ADULT ICU MEDICATION ADMINISTRATION REFERENCE CARD

THE DOSAGES OF THIS ENTIRE CHART IS FOR USE IN PATIENTS WITH NORMAL RENAL AND HEPATIC FUNCTION
MIXTURE CALCULATION SUGGESTED ADDITIONAL
MEDICATIONS TREATMENT NS OR D5W METHOD CONCENTRATION INITIAL MAINTENANCE NOTES
USED FOR UNLESS PER ML BOLUS OR REPEATING MAXIMUM
GENERIC NAME *** AKA NOTED RATE GIVEN DOSAGE DOSAGE DOSES
ANTAGONISTS REVERSAL OF
FLUMAZENIL * ROMAZICON BENZODIAZEPINES UNDILUTED MG / MIN 0.1 MG / 1 ML 0.2 MG 0.3 – 0.5 MG / MINUTE, UP TO 3 MG /HR MAX:
NALOXONE * NARCAN OPIATES UNDILUTED MG / MIN 0.4 MG / ML 0.4 – 2 MG 0.4 – 2 MG Q 2 – 3 MIN, UP TO 10MG MAX:
ANTIARRHYTHMICS
ADENOSINE * ADENOCARD PSVT UNDILUTED BOLUS 6 MG / 2 ML 6 MG 2ND = 12 MG, MAY REPEAT WITH 12 MG X 1
AMIODARONE * CORDARONE ACLS UNDILUTED MG / MIN VIAL = 50 MG / ML 300 MG If VF or pulseless VT recurs, may consider
CARDIAC ARREST 3 ML = 150 MG RAPID INFUSION extra doses of 150 mg rapid infusion.
PER VIAL
Max daily dose = 2 gm
AMIODARONE * CORDARONE V-FIB 450 MG / 250 ML MG / MIN GTT = 1.8 MG / ML 150 MG INITIALLY START GTT @ 33.3 ML / HR THEN
V-TACH D5W IN GLASS START GTT @ OVER 10 MIN INFUSE 360 MG OVER 6 HRS = 1 MG / MIN
33.3 ML/HR THEN 540 MG OVER 18 HRS = 0.5 MG / MIN
IBUTILIDE * CORVERT A-FIB / A-FLUTTER UNDILUTED OR 1 1 MG / 10 MIN UNDILUTED = 1 MG OR .01 MG / MAY REPEAT IN 10 MINUTES IF
MG / 50 ML 0.1 MG / ML KG IF LESS THAN INADEQUATE RESPONSE
60 KG
LIDOCAINE * XYLOCAINE V-TACH 2 GM / 250 D5W MG / MIN 8 MG / ML 1 – 1.5 MG / KG 1 – 4 MG MIN 2 MG / MIN = 15 ML/HR
PROCAINAMIDE * PRONESTYL V-TACH 2 GM / 250 ML MG / MIN 8 MG / ML 1 GM / 20 MIN 1 – 6 MG MIN 2 MG / MIN = 15 ML/HR
ANTICOAGULANTS
ABCIXIMAB * REO PRO PTCA / AMI VARIES BOLUS = MG/KG VIAL=10 MG / 5 ML 0.25 MG / KG 0.125 MCG / KG / MIN x 12 HRS….ALL GTT’s
SEE CHART GTT = MCG/KG/MIN GTT = VARIES OVER 5 MIN RUN AT 21 ML/HR...USE 0.22 MICRON FILTER
ARGATROBAN * HEPARIN INDUCED 250 MG / MCG / KG / MIN 1 MG / ML AS ORDERED MAINTENANCE DOSE BASED ON PTT
THROMBOCYTOPENIA 250 ML NS OR ML / HR SEE NOMOGRAM * MAX = 10 MCG/KG/MIN
EPTIFIBATIDE * INTEGRILLIN ACS / PCI 75 MG / 100 ML MCG / KG 0.75 MG / ML 180 MCG / KG MAINT: = 2 MCG / KG / MIN * FOR PCI, 2ND
OVER 1 MIN BOLUS OF 180 MCG / KG 10 MIN AFTER 1ST
HEPARIN AMI / PE / 25,000 UNITS / UNITS / HR OR 100 UNITS / ML AS ORDERED OR AS ORDERED BY PHYSICIAN
DVT / A - FIB 250 ML D5W UNITS/ KG/ HR PER NOMOGRAM ---OR--- PER NOMOGRAM
LEPIRUDIN * REFLUDAN AMI / HEPARIN 100 MG / ML / HR GTT = 0.4 MG / ML AS ORDERED BOLUS DOSE AND MAINTENANCE INFUSION
INDUCED 250 ML NS OR BOLUS DOSE = OVER PER DOSING CHART.
