IVP | 8mg / 250ml D5W or NSS | 32mcg / ml | Incompatible with alkaline solutions (see above). | 24 hours | ||||||||||
| Main: 1-4mcg/min | |||||||||||||||
| Esmolol (Brevibloc) | Bolus: 500mcg/kg over 1 minute | 5g / 500ml D5W or NSS | 10mg / ml | Monitor for hypotension. Morphine may increase pharmacological effects. Esmolol may potentiate neuro-muscular blocking agents. MUST BE DILUTED | 24 hours | ||||||||||
| Main: 50-200mcg/kg/min | |||||||||||||||
| Famotidine (Pepcid) | 40mg / 24 hours | 40mg / 250ml D5W or NSS | 0.16mg / ml | Infuse over 24 hours at 10.4ml/hr. If CrCl is less than 10ml/min, decrease dose to 20mg/24 hours. | 14 days | ||||||||||
| Fentanyl (Duragesic) | Bolus: 50-100mcg IVP | 1000mcg / 100ml D5W or NSS | 10mcg / ml | Mechanical ventilation recommended. Do not use concurrently with Diprivan. Monitor sedation using Ramsey scale. Maximum infusion 500mcg/hr | 7 days | ||||||||||
| Main: 50mcg/hr | 2500mcg / 250ml D5W or NSS | ||||||||||||||
| Heparin | Bolus: 80units/kg IVP | 25000 units / 500ml D5W or NSS | 50 units / ml | Monitor PTT and INR. Treat acute overdose with protamine. Infuse in "units/hr" | 4 days | ||||||||||
| Main: 18units/kg/hr then adjust to PTT | |||||||||||||||
| Insulin-R | Bolus: 0.1 units/kg IVP | 50 units / 250ml NSS | 0.2 units / ml | Use ONLY regular U-100 insulin. Mix insulin thoroughly in solution and prime tubing. | 24 hours | ||||||||||
| Main: 0.1 units/kg/hr | 100 units / 100ml NSS (fluid restricted) | ||||||||||||||
| 1 units / ml | |||||||||||||||
| Isoproterinol (Isuprel) | Bolus: 20-60mcg slow IVP | 2mg / 500ml D5W or NSS | 4mcg / ml | Dilute IV bolus in 10ml D5W or NSS before administering. Avoid using with epinephrine. Incompatible with alkaline solutions. | |||||||||||
| Main: 2-10mcg/min | |||||||||||||||
| Labetolol (Trandate or Normodyne) | 2mg/min (adjust to BP) | 200mg / 200ml D5W or NSS | 1mg / ml | Keep patient in supine position to avoid postural hypotension. Use with caution in patients with CHF, DM, hepatic dysfunction, hyper-reactive airway disease. | 48 hours | ||||||||||
| 1200mg / 240ml | |||||||||||||||
| 4mg / ml | |||||||||||||||
| Lorazepam (Ativan) | Bolus: 2mg IVP over 1 minute | 25mg / 250ml D5W or NSS | 0.1mg / ml | Mechanical ventilation recommended. Use NTG tubing. Dilute IVP dose with equal volume of D5W, NSS, or SWFI. Sedative effects may be prolonged in sepsis, trauma, hypoxia, decreased hepatic flow. Monitor sedation with Ramsey scale. | 24 hours | ||||||||||
| Main: 0.5-1mg/hr | 25mg / 100ml D5W or NSS (fluid restricted patients) | ||||||||||||||
| 0.25mg / ml | |||||||||||||||
| Magnesium sulfate (Cardiac) | Bolus: 2g/100ml D5W over 12 hours | 16g / 250ml D5W or NSS | 64mg / ml | Used as antiarrhythmic agent. Use with caution in renal patients. Rapid infusion may cause hypotension | |||||||||||
| Main: 16g / 24 hours | |||||||||||||||
| Magnesium sulfate (OB/GYN) | Main: 1-3g / hr | 50g / 500ml D5W&NSS | 0.1g / ml | Used in obstetrics only | |||||||||||
| Midazolam (Versed) | Bolus: 0.05-0.2mg/kg IVP | 100mg / 250ml D5W or NSS | 0.4mg / ml | Mechanical ventilation recommended. Use caution in CHF and renal impairment. Monitor for hypotensive effects. Theophylline may decrease sedative dose. | 48 hours | ||||||||||
| Main: 0.25-2mcg/kg/min | |||||||||||||||
| Milrinone (Primacor) | Bolus: 50mcg/kg IVP over 10 minutes | 50mg / 250ml D5W or NSS | 200mcg / ml | Incompatible with IV furosemide. Adjust dose for renal impairment. | 7 days | ||||||||||
| Main: 0.375-0.75mcg/kg/min | 100mg / 250ml D5W or NSS (fluid restricted patients) | ||||||||||||||
| 400mcg / ml | |||||||||||||||
