Formulas and Drips
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7/25/2019 Formulas and Drips
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FORMULAS
ABG
I (FiO2x 713) pCO20.8
II PaO2I
III Target FiO2 + pCO2II 0.8
713
x100
FiO2: RA = 0.21NP = Lpm x 4 + 20FM = Lpm x 10 10RB = Lpm x 10VR = 100%AB = 80CPAP = Lpm x 4 + 20
FM: 5-6 = 40%6-7 = 50%7-8 = 60%
TP: 6 = 40%7 = 70%
8 = 80%9 = 90%
10 = 100%
Target FiO2:< 60 = 80> 60 = 80 age above 60COPDier = 60
Expected PF = Age x 5
Delta H[H+] = 24 x pCO2
HCO3
H = [H+] 40pCO2- 40
0.7 Acute RF, INTUBATE
HCO3DEFICIT
[Wt (kg) x 0.4] x [Desired - Actual]
Desired HCO3:Normal = 20CRF = 15
Give only of the computed deficit
1 amp = 44 meqs NaHCO3
HYPONATREMIA
Na Deficit = 10/12 x TBW
TBW = wt (kg) x 0.6
Example: wt = 40 kgNa Deficit = (10) (40) (0.6)
= 240 meqsusing PNSS 1L, 240 meqs
154 meqs/L 1.6 L 1600 mL/24H = 67 cc/hr
HYPERNATREMIA
Water Deficit =[Actual Na-140] x TBW
140
TBW = wt (kg) x 0.6 (male)0.5 (female)
Half-correction: 1/3 D5W2/3 PNSS
CREATININE CLEARANCE
(140-Age) (wt in kg) X 0.85 (F)1 (M)
Crea (mg/dL) x 72
Normal 80-120Impairment 50-80CRI 20-50CRF 5-20ESRD < 5
Stage Description GFR
(mL/min/1.73m2)
1 Kidney Damage w/ Normal or inc GFR 902 Kidney Damage w/ mild dec GFR 60-903 Moderate dec GFR 30-594 Severe dec GFR 15-295 Kidney Failure < 15 or dialysis
BUN:CREABUN:Crea Ratio = BUN x 2.8
Crea88.4
Normal 247.26Pre-renal > 15Renal < 15Both 15-25
24H Creatinine Clearance (mL/min)
CrCl = Urine Cr (mg/dL) x Volume (mL)Plasma Cr (mg/dL) x Time (min)
Conversion Factors:BUN (mg/dL) x 0.357 = __ mmol/L Crea (mg/dL) x 88.4 = __ mmol/L
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Anion Gap
Na - (Cl + HCO3)
Normal = 12 4 meqs
Elevated AG:KetoacidosisLactic AcidosisRF (GFR < 20-30)Methanol & Ethylene
Intoxication
Corrected Ca (mg/dL)
(Calcium x 4) + 0.8 x (4-Albumin)4
Serum Osmolality (mOsm/L)
[2 (Corrected Na + K)] + RBS (mmol/L)
Corrected Na = Actual Na + 1.6 [RBS (mg/dL) 100]100
RBS (mmol/L) x 18 = ___ mg/dL
Normal 280-300 mOsm/LDKA 300-320HHS 330-380
Urine Osmolality
Specific Gravity 1 x 40,000
Mean Arterial Pressure (MAP; mmHg)
Systolic BP + 2Diastolic BP3
Body Mass Index (BMI)
weight (kg)height (m)2
Normal 30
Reticulocyte Index
Reticulocyte count x [Hgb x 15]2
orReticulocyte count x [Hct abn] x
[Hct N]
> 2.5 Hemolysis< 2.0 Hypoproliferative Anemia or Maturation Disorder
Diabetic DietIdeal Body Weight (IBW) x 35 cal/kg = Total cal/day
IBW = [height (in) x 2.54 150] 10% (if female)
Example:Total Cal Reqt. = 2000 kcal/day
60% CHO = 2000 x 0.60 = 1200/4 = 300 g20% CHON = 2000 x 0.20 = 400/4 = 100 g20% Fats = 2000 x 0.20 = 400/9 = 45 g
OTF FeedingWeight (kg) x 35 kcal = ___ kcal/day
x 60% CHO/4x 20% CHON/4
x20% Fats/9
kcal/scoopNutren = 35Isocal = 83Ensure = 42-43
Glucerna = 36-37
IV FluidsD5W D10W PNSS D5LR D5NM D5NMK D5IMB
Gluc 50g/L Gluc 100g/L Na154
Na130
Na40
Gluc50
Na-5
Cl154
Cl109
Cl40
Na40
Cl22
K4
K13
Cl40
K20
Ca3
K30
Mg3
HCO328
Acetate23
PO43
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DRIPS
CA Drip
Clonidine 2 amps (150 mg/amp) + Apresoline2 amps (20 mg/amp) in 500cc PNSS or D5W x
___ gtts/min
Titrate by increments of __ gtts to maintainBP ___ mm Hg (up to 60 gtts/min)
Apresoline Drip
Apresoline 2 amps (20 mg/amp) in PNSS250cc