THROMBOCYTOPENIA MG / KG / HR 5 MG / ML NS 20 – 30 SECONDS MAXIMUM BOLUS DOSE = 44 MG
TIROFIBAN HCL * AGGRASTAT NON Q-AMI / PCI 12.5 MG / 250 ML MCG/KG/MIN 50 MCG / ML 0.4 MCG / KG MAINTENANCE = 0.1 MCG / KG / MIN
POST PTCA PREMIXED OVER 30 MIN FOR SEVERE RENAL IMPAIRMENT,
THROMBOCYTOPENIA FOR AMI DECREASE DOSE AND GTT RATE BY 50%
BETA BLOCKERS
ESMOLOL * BREVIBLOC PSVT / AMI / 2.5 GM / MCG/KG/MIN 10 MG / ML 500 MCG / KG BOLUS DOSE IN ML = KG DIVIDED BY 20
A-FIB 250 ML NS OVER 1 MIN MAINT : = 50 – 300 MCG / KG / MIN..
METOPROLOL * LOPRESSOR AMI / HTN UNDILUTED BOLUS 1 MG / 1 ML 5 MG 2 – 5 MG EVERY 2 MINUTES X 2 DOSES
PROPRANOLOL * INDERAL PSVT / A- FIB UNDILUTED 1 MG / MIN 1 MG / 1 ML 0.5 – 3 MG 0.5-3 MG AFTER 2-3 MIN X 1, THEN Q 4 HR

MIXTURE CALCULATION SUGGESTED ADDITIONAL

TREATMENT NS OR D5W METHOD CONCENTRATION INITIAL MAINTENANCE NOTES
MEDICATIONS USED FOR UNLESS PER ML BOLUS OR REPEATING MAXIMUM
NOTED RATE GIVEN DOSAGE DOSAGE DOSES
GENERIC NAME *** AKA
BENZODIAZEPINES * UNDILUTED *
LORAZEPAM * ATIVAN ANXIETY * 20 – 60 ML * MG / HR 4 MG / ML AS ORDERED AS ORDERED BY PHYSICIAN
MIDAZOLAM * VERSED ANXIETY * SYRINGES * MG / HR 1 MG / ML AS ORDERED AS ORDERED BY PHYSICIAN
NARCOTIC ANALGESICS
FENTANYL * SUBLIMAZE PAIN UNDILUTED MCG / HR OR 50 MCG / ML 1 – 2 MCG / KG 1 – 2 MCG / KG / HR…..O2 / AMBU BAG /
20 – 60 ML MCG/KG/HR OVER 1 – 2 MIN NARCAN AVAILABLE AT BEDSIDE
HYDROMORPHONE * DILAUDID PAIN 60 MG / MG / HR 1 MG / ML AS ORDERED AS ORDERED BY PHYSICIAN
60 ML NS
MORPHINE SULFATE * MSO4 PAIN UNDILUTED MG / HR 1 MG / ML OR AS ORDERED AS ORDERED BY PHYSICIAN
20 – 60 ML 15 MG / ML
GENERAL ANESTHETICS ********** ATTENDING PHYSICIAN MUST BE PRESENT TO GIVE IVP **********
ETOMIDATE * AMIDATE PROCEDURES UNDILUTED MG / MIN 2 MG / ML 0.1 – 0.3 MG / KG GIVE OVER 30 – 60 SECONDS

KETAMINE * KETALAR CHILD NA / SEE MG / MIN 50 MG / 1 ML 0.5 – 2 MG/KG/ 1 MIN 1 – 2 MG / KG = 5 – 10 MIN ANESTHESIA
PHARMACY MG / MIN 100 MG / 1 ML 1 – 4.5 MG/KG/ 1 MIN 2 MG / KG = 5 – 10 MIN ANESTHESIA
ADULT
PROPOFOL * DIPROVAN SEDATION PREMIXED MCG/KG/MIN 10 MG / ML 0.5 MG / KG OVER THEN 5 – 75 MCG / KG / MIN.…SHOULD BE
3 – 5 MIN VENTED… CHANGE IV TUBING Q 12 HRS
TO INDUCE
ANALGESIC SEDATIVE