| Morphine sulfate | Main: 0.5-10mg/hr | 62.5mg / 250ml D5W or NSS | 0.25mg / ml | Mechanical ventilation recommended. Monitor for respiratory depression. Cancer patients may require higher doses. | 24 hours | ||||||||||
| 125mg / 250ml D5W or NSS | |||||||||||||||
| 0.5mg / ml | |||||||||||||||
| Naloxone (Narcan) | Bolus: 0.1-2mg IVP | 10mg / 250ml D5W or NSS | 40mcg / ml | ||||||||||||
| Addict: 0.1mg (first dose), if no response then progress in doubling fashion until response or up to 10mg | |||||||||||||||
| Main: hourly infusion dose rate should equal response dose | |||||||||||||||
| Nitroglycerin (Tridil) | 50-500mcg/min | 50mg / 250ml D5W or NSS | 200mcg / ml | Use NTG tubing. Not for direct administration. Do not mix with other drugs. Monitor for hypotension and bradycardia | 7 days | ||||||||||
| 100mg / 250ml D5W or NSS (fluid restricted patients) | |||||||||||||||
| 400mcg / ml | |||||||||||||||
| Nitroprusside (Nipride) | 0.5-10mcg/kg/min | 50mg / 250ml D5W | 200mcg / ml | Use lowest dose and shortest duration possible. Maxmum dose rate (10mcg/kg/min) should not last more than 10 minutes when possible. Montior for metabolic acidosis, thiocyanate, and cyanide toxiciity (protect infusion from light) | 48 hours | ||||||||||
| 100mg / 250ml D5W (fluid restricted patients) | |||||||||||||||
| 400mcg / ml | |||||||||||||||
| Norepinephrine (Levophed) | Initial: 8-12mcg/min | 8mg / 500ml D5W | 16mcg / ml | Use central line ONLY. Administer in dextrose containing solutions. Avoid abrupt withdrawal. Some patients require up to 40mcg/min | 72 hours | ||||||||||
| Main: 2-4mcg/min | |||||||||||||||
| Phenylephrine (Neo-Synephrine) | Init: 100-180mcg/min | 20mg / 500ml D5W or NSS | 40mcg / ml | Contraindicated in severe hypertension, bradycardia. Treat tissue necrosis by infiltrating area with 5-10mg or phentolamine in 10ml NSS | 24 hours | ||||||||||
| Main: 40-60mcg/min | |||||||||||||||
| Procainamide (Pronestyl) | Bolus: 15-18mcg/kg by slow infusion over 25-30 minutes | 2g / 500ml D5W or NSS | 4mg / ml | Monitor administration with ECG. Keep patient supine and monitor BP. Watch for unexplained fever, joint pain or stiffness. | 24 hours | ||||||||||
| Main: 1-5mg/min | |||||||||||||||
| Propofol (Diprivan) | Main: 5-50mcg/kg/min | 1000mg / 100ml (premixed) | 10mg / ml | Mechanical ventrilation recommended. Use NTG tubing. Monitor triglyceride levels. Tubing and bottle should be changed every 12 hours. Monitor sedation using Ramsey scale. | |||||||||||
| Theophylline | Bolus: 5mg/kg | 400mg / 500ml D5W | 0.8mg / ml | Cimetidine, Erythromycin, and Ciprofloxacin may enhance toxiciity. Rapid infusion may cause tachycardia. Use with caution in renal, liver, cardiac disease and sever hypertension | |||||||||||
| Main: 0.4mg/kg/hr | |||||||||||||||
| t-PA (Activaste) | Bolus: 15mg IVP over 1-2 minutes | 100mg / 100ml SWFI | 1mg / ml | If patient weighs less than 70kg, use 15mg bolus, and 0.75mg/kg drip for 30 minutes then 0.5mg/kg for 1 hour. Check for signs of hemorrhage. Total dose of t-PA should not exceed 100mg. Patient must be on cardiac monitor | |||||||||||
| Main: 50mg over 30 minutes, then 35mg over 60 minutes | |||||||||||||||
| Vasopressin (Pitressin) | 0.1-0.9 units/min | 200 units / 250ml D5W or NSS | 0.8 units / ml | Monitor fluid intake and output. Monitor BP for hypotension | 48 hours | ||||||||||
| Vecuronium (Norcuron) | Init: 0.08-0.1mg/kg IVP | 100mg / 500ml D5W or NSS | 0.2mg / ml | Aminoglycoside may potentiate neuromuscular blockade. Utilize peripheral nerve stimulation to assess degree of blockade | 24 hours | ||||||||||
| Main: 0.8-1.2mcg/kg/min | |||||||||||||||
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