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    CBG Coverage CBG Coverage: Actrapid Sliding Scale

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    Serious Leo
    This document contains instructions for various intravenous medication drips and infusions, including: 1. Actrapid sliding scale for coverage of insulin based on blood glucose levels. 2. Instructions for several medication drips including Burinex, Calcium Gluconate, Cordarone, Bricanyl, Diazepam, Dormicum, Epinephrine, and others. 3. Concentrations, infusion rates, and maximum rates are provided for drips like Dobutamine, Dopamine, Fraxiparine, Furosemide, Glucose-Insulin-HCO3. 4. Bolus and maintenance dosing regimens are listed for

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    CBG Coverage CBG Coverage: Actrapid Sliding Scale

    Uploaded by

    Serious Leo
    195 views10 pages
    This document contains instructions for various intravenous medication drips and infusions, including: 1. Actrapid sliding scale for coverage of insulin based on blood glucose levels. 2. Instructions for several medication drips including Burinex, Calcium Gluconate, Cordarone, Bricanyl, Diazepam, Dormicum, Epinephrine, and others. 3. Concentrations, infusion rates, and maximum rates are provided for drips like Dobutamine, Dopamine, Fraxiparine, Furosemide, Glucose-Insulin-HCO3. 4. Bolus and maintenance dosing regimens are listed for

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    This document contains instructions for various intravenous medication drips and infusions, including: 1. Actrapid sliding scale for coverage of insulin based on blood glucose levels. 2. Instructions for several medication drips including Burinex, Calcium Gluconate, Cordarone, Bricanyl, Diazepam, Dormicum, Epinephrine, and others. 3. Concentrations, infusion rates, and maximum rates are provided for drips like Dobutamine, Dopamine, Fraxiparine, Furosemide, Glucose-Insulin-HCO3. 4. Bolus and maintenance dosing regimens are listed for

    Copyright:

    © All Rights Reserved
    Download as DOC, PDF, TXT or read online from Scribd
    Download as doc, pdf, or txt
    195 views10 pages

    CBG Coverage CBG Coverage: Actrapid Sliding Scale

    Uploaded by

    Serious Leo
    This document contains instructions for various intravenous medication drips and infusions, including: 1. Actrapid sliding scale for coverage of insulin based on blood glucose levels. 2. Instructions for several medication drips including Burinex, Calcium Gluconate, Cordarone, Bricanyl, Diazepam, Dormicum, Epinephrine, and others. 3. Concentrations, infusion rates, and maximum rates are provided for drips like Dobutamine, Dopamine, Fraxiparine, Furosemide, Glucose-Insulin-HCO3. 4. Bolus and maintenance dosing regimens are listed for

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    Actrapid Sliding Scale

    CBG Coverage
    CBG ≤200 no coverage
    Coverage 201-250 3 units
    <160 no coverage 251-300 5
    161-200 3 301-350 7
    201-249 5 351-400 8
    250-299 7 401-450 9
    300-349 9 451-500 11
    350-399 11 >500 12 & refer
    400-449 13
    450-499 14
    ≥500 15 &
    refer

    Burinex Drip Calcium-Glucose Drip


    Burinex 3 amps in 54cc Ca gluconate 4 amps in 500cc
    PNSS D5W x 24hr
    x 10 cc/hr see to it that the patient has no
    beta-blocker

    Calcium Gluconate Drip Cordarone Drip


    Calcium Gluconate 4 amps Cordarone 4 amps + 500cc PNSS
    (10mg/amp) in 500cc D5W x 60 cc/hr x 1st 6 hours
    x 24hr Subsequently 25 cc/hr

    Cordarone 150 mg IV now


    Cordarone 4 amps + 500cc D5W x
    Bricanyl Drip 24H
    Bricanyl 5 amps in 500cc Cordarone 4 amps + 500cc D5W x
    D5W 25 μgtts/min x 6H, then 12 cc/hr
    x 24H

    Increase to 30-40 cc/hr

    Bricanyl 2.5 mg/tab TID


    Diazepam Drip
    Diazepam 10 mg/100cc D5W
    Diazepam 20 mg/100cc D5W

    Initial: 50-100 mg IV
    Max: 60 mg/day

    Diazepam 50 mg in 100cc PNSS x 6 cc/hr to titrate to control


    seizure, hold for BP < 90/60 mm Hg

    Dormicum Drip
    Dormicum 3 amps (1.5 mg/amp) + 500cc PNSS x 2 mg/hr

    Epinephrine Drip
    Epinephrine 5 amps (5 mg) + 500cc D5W to run for 6 cc/hr

    Dobutamine Drip Dopamine Drip


    Dobutamine 250 Dopamine 2 amps (400 mg) +
    mg/amp + D5W 250cc x 250cc D5W
    ___ μgtts/min (max: 10-20 mg/kg/min)
    (max rate: 60
    μgtts/min) Renal Vasocons: 0-5
    mg/kg/min
    Rate drip: Inotropic: 5-10 mg/kg/min
    Drip mcg x kg BW Vasoconstriction: > 10
    16.6 mg/kg/min

