Page 260 - Critical Care Notes

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CC MEDS
lidocaine: Antidysrhythmic (class Ib). Uses: Ventricular tachycardia, ventricular
dysrhythmias during cardiac surgery, MI, digitalis toxicity, cardiac catheteri-
zation. Dosages: IV bolus 50–100 mg (1 mg/kg) over 2–3 min, repeat every
3–5 min, not to exceed 300 mg in 1 hr; begin IV infusion. IV infusion
20–50 mcg/kg/min; IM 200–300 mg (4.3 mg/kg) in deltoid muscle, may
repeat in 1–1 ⁄2 hr if needed.
1
lorazepam, Ativan: Benzodiazepine. Uses: labeled indications: PO manage-
ment of anxiety disorders or short-term (<4 mo) relief of symptoms of
anxiety, anxiety associated with depressive symptoms, or insomnia related
to anxiety or transient stress. IV status epilepticus, amnesia, sedation.
Unlabeled indications: Ethanol detoxification; psychogenic catatonia; partial
complex seizures; agitation; antiemetic for chemotherapy; rapid tranquiliza-
tion of the agitated patient. Dosages: Antiemetic: PO, IV- 0.5–2 mg every
4–6 hr as needed. Anxiety, sedation, and procedural amnesia: PO 1–10 mg/day
in 2–3 divided doses; usual dose 2–6 mg/day in divided doses or 1–2 mg
1 hr before procedure. IM 0.05 mg/kg administered 2 hr before surgery
(max dose 4 mg). IV 0.044 mg/kg 15–20 min before surgery (usual dose 2
mg; max dose 4 mg). Insomnia: PO 2–4 mg at bedtime. Status epilepticus:
IV 4 mg/dose slowly (max rate 2 mg; max dose 4 mg). Rapid tranquilization
of agitated patient (unlabeled use): PO, IM 1–2 mg administered every
30–60 min. Agitation in the ICU patient (unlabeled use): IV loading dose:
0.02–0.04 mg/kg (max single dose 2 mg); maintenance 0.02 mg–0.06 mg/kg
every 2–6 hr as needed or .01–0.1 mg/kg/hr. Alcohol withdrawal syndrome
(unlabeled use): PO 2 mg every 6 hr for 4 doses, then 1 mg every 6 hr for
8 additional dosages. Alcohol withdrawal delirium (unlabeled use): IV
1–4 mg every 5–15 min until calm, then every hr as needed to maintain
light somnolence. IM 1–4 mg every 30–60 min until calm, then every hr as
needed to maintain light somnolence.
magnesium sulfate: Anticonvulsant, miscellaneous, electrolyte supplement,
parenteral; magnesium salt. Uses: Treatment and prevention of hypomag-
nesemia; prevention and treatment of seizures in severe pre-eclampsia or
eclampsia, torsade de pointes; treatment of cardiac arrhythmias (VT/VF)
caused by hypomagnesemia; soaking aid. Dosages: Dose represented as
magnesium sulfate unless stated otherwise. Hypomagnesemia—Mild
magnesium deficiency: IM 1 g every 6 hr for 4 doses, or as indicated by
serum magnesium concentrations. Severe magnesium deficiency: IM Up
to 250 mg/kg within a 4-hr period. Severe non–life-threatening deficiency:
IV 1–2 g/hr for 3–6 hr then 0.5 g/hr as needed to correct deficiency.
Symptomatic magnesium deficiency: IV 1–2 g over 50–60 min: maintenance
infusion may be required to correct deficiency (0.5–1 g/hr). Polymorphic VT
(including torsades de pointes): IV push 1–2 g. Seizures IV 2 g over 10 min.
Eclampsia: IV 4–5 g infusion: followed by a 1–2 g/hr continuous infusion or
may follow with IM 4–5 g in each buttock every 4 hr. Pre-eclampsia (severe):
IV infusion 4–5 g; followed by a 1–2 g/hr continuous infusion; or may follow
with IM doses of 4–5 g in each buttock every 4 hr; max dose 40 g/24 hr.
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