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α1- and nonselective β-adrenergic agonist
Alpha : 周邊血管收縮 / Beta : 心臟收縮
Bradycardia : 2-10 mcg/min
Shock : 0.05–2 micrograms/kg/min
套餐 :
4 mg epinephrine in D5W/NS 250 mL, concentration 16 mcg/mL
Shock: Start at 2 mcg/min(7.5ml/hr), range 0 - 10 mcg/min (0.0-37.5ml/hr)
【Dilution/Conc】4 mg epinephrine in D5W/NS 246 mL, concentration 16 mcg/mL (>16mcg/mL : CVC)
【Rate】Start at 2 mcg/min, range 0 - 10 mcg/min (>25mcg/min: CVC)
(Dose above recommended range is justified by clinical judgement)
【Goal】Mean arterial pressure ≧ 65 mmHg or Systolic BP ≧ 90 mmHg
【Titration/Taper】
# Titration：check BP Q5-15 min and increase by 2-5 mcg/min
# Taper (by clinical judgement)：check BP Q15-30 min and decrease by 1 mcg/min
Hypotension after intubation or sedation
5–20 micrograms/bolus dose over 20–30 s every 2–5 min as needed
1000 微克 = 1毫克
5 - 20 microgram = 0.02 mg
Push dose : 1mg in 100 ml --> 0.01 mg/ml = 10 microgram/ml
1 ml IV bolus
1 mg 泡 100 ml, 給 1 ml bolus
V1 receptors in vascular smooth muscle, causing direct peripheral vasoconstriction
decrease in heart rate and cardiac output.
Vasopressin also acts on V2 receptors in the kidneys, causing an antidiuretic effect.
20 unit/ml
【Dilution/Conc】40 units vasopressin in D5W/NS 98 mL, concentration 0.4 unit/mL (限 CVC)
【Rate】Start at 0.01 units/min, range 0-0.03 units/min
【Goal】Mean arterial pressure ≧ 65 mmHg or Systolic BP ≧ 90 mmHg
【Titration/Taper】
# Titration：check BP Q5-15 min and increase by 0.005 units/min
# Taper (by clinical judgement)：check BP Q1 h and decrease by 0.005 units/min
# Taper vasopressin AFTER the catecholamine vasopressors are off (vasopressin 最後 taper)
Run 0 - 4.5 ml/hr
(0.03 * 60 / 0.4 = 4.5)
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