Upon Dexamethasone 0.6 mg/kg IV/IO/ IM/PO Maximum daily dose 16 mg Methylprednisolone sodium succinate 12 mg/kg IV/IO/IM Maximum single dose 60 mg Do not give with amiodarone Sodium Bicarbonate 1 mEq/kg IV/IO Give as a slow bolus Use 4.2% concentration in infants less than 1 month of age Seizures Drug Dose Comment Amiodarone [SVT with pulses] 150mg Rapid infusion over 10 minutes 15mg/minute, may repeat q10 minutes as needed Stable in D5W, NS Incompatible with heparin Maximum cumulative dose 2.2g over 24 hours Ativan (lorazepam) 0.1mg/kg Max dose 4mg Dilute 1:1 with NS Max rate 2mg/minute Stable in D5W, LR, NS Monitor IV site avoid extravasation Chronic use of amiodarone causes a host of side effects. Negative inotropy is an adverse feature of most antiarrhythmic drugs. Description. This updated dose conversion is based on recent literature which has shown that the bioavailability of levothyroxine is estimated to be around 79-81 percent. The initial infusion rate is not greater than 30 mg/min. Digoxin Second line rate control agent, primarily because it tends to exert its rate controlling effect at rest, The plasma half-life of amiodarone after single-dose administration has been reported to be in the range of 3.2 to 79.7 hours. For oral dosage form (tablets): For ventricular arrhythmias: AdultsAt first, 800 to 1600 milligrams (mg) per day taken in divided doses. Early switch over from IV to oral therapy has the following major advantages: Reduced risk of cannula-related infections: For the administration of IV medications, one is required to insert a cannula, which remains in place for some days and eventually can result in secondary infections caused by bacteria and fungi. (25033747, 10942741) Loading dose is 0.3-0.5 mg/kg IV (~30 mg). (10942741, 25745472, 32345562) Oral regimen: Propranolol 40 mg PO q6hrs has been proven superior to metoprolol (50 mg q6hr). 100 unit / 100 ml (1 unit/ml). Monitor apical pulse daily. 3. IV: 150 mg IV over 10 minutes. 3. If rounding is required, round to the nearest tenth.) Therefore, serious side effects may occur weeks to months after taking amiodarone. You're typically looking at 400600 mg daily in divided doses for 24 weeks. The total daily dose should be divided q6h. 1) 5) 1) 5) Restated: Duration of IV infusion < 1 week: 800-1600mg/day po initially x 1-2 weeks or complete current week; 1-3 weeks: 600-800mg/day po initially - total therapy ~ 1 month counting IV infusion ; >3 weeks: 400mg po qd initially. IV. Although amiodarone exerts its antiarrhythmic effect by an interplay of different actions on cardiac cells, it has been regarded to be the prototype class III drug due to its prolongation of action potential duration. Use the equianalgesic ratio: 30 mg PO Morphine = 7.5 mg PO Hydromorphone. 15 mg/hr to 480 mg/day. The physician orders Zantac elixir 150 mg po twice a day for heartburn. IV: 30 mg/kg over 15 min, followed in 45 min by a continuous infusion of 5.4 mg/kg per h for 23 h. Administration within 8 h of injury is optimal. Oral. Loading dose. IV/PO: 4-8 hrs initially; increases to 22-48 hrs with repeated doses. 125 mcg once a day. This calculator is not appropriate for the following patient populations: Significant drug interactions (eg, amiodarone, quinidine, verapamil, or macrolide antibiotics) End-stage renal disease on hemodialysis; Acute renal failure or unstable renal function; The following bioavailabilities (F) are used for calculation: Tablet = 0.75; Intravenous = 1 At 23 hours after each subsequent dose of Tikosyn, determine the QTc or QT (if heart rate is less than 60 beats per minute) (for in-hospital doses 25). Amiodarone was discontinued and IV sotalol was initiated at 42 mg/m2/day, divided to 3 doses, and administered every 8 h, which completely suppressed the arrhythmia. 