DEXMEDETOMIDINE * SEDATION 2 ML / 48 ML GTT = 100 MCG / ML 1 MCG / KG 0.2 – 0.7 MCG / KG / HR
PRECEDEX NS = 50 ML MCG/KG/HR GTT = 4 MCG / ML OVER 10 MIN NOT TO EXCEED 24 HOURS
VASODILATORS
MILRINONE * PRIMACOR HEART 40 MG / 50 ML MCG/KG/MIN 420 MCG / ML 50 MCG / KG 0.5 – 0.75 MCG / KG / MIN
FAILURE NS = 95 ML 0.42 MG / ML OVER 10 MIN ADJUST DOSE FOR RENAL PATIENTS
NESIRITIDE * NATRECOR CHF 1.5 MG / 250 ML MCG/KG/MIN 6 MCG / ML 2 MCG / KG START AT 0.01 MCG/KG/MIN,
OVER 1 MINUTE MAY INCREASE BY
(Use Caution) 0.005 MCG/KG/MIN EVERY 3 HOURS TO A
MAXIMUM DOSE OF 0.03 MCG/KG/MIN
NITROGLYCERIN * TRIDIL HTN / AMI 100 MG / MCG / MIN 400 MCG / ML NONE 5 – 200 MCG / MIN = 0.75 – 30 ML / HR
ANGINA 250 ML D5W 0.4 MG / ML 10 MCG / MIN = 1.5 ML / HR
RAPID ACTING INSULIN
INSULIN, HUMAN REGULAR HYPERGLYCEMIA 100 UNITS / UNITS / HR 1 UNIT / 1 ML AS ORDERED TITRATE TO EFFECT AS
100 ML NS ORDERED BY PHYSICIAN
(RATE) MCG/KG/MIN = MCG x KG x MIN ( DIVIDED BY ) CONCENTRATION ** EXAMPLE – DOPAMINE @ 2 MCG/KG/MIN. = 2 MCG X 75 KG X 60 MIN DIVIDED BY 3200 MCG
APPROVED BY UMHC PHARMACY--------INTENDED FOR USE IN THE ADULT INTENSIVE CARE SETTING ------UPDATED July, 2007
ADULT ICU MEDICATION ADMINISTRATION REFERENCE CARD

THE DOSAGES OF THIS ENTIRE CHART IS FOR USE IN PATIENTS WITH NORMAL RENAL AND HEPATIC FUNCTION
MIXTURE CALCULATION SUGGESTED ADDITIONAL
MEDICATIONS TREATMENT NS OR D5W METHOD CONCENTRATION INITIAL MAINTENANCE NOTES
USED FOR UNLESS PER ML BOLUS OR REPEATING MAXIMUM
GENERIC NAME *** AKA NOTED RATE GIVEN DOSAGE DOSAGE DOSES
ANTIHYPERTENSIVES
FENOLDOPAM * CORLOPAM HTN 10 MG / 250 ML MCG/KG/MIN 40 MCG / ML NONE START AT 0.03 – 0.1 MCG/KG/MIN,
MAY INCREASE BY 0.05 – 0.1 MCG/KG/MIN
EVERY 15 – 20 MINUTES
HYDRALAZINE * APRESOLINE HTN 20 MG / ML MG / MIN 20 MG / ML 10 – 20 MG 10 – 20 MG EVERY 2 – 4 HOURS
UNDILUTED OVER 1 MIN MAXIMUM = 1.7 – 3.5 MG / KG / DAY
LABETALOL * NORMADYNE HYPERTENSIVE 200 MG / MG / MIN 0.67 MG / ML AS ORDERED BY START GTT AT 2 MG / MIN
CRISIS 300 ML PHYSICIAN. 2 MG / MIN = 180 ML / HR
START GTT @ MAXIMUM = 300 MG IV GIVEN
2 MG / MIN
LABETALOL * NORMADYNE HTN UNDILUTED MG / 2 MIN 5 MG / ML 20 MG 40 – 80 MG EVERY 10 MINUTES
OVER 2 MIN MAXIMUM = 300 MG GIVEN
NITROPRUSSIDE * NIPRIDE HTN 200 MG / MCG/KG/MIN 800 MCG / ML NONE 0.05 – 10 MCG / KG / MIN
