Dosage Calculations

Milrinone -comes premixed from pharmacy at 200 mcg/cc -loading dose 50 mcg/kg over 10-20 min -then 0.5 mcg/kg/min -EASYCALC: (0.5 mcg/kg/min * bodyweight/200)* 60 = cc/hour Bretylium (Bretylol) -Initially 5 mg/kg, repeat 10 mg/kg if needed -Infusion 500 mg in 50 cc D5W (10 mg/ml) at 1-3 mg/min (7-21 cc/hr) LidocaineDrip 2gm /250 cc (8 mg/ml);1-4 mg/min (7-30 cc/hr) Procainamide(Pronestyl) Bolus:100 mg IV q 10 minutes or Drip: 2 grams/250 ml D5W (8 mg /ml) -run infusion at 20 mg/min (150 cc/hr) until: 1) QRS or PR widens >50%, or 2) Dysrhythmia suppressed, or 3) Hypotension, or 4) Total of 17 mg/kg or 1000 mg infused Then 2-6 mg/min (15-45 cc/hr) Cardizem Drip (for free radial artery grafts) -mix 125 mg in 100c NaCl bag with additional 25 cc NaCl -run @ 2mg/hr (2cc/hr) if started on patient warming Nitric Oxide (inhaled) Cam Clark 7/8/99 -therapeutic range 20-80 ppm; no increased benefit from higher concentration -once started, must wean gradually to avoid rebound Toxicity of NO2 - Methemoglobinemia; rarely an issue clinically - circuit: essentially a modified BAIN Vasopressin Drip 1/13/99

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often used to provide increased SVR during milrinone administration 100 units vasopressin/100 cc comes from pharmacy pre-mixed run @ 2.4 cc/hr (0.04 units/min) dose is NOT weight dependent convert IVAC multi-channel pump to neonatal to allow decimals in rate (More Options-> Device->Neonatal)

Insulin Drip for Heart Cases 2/14/99- Cam Clark

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mix 100 units of reg Insulin in 100 ml NS for BS > 350, bolus 15 units and run infusion at 5 units/hr. for BS > 270 and < 350, bolus 10 units and run infusion at 4 units/hr. Obviously a carrier will be required with the INS infusion.

Amiodarone (Cordarone®) Protocol 3/99 **for ventricular arrhythmias, and atrial fibrillation prophylaxis; **May cause dramatic hypotension with concurrent alpha blockade

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order the solution from the pharmacy: -150mg /100ml parfill bag -900mg /500 ml glass bottle (1.8mg/ml) -multichannel pump, extension set BOLUS (Loading) Dose: (Bag) o 150mg (100ml) over 10 minutes MAINTENANCE Dose: (Bottle) o 33 ml/hr (60mg /hr) o after 6 hours: decrease rate to 17 ml/hr (30 mg/hr)