Adrenaline

Strength 1mg / 1ml

Compatibility NS, D5W.
Dilution 2 mg (2 amp) *50 ml
40 mcg/ ml
Concentration
Dose 0.04–1 mcg/kg/minute
 24 hr.
 Epinephrine is sensitive to light and air; protection from
Stability
light is recommended

30 40 50 60 70 80 90 100
Dose (mcg) WT(kg)
Infusion Rates ml/ hr
0.025 1.1 1.5 1.9 2.3 2.6 3.0 3.4 3.8

0.05 2.3 3.0 3.8 4.5 5.3 6.0 6.8 7.5

0.075 3.4 4.5 5.6 6.8 7.9 9.0 10.1 11.3

0.1 4.5 6.0 7.5 9.0 10.5 12.0 13.5 15.0

0.125 5.6 7.5 9.4 11.3 13.1 15.0 16.9 18.8

0.15 6.8 9.0 11.3 13.5 15.8 18.0 20.3 22.5

0.175 7.9 10.5 13.1 15.8 18.4 21.0 23.6 26.3

0.2 9.0 12.0 15.0 18.0 21.0 24.0 27.0 30.0

0.25 11.3 15.0 18.8 22.5 26.3 30.0 33.8 37.5

0.3 13.5 18.0 22.5 27.0 31.5 36.0 40.5 45.0

0.35 15.8 21.0 26.3 31.5 36.8 42.0 47.3 52.5

0.4 18.0 24.0 30.0 36.0 42.0 48.0 54.0 60.0

0.45 20.3 27.0 33.8 40.5 47.3 54.0 60.8 67.5

0.5 22.5 30.0 37.5 45.0 52.5 60.0 67.5 75.0

 Noradrenaline
Strength 4mg / 4ml
Compatibility D5W.
Dilution 4 mg (1 amp) * 50 ml
80 mcg/ ml
Concentration
Dose 0.01–3 mcg/kg/minute

 24 hr.
Stability  keep away from light ,don’t use if brown coloration
(oxidized),

30 40 50 60 70 80 90 100
Dose (mcg) WT(kg)
Infusion Rates ml/ hr
0.025 1.1 1.5 1.9 2.3 2.6 3.0 3.4 3.8

0.05 2.3 3.0 3.8 4.5 5.3 6.0 6.8 7.5

0.075 3.4 4.5 5.6 6.8 7.9 9.0 10.1 11.3

0.1 4.5 6.0 7.5 9.0 10.5 12.0 13.5 15.0

0.125 5.6 7.5 9.4 11.3 13.1 15.0 16.9 18.8

0.15 6.8 9.0 11.3 13.5 15.8 18.0 20.3 22.5

0.175 7.9 10.5 13.1 15.8 18.4 21.0 23.6 26.3

0.2 9.0 12.0 15.0 18.0 21.0 24.0 27.0 30.0

0.25 11.3 15.0 18.8 22.5 26.3 30.0 33.8 37.5

0.3 13.5 18.0 22.5 27.0 31.5 36.0 40.5 45.0

0.35 15.8 21.0 26.3 31.5 36.8 42.0 47.3 52.5

0.4 18.0 24.0 30.0 36.0 42.0 48.0 54.0 60.0

0.45 20.3 27.0 33.8 40.5 47.3 54.0 60.8 67.5

0.5 22.5 30.0 37.5 45.0 52.5 60.0 67.5 75.0

 Dobutamine
Strength 250 mg / 20 ml
Compatibility D5W, NS
Dilution 250 mg (1 amp) *50 ml
5000 mcg/ ml
Concentration
2–20 mcg/kg/minute
Dose  Some literature state that maximum dose is 40mcg/kg/min
 But ACC/AHA recommend maximum dose of 20mcg/kg/min

Stability  24 hr.

