IV infusion is preferred to bolus due to the haemodynamic effects sometimes associated with rapid injection (see section 4.8). #23. Serious side effects may include lung or liver problems. Step 6. Note: This is for converting oral opioids only, and should not be used for IV to oral conversions. RxAdvanced: Guide to Cannabis training for pharmacists that offers 16 hours of ACPE-accredited training based on the latest, science-based cannabis research. Description. This has to do with the very high volume of distribution (part of why you give the 150mg load). Includes dosages for Arrhythmias; plus renal, liver and dialysis adjustments. Calculate the number of units required to deliver the initial bolus dose. Steroid Conversion Calculator. What is the simpliest method to calculate this into ml/hr. The dosing schedule of amiodarone, with intravenous loading protocols, may mean that the automated intravenous to oral conversion prompt does not provide physicians with the dose recommendations they need for this drug. Prepare solution with 900 mg amiodarone in 500 mL D5W glass bottle. 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. May repeat every 10 minutes PRN. INSTRUCTIONS. Calculate the 24 hour current dose: 90 Q12 x 2 = 180 mg PO Morphine/24 hrs. IV regimen: Bolus 0.15 mg/kg IV over 10 minutes, then 3-5 mg IV Q6hr. Give VERY RAPID IVP over 1-3 sec. Note: Half-life is shortened in children vs adults. Amiodarone may take 2 weeks or longer to have an effect in your body. 3. is a mathematical representation of the human body used to calculate. If intravenous amiodarone is administered during pregnancy, the patient should be apprised of the potential hazard to the fetus. EKG. 5. Peak levels after 150 mg of supplemental infusions in patients with VT/VF range between 7 and 26 mg/L. Chronic use of amiodarone causes a host of side effects. Description. 4. Therefore, serious side effects may occur weeks to months after taking amiodarone. 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. 26 - 107 days. The actual drugs and their doses should be administered only following discussion with the attending. Use the equianalgesic ratio: 30 mg PO Morphine = 7.5 mg PO Hydromorphone. 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. 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. Flush post dose. 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. 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. Click to see full answer. No matter which strategy you follow with amiodarone, the goal is to transition to PO within 24 hours. For combination drugs (e.g. Detailed Amiodarone dosage information for adults. New! is about 1000 mg over the first 24 hours of 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. VF and pulseless VT: 300 mg IV/IO push. 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. The medication is supplied in 15 mg/mL. including oral and intravenous regimens: -Oral: Starting in postop recovery, 400 mg twice daily for up to 7 days. 4. 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. 125 mcg once a day. 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. Digoxin loading oral: 500-750mcg 2 doses 6 hours apart (max 1500mcg in 24 hours) Maintenance dose. 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. All microdrip tubing delivers 60 gtt/mL and is used to deliver a small or very precise amount of fluid. if 5 mg/325 mg, enter "5"). 1)The physician orders amiodarone IV drip at 0.5 mg/min for ventricular dysrhythmias. Peak serum concentrations after 15-minute infusions in healthy volunteers range from 5 to 41 mg/L. Oral maintenance dose. Maintenance = (Cl) (Cp) (t) Dose (F) Cp = (F) (dose/ t) Cl Cl equations for digoxin <2400mg. 290.914.916.010. Articles describing intravenous to oral conversion protocols for any therapeutic category were identified in an English-language MEDLINE search (1990-April 2010) using a 2. 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. IV/PO: 4-8 hrs initially; increases to 22-48 hrs with repeated doses. Note: Pharmacy sent the bolus in a separate 100 ml bag and the continuous drip in a 500 ml bag. 1) 5) 1) 5) PO. The patient was in Afib and the MD ordered a bolus of Ami followed by a continious drip. 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. With intravenous use: Avoid rapid intravenous administration (risk of hypertension and reduced coronary flow). IV. How to load digoxin. As you can imagine, many of the patients cant take PO, pick your variety of reasons: SBO, Postoperative Ileus, Sigmoid Cancer, blah blah blah. Oct 27, 2007. 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. 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. Oral loading dose. 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 From what I've been taught IV Amio has immediate effect, while PO Amio takes days/weeks to kick in. Upon Alternatively, it is NOT necessary to dilute amiodarone for IV push administration and a filter is not necessary. 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 I've seen an IV Amio bolus drop pressures, but that's typically when it's given over 15 minutes. [onset time < 20min] EP or general cardiology consult should be requested if long-term amiodarone use is contemplated. (Enter numeric value only. A dose of one 200-mg tablet (20 mg/kg q24h) was given to 6 dogs Dose titration every 3 days monitored or 7 days in chronic use. Can be used to convert between corticosteroid medication dosages for oral and IV administration. The total daily dose should be divided q6h. 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. 11. Amiodarone should only be used when facilities exist for cardiac monitoring, defibrillation, and cardiac pacing. Also, this drug stays in your body for weeks to months, even after you are no longer taking it. Amiodarone is widely prescribed, largely due to its efficacy in the management of both supraventricular and ventricular arrhythmias. 100 unit / 100 ml (1 unit/ml). For example, patients are frequently prescribed intravenous glucose 5%. Asymptomatic blue-grey discolouration of exposed areas can also occur. Infusion Pump Required. Patients in the amiodarone group were given a STAT dose of 300 mg of amiodarone (A) followed by a dose of 13 mg/kg for every 6 h and 0.5 mg/kg 18 h later. Then i-Vents acuity will now have a 10 to signify there is a open i-Vent. 2) Despite a reported duration of 5-8 hours, the peak/effective duration for IV is 30-60 minutes at best. 12. Only $199. 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. 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. What is the rate of the infusion in mL/h? 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.] 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 This should be administered as a dilute solution in 250ml 5% w/v dextrose. A patient started on oral (PO) amiodarone approximately 1 week ago (400 mg/day). 200mg tds. Intravenous administration Extravasation of amiodarone can cause significant tissue damage including necrosis. IV: 0.050.10 mg/kg given over 23 min (maximum single dose: 5 mg). 125 mcg twice daily. Flush with 20 ml of D5W/NS. 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 Half-life: 38-48 hrs. 15mg q6hr, even if equivalent, is hitting them with a whopping dose upfront. VT with pulse unstable: 1st dose 150mg IVP/IOP under 2 minutes - 2nd dose 150mg IV/IO in 50ml D5W/NS over 10 min.