250 ML D5W 0.8 MG / ML DO NOT PUSH
ANTICONVULSANTS
DIAZEPAM * VALIUM ANXIETY UNDILUTED MG / HR 5 MG / ML AS ORDERED AS ORDERED BY PHYSICIAN
20 - 60 ML
FOSPHENYTOIN * CEREBYX SEIZURES DILUTE TO MG PE / MIN 50 MG / ML 15 – 20 MG PE / KG DILUTE TO 25 MG PER ML WITH NS OR D5W
25 MG / ML * SEE NOTES * GIVE NO FASTER THAN 150 MG PE / MIN
PHENYTOIN * DILANTIN SEIZURES UNDILUTED MG / MIN 50 MG / ML 10 – 15 MG / KG LOADING DOSE RATE = 1 MG / KG / MIN
* SEE NOTES * UP TO MAXIMUM OF 50 MG / MINUTE
BRONCHODILATORS
THEOPHYLLINE BRONCHOSPASM 400 MG / MG /KG /HR 4 MG / ML 5 MG / KG -- OVER MAINTENANCE = 0.2 – 0.7 MG / KG/ HR
100 ML D5W 20 – 30 MINUTES DECREASE DOSE FOR CHF OR LIVER FAILURE
ASTHMA
MAX = 20 MG/MIN INFUSE NO FASTER THAN 20 MG / MIN
COPD
CA CHANNEL BLOCKERS
DILTIAZEM * CARDIZEM PSVT / HTN / 125 MG / MG / HR 1 MG / 1ML 0.25 MG / KG 2ND DOSE = 0.35 MG / KG …
A-FIB with RVR 125 ML ML / HR OVER 2 MIN GTT = 5 – 15 MG / HR FOR 24 HOURS ONLY
NICARDIPINE * CARDENE HTN / CHF 25 MG / 250 ML MG / HR 0.1 MG / ML NONE START @ 5 MG / HR ( 5 MG / HR = 50 ML / HR )
INCREASE BY 2.5 MG / HR Q 5 – 15 MIN. ---
MAX DOSE = 15 MG / HR
VERAPAMIL * CALAN PSVT / A-FIB / UNDILUTED MG / 2 MIN 2.5 MG / ML 2.5 – 5 MG 2ND DOSE = 5 – 10 MG EVERY 15 – 30 MIN
HTN / ANGINA OVER 2 - 4 MIN TO MAXIMUM OF 20 MG GIVEN

MIXTURE CALCULATION SUGGESTED ADDITIONAL

MEDICATIONS TREATMENT NS OR D5W METHOD CONCENTRATION INITIAL MAINTENANCE NOTES
USED FOR UNLESS PER ML BOLUS OR REPEATING MAXIMUM
GENERIC NAME *** AKA NOTED RATE GIVEN DOSAGE DOSAGE DOSES
PRESSORS MAINT: DOSE
DOBUTAMINE * DOBUTREX HYPOTENSION 1000 MG / MCG/KG/MIN 4000 MCG / ML NONE 2–20 MCG/KG/MIN MAX = 40 MCG/KG/MIN
250 ML 4 MG / ML
DOPAMINE * INTROPIN HYPOTENSION 800 MG / MCG/KG/MIN 3200 MCG / ML NONE 2–20 MCG/KG/MIN MAX = 50 MCG/KG/MIN
250 ML 3.2 MG / ML
EPINEPHRINE * ADRENALIN BRADYCARDIA 8 MG / 250ML MCG/KG/MIN 32 MCG / ML NONE 0.01– 0.1 MCG/KG/MIN
HYPOTENSION MCG / MIN 32 MCG / ML 1 – 10 MCG / MIN * 5 MCG / MIN = 9.375 ML/HR
ISOPROTERENOL * ISUPREL HEART BLOCK 8 MG / MCG / MIN 32 MCG / ML NONE 1– 10 MCG / MIN * 5 MCG / MIN = 9.375 ML/HR
HYPOTENSION 250 ML D5W MCG/KG/MIN 32 MCG / ML 0.01 – 0.2 MCG/KG/MIN
NOREPINEPHRINE * HYPOTENSION 8 MG / MCG/KG/MIN 32 MCG / ML NONE 0.01– 3 MCG/KG/MIN
