Formulas and Drips

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/minconc: 8mcg Noradrenaline/mldrip 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

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Formulas and Drips