Dosing for Exam 2 (Arrhythmias) Flashcards
What is the correct diltiazem IV loading dose, infusion dose, and maintenance oral dose for afib?
LD: 0.25mg/kg over 2 minutes
Infusion: 5-15mg/hr
Oral: 120-360mg ER daily
Dose of atropine for sinus bradycardia?
0.5mg IV, repeat every 5 minutes
MAX 3mg or 0.04mg/kg
What is the correct verapamil IV loading dose, infusion dose, and maintenance oral dose for afib?
LD: 0.075-0.15 mg/kg IV over 2 minutes. May give add’l 10mg IV 30 minutes later.
Infusion: 0.005 mg/kg/min
Oral: 120-360mg ER daily
What is the correct esmolol IV loading dose and daily dose for afib?
LD: 500 mcg/kg IV over 1 minute
Daily: 50-300 mcg/kg/min IV
What is the correct propranolol loading dose and daily dose in afib?
LD: 1mg IV over 1 minute; up to 3 doses at 2 minute intervals
Daily: 30-160mg PO daily in divided doses
What is the loading dose and daily dose for metoprolol in afib?
LD: 2.5-5mg IV over 2 minutes, up to 3 doses
Daily: tartrate 25-100mg PO BID or succinate 50-400mg PO daily
What is the correct loading dose and daily dose for digoxin in afib?
LD: 0.25mg IV every 2 hours up to 1.5mg
Daily: 0.125-0.375mg PO or IV daily
What is the correct loading dose, infusion dose, and oral dose of amiodarone for rate control in afib?
LD: 300mg IV over 1 hour
Infusion: 10-50mg/hour over 24 hours
Oral: 100-200mg daily
What is the correct loading and infusion dose for amiodarone when used for conversion to sinus rhythm?
LD: 150mg IV over 10 minutes
Infusion: 1mg/min IV infusion for 6 hours then 0.5mg/min for 18 hours
How is ibutilide dosed for conversion of afib to NSR?
1mg IV over 10 minutes followed by second dose 1mg IV 10 minutes later if necessary. Use 0.01mg/kg IV if weight
How is propafenone dosed for conversion of afib to NSR?
450-600mg single oral dose
How is flecainide dosed for conversion of afib to NSR?
200-300mg single oral dose
How is dofetilide dosed for conversion of afib to NSR (based on CrCl)?
Over 60 mL/min: 500mcg PO BID
40-60mL/min: 250mcg PO BID
20-39mL/min: 125mcg PO BID
Under 20mL/min: CI
How is amiodarone dosed for maintenance of NSR?
LD: 400-600mg daily in divided doses for 2-4 weeks
Maintenance: 100-200mg PO daily
How is dronadarone dosed for maintenance of NSR?
400mg PO daily
How is sotalol dosed for maintenance of NSR?
40-160mg PO BID
How is propafenone dosed for maintenance of NSR?
150-300mg PO TID
225-425mg PO BID if ER
How is flecainide dosed for maintenance of NSR?
50-200mg PO BID
How is dabigatran dosed for afib in normal kidney function? In severe kidney dysfunction?
CrCl over 30mL/min: 150mg BID
CrCl 15-30mL/min: 75mg BID
How is rivaroxaban dosed for afib in normal kidney function? In severe kidney dysfunction?
CrCl over 50mL/min: 20mg PO daily with PM meal
CrCl 15-50mL/min: 15mg PO daily with PM meal
How is apixaban dosed for afib?
2.5 or 5mg BID (not in CrCl under 30)
How is edoxaban dosed for afib in normal kidney function? In severe kidney dysfunction?
CrCl over 50mL/min: 60mg daily (unless over 95mL/min)
CrCl 15-50mL/min: 30mg daily
How is adenosine dosed to terminate PSVT?
6mg IV rapid bolus
If no response in 1-2 minutes, 12mg IV bolus
How are the beta blockers, CCBs, and amiodarone dosed for PSVT?
IV as used in afib (amiodarone conversion to sinus rhythm)
How is procainamide dosed to terminate VT?
LD: 20-50mg/min IV infusion
Maintenance: 1-4mg/min IV infusion
How is amiodarone dosed to terminate VT?
LD: 150mg IV over 10 minutes
Maintenance: 1mg/min IV infusion for 6 hours, then 0.5mg/min for 18 hours
How is amiodarone dosed for prevention of sudden cardiac death after VT?
400mg PO daily
How is sotalol dosed for prevention of sudden cardiac death after VT or to reduce the frequency of shocks in patients with ICDs and prolong battery life?
80-160mg PO daily
How is epinephrine dosed for treatment of Vfib?
1mg IV or IO every 3-5 minutes
How is amiodarone dosed for treatment of Vfib?
300mg IV/IO followed by 150mg IV/IO
diluted in 20-30mL D5W
