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レジデントノート

米国にて内科修行中。何ができるか模索している過程を記録していく

ICU持続静脈注射薬

Amiodarone

[bolus]

amiodarone 150mg in 100ml D5W at 618ml/hr iv x 1

[continuous]

amiodarone/D5W 750mg/500ml

Start at 1 mg/min x 6 hours, then 0.5 mg/min

Maximum rate 1.5 mg/min

 

Diltiazem

diltiazem/NS 100mg/100ml

Loading dose 0.25mg/kg over 2 min

Start at 5 mg/hr

titrate by 5 mg/hr q10 min

Titrate to Goal Ventricular Rate <100

Hold for HR<50 or SBP <90

to a maximum of 15 mg/hr

(Usual range 5 mg/hr to 15 mg/hr)

 

Dobutamine

dobutamine/D5W 250mg/250ml

Start at 2 mcg/kg/min

titrate by 2 mcg/kg/min every 5 min

Titrate to Goal parameter:

to a maximum of 20 mcg/kg/min

(Usual range 1 mcg/kg/min to 20 mcg/kg/min)

 

Dopamine

dopamine/D5W 400mg/250ml

Start at 2 mcg/kg/min

Titrate by 1 mcg/kg/min every 5 min

To a Goal MAP > or = 65 mmHg to a maximum of 25 mcg/kg/min

(Usual range 1 mcg/kg/min to 25 mcg/kg/min)

 

Epinephrine

epinephrine 1mg/NS250ml

Start at 0.01 mcg/kg/min

Titrate by 0.01 mcg/kg/min every 5 min

To a maximum of 1 mcg/kg/min or MAP > 65 mmHg

(Usual range 0.01 mcg/kg/min to 1 mcg/kg/min)

 

Esmolol

esmolol/NS 2500mg/250ml

Start at 50 mcg/kg/min

titrate by 50 mcg/kg/min q5 min

Titrate to Goal to keep HR <100

Hold for HR <50 or SBP <90

to a maximum of 300 mcg/kg/min

(Usual range 50 mcg/kg/min to 300 mcg/kg/min) 

 

Furosemide

furosemide 1000mg/100ml

Start at 5 mg/hr

titrate by 5 mg/hr q60 min

Titrate to Goal Urine Output 0.5 ml/kg/hr

to a maximum of 40 mg/hr

(Usual range 5 mg/hr to 40 mg/hr)

 

Isoproterenol

isoproterenol/D5W 1mg/250ml

Start at 0.01 mcg/kg/min

titrate by 0.01 mcg/kg/min every 5 min

Titrate to Goal parameters:

to a maximum of 0.4 mcg/kg/min

(Usual range 0.01mcg/kg/min to 0.4 mcg/kg/min)

 

Labetalol

labetalol/NS 200mg/200ml

Loading dose 10 mg IV

Start at 2 mg/min

titrate by 1 mg/min every 5 min

Titrate to Goal SBP [      ] mmHg

Hold for HR <50

to a maximum of 8 mg/min

(Usual range 2 mg/min to 8 mg/min)

 

Lidocaine

lidocaine/D5W 2000mg/250ml

Start at 14 mcg/kg/min

titrate by 7 mcg/kg/min

Titrate to eliminate Ventricular Tachycardia

to a maximum of 57 mcg/kg/min

(Usual range 14 mcg/kg/min to 57 mcg/kg/min)

 

Milrinone

milrinone/D5W 20mg/100ml

Loading dose 50 mcg/kg over 10 min

Start at 0.375 mcg/kg/min

titrate by 0.05 mcg/kg/min q30 min

Titrate to Goal parameter:

to a maximum of 0.75 mcg/kg/min

(Usual range 0.375 mcg/kg/min to 0.75 mcg/kg/min)

 

Nicardipine

nicardipine/NS 20mg/200ml

Start at 5 mg/hr

titrate by 2.5 mg/hr every 5 min

Titrate to Goal SBP [      ] mmHg

Hold for HR <50

to a maximum of 15 mg/hr

(Usual range 5 mg/hr to 15 mg/hr)

 

Nitroglycerin

nitroglycerin/D5W 100mg/250ml

Start at 0.1 mcg/kg/min

titrate by 0.2 mcg/kg/min q3 min

Titrate to eliminate chest pain

Maintain SBP > 100 mmHg

to a maximum of 5 mcg/kg/min

(Usual range 0.1 mcg/kg/min to 5 mcg/kg/min)

 

Nitroprusside

nitroprusside/NS 100mg/250ml

Start at 0.5 mcg/kg/min

titrate by 0.5 mcg/kg/min every 2 min

Titrate to Goal SBP [      ] mmHg

to a maximum of 10 mcg/kg/min

(Usual range 0.5mcg/kg/min to 10mcg/kg/min)

 

Norepinephrine

norepinephrine/NS 8mg/250ml

Start at 0.01 mcg/kg/min

Titrate by 0.02 mcg/kg/min every 5 min

To a Goal MAP > or = 65 mmHg to a maximum of 3 mcg/kg/min

(Usual range 0.01 mcg/kg/min to 3 mcg/kg/min)

 

Phenylephrine

phenylephrine/NS 50mg/250ml

Start at 0.3 mcg/kg/min

Titrate by 0.1 mcg/kg/min every 5 min

To a Goal MAP > or = 65 mmHg to a maximum of 10 mcg/kg/min

(Usual range 0.3 mcg/kg/min to 10 mcg/kg/min)

 

Procainamide

procaineamide/NS 1000mg/250ml

Start at 1 mg/min;

titrate by 1mg/min q 20 min

Titrate to Goal parameter:

to a maximum of 6mg/min up to 24 hr

(Usual range 1 mg/min to 6 mg/min)

 

Vasopressin

vasopressin/NS 50units/250ml

Start at 0.01 units/min

Goal MAP > or = 65 mmHg

(Usual range 0.01 units/min to 0.04 units/min)

 

(米国一施設基準)