LEVOPHED 250 ML D5W MCG / MIN 32 MCG / ML NONE 1 - 12 MCG / MIN * 5 MCG / MIN = 9.375 ML/HR
PHENLYEPHRINE * HYPOTENSION 60 MG / MCG / MIN 240 MCG / ML 0.2 MG = 5 – 180 MCG / MIN * 20 MCG / MIN = 5 ML/HR
NEOSYNEPHRINE 250 ML MCG/KG/MIN 0.24 MG / ML 0.8 ML BOLUS 0.1 – 3 MCG/KG/MIN
VASOPRESSIN * PITRESSIN G.I. / VARICES 250 UNITS / UNITS / MIN 1 UNIT / 1 ML NONE G.I. BLEED --- MAINT: = 0.2 – 1 UNIT / MIN
SHOCK 250 ML NS UNITS / MIN 1 UNIT / 1 ML NONE SHOCK --- 0.01 – 0.04 UNIT / MIN
OR AS ORDERED BY PHYSICIAN (use caution)
DIURETICS
FUROSEMIDE * LASIX LOOP 1000 MG / MG / HR 10 MG / ML AS ORDERED MAX: RATE OF 4 MG / MIN IN PT’S WITH
DIURETIC 100 ML CARDIAC OR RENAL FAILURE
IVP NOT TO EXCEED 20 MG / MIN
MANNITOL * OSMITROL INCREASED ICP 100 GM / 500 ML = GM / MIN 25 GM = 125 ML OF 20 % AS ORDERED AS ORDERED BY PHYSICIAN
OSMOTIC 20% PREMIXED 20 % = 200 MG / ML USE 5 MICRON FILTER
DIURETIC 25 % = 250 MG / ML MAY GIVE 25 GM OVER 6 – 10 MIN
PARALYTICS
CISATRACURIUM * NIMBEX * NEURO- * UNDILUTED MG / HR 2 MG / ML OR AS ORDERED TITRATE TO EFFECT ---- USE WITH PNS
* MUSCULAR * 20 – 60 ML 10 MG / ML PT MUST BE VENTED ON P C MODE
VECURONIUM * NORCURON * BLOCKING * 100 MG / MG / HR 1 MG / ML AS ORDERED TITRATE TO EFFECT---- USE WITH PNS
100 ML PT MUST BE VENTED ON P C MODE
PANCURONIUM * PAVULON * AGENTS * UNDILUTED MG / KG 1 MG / ML 0.04 – 0.1 MG / KG USE WITH PNS
PT MUST BE VENTED ON P C MODE
MISCELLANEOUS
PENTOBARBITAL * INDUCED UNDILUTED MG / KG / HR 50 MG / ML 10 MG / KG SEE PROTOCAL * START AT 5 MG/KG/HR
NEMBUTAL SODIUM COMA 1000 MG / 20 ML OVER 30 MIN. FOR 3 HRS. THEN 1 MG/KG/HR. DO NOT
EXCEED 50 MG / MINUTE
OCTREOTIDE * SANDOSTATIN G.I. BLEED 500 MCG / MCG / HR 2 MCG / ML NONE 25 MCG / HOUR
S. B. FISTULA 250 ML D5W 25 MCG / HR = 12.5 ML / HR
FAMOTIDINE * PEPCID STRESS ULCER 20mg / 2 ml 20 MG / 2 MIN 2 MG / ML NONE 20 MG BID = GIVE IV OVER 2 MINUTES
PROPHYLAXIS DILUTE WITH 1O ML NS DILUTE VIAL WITH 10 ML NS
(RATE) MCG/KG/MIN = MCG x KG x MIN ( DIVIDED BY ) CONCENTRATION ** EXAMPLE – DOPAMINE @ 2 MCG/KG/MIN. = 2 MCG X 75 KG X 60 MIN DIVIDED BY 3200 MCG
APPROVED BY UMHC PHARMACY--------INTENDED FOR USE IN THE ADULT INTENSIVE CARE SETTING ------UPDATED July, 2007