| Drip Titration Administration | |||
| Starting Dose | Administration | Comments | |
|---|---|---|---|
| Pressors | |||
| Dopamine | 2.5 mcg/kg/min | Titrate up/down by 2.5 mcg/kg/min q 10-20 min to maintain SBP (90-140)/MAP (60-90) | for Heart rate/BP support. Contact MD if over 20 mcg/kg/min |
| Epinephrine | 1 mcg/min | Titrate up/down by 1 mcg/min q5-10 min to maintain SBP (90-140)/MAP (60-90) | for hemodynamic support/cardiogenic shock. Contact MD if over 20 mcg/min |
| Norepinephrine | 2.5 mcg/min | Titrate up/down by 2.5 mcg/min q5-10 min to maintain SBP (90-140)/MAP (60-90) | for BP support/Septic shock. Contact MD if over 30 mcg/min. May wean off once down to 2.5 mcg/min |
| Phenylephrine | 20 mcg/min | Titrate up/down by 10 mcg/min q10 min to maintain SBP (90-140)/MAP (60-90) | for Hemodynamic support/severe hypotension. Contact MD if over 300 mcg/min. May wean off once down to 10 mcg/min |
| Vasopressin | 0.02-0.03 units/min | Max dose 0.04 units/min. | for Vasodilatory shock (w/Norepi). Slowly taper by 0.01 units/min q30-60 min. D/C when Norepi down to <=10 mcg/min |
| Anti-Hypertensives | |||
| Esmolol | 25 mcg/kg/min | Titrate up/down by 25 mcg/kg/min q5-10 min to maintain SBP (100-140)/HR (50-110) | for SVT/AF/A-flutter/ST or HTN emergency. Contact MD if over 300 mcg/kg/min |
| Labetalol | 0.5 mg/min | Titrate up/down by 0.5 mg/min q10 min to maintain SBP (100-140)/MAP (60-90)/HR (60-100) | for HTN emergency/urgency. Max cumulative dose: 300 mg/day |
| Nicardipine | 2.5 mg/hr | Titrate up/down by 2.5 mg/hr q15 min to maintain SBP (90-140) | for Acute HTN and HTN in AIS. Max rate: 15 mg/hr. Change inusion site q12h if through large peripheral vein |
| Nitroglycerin | 5 mcg/min | Heart Failure: Titrate up/down by 10 mcg/min q10-15 min for dyspnea/tacypnea. Hold if SBP <85 ACS: Titrate up/down by 5 mcg/min q3-5 min until 20 mcg/min then up/down by 10 mcg/min q3-5 min for CP. Hold if SBP <90 HTN: Titrate up/down by 10 mcg/min q5-10 min to maintain SBP (90-140)/MAP(60-90) | Max rate: 400 mcg/min. Contact MD if rate over 300 mcg/min |
| Nitroprusside | 0.3 mcg/kg/min | Titrate up/down by 0.5 mcg/kg/min q5 min to maintain HR (50-120) and SBP (90-140) | for HTN emergency. Contact MD if rate over 10 mcg/kg/min |
| Chronotropics | |||
| Diltiazem | 5 mg/hr | Titrate up/down by 5 mg/hr q2h to maintain HR (50-120) and SBP (90-140) | for AF/A-Flutter/SVT. Max rate 15 mg/hr |
| Inotropics | |||
| Dobutamine | 2.5 mcg/kg/min | Titrate up/down by 1 mcg/kg/min q5-10 min to maintain SBP (85-120)/MAP (60-90) | for Cardiac decompensation. Contact MD if rate over 20 mcg/kg/min |
| Milrinone | 0.125 mcg/kg/min | Maximum dose 0.75 mcg/kg/min. Do not titrate | for ionotropic support for patients w/heart failure |