Max: 400 mg/day
Clonidine Drip
Clonidine 2 amps in 500ccPNSS
Systolic BP Dose(gtts/min)
200 30
Aminophylline Drip
Aminophylline 4 amps in500cc D5W x ___ gtts/min
LD: 5-6 mg/kg BWMD: 0.2-0.5 mL/hr
Actrapid Drip20 uActrapid + 100cc PNSS
HGT Actrapid< 160 close
160-199 3 cc/hr200-249 8250-299 10300-349 15350-399 20400-499 25 500 30 & refer
< 200 close200-249 15250-299 20300-349 25350-399 30400-449 35450-499 40
> 500 45 & refer
Actrapid Drip for GDM10 u Actrapid + 100ccPNSS
HGT Actrapid
< 120 close121-140 6 cc/hr141-160 8161-180 10181-220 14221-240 16241-260 18261-280 20281-300 22> 300 refer
Actrapid Sliding Scale
CBG Coverage500 12 & refer
Burinex DripBurinex 3 amps in 54cc PNSSx 10 cc/hr
Calcium Gluconate Drip
Calcium Gluconate 4 amps (10mg/amp) in500cc D5W x 24hr
Bricanyl Drip
Bricanyl 5 amps in 500cc D5Wx 24H
Increase to 30-40 cc/hr
Bricanyl 2.5 mg/tab TID
Calcium-Glucose DripCa gluconate 4 amps in 500ccD5W x 24hr
see to it that the patient hasno beta-blocker
Cordarone Drip
Cordarone 4 amps + 500ccPNSS x 60 cc/hr x 1st 6hoursSubsequently 25 cc/hr
Cordarone 150 mg IV nowCordarone 4 amps + 500ccD5W x 24HCordarone 4 amps + 500ccD5W x 25 gtts/min x 6H,then 12 cc/hr
Diazepam Drip
Diazepam 10 mg/100cc D5WDiazepam 20 mg/100cc D5W
Initial: 50-100 mg IVMax: 60 mg/day
Diazepam 50 mg in 100cc PNSS x 6 cc/hr to titrate to control seizure, hold forBP < 90/60 mm Hg
Dormicum Drip
Dormicum 3 amps (1.5 mg/amp) + 500cc PNSS x 2 mg/hr
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Epinephrine Drip
Epinephrine 5 amps (5 mg) + 500cc D5W to run for 6 cc/hr
Dobutamine DripDobutamine 250 mg/amp + D5W 250cc x ___gtts/min
(max rate: 60 gtts/min)
Rate drip:Drip mcg x kg BW
16.6
For patients w/ CHF:Dobutamine 2 amps (500 mg) +D5W 250 cc(max rate: 30 gtts/min)
Dopamine DripDopamine 2 amps (400 mg)+ 250cc D5W
(max: 10-20 mg/kg/min)
Renal Vasocons:0-5mg/kg/minInotropic:5-10 mg/kg/minVasoconstriction:> 10
mg/kg/min
Rate (gtts/min):mg/kg/min x BW
13.3 or 26.6
Fraxiparine Drip
Fraxiparine 2 amps in 1 L D5W or D5NSS
88 U/kg BW or 0.1 cc/kg x 24H
Fraxiparine85 cc/kg or 0.1 cc/10 kg
Furosemide Drip
Furosemide 3 amps + 54ccPNSS in a soluset x 10 cc/hr
Furosemide 80 mg in 80ccPNSS via soluset x 10 cc/hr
Furosemide Drip
(Dr. Caro)
In a soluset: Furosemide 3 amps + 54cc PNSSx 10cc/hr
OrD5W 250cc + Furosemide 250mg/amp x 5-30gtts/minConc: 1 mg/mL
OrPLR 500cc + 18 amps Furosemide x 18-20gtts/min
Furosemide-Albumin Drip
25% Albumin 50cc +Furosemide 20mg to run for4hrs
Albumin 50cc + PNSS 950cc+ Furosemide 100mg x 24hrs
Albumin 100cc + Furosemide40mg to run for 4-6hrs
Dr. Caro:Furosemide 60mg + PNSS54cc x 10cc/hrSD: Plasbumin 25% 100cc torun for
6 hrs
Glucose-Insulin-HCO3 Dr ip
D5W 150cc + D50W 1 vial + NaHCO3 1 amp +Actrapid 8 units to run for 6 or 8 or 12 hrs
Repeat K post-drip
Glucose
HGT < 60 D50W 1 ampHGT < 40 D50W 2 amps
Target FBS 60-90, RBS 80-120
Glucose-Insulin Drip
(Hyperkalemia 6)
In a soluset, 50cc D50W +Actrapid 8-10 units x 1hr x 3cycles
CBG monitoring qHourly whileon drip
Repeat K 1 hr after the lastcycle
Heparin DripD5W 250cc + Heparin 10,000 units x 10-20gtts/min via infusion pump
Conc.: 50 U/mLDrip of 500-1000 U ~ 10-20 gtts/min
ORIn a soluset, Heparin 4cc in 36cc D5W(Heparin 1000 IU/cc)