30 40 50 60 70 80 90 100
Dose (mcg) WT(kg)
Infusion Rates ml/ hr
5 1.8 2.4 3.0 3.6 4.2 4.8 5.4 6.0
6 2.2 2.9 3.6 4.3 5.0 5.8 6.5 7.2
7 2.5 3.4 4.2 5.0 5.9 6.7 7.6 8.4
8 2.9 3.8 4.8 5.8 6.7 7.7 8.6 9.6
9 3.2 4.3 5.4 6.5 7.6 8.6 9.7 10.8
10 3.6 4.8 6.0 7.2 8.4 9.6 10.8 12.0
11 4.0 5.3 6.6 7.9 9.2 10.6 11.9 13.2
12 4.3 5.8 7.2 8.6 10.1 11.5 13.0 14.4
13 4.7 6.2 7.8 9.4 10.9 12.5 14.0 15.6
14 5.0 6.7 8.4 10.1 11.8 13.4 15.1 16.8
15 5.4 7.2 9.0 10.8 12.6 14.4 16.2 18.0
16 5.8 7.7 9.6 11.5 13.4 15.4 17.3 19.2
17 6.1 8.2 10.2 12.2 14.3 16.3 18.4 20.4
18 6.5 8.6 10.8 13.0 15.1 17.3 19.4 21.6
19 6.8 9.1 11.4 13.7 16.0 18.2 20.5 22.8
20 7.2 9.6 12.0 14.4 16.8 19.2 21.6 24.0
 Dopamine
Strength 200 mg / 5 ml
Compatibility D5W, NS
Dilution 200 mg (1 amp) *50 ml
4000 mcg/ ml
Concentration
Dopa dose 1-3mcg/kg/min (evidence does not support this practice)
Dose Beta dose 4- 10mcg/kg/min
Alpha dose >10mcg/kg/min (above 20 mcg/kg/min not recommended)

Stability  24 hr.

30 40 50 60 70 80 90 100
Dose (mcg) WT(kg)
Infusion Rates ml/ hr
1 0.5 0.6 0.8 0.9 1.1 1.2 1.4 1.5

2 0.9 1.2 1.5 1.8 2.1 2.4 2.7 3.0

3 1.4 1.8 2.3 2.7 3.2 3.6 4.1 4.5

4 1.8 2.4 3.0 3.6 4.2 4.8 5.4 6.0

5 2.3 3.0 3.8 4.5 5.3 6.0 6.8 7.5

7.5 3.4 4.5 5.6 6.8 7.9 9.0 10.1 11.3

10 4.5 6.0 7.5 9.0 10.5 12.0 13.5 15.0

12.5 5.6 7.5 9.4 11.3 13.1 15.0 16.9 18.8

15 6.8 9.0 11.3 13.5 15.8 18.0 20.3 22.5

17.5 7.9 10.5 13.1 15.8 18.4 21.0 23.6 26.3

20 9.0 12.0 15.0 18.0 21.0 24.0 27.0 30.0

 Nitrogylcerine
Strength 50 mg / 10 ml
Compatibility D5W
Dilution 10 mg (2 ml) *50 ml
Concentration 200 mcg/ ml

5- 200 mcg/minute
Dose
(increase by 5 mcg/minute every 5 min)

Stability  24 hr.

Dose Infusion Rates Dose Infusion Rates

(mcg/min) (ml/ hr) (mcg/min) (ml/ hr)
5 1.5 100 30

10 3 110 33

15 4.5 120 36

20 6 130 39

30 9 140 42

40 12 150 45

50 15 160 48

60 18 170 51

70 21 180 54

80 24 190 57

90 27 200 60
 Nitroprusside
Strength 50 mg / 2 ml
Compatibility D5W
Dilution 50 mg( 1 amp) *250 ml
Concentration 200 mcg/ ml
0.2 - 10 mcg/kg/minute
Dose Doses >5 mcg/kg/minute are not recommended

 24 hr.
Stability  Prepare it away from light
 wrapped immediately with aluminum foil

30 40 50 60 70 80 90 100
Dose (mcg) WT(kg)
Infusion Rates ml/ hr
0.1 0.9 1.2 1.5 1.8 2.1 2.4 2.7 3

0.2 1.8 2.4 3 3.6 4.2 4.8 5.4 6

0.3 2.7 3.6 4.5 5.4 6.3 7.2 8.1 9

0.4 3.6 4.8 6 7.2 8.4 9.6 10.8 12

0.5 4.5 6 7.5 9 10.5 12 13.5 15

1 9 12 15 18 21 24 27 30

2 18 24 30 36 42 48 54 60

3 27 36 45 54 63 72 81 90

4 36 48 60 72 84 96 108 120

5 45 60 75 90 105 120 135 150

6 54 72 90 108 126 144 162 180

7 63 84 105 126 147 168 189 210

8 72 96 120 144 168 192 216 240

9 81 108 135 162 189 216 243 270

10 90 120 150 180 210 240 270 300

 Heparin
Strength 5000 IU /amp
Compatibility NS
Dilution 25000 IU ( 5 amp) *50 ml
Concentration 500 IU / ml

