Precautions
What is Cardene I.V. used for?
Cardene I.V. is intended for intravenous use. Titrate dose to achieve the desired blood pressure reduction. Individualize dosage depending on the blood pressure to be obtained and the response of the patient.
How much cardene should I take for tachycardia?
Then, when blood pressure has stabilized, infusion of Cardene I.V. Premixed Injection may be restarted at low doses such as 30-50 mL/hr (3 - 5 mg/hr) for 20 mg in 200 mL or 15-25 mL/hr (3 - 5 mg/hr) for 40 mg in 200 mL and adjusted to maintain desired blood pressure.
How long does it take for blood pressure to decrease?
With constant infusion, blood pressure begins to fall within minutes. It reaches about 50% of its ultimate decrease in about 45 minutes.
Can you mix Cardene I.V. with other medications?
Do not combine Cardene I.V. Premixed Injection with any product in the same intravenous line or premixed container. Do not add supplementary medication to the bag. Protect from light until ready to use.
Is Cardene I.V. premixed?
Cardene I.V. Premixed Injection is available as a single-use , ready-to-use , iso-osmotic solution for intravenous administration. No further dilution is required.
How much Cardene I.V. should be diluted?
Dilution: Cardene I.V. is administered by slow continuous infusion at a CONCENTRATION OF 0.1 MG/ML. Each ampul (25 mg) should be diluted with 240 mL of compatible intravenous fluid (see below), resulting in 250 mL of solution at a concentration of 0.1 mg/mL.
What color is Cardene I.V?
Cardene I.V. is normally light yellow in color.
How to store ampuls?
Protect from light. Store ampuls in carton until used.
Is Cardene I.V. compatible with Sodium Bicarbonate?
is NOT compatible with Sodium Bicarbonate (5%) Injection, USP or Lactated Ringer’s Injection, USP.
Is nicardipine a substitute for clinical judgment?
Nicardipine (Cardene ®) The authors make no claims of the accuracy of the information contained herein; and these suggested doses and/or guidelines are not a substitute for clinical judgment. Neither GlobalRPh Inc. nor any other party involved in the preparation of this document shall be liable for any special, consequential, ...
How long does a 300mg bolus last?
The total time is 24 hours.
How long does it take to take D5W?
The dosing is standard for all patients with a bolus of 150 mg/100 mL D5W (1.5mg/ml) over 10 minutes. The bolus may be repeated if needed. A 300 mg bolus, diluted in 100ml D5W over 10 minutes, may also be used for VF, VT, and cardiac arrest unresponsive to CPR.
What is the drug used for severe hypotension?
Levophed (norepinephrine) is an alpha/beta-agonist, causing vasoconstriction and an increase in blood pressure. It is used for severe hypotension, shock, or bradycardia. Dopamine and Dobutamine are contraindicated with a Sulfite allergy.
What is cardiac output?
The cardiac output is a vital part of oxygen delivery, blood pressure, urine output, and perfusion. There are many drugs used for hemodynamic instability, cardiogenic shock, and neurogenic shock. Norepinephrine, epinephrine, phenylephrine, vasopressin, dopamine, and dobutamine are a few of the medications used.
What is levophed used for?
It is used for severe hypotension, shock, or bradycardia. Mix 4mg levophed in 250ml of D5W, making the drip 16mcg/ml. The standard effective dose is 2-12 micrograms/min. This drug has a rapid onset and short half-life. The drip is usually started at 2 mcg/min or 7.5 ml/hr and titrated up for effect or until blood pressure becomes normotensive with a MAP 60-65mmHg and/or SBP >90. Vital signs are monitored continuously and documented every 5 minutes during titration.
When to use vasoactive medication?
Vasoactive medications are indicated when the Systolic Blood Pressure (SBP) has a decrease of > 30mmHg from the baseline or a Mean Arteriole Pressure (MAP) less than 60-65mmHg and when either condition results in end-organ dysfunction due to hypoperfusion. Additionally, vasoactive medications are used for the management of a hypertensive crisis, flash pulmonary edema, sepsis, shock states, atrial fibrillation with rapid ventricular response, supraventricular tachycardia, heart failure, and hemodynamically unstable patients.
How does adenosine work?
It is an anti-arrhythmic. Initially, an adenosine 6 mg rapid bolus (over 1-2 seconds) with a 10ml normal saline flush immediately after the intravenous push is administered for PSVT. If not effective within 1-2 minutes, 12 mg may be given again; a third 12 mg bolus if needed for persistent SVT; maximum single dose: 12 mg. Adenosine is an extremely strong vasodilator in most vascular beds. Adenosine is thought to work through the activation of purine receptors. There is evidence to support both inhibition of the slow inward calcium current reducing calcium uptake, and activation of adenylate cyclase. Adenosine modulates sympathetic neurotransmission lessening vascular tone — adenosine blocks faulty circuitry in the heart, which causes irregular heart rhythm. Adenosine slows conduction time through the A-V node and interrupts the reentry pathways through the A-V node. A transient episode of asystole will occur after the administration of adenosine. This is usually self-limited, secondary to the extremely short half-life of adenosine. The patient usually returns to their normal underlying rhythm after the administration of adenosine. Patients frequently complain of chest pain and shortness of breath after the administration of adenosine. This medication is never given as a continuous infusion.
How much HTN is needed for emergency?
for HTN emergency/urgency. Max cumulative dose: 300 mg/day
What is the maximum mcg/kg/min for HTN?
for HTN emergency. Contact MD if rate over 10 mcg/kg/min
How much mcg/min for cardiac shock?
for hemodynamic support/cardiogenic shock. Contact MD if over 20 mcg/min
What is the maximum cardiac decompensation rate?
for Cardiac decompensation. Contact MD if rate over 20 mcg/kg/min
How long to wait to administer nicardipine after IV?
Transition from IV Nicardipine to an Oral Antihypertensive Agent: If oral nicardipine is to be used after IV nicardipine, administer the first dose 1 hour prior to discontinuation of the IV infusion.
What should be consulted in reconstitution?
Reconstitution/preparation techniques: The manufacturer product information should be consulted.
Can you use nicardipine after IV?
If an oral antihypertensive agent other than nicardipine is to be used after IV nicardipine, initiate therapy upon discontinuation of IV nicardipine. Use: Short-term treatment of hypertension when oral therapy is not feasible or not desirable.
When should IV infusions be discontinued?
The IV infusion should be discontinued if there is concern of impending hypotension or tachycardia. Following stabilization of blood pressure, the infusion may be restarted at low doses (such as 3 to 5 mg/hour) and adjusted to maintain desired response.