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ADULT EMERGENCY IV DRUG INFUSION REGIMENS—A QUICK REFERENCE GUIDE

Please note that, for the sake of accuracy, the volume of the carrier solution that is removed from the container prior to mixing should match the volume of the drug ampoule(s).

Adrenaline

Mix 6 mg adrenaline with 100 mL of 5% glucose (60 mcg/mL). Start the infusion at 5 mL/h and titrate to effect. Can be commenced through a peripheral IV cannula in an emergency until central venous access is established.

Clevidipine

This drug is administered undiluted (0.5 mg/mL), starting with an initial dose of 1–2 mg/h. Double the dose every 90 s until the desired MAP is achieved, to a maximum of 32 mg/h.

Dobutamine

Mix 250 mg with 100 mL 5% glucose (2.5 mg/mL). Initial dose is 0.5–1 mcg/kg/min. In a 70 kg patient this equals 0.8–1.6 mL/hr. Maintenance dose is 2–20 mcg/kg/min (70 kg patient 3.2–32 mL/h). The maximum dose is 40 mcg/kg/min. It can be given peripherally through a large-bore cannula. Titrate to heart rate and blood pressure.

Esmolol

Administer undiluted. Esmolol ampoules contain 100 mg of drug in 10 mL. The LD is 500 mcg/kg over 1 min (70 kg patient = 3.5 mL). Commence the infusion at 20 mL/h and titrate to effect to a maximum of 60 mL/h.

Glyceryl trinitrate (GTN)

Mix 50 mg GTN with 500 mL 5% glucose in a glass bottle (100 mcg/mL). Administer at an initial rate of 3–5 mL/h. Titrate to effect to a maximum of 120 mL/h. Administer via an approved giving set (blue) to reduce absorption into plastics.

Isoprenaline

Mix 2 mg of isoprenaline with 50 mL of 5% glucose (40 mcg/mL). Administer through a central venous line only. For complete heart block, give 10–20 mcg then an infusion of 0.5–8 mcg/min (1–12 mL/h).

Levosimendan

Mix 12.5 mg levosimendan with 250 mL 5% glucose (50 mcg/mL). Administer a LD of 6–24 mcg/kg over 10 min–1 h (70 kg patient = 8.4–33.6 mL), then commence an infusion of 0.1 mcg/kg/min (70 kg patient = 8.4 mL/h). If after 30–60 min there is excessive hypotension or tachycardia, reduce the rate by half. If the initial infusion is well tolerated, double the infusion rate.

Milrinone

Mix 20 mg of milrinone with 100 mL 5% glucose (200 mcg/mL). Infuse preferably through a central line. Start the infusion at 0.5 mcg/kg/min and assess response in 2 h. Increase or decrease dose by increments of 0.125 mcg/kg/min. The usual dose range is 0.125–0.5 mcg/kg/min and the maximum dose 0.75 mcg/kg/min.

Noradrenaline

Mix 6 ...

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