Dose 80 units/kg then 18 units/kg/hour

 24 hr.
Stability  Prepare it away from light
 wrapped immediately with aluminum foil

Dose (IU) WT(kg) 30 40 50 60 70 80 90 100

Loading (80 2400 3200 4000 4800 5600 6400 7200 8000
units/kg) IU IU IU IU IU IU IU IU

Infusion Rates ml/ hr

Maintenance
(18 units/kg/hour) 0.768 1.024 1.28 1.536 1.792 2.048 2.304 2.56
 Fentanyl
Strength 50 mcg/ml amp=2ml
Compatibility D5W, NS.
Dilution 500 mcg (5 amp) *50 ml
Concentration 10 mcg / ml

Dose 0.5 to 10 mcg/kg/hr IV

Stability  24 hr

30 40 50 60 70 80 90 100
Dose (mcg) WT(kg)
Infusion Rates ml/ hr
0.5 1.5 2 2.5 3 3.5 4 4.5 5

0.75 2.25 3 3.75 4.5 5.25 6 6.75 7.5

1 3 4 5 6 7 8 9 10

1.25 3.75 5 6.25 7.5 8.75 10 11.25 12.5

1.5 4.5 6 7.5 9 10.5 12 13.5 15

1.75 5.25 7 8.75 10.5 12.25 14 15.75 17.5

2 6 8 10 12 14 16 18 20

2.25 6.75 9 11.25 13.5 15.75 18 20.25 22.5

2.5 7.5 10 12.5 15 17.5 20 22.5 25

3 9 12 15 18 21 24 27 30

3.5 10.5 14 17.5 21 24.5 28 31.5 35

4 12 16 20 24 28 32 36 40

4.5 13.5 18 22.5 27 31.5 36 40.5 45

5 15 20 25 30 35 40 45 50
 Midazolam
Strength 5 mg/ml amp=3ml
Compatibility D5W, NS. Incompatible with LR.
Dilution 45 mg (3 amp) *45 ml
Concentration 1 mg / ml
Initial dose (0.01 – 0.05 mg/kg) OR 0.5 to 4 mg
Dose
Maintenance infusion: 0.02 to 0.1 mg/kg/hour
Stability  24 hr

30 40 50 60 70 80 90 100
Dose (mg) WT(kg)
Infusion Rates ml/ hr

0.02 0.6 0.8 1 1.2 1.4 1.6 1.8 2

0.03 0.9 1.2 1.5 1.8 2.1 2.4 2.7 3

0.04 1.2 1.6 2 2.4 2.8 3.2 3.6 4

0.05 1.5 2 2.5 3 3.5 4 4.5 5

0.06 1.8 2.4 3 3.6 4.2 4.8 5.4 6

0.07 2.1 2.8 3.5 4.2 4.9 5.6 6.3 7

0.08 2.4 3.2 4 4.8 5.6 6.4 7.2 8

0.09 2.7 3.6 4.5 5.4 6.3 7.2 8.1 9

0.1 3 4 5 6 7 8 9 10
 Propofol
Strength 10 mg/ml (1%) amp=20ml
Compatibility Does not need to be diluted
Dilution 500 mg (2.5 amp) Total 50 ml
Concentration 10 mg / ml
 Initial dose (0.3 mg/kg)
Dose
 Maintenance infusion: 0.3 to 3 mg/kg/hour
 If transferred to a syringe or other container prior to
administration, use within 6 hours.
Stability
 If diluted in 5% dextrose stable for 8 hours at room
temperature

30 40 50 60 70 80 90 100
Dose (mg) WT(kg)
Infusion Rates ml/ hr
0.3 0.9 1.2 1.5 1.8 2.1 2.4 2.7 3