3. IV: 0.050.10 mg/kg given over 23 min (maximum single dose: 5 mg). 11. Only $199. Start at 400 mg PO BID, until the patient has received a total of 10 grams cumulative dose (both IV and PO). 250 mcg twice daily. Eventually transition to another agent. To prepare Amiodarone for an IV infusion, mix with D5W and give through an in-line filter. The patient was also started on PO amiodorone 400mg BID. Critical Care Intravenous Flow Rates Example 1: The order is to infuse nitroglycerin at 5 mcg/min; 50 mg of Study Resources Follow with a slow infusion of 360 mg over the next 6 hours (1 mg/min). Warfarin Mr Smith is to receive 800 mL of an antibiotic via an IV infusion over 15 hours. some source region to absorbed dose in a target region. Drug Usual IV Dose* Approximate PO Dose* PO to IV Considerations/Comments Reference digoxin 0.1 -0.4 mg IV Q 24 H 0.125 -0.5 mg PO Q 24 H Oral bioavailability about 80% for tablets and liquid 1,2 dimenhyDRINATE 25-50 mg IV 25-50 mg PO Conversion of Amiodarone shows considerable interindividual variation in response. 200mg tds. (Enter numeric value only. Also remove sticky note when IV to po is addressed. HOW SUPPLIED -----Amiodarone Hydrochloride Injection, 50 mg/mL is supplied in: 3 mL (150 mg) 10 Single-dose vials per carton (NDC 60505-0722-0). Note: This is for converting oral opioids only, and should not be used for IV to oral conversions. amiodarone pediatric dosing. 3 Based on this data, the ATA Guidelines and Lexicomp recommend administering an IV dose that is 75 percent of the oral dose when converting from a parenteral to enteral route. A percentage means out of 100, so a percentage concentration can be defined as the amount of drug in 100 parts of the product. Amiodarone Intravenous should only be used in a special care unit under continuous monitoring (ECG and blood pressure). Loop diuretic PO --> IV conversions Furosemide 40 mg PO = Furosemide 20 mg IV = Torsemide 20 mg PO/IV = Bumetanide 1 mg PO/IV #Pharmacology #Cardiology #Loop #Diuretics #Equivalent #Dose #Conversion #Table #Furosemide #Torsemide #Bumex #Lasix #Bumetanide ** GrepMed Recommended Text: Clinical Pharmacology Made Give first PO dose 1 hour prior to Amiodarone PO dosing in hospital After converts to NSR or after 24 hrs, 400mg PO BID up to 10g load (includes IV), then 200mg daily. Prepare solution with 150 mg amiodarone in 100-mL D5W bag. received via the IV route, as follows: -. Percocet = acetaminophen + oxyCODONE), enter only the dose of the opioid component (e.g. 5. Flush with 20 ml of D5W/NS. This number means that the PO dose is 5 times more than the IV dose to get the same amount of drug into the bloodstream. From what I've been taught IV Amio has immediate effect, while PO Amio takes days/weeks to kick in. Cumulative dose, X = (total IV dose * 2) - (days of treatment * 200); This is then used to determine the appropriate loading dose: -. Atrial Fib 150 mg IV/IO in 50 ml D5W/NS over 10 minutes. I've seen an IV Amio bolus drop pressures, but that's typically when it's given over 15 minutes. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine. Typical amiodarone dosages in the ACLS setting are provided in Table 1. Calculate the oral loading dose for a 70 yo, 70 kg adult male with a serum creatinine of 3.0, if the desired Cp is 1.0 ng/ml. Asymptomatic blue-grey discolouration of exposed areas can also occur. Patient had also received 3 doses of PO Amio in addition to the drip in the 24 hours. The medication is supplied in 900 mg/500 mL of D 5 W. Calculate the flow rate in milliliters per hour.. 2) The physician orders a lidocaine IV drip to infuse at 3 mg/min for premature ventricular contractions. Suggested Pediatric Drug Dosages 07/05/2005 Zwi Jacob, MD Download 2 page pdf version for printing The dosages and drugs are intended as general guidelines ONLY. Where volume is the amount of fluid in the IV bag, time is total number of minutes the fluid is to infuse over, and the drop factor (or drip factor) is related to the size of the IV tubing you are using; the number of drops per mL delivered for a particular drip chamber. 