    For patients w/ CHF: Rate (μgtts/min):


    Dobutamine 2 amps mg/kg/min x BW
    (500 mg) + 13.3 or 26.6
    D5W 250 cc
    (max rate: 30
    μgtts/min)
    Fraxiparine Drip Furosemide Drip
    Fraxiparine 2 amps in 1 L D5W or Furosemide 3 amps +
    D5NSS 54cc PNSS in a soluset x
    10 cc/hr
    88 “U”/kg BW or 0.1 cc/kg x 24H
    Furosemide 80 mg in
    Fraxiparine 80cc PNSS via soluset x
    85 cc/kg or 0.1 cc/10 kg 10 cc/hr

    Furosemide Drip Furosemide-Albumin


    (Dr. Caro) Drip
    25% Albumin 50cc +
    In a soluset: Furosemide 3 amps + Furosemide 20mg to run
    54cc PNSS x 10cc/hr for 4hrs
    Or
    D5W 250cc + Furosemide Albumin 50cc + PNSS
    250mg/amp x 5-30 μgtts/min 950cc + Furosemide
    Conc: 1 mg/mL 100mg x 24hrs
    Or
    PLR 500cc + 18 amps Furosemide x Albumin 100cc +
    18-20 μgtts/min Furosemide 40mg to run
    for 4-6hrs

    Dr. Caro:
    Furosemide 60mg +
    PNSS 54cc x 10cc/hr
    SD: Plasbumin 25%
    100cc to run for
    6 hrs
    Glucose-Insulin-HCO3 Drip Glucose-Insulin Drip
    D5W 150cc + D50W 1 vial + (Hyperkalemia ≥ 6)
    NaHCO3 1 amp + Actrapid 8
    units to run for 6 or 8 or 12 In a soluset, 50cc D50W + Actrapid
    hrs 8-10 units x 1hr x 3 cycles

    Repeat K post-drip CBG monitoring qHourly while on


    drip
    Glucose
    HGT < 60 – D50W 1 amp Repeat K 1 hr after the last cycle
    HGT < 40 – D50W 2 amps
    Target FBS 60-90, RBS 80-
    120

    Heparin Drip Heparin for Flushing


    D5W 250cc + Heparin 10,000 > 500 ‘U’ Heparin in 100 mL PNSS
    units x 10-20 μgtts/min via
    infusion pump
    Hepamerz Drip
    Conc.: 50 U/mL < 4 amps in 500cc D5W x 12hrs BID
    Drip of 500-1000 ‘U’ ~ 10-20
    μgtts/min
    OR IVIG
    In a soluset, Heparin 4cc in LD: 2 g/kg given in 5-6hrs in 3-5
    36cc D5W (Heparin 1000 days
    IU/cc) MD: 400 mg/kg or 0.4g/kg
    OR
    Heparin 5000 ‘U’ IV initially,
    then 4000 ‘U’ in 36cc PNSS via Insulin Drip
    soluset x 1000 ‘U’/hr PNSS 250cc + Humulin R 50 ‘u’

    LD: 3000-5000 ‘U’ slow IV Conc.: 0.2 ‘U’/mL

    LD = 80 U/kg Drip of 5-50 μgtts/min ~ 1-10 ‘u’


    MD = 18 U/kg Humulin

    APTT det’n q6h


    APTT 1.5-2x the baseline
    Isoket Drip
    Isoket 10mg/amp (1amp) + Toradol Drip
    PNSS 90cc x 10 μgtts/min (1 Toradol 30mg + PNSS 80cc via
    mg/hr) soluset x 8H
    Toradol 100mg + PNSS 80cc x
    10cc/H
    Miacalcic Drip
    Miacalcic 2 amps (200 IU) + Tramadol Drip
    D5W 250 cc x 15H Tramadol 100mg + PNSS 80cc x 10
    μgtts/min

    NaHCO3 Drip Trental Drip


    NaHCO3 2 amps (50cc/amp) in Trental 4amps in PNSS 500cc x 24H
    D5W x 24H
    or Zantac Drip
    NaHCO3 3 amps in 100cc D5W Zantac 5amps in D5W 500cc x 16H
    x 24H
    Zithromax Drip
    Zithromax 500mg in 90cc IVF via
    soluset to run for 5H