0.4 1.2 1.6 2 2.4 2.8 3.2 3.6 4

0.5 1.5 2 2.5 3 3.5 4 4.5 5

0.75 2.25 3 3.75 4.5 5.25 6 6.75 7.5

1 3 4 5 6 7 8 9 10

1.25 3.75 5 6.25 7.5 8.75 10 11.25 12.5

1.5 4.5 6 7.5 9 10.5 12 13.5 15

1.75 5.25 7 8.75 10.5 12.25 14 15.75 17.5

2 6 8 10 12 14 16 18 20

2.25 6.75 9 11.25 13.5 15.75 18 20.25 22.5

2.5 7.5 10 12.5 15 17.5 20 22.5 25

2.75 8.25 11 13.75 16.5 19.25 22 24.75 27.5

3 9 12 15 18 21 24 27 30
 Insulin Infusion Protocol
1. Standard infusion: 50 Units Regular insulin/50 mL NS via an infusion device
2. For most patients, the goal BG should be between 90-140 mg/dL.
3. Initiating the Infusion:
 Algorithm 1: Start here for most patients.
 Algorithm 2: Start here if the patient has a glucose > 600 mg/dL, is in diabetic ketoacidosis, or
is s/p CABG, s/p solid organ transplant, receiving glucocorticoids, or patient with diabetes
receiving over 80 units/day of insulin as an outpatient, has a BMI more then 35, or is pregnant.
 Algorithms 3-8: Do not start patients in these algorithms.
4. Patient Monitoring:
 Hourly monitoring is indicated for most critically ill patients.
 For stable patients, check BG every hour until it is within goal range (90 – 140 mg/dL) for 4
hours, then decrease BG checks to every 2 hours.
6. Moving down from Algorithm to Algorithm When glucose decreases >60 mg/dl in 1 hour

Blood Glucose Adjustment

BG < 60 mg/dL
BG 61-90 mg/dL
BG between 90 and 140 mg/dL (goal)
BG between 141 and 180 mg/dL and decreased by
30 mg/dL or more
BG between 141 and 180 mg/dL and did not
decrease by at least 30 mg/dL
BG > 180 mg/dL and decreased by 60 mg/dL or
more
BG > 180 mg/dL and did not decrease by at least 60
mg/dL
Treatment of Hypoglycemia
Turn off the infusion and recheck BG every 1 hour
until> 90 mg/dL and then restart infusion in next
Lower algorithm
Adjust the rate within the SAME algorithm
Adjust the rate within the SAME algorithm
Adjust the rate to the next HIGHER algorithm
Adjust the rate within the SAME algorithm
Adjust the rate to the next HIGHER algorithm

Blood Glucose Scale 1 Scale 2 Scale 3 Scale 4 Scale 5 Scale 6 Scale 7 Scale 8
(mg/dl) (ml/hr) (ml/hr) (ml/hr) (ml/hr) (ml/hr) (ml/hr) (ml/hr) (ml/hr)

≥400 3 4 5 6 7 8 10 11
320-399 2.5 3.5 4 5 6 6 8 9
250-319 2 3 3 4 5 5 6 7
210-249 1.5 2.5 2.5 3 4 4 4 5
180-209 1 2 2 2 3 3 3 4
140-179 1 1.5 1.5 1.5 2 2 2.5 3
110-139 0.5 1 1 1 1.5 1.5 2 2
90-109 0.5 0.5 0.5 1 1 1 1.5 1.5

<90 Stop IV insulin infusion and inform doctor

 Rocuronium Bromide (Esmeron)

Strength 10 mg/ml amp=5ml

Compatibility D5W, NS.
Dilution 250 mg (5 amp) *50 ml
Concentration 5 mg / ml
Initial dose (0.6 mg/kg)
Dose
Maintenance infusion: 0.3 to 0.6 mg/kg/hour
Stability  24 hr

30 40 50 60 70 80 90 100
Dose (mg) WT(kg)
Infusion Rates ml/ hr

0.3 1.8 2.4 3 3.6 4.2 4.8 5.4 6

0.35 2.1 2.8 3.5 4.2 4.9 5.6 6.3 7

0.4 2.4 3.2 4 4.8 5.6 6.4 7.2 8

0.45 2.7 3.6 4.5 5.4 6.3 7.2 8.1 9

0.5 3 4 5 6 7 8 9 10

0.55 3.3 4.4 5.5 6.6 7.7 8.8 9.9 11

0.6 3.6 4.8 6 7.2 8.4 9.6 10.8 12