A Fib with RVR

Question 1

1. Diltiazem

Answer 1

1st dose: 0.25 mg/kg (max of 20 mg) over 2 min
2nd dose: 0.35 mg/kg (max of 25 mg) over 2 min
then IV drip start at 5 mg/hr titrate up to 15 mg/hr

Question 2

2. Metoprolol

Answer 2

5 mg Iv q5m, max of 15 mg (may start with 2.5 mg for old folks, may consider propranolol or esmolol if required (if you do this at SAMMC you’ll likely be crucified)

Question 3

3. Amiodarone

Answer 3

7 mg/kg

Question 4

4. Digoxin

Answer 4

8-12 mcg/kg load (1/2 up front then 1/4 q6-8h)

Question 5

5. Magesium

Answer 5

(2.5 g over 20 min then 2.5 g over 2 hours)… helps the other 4 with effectiveness, NOT for monotherapy