2, 10 In patients who require long-term treatment, intravenous dosing should be switched to oral dosing. Calculate the total daily opioid dosage (long acting and break through) and convert to morphine equivalents (either IV or PO) using an equianalgesic dosing table. followed by 20 ml saline flush Amiodarone 50 mg/ml vial Pulseless VT or VF: 300 mg IVP. 26 - 107 days. Next. if 5 mg/325 mg, enter "5"). received, X. IV fluids help if patient is dehydrated which can cause AFib. Alternatively, it is NOT necessary to dilute amiodarone for IV push administration and a filter is not necessary. Oral loading dose. Posology. Half-life: 38-48 hrs. IV amiodarone must be administered via a central line. In practice, steroids may have to be administered alternatively or substituted for oral and IV administration. Loop diuretic PO --> IV conversions Furosemide 40 mg PO = Furosemide 20 mg IV = Torsemide 20 mg PO/IV = Bumetanide 1 mg PO/IV #Pharmacology #Cardiology #Loop #Diuretics #Equivalent #Dose #Conversion #Table #Furosemide #Torsemide #Bumex #Lasix #Bumetanide ** GrepMed Recommended Text: Clinical Pharmacology Made Also, this drug stays in your body for weeks to months, even after you are no longer taking it. Can be used to convert between corticosteroid medication dosages for oral and IV administration. May repeat every 10 minutes PRN. Peak serum concentrations after 15-minute infusions in healthy volunteers range from 5 to 41 mg/L. 125 mcg twice daily. doses bid w/ meals if GI intolerance PO amiodarone 25.7 mg/kg vs. IV amiodarone 35 mg/kg bolus then 1015 mg/kg over 24 h No difference in conversion to SR between PO and IV (64% vs. 68%, respectively; p=NS) 223 patients with symptomatic atrial fibrillation on digoxin PO amiodarone 600 mg in3 divided doses vs. IV amiodarone 5mg/kg over Amiodarone Mechanism : Amiodarone is a class three anti-arrhythmic drug. After IVP, Flush with 20 ml of D5W or NS. Calculate the flow rate to be set. Amiodarone is widely prescribed, largely due to its efficacy in the management of both supraventricular and ventricular arrhythmias. When infusions exceed 2 hours, amiodarone can absorb into the plastic used for standard IV bags. VF and pulseless VT: 300 mg IV/IO push. All microdrip tubing delivers 60 gtt/mL and is used to deliver a small or very precise amount of fluid. PO. Loading dose: 8001,600 mg/day PO in divided doses, for 13 wk; reduce dose to 600800 mg/day in divided doses for 1 mo; if rhythm is stable, reduce dose to 400 mg/day in one to two divided doses for maintenance dose. 125 mcg twice daily. What is the rate of the infusion in mL/h? Amiodarone HCl 30 mg IV J0282 Amitriptyline HCl up to 20 mg IM J1320 Amobarbital up to 125 mg IM, IV J0300 Amphocin, see Amphotericin B Amphotericin B 50 mg IV J0285 Amphotericin B, lipid complex 10 mg IV J0287-J0289 If intravenous amiodarone is administered during pregnancy, the patient should be apprised of the potential hazard to the fetus. Determine the new opioid analgesic to convert to and using equianalgesic dosing data (taking into consideration the limitations) convert to new opioid dose. Prepare solution with 900 mg amiodarone in 500 mL D5W glass bottle. The physician orders amiodarone IV drip at 0.5 mg/min for ventricular dysrhythmias. Amiodarone should only be used when facilities exist for cardiac monitoring, defibrillation, and cardiac pacing. Includes dosages for Arrhythmias; plus renal, liver and dialysis adjustments. It exhibits all four of the classic Vaughan