01 Critical Care IV Drug Infusions - Adult.ppt
Transcript of 01 Critical Care IV Drug Infusions - Adult.ppt
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ADULT CRITICAL CARE IV DRUG INFUSIONS
Angelo P. Ampong, M.D., R.M.T.
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Microdrip:
60 microdrops = 1 mL
Macrodrip:
15 drops = 1 mL
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Computation of IV infusion
Step1: Compute for the Concentration
of the Drug
Step2: Compute for the rate of
infusion
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CONCENTRATION OF DRUG
mL
(Volume of Drug)x(Preparation) mg
mL
1,000 mcg
1 mgx
(Total volume: vol of drug + diluent) mL
= Concentration mcg
mL
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RATE
kg
(Weight)x (Dose) mcg
kg/min
60 min
1 hrx
= rate
mL/hr
Concentration mcgmL
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60 kg, 4 amps + 500 mL D5W
20 mL x40mg
mL
1,000 mcg
1 mg
x
520 mL
1,538.5 mcg
mL
Dopamine 200mg / 5mL ampule
Preparation: 40mg/mL
Dose: 5ug/kg/min
Dilution: 20mL Dopa+ 500mL D5W
Total Volume : 520 mL
60 kg x5 mcg
kg/minx
60 min
1 hrx
__1mL___1538.5 mcg
= 11.7mL
hr
= 11-12mL
hr
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DROP FACTOR METHOD
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Computation of IV infusion
Step1: Compute for the Drop Factor
Step2: Compute for the rate ofinfusion
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DROP FACTOR
mg
(Amount of Drug)
1,000 mcg
1 mgx
Volumeof diluent mL
= mcg
mL min/hr
60 min1 hr
x
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RATE
kg
(Weight)x
(Dose) mcg
kg/min
= rate
mL/hr
(Drop factor) mcgmLmin/hr
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DOPAMINE
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Dose Effects
1-2 mcg/kg/min dilates renal and mesenteric blood vessels
(no effect on heart rate or blood pressure).
2-10 mcg/kg/min beta effects on heart usually increase cardiac
output without increasing heart rate.
10-20 mcg/kg/min alpha peripheral effects cause peripheral
vasoconstriction and increased blood
pressure
20-40 mcg/kg/min alpha effects reverse dilatation of renal and
mesenteric vessels with resultant decreased
flow
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60 kg, 4 amps + 500mL D5W
20 mL x40mg
mL
1,000 mcg
1 mg
x
500 mL
26.66 mcg
mLmin/hr
Dopamine 200mg / 5mL ampule
Preparation: 40mg/mL
Dose: 5ug/kg/min
Dilution: 20mL Dopa+ 500mL D5W
Amount of Dopamine : 800 mg
60 kg x5 mcg
kg/min
60 min
1 hr
x
1mL min
hr___
26.66 mcg
= 11.25mL
hr
= 11-12mL
hr
x
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60 kg, 2 amps + 250mL D5W
10 mL x40mg
mL
1,000 mcg
1 mg
x
250 mL
26.66 mcg
mLmin/hr
Dopamine 200mg / 5mL ampule
Preparation: 40mg/mL
Dose: 5ug/kg/min
Dilution: 10mL Dopa+ 250mL D5W
Amount of Dopamine : 400 mg
60 kg x5 mcg
kg/min
60 min
1 hr
x
1mL min
hr___
26.66 mcg
= 11.25mL
hr
= 11-12mL
hr
x
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60 kg, 2 amps + 500mL D5W
10 mL x40mg
mL
1,000 mcg
1 mg
x
500 mL
13.33 mcg
mLmin/hr
Dopamine 200mg / 5mL ampule
Preparation: 40mg/mL
Dose: 5ug/kg/min
Dilution: 10mL Dopa+ 250mL D5W
Amount of Dopamine : 400 mg
60 kg x5 mcg
kg/min
60 min
1 hr
x
1mL min
hr___
13.33 mcg
x
= 22.51mL
hr
= 22-23mL
hr
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60 kg, 1 amp + 250mL D5W
