IV pump 泡法

監測項目：Heart rate (EKG) and rhythm throughout therapy; assess patient for signs of thyroid dysfunction (thyroid function tests and liver enzymes), lethargy, edema of hands, feet, weight loss, and pulmonary toxicity (baseline pulmonary function tests)

Digoxin (250ug/1ml/amp)

劑量：

1 amp slow push

1 amp dilute with N/S 10ml (20ml), slow push

RAPID DIGITALIZATION - LOADING DOSE REGIMEN (IV)

DOSAGE SUMMARY: Patients with CHF and normal sinus rhythm

- Total loading dose, 10 mcg/kg lean body weight (range 8 - 12 mcg/kg)

or 0.6 - 1 mg intravenously

Initial dose, 5 mcg/kg (or 0.4 –0.6 mg, approximately one-half the total dose);

additional fractions (0.1 to 0.3 milligrams) given at 6 to 8 hour intervals

until clinical response

Maintenance dose, 0.075 to 0.35 mg/day

作用：Inotropic Agent

監測項目：heart rate and rhythm, EKG , digoxin serum levels, renal function, electrlyte (K⁺, Mg⁺⁺, Ca⁺⁺)

Diltiazem；Herbesser ® (10mg/amp)

泡製：1 vial + D5W or N/S 5ml--bolus

10vial + D5W or N/S 100ml--infusion

劑量：

Initial dose: 0.25mg/kg or 20 mg (2 vial) iv bolus over 2 min

Repeat dose: 15 min after then 0.35/kg or 25 mg iv bolus

if needed, infusion 10 mg/hr (100mg add in N/S 100 ml) rate may be increased in 5 mg/hr increments up to 15mg/hr as needed

作用：Calcium Channel Blocking Agent

監測項目：BP, EKG, liver function test

Dobutamine (250mg/20ml/amp)

泡製：1amp + D5W or N/S 100 ml (2ml/hr =1ug/kg/min)

劑量：start with 5ug/kg/min (10ml/hr) and increase as needed

usual rate: 2-20 ug/kg/min

作用：Vasopressors Used In Shock（β1>β2 >α）

監測項目：BP, heart rate, EKG, CVP, RAP, MAP, urine output; if pulmonary artery catheter is in place, monitor CI, PCWP, and SVR; also monitor k+ (k+ ↓)

保存: 稀釋後可保存24小時

Dopamine (200mg/5ml/amp)

泡製：

(1) 1amp + D5W or N/S 95ml （2ml/hr =1ug/kg/min）

(2) 2amp + D5W or N/S 500ml（4.5ml/hr =1ug/kg/min）

劑量：start with 5ug/kg/min (1)10ml/hr (2) 22.5ml/hr and increase as needed

usual rate: 2-20ug/kg/min

監測項目：BP, heart rate, EKG, urine output, renal function, decreased perfusion

作用：Vasopressors Used In Shock

1-3 ug/kg/min 以dopaminergic 受器效果為主，增加腎臟血流

3-10 ug/kg/min 以β1 受器效果為主，增加心臟收縮力

10-20 ug/kg/min 以α 受器效果為主，增加血壓(SVR↑)

keep SBP >100-110mmHg or MAP 90-105mmHg(1/3SBP+2/3DBP)

or Urine output > 60ml/hr or 1000ml/day

Epinephrine；Adrenaline；Bosmin® (1mg/ml/amp)

方法一

1 mg IV push, may repeat q3-5 min

may given 2-2.5mg dose via ETT if no IV access

方法二

泡製：1amp + D5W 250 ml (4ug/ml)

劑量：start with 1ug/min (15ml/hr) and increase as needed

usual rate: 1-4 ug/min

作用：Vasopressors Used In Shock（β1=β2 >α）

監測項目：BP, heart rate, EKG, Pulmonary function, site of infusion for blanching, extravasation

Isosorbid dinitrate；Isoket® (10mg/10ml/amp)

泡製：2 amp + D5W 80ml (0.2mg/ml, 3ml/hr =10ug/min)