ORHeparin 5000 U IV initially, then 4000 U in36cc PNSS via soluset x 1000 U/hr
LD: 3000-5000 U slow IV
LD = 80 U/kgMD = 18 U/kg
APTT detn q6hAPTT 1.5-2x the baseline
Heparin for Flushing> 500 U Heparin in 100 mLPNSS
Hepamerz Drip
< 4 amps in 500cc D5W x12hrs BID
IVIG
LD: 2 g/kg given in 5-6hrs in3-5 daysMD: 400 mg/kg or0.4g/kg
Insulin Drip
PNSS 250cc + Humulin R 50u
Conc.: 0.2 U/mL
Drip of 5-50 gtts/min ~ 1-10 u Humulin
Isoket Drip
Isoket 10mg/amp (1amp) + PNSS 90cc x 10gtts/min (1 mg/hr)
Miacalcic DripMiacalcic 2 amps (200 IU) + D5W 250 cc x15H
NaHCO3 Drip
NaHCO3 2 amps (50cc/amp)in D5W x 24H
orNaHCO3 3 amps in 100cc
D5W x 24H
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Nicardipine Drip
- 5mg/10ml
- Nicardipine 10mg in 90cc PNSS or D5W in a soluset to run for 10cc/hr, titrateby increments of 5 gtts/min to maintain BP at ____ mmHg
- Max of 150 cc/hr at 15mg/hr (0.5 mk/BW), give initial bolus of 2mg IVTT,titrate to BP ___
Lidocaine Drip-give 50 as blous, then start drip as follows:1 g in 250cc D5W at 15cc/hr (1mg/h)
increase by increments of 15
LD: 1mg/HConc: 4mg/ccDrip: 1-4mg/min
Mannitol(prep 20%)
Dose: Amt given (cc)x0.2/kBWLD: 1-2 g/kgMD: 0.5-1 g/kg
Action: 30minsPeak: 2hrs
Complications:- rebound increase in ICP- IV volume expansionpulmonary edemaCHF
- DHN- Hypernatremia
Mannitol-Furosemide Drip:
Mannitol 250cc + Furo 100mgx 10 gtts/min
ORMannitol 36cc + Furo 240mg(24mL) x 6H
MgSO4DripD5W 250cc + MgSO42g x20 cc/H
Conc: 250mg/mL x 10 amps(2.5 g/amp)
Morphine DripMoSO410 mg/amp (1 amp) + PNSS 60cc in a soluset x 10 gtts/min
MoSO4 1 amp (16mg/amp) + PNSS 50cc x 6 gtts/min (2mg/H)
PRN: 1-3mg MoSO4 SQ
Nimotop DripNimotop vial + D5W 500cc x 24H
Nootropil DripNootropil 12g in 60cc x 24H
Noradrenaline (Levophed) Drip
- 2mg Noradrenaline/2ml amp- D5W 250cc + Levophed 1amp x 15-60 gtts/min- conc: 8mcg Noradrenaline/ml- drip of 2-8 mcg Noradrenaline ~ 15-60 gtts/min
Levophed 2 amps (2 mg/mL/amp) in D5W 250cc x 10 gtts/min
Levophed 4 amps in D5W 500cc x ___ gtts/min
Pantoloc Drip
- maintain GI acidity to stabilize clot- Pantoloc 80mg IV bolus then 5 amps in PNSS 1L x 24H for 3 days
Octreotide (Sandostatin) Drip- prep: 0.5 mg/mL- 0.2 mg/mL IV bolus, give for 1 min, then start drip as ff: 4 amps +remaining 0.03 mg in 500cc PNSS x 24H
Sandostatin Drip- sandostatin 0.5mg/amp 0.2mL now then drip as ff: 0.8mL in D5W 500cc x8H- ff by 2 amps sandostatin 0.5mg/amp + D5W or D5NSS 1L x 24H
Solumedrol DripSolumedrol 2g + D5W 500cc x 20 gtts/min
Somatostatin DripSomatostatin 250mcg IV bolus then 2amps (3mg/amp) + PNSS 1L x 24H for 5days w/o interruption
Streptokinase Drip
Streptokinase 1.5M units + D5W 90cc x100cc/H (1H running rate) via soluset
Give prior: Benadryl 50mg ivttSolucortef 250mg ivtt
APTT monitoring q6H
Terbutaline (Bicanyl) Drip
D5W 250cc + Bricanyl 5ampsx 10-30 gtts/min
Thiamine Drip:
50-100mg IV (for 40-50 y.o.)
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Toradol Drip
Toradol 30mg + PNSS 80cc via soluset x 8HToradol 100mg + PNSS 80cc x 10cc/H
Tramadol DripTramadol 100mg + PNSS 80cc x 10 gtts/min
Trental Drip
Trental 4amps in PNSS 500cc x 24H
Zantac DripZantac 5amps in D5W 500cc x 16H
Zithromax Drip
Zithromax 500mg in 90cc IVF via soluset to run for 5H