Williams mechanisms of action, namely sodium and potassium channel blockade, a mild antisympathetic action and some calcium channel blockade, but it is usually classified as a Class III antiarrhythmic drug (see Table 1).It prolongs the The following pharmacist will check on these open i-Vents and close then when appropriate. Cumulative dose. For example, patients are frequently prescribed intravenous glucose 5%. Oral Amiodarone Amiodarone has a very long half life so requires a loading regime of 200mg tds for one week, bd for 2nd week then 200mg od When a change in dose is part of a standard initiation regime, further details on the chart can ensure the change is automatically implemented and prevents missing the review date. Reduce dose 50% for cross-tolerance: 45 x 0.5 = 22 mg/24 hours = 4 mg q4h. N-desethylamiodarone (active metabolite): Prolonged in severe left ventricular dysfunction. IV infusion IV Infusion IV Infusion (OB) Only REGULAR insulin may be administered by the IV route. including oral and intravenous regimens: -Oral: Starting in postop recovery, 400 mg twice daily for up to 7 days. VT with pulse unstable: 1st dose 150mg IVP/IOP under 2 minutes - 2nd dose 150mg IV/IO in 50ml D5W/NS over 10 min. an oscillometric method.c Amiodaroned was administered, 200 mg/dog, PO q12h for 3.5 weeks, and then 200 mg/dog PO q24h for 3.5 addi-tional weeks. Digoxin loading oral: 500-750mcg 2 doses 6 hours apart (max 1500mcg in 24 hours) Maintenance dose. EKG. A dose of one 200-mg tablet (20 mg/kg q24h) was given to 6 dogs This medicine half life calculator estimates the action of any medicine and the way concentration decreases in percentage in plasma according to half life and dosage. The drip has been infusing for almost 24 hours and the patient had not yet converted. Drug Usual IV Dose* Approximate PO Dose* PO to IV Considerations/Comments Reference digoxin 0.1 -0.4 mg IV Q 24 H 0.125 -0.5 mg PO Q 24 H Oral bioavailability about 80% for tablets and liquid 1,2 dimenhyDRINATE 25-50 mg IV 25-50 mg PO Conversion of Lidocaine. Calculate total daily oral dose 2. Description. The medication is supplied in 1 g/250 mL of D 5 W. Calculate the flow 4. Calculate the number of units required to deliver the initial bolus dose. Round dose to a 30 mg increment, divide this daily dose by 4 to give Q6H dosing 3. Common IV to PO Drug Conversions 1) Metoprolol 1:2.5 2) Diltiazem Oral Dose (mg/day) = [ rate (mg/hr) x 3 + 3 ] x 10 3) Digoxin 0.75:1 4) Levothyroxine 0.75:1 5) Aminophylline to Theophylline 1:0.8 6) Ciprofloxacin 1:1.25 #IVtoPO #Drug #Conversion #Pharmacology #Common #Intravenous #Oral. Guardrail Drug Requires documentation of two (2) RNs for double-checking. Then you'd transition to a maintenance dose of 100 - 200 mg daily. Subsequently, the dose may be decreased to 200 mg daily. IV loading should only be performed when a rapid response is required. What is the simpliest method to calculate this into ml/hr. Dose titration every 3 days monitored or 7 days in chronic use. For continuous infusions, conc. If the patient achieves ROSC, a continuous infusion is started at 1 mg/min for 6 hours, followed by 0.5 mg/min. Dose: 150 mg IV x1 over 10min, then 1 mg/min IV x6h, then 0.5 mg/min IV x18h [PO route] Dose: 400 mg PO qd; Start: load 800-1600 mg PO qd x1-3wk until response, then 400-600 mg PO qd x4wk; Info: divide loading doses >1000 mg/day bid-tid w/ meals; divide maint. Indication : Refractory supraventricular tachycardia; Junctional ectopic tachycardia; Atrial fibrillation 154/ 2.2 = 70 kg 70 x 80 = 5,600. The objective of this study was to assess the impact of IV and PO amiodarone overlap on short-term tachyarrhythmia recurrence and adverse hemodynamic outcomes in the intensive care unit. Note: Half-life is shortened in children vs adults. Serious side effects may include lung or liver problems. However, patients in the metoral group (M) were given a dose of 13 mg/kg/h for 24 h. For each group, antiarrhythmia medicines were prescribed for 24 h. 4. In adult patients, amiodarone can be given for VT/VF cardiac arrest via intravenous (IV)/intraosseous (IO) infusion as a 300 mg rapid bolus followed by an additional bolus of 150 mg IV/IO if VT or VF persists. Description. 