Published May 21, 2007
ECU_CRNA2B
47 Posts
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
12 Posts
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, BSN, RN
739 Posts
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
25 Posts
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
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
145 Posts
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
457 Posts
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
67 Posts
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.