劑量：start with 10ug/min (3ml/hr)

In general, a dose of 2-7mg/hr (10-35ml/hr) is suitable; may be increased up to 10 mg/hr if necessary

作用：Vasodilator/Nitrates

監測項目：BP, heart rate

Labetalol ；Trandate® (25mg/5ml/amp)

方法一

50 mg IV push ( > 1min) , may repeat q5 min, total dose≦200mg

方法二

泡製：8amp + D5W or NS 160 ml (1mg/ml)

劑量：start with 15-20ml/hr and increase as needed

maximum dose : 160mg/hr

作用：Agent For Hypertensive Emergencies

監測項目：BP, heart rate, EKG

保存: 稀釋後可保存24小時

Lidocaine；Xylocaine® (100mg/5ml/amp)

方法一

5-10 mg IV push, may repeat q5-10 min

Max: 300mg/15ml/hr

方法二

泡製：5 amp + D5W 75ml (5mg/ml, 12ml/hr =1mg/min)

劑量：start with 1mg/min (12ml/hr), may be increased if necessary

作用：Antiarrhythmic agents

Magnesium sulfate；MgSO4（2g/20ml/amp）

劑量：

preeclampsia 10-14g IV or IM x 1

hypomagnesemia IM 1g Q6H x 4, IV 5g x 1

cardiac arrhythmias 1-2g IV bolus over 1-2 min, repeat prn

hypomagnesemia - emergent 1-2 g in 100 ml D5W over 1-2 minutes

torsade de pointes 1-2 g in 50-100 ml D5W over 5 to 60 min, then 0.5-1g/hr

Milrinone；Primacor® (10mg/10ml/vial)

泡製：1 amp + D5W or N/S 90ml (0.1mg/ml, 3ml/hr =10ug/min)

劑量：loading dose: 50ug/kg (~ 3ml, >10min IV)

maintenance dose: 0.5ug/kg/min (18ml/hr)

作用：Inotropic Agent/Vasodilator

監測項目：BP, heart rate, serum potassium

Nicardipine；Perdipine® (10mg/10ml/amp)

泡製：6amp in D5W or N/S 100ml (0.6 mg/ml, 6ml/hr =1ug/kg/min)

也可稀釋為0.1mg/ml

劑量：start with 1ug/kg/min (6ml/hr) and increase as needed

usual rate: 1-6 ug/kg/min

作用：Calcium Channel Blocking Agent

監測項目：BP, heart rate, EKG

Nitroglycerin；NTG；Millisrol® (50mg/100ml/vial)

劑量：10ug/min（1.2ml/hr）up to 400ug/min

作用：Vasodilator/Nitrates

監測項目：BP, heart rate

Nitroprusside；Nipride® (50mg/vial)

泡製：(1) 1 vial + D5W 140ml (0.36mg/ml, 2ml/hr =10ug/min)

(2) 1 vial + D5W 250ml (0.2mg/ml)

劑量：

start with (1)10ug/min (2ml/hr) or (2) 0.3 ug/kg/minute (5ml/hr)

In general, a dose of 0.3-0.5 ug/kg/minute; increase 0.5 mcg/kg/minute,

usual dose: 3ug/kg/minute; maximum: 10ug/kg/minute

作用：Agent For Hypertensive Emergencies

監測項目：

BP, heart rate; monitor for cyanide and thiocyanate toxicity; monitor acid-base status as acidosis can be the earliest sign of cyanide toxicity; monitor thiocyanate levels if requiring prolonged infusion (>3 days) or dose ≧4 mcg/kg/minute or patient has renal dysfunction;

Norepinephrine；Levophed® (4mg/4ml/amp)

泡製：2amp + D5W or N/S 92 ml (10ml/hr = 0.2ug/kg/min)

劑量：start with 0.2ug/kg/min (10ml/hr) and increase as needed

usual rate: 0.5-30ug/min

監測項目：BP, heart rate, EKG, decreased perfusion

作用：Vasopressors Used In Shock（β1>α>β2）