5. Considerations for IV-to-PO Conversions. This will change the medication concentration. 1)The physician orders amiodarone IV drip at 0.5 mg/min for ventricular dysrhythmias. The initial sotalol dose was calculated based on a daily dose of 90 mg/m2 and reduced by an age-related factor as recommended by the FDA approved prescribing information. Then i-Vents acuity will now have a 10 to signify there is a open i-Vent. IV Push for Hyperkalemia. <2400mg. is a mathematical representation of the human body used to calculate. Equivalents are based on 30 mg morphine PO = 10 mg morphine IV = 100 mcg fentanyl IV = 30 mg HYDROcodone PO = 1.5 mg HYDROmorphone IV = 7.5 mg HYDROmorphone PO = 20 mg OXYcodone PO = 1 mg OXYmorphone IV = 10 mg OXYmorphone PO Looking for a more detailed calculator? Monitor BUN and serum creatinine q2days (qd if unstable). It works in two ways (1) prolongation of the myocardial cell-action potential duration and refractory period and (2) non-competitive alpha- and beta-adrenergic inhibition. Follow up with an infusion of 1 mg/min IV x 6 hours, then 0.5 mg/min IV x 18 hours. The actual drugs and their doses should be administered only following discussion with the attending. RxAdvanced: Guide to Cannabis training for pharmacists that offers 16 hours of ACPE-accredited training based on the latest, science-based cannabis research. Note: Pharmacy sent the bolus in a separate 100 ml bag and the continuous drip in a 500 ml bag. Amiodarone: Single dose: 58 days (range: 15 to 142 days) Oral chronic therapy: Mean range: 40 to 55 days (range: 26 to 107 days) IV single dose: Mean range: 9 to 36 days. If the patient is taking 0.5 mg IV then the PO dose would be 0.5 mg multiplied by 5, which is 2.5 mg. 15mg q6hr, even if equivalent, is hitting them with a whopping dose upfront. Oral maintenance dose. However, after withdrawal of long term amiodarone treatment the half-life is as long as 100 days. Click to see full answer. The standard recommended dose is 5mg/kg bodyweight given by intravenous infusion over a period of 20 minutes to 2 hours. Onset/peak: IV: 5-30min/ 1-4hrs Oral: 1-2hrs/ 2-8 hrs. Pharmacist initiated IV to PO conversion program of antimicrobials. Intravenous amiodarone has interesting and complex pharmacokinetics. Flush post dose. 62.5mcg 250mcg daily. Amiodarone increases PO digoxin serum concentrations by ~70% and IV digoxin by ~17%; measure digoxin levels before initiating amiodarone and reduce PO digoxin dose by 30-50%; decrease IV digoxin dose by 15-30% amiodarone will increase the level or effect of digoxin by basic (cationic) drug competition for renal tubular clearance. Automatic IV to PO Conversion Protocol Purpose: To allow for the conversion of intravenous medications to oral equivalents when medically appropriate in an effort to reduce line-associated risk, reduce nosocomial-acquired infection risk, improve patient satisfaction, promotes earlier and easier ambulation, and reduce As you can imagine, many of the patients cant take PO, pick your variety of reasons: SBO, Postoperative Ileus, Sigmoid Cancer, blah blah blah. Ketorolac (Toradol) 1 yr. ago. You can discover more on this subject, check an example calculation and the half times of most known active substances below the form. 1. Give VERY RAPID IVP over 1-3 sec. Thus, although a starting dose adequate to suppress life-threatening