5 mL x40mg
mL
1,000 mcg
1 mg
x
250 mL
13.33 mcg
mLmin/hr
Dopamine 200mg / 5mL ampule
Preparation: 40mg/mL
Dose: 5ug/kg/min
Dilution: 5mL Dopa+ 250mL D5W
Amount of Dopamine : 200 mg
60 kg x5 mcg
kg/min
60 min
1 hr
x
1mL min
hr___
13.33 mcg
= 22.51mL
hr
= 22-23mL
hr
x
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60 kg, 1 amp + 100mL D5W
5 mL x40mg
mL
1,000 mcg
1 mg
x
100 mL
33.33 mcg
mLmin/hr
Dopamine 200mg / 5mL ampule
Preparation: 40mg/mL
Dose: 5ug/kg/min
Dilution: 5mL Dopa+ 250mL D5W
Amount of Dopamine : 200 mg
60 kg x5 mcg
kg/min
60 min
1 hr
x
1mL min
hr___
33.33 mcg
= 9 mL
hr
x
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60 kg, 2 amps + 100mL D5W
10 mLx40mg
mL
1,000 mcg
1 mg
x
100 mL
66.67 mcg
mLmin/hr
Dopamine 200mg / 5mL ampule
Preparation: 40mg/mL
Dose: 5ug/kg/min
Dilution: 10mL Dopa+ 100mL D5W
Amount of Dopamine : 400 mg
60 kg x5 mcg
kg/min
60 min
1 hr
x
1mL min
hr___
66.67 mcg
= 4 -5 mL
hr
x
= 4.49 mLhr
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DOBUTAMINE
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Dobutamine
250mg / 5mL ampule
Preparation: 50mg/mL Dose: 2.5 20 mcg/kg/min
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60 kg, 1 amp + 250mL D5W
5 mL x50mg
mL
1,000 mcg
1 mg
x
250 mL
16.66 mcg
mLmin/hr
Dopamine 250mg / 5mL ampule
Preparation: 50mg/mL
Dose: 5ug/kg/min
Dilution: 5mL Dobu+ 250mL D5W
Amount of Dopamine : 250 mg
60 kg x5 mcg
kg/min
60 min
1 hr
x
1mL min
hr___
16.66 mcg
= 18 mL
hr
x
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60 kg, 2 amps + 250mL D5W
10 mLx50mg
mL
1,000 mcg
1 mg
x
250 mL
33.33 mcg
mLmin/hr
Dopamine 250mg / 5mL ampule
Preparation: 50mg/mL
Dose: 5ug/kg/min
Dilution: 10mL Dobu+ 250mL D5W
Amount of Dopamine : 500 mg
60 kg x5 mcg
kg/min
60 min
1 hr
x
1mL min
hr___
33.33 mcg
= 9 mL
hr
x
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RULE OF 6 METHOD
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Computation of IV infusion
Step1: Determine volume of
dopamine to be added to makesolution using 6 mg dopamine /kg ofpatients weight
Step2: Compute for the rate ofinfusion
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Dopamine Solution
6 mg Dopamine
kg
Patients weight kgx
=____ mL Dopamine + ____ mL D5W to make a
total infusion of 100 mL
200 mg5 mL
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RATE
kg
(Weight)x
(Dose) mcg
kg/min
60 min
1 hrx
= rate mL/hr
Amt of Dopa mgTotal volume mL
1,000 mcg1 mg
x
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RULE OF 6 METHODCASE 1: 5 KG, 5 mcg/kg/min
h k
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Step 1. Weight: 5 kg
6 mg
kg
5kg
x
= 0.75 mL Dopamine + 99.25 mL D5W
200 mg
5 mL
30 mg ( Amt of Dopamine)
=40 mg (Preparation of Dopa)
mL
h k k
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Step 2. Weight: 5 kg, 5mcg/kg/min
5 kgx
5mcg
kg/min
60 min
1 hrx
= 5 mL/hr
30 mg100mL
1,000 mcg1 mgx
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RULE OF 6 METHODCASE 1: 35 KG, 15 mcg/kg/min
S W i h k
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Step 1. Weight: 35 kg
6 mg
kg
35kg
x
= 5.25 mL Dopamine + 94.75 mL D5W
200 mg
5 mL
210 mg ( Amt of Dopamine)
=40 mg (Preparation of Dopa)
mL
k /k / i
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35 kg, 15mcg/kg/min
35kg
(Weight)x
15mcg
kg/min
60 min
1 hrx
= 15 mL/hr
210 mg100mL
1,000 mcg1 mgx