[ECU_CRNA2B]

Was wondering if anyone has suggestions for administering cardene via IV BOLUS.... how you mix it/concentration and how much you 'bump' in at a time....
grazi

[ERJUNKIE4LIFE]

Grazi,

Cardene is not to being given IV bolus it is a slow continuous infusion of a concentration of 0.1mg/ml mixed in 240cc of compatible ivf resulting in a 250ml solution (not compatible w/ sodium bicarb or LR) MUST BE DILUTED
The ampule is 25mg per 10cc
The diluted soln is good for 24 hours
Initial therapy is at 50ml/hr (5mg/hr) for rapid decrease in BP increase rate Q 5min by 25ml/hr (2.5mg/hr) up to 150ml/hr (15mg/hr) do not exceed this amount. Once desired BP reached decrease rate to 30ml/hr (3mg/hr)
If trying to gradually lower BP increase Q 15 min. until desired BP is reached
There are quite a few contraindications if you want to know those also let me know
Hope this helps

[hogan4736]

shouldn't be given as a bolus...at least not that I've ever done/heard of...

we used it for HTN in acute CVAs

5 mg/hour, titrated up to a max of 15mg/hr

our concentration was 25 mg in a 240 cc bag of D5 1/2 NS, and start at a rate of 50 cc/hr

[ralatek]

I seem to be seeing it used more at our main clinical site. We do the standard 25mg in 250ml (0.1mg/ml). Some will then draw up 10ml into a syringe and bolus 0.5-1ml increments

[ECU_CRNA2B]

thanks ralatek for the dosing guidelines....to the others, I understand the FDA approves of only gtt purposes of cardene however, like many drugs in this profession, things aren't always administered under FDA guidelines or approval.
Much thanks!!!!!!!!

[Summitk2]

I would love to hear about bolus dosing, if anyone's done it.

I've only used it a couple times in CVICU and don't like it. It took me 30-60 mins to see results following dosing guidelines, then the pressure rose as soon as I decreased to the "maintenance" dose of 3mg. I ended up titrating it, but took about 4 hours to find the dose that worked best.

[gaspassah]

i have given it bolus by mixing in the standard fashion then drawing some in a 10 cc syringe to give by 1 ml increments. i will also free flow cardene on regular iv tubing if the patient has an art line. i use it alot for intracranial interventional radiology stuff, aneurysms and the like. it is a very safe drug and has a relatively fast half life. doesnt stick around for very long.
d

[arkgolfer]

Cardene is a great short acting antihypertensive. I use it mostly during CABG, mainly when getting the pressure down for cannulation. I mix it 2cc with 8cc ns for a 0.5mg/ml concentration. I give 1/2 to 1cc at a time. I like to give a cc early in the case to get an idea of how much of a drop in bp I get. Usually 0.5 mg will give me about a 15 to 20 pt decrease in bp. It will usually last for about 10 minutes. You do get a reflex increase in hr, so watch out for that. I used it today, and it worked great. The cardene rep inserviced us on this bolus technique.