arrhythmias is needed, close monitoring with adjustment of dose as needed is essential.The recommended starting dose of Cordarone I.V. Stable VT: 150 mg IV over 10 min May repeat with 150 mg IVP if needed. For combination drugs (e.g. Step 6. DOSAGE. Oct 27, 2007. With intravenous use: Avoid rapid intravenous administration (risk of hypertension and reduced coronary flow). Medline Abstract for Reference {{configCtrl2.info.canonicalUrl}} of 'Amiodarone: Clinical uses' 1) IV metoprolol has immediate action, PO has slow and graded release over hours. This has to do with the very high volume of distribution (part of why you give the 150mg load). 12 mg IV x1 dose. Infuse 150 mg over 10 minutes (15 mg/min). How to load digoxin. INSTRUCTIONS. If you're unable to convert to PO before 24 hours, consider decreasing the IV dose to 0.25 mg/min. Store at 20 to 25C (68 to 77F) Protect from light. Amiodarone increases PO digoxin serum concentrations by ~70% and IV digoxin by ~17%; measure digoxin levels before initiating amiodarone and reduce PO digoxin dose by 30-50%; decrease IV digoxin dose by 15-30% amiodarone will increase the level or effect of digoxin by basic (cationic) drug competition for renal tubular clearance. Cardizem 5-20mg iv bolus [or Metoprolol 5mg IV], a repeat dose may be needed in 15min and if not converted to sinus>Cardizem iv drip starting with 5mg/hr [or Amiodarone bolus f/b drip if BP is low.] The pharmacist leaving the sticky not will open and IV to po i-Vent, leave this i-Vent open until the medication is changed. Articles describing intravenous to oral conversion protocols for any therapeutic category were identified in an English-language MEDLINE search (1990-April 2010) using a Adjust to the lowest possible dose to limit side effects. Amiodarone IV bolus at 150mg over 1 minute, then 1mg/min for 6hours and then 0.5mg/min for 18hours. Alternative regimen of amiodarone: 600 mg/day for 7 days prior to surgery, followed by 200 mg/day until hospital discharge, has also been shown to decrease the risk of postoperative atrial fibrillation. IV infusion is preferred to bolus due to the haemodynamic effects sometimes associated with rapid injection (see section 4.8). (anephric: 4-6 days). Calculate the Cp if a 70 yo, 70 kg man with a serum creatinine of 3.0 is given a 1 mg IV loading dose of digoxin. Calculate the flow rate if 1.2 L is to be infused over 24 hours. For intravenous infusion ( Lanoxin ), give intermittently in Glucose 5% or Sodium chloride 0.9%; dilute to a concentration of not more than IV regimen: Bolus 0.15 mg/kg IV over 10 minutes, then 3-5 mg IV Q6hr. Methods. Calculate the 24 hour current dose: 90 Q12 x 2 = 180 mg PO Morphine/24 hrs. [onset time < 20min] EP or general cardiology consult should be requested if long-term amiodarone use is contemplated. Intravenous to Oral Conversion for Antimicrobials 1-20-6-1-010 Author(s): Antimicrobial Stewardship Program Coordinator Page 6 of 6 Issuing Authority: Vice President Medicine and Clinical Programs; Regional Director, Pharmacy Services The medication is supplied in 15 mg/mL. IV. Dose titration every 3 days monitored or 7 days in chronic use. Time to steady state: 5-7 days (average) ESRD: 15-20 days. Peak levels after 150 mg of supplemental infusions in patients with VT/VF range between 7 and 26 mg/L. Steroid Conversion Calculator. 12. Calculate new dose using ratios: 180/30 X 7.5 = 45 mg oral Hydromorphone/24 hours. Dogs were given amiodarone at 8:00 AM and 8:00 PM daily for the loading dose and at 8:00 AM daily for the maintenance. 2. Amiodarone is an iodinated benzofuran derivative that was synthesized and tested as an antianginal agent in the 1960s but was later discovered to have antiarrhythmic properties.
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