    Nicardipine Drip
    - 5mg/10ml
    Mannitol (prep 20%) Mannitol-
    Dose: Amt given (cc)x0.2/kBW Furosemide Drip:
    - Nicardipine
    LD: 1-2 g/kg 10mg in 90cc PNSS Mannitol
    or D5W in250cc
    a soluset
    +
    to run
    MD: forg/kg
    0.5-1 10cc/hr, titrate by increments of 5 μgtts/min
    Furo 100mg x 10
    to maintain BP at ____ mmHg μgtts/min
    Action: 30mins OR
    - Max
    Peak: of 150 cc/hr at 15mg/hr (0.5
    2hrs mk/BW),
    Mannitol give
    36cc +
    initial bolus of 2mg IVTT, titrate to BP ___
    Furo 240mg (24mL)
    Complications: x 6H
    Lidocaine
    - rebound Drip in ICP
    increase
    -give
    - IV 50 asexpansion
    volume blous, then start drip as follows:
    1 g in 250cc
    pulmonary D5W at 15cc/hr (1mg/h)
    edema MgSO4 Drip
    increase by increments of 15
    CHF D5W 250cc +
    - DHN MgSO4 2g x
    LD: 1mg/H
    - Hypernatremia 20 cc/H
    Conc: 4mg/cc
    Drip: 1-4mg/min
    Conc: 250mg/mL x
    10 amps
    (2.5 g/amp)

    Morphine Drip
    MoSO4 10 mg/amp (1 amp) + PNSS 60cc in a soluset x
    10 μgtts/min

    MoSO4 1 amp (16mg/amp) + PNSS 50cc x 6 μgtts/min


    Midazolam Drip ( Dr. Beltran )
    (2mg/H)
    0.3mcg per kg per minute.
    30 mg
    PRN: midazolam
    1-3mg in 50 cc D5W to run at 3 ugtts per
    MoSO4 SQ
    min. Titrate by increments of 1 ugtts every 15 minutes
    as needed.
    Nimotop Drip
    Nimotop ½ vial + D5W 500cc x 24H
    Noradrenaline (Levophed) Drip
    - 2mg Noradrenaline/2ml amp
    - D5W 250cc
    Nootropil Drip+ Levophed 1amp x 15-60 μgtts/min
    - conc: 12g
    Nootropil 8mcginNoradrenaline/ml
    60cc x 24H
    - drip of 2-8 mcg Noradrenaline ~ 15-60 μgtts/min

    Levophed 2 amps (2 mg/mL/amp) in D5W 250cc x 10


    μgtts/min

    Levophed 4 amps in D5W 500cc x ___ μgtts/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 x 8H
    - ff by 2 amps sandostatin 0.5mg/amp + D5W or D5NSS 1L x
    24H

    Solumedrol Drip
    Solumedrol 2g + D5W 500cc x 20 μgtts/min

    Somatostatin Drip
    Somatostatin 250mcg IV bolus then 2amps (3mg/amp) + PNSS
    1L x 24H for 5 days w/o interruption

    Streptokinase Drip Terbutaline (Bicanyl)


    Streptokinase 1.5M units + D5W Drip
    90cc x 100cc/H (1H running rate) D5W 250cc + Bricanyl
    via soluset 5amps x 10-30
    μgtts/min
    Give prior: Benadryl 50mg ivtt
    Solucortef 250mg ivtt
    Thiamine Drip:
    APTT monitoring q6H 50-100mg IV (for 40-50
    y.o.)
    Burn Replacement:
    4 ml/kg in 1st 24H: ½ 1st 8 H
    ½ next 16 H
    Start initially w D5LR--- D5NSS
    Prednisone Tapering
    Prednisone 20 mg/tab 1 tab p BF
    1 tab p lunch x 3 days
    1 tab p BF, ½ tab p lunch x 3 days
    1 tab p BF x 3 days
    Then DC

    Dilantin Drip 500 mg IVTT as LD via slow IVTT c PNSS as


    mainline to be given at 110 mg/min then 300 mg IV Q6H

    RHD Prophylaxis Ampicillin 2 g + Gentamycin 2 mg/kg

    RITUXIMAB 90-120 meqs/kg


    1st infusion, 50 mg/hr—100mg/hr
    Max 400 mg/H
    SE: pulmonary events, rapid tumor lysis
    MOA: Binds to CD20 in pre B and mature B Lymp

    Myoclonic seizure
    Clonazepam – 0.02 mg/KBW

    Lumbar Puncture
    Send CSF for exam
    1 Sugar, protein
    2 centrifuge x 1 H at 1000 cpm
    Sediment AFB, india ink, GS, CS
    3 Cell Ct/Diff
    4 save specimen: centrifuge x 1 H at 1000 cpm then exam
    supernantant for CALAS

    Flat on bed x 6H
    NPO x 4H
    Monitor Vs Q4H

    Prepare materials
    Spinal needle gauge 23
    LP set
    Manometer
    Sterile test tube # 4
    OS
    Betadine
    Lidocaine 2 %
    Syringe 3 cc with guage 23 needle #2
    Plaster

    POST LP ORDERS (Dr Beltran)


    Flat on bed x 6H
    Monitor NVS Q30 mins x 4H until stable
    NPO x 4H
    For RBS
    Include Na, K, Ca

    Send CSF for analysis


    tt1 sugar protein
    tt2 centrifuge at 1000 cpm x 1 H
    a. Sediment- gs, cs, afb, india ink, sabouraud
    b. Supernatant- CALAS if avail
    tt3 cell ct, diff ct
    tt4 cell cytology

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