cardene gtt

  1. Hey all!

    I am just wondering your thoughts on a cardene gtt post op cabg or any other vascular surgery. our surgeons on on this cardene kick this month instead of nipride. I don't think it works that well. especially for the hearts getting their pressure down quickly. Just want your thoughts. thanks:spin:
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    About chaosRN

    Joined: Oct '03; Posts: 213; Likes: 9

    5 Comments

  3. by   Mayflye
    I ask for it when we have pts w/ malignant htn. I think it is one of the most effective and easily titratable drug I use. Never seen it not work.
  4. by   TennRN2004
    I use it all the time for the hearts...love it, it works wonders for both htn and afterload reduction. If I'm getting up to 100-150 mcg on my ntg gtt, I'll start thinking about some cardene. For htn, usually start it a 5 mg/hr, for svr reduction, usually 2.5 mg/hr. We use it over nipride, although they are both on our standing orders, because of renal issues and b/c it is much smoother pressure control and easier to titrate. When you're seeing it not work, what kind of doses and pressues are you using? We all love it in my unit, and I agree with above post that I've never seen it not work.
  5. by   chaosRN
    I just don't see it work well. We usually use on our immediate post op cabg pts, instead of NTG or Nipride. We (I) begin at 2.5 and work my way up prn. From what I've experienced, it will work, but at such a high dosage, that you're giving the pt so much volume. Our pharm is strange & won't dbl strength it.
  6. by   RoxanRN
    Quote from chaosRN
    I just don't see it work well. We usually use on our immediate post op cabg pts, instead of NTG or Nipride. We (I) begin at 2.5 and work my way up prn. From what I've experienced, it will work, but at such a high dosage, that you're giving the pt so much volume. Our pharm is strange & won't dbl strength it.
    Our neurologists very much prefer nicardipine over NTG or Nipride and we have great success with it. Voice your concerns to your manager and cardiologists about the potentally high volumes and your pharmacy not concentrating medications. Our pharmacy will double, triple or quad strength it (or any drug) on request if it is possible.
  7. by   TennRN2004
    Quote from chaosRN
    I just don't see it work well. We usually use on our immediate post op cabg pts, instead of NTG or Nipride. We (I) begin at 2.5 and work my way up prn. From what I've experienced, it will work, but at such a high dosage, that you're giving the pt so much volume. Our pharm is strange & won't dbl strength it.
    It does end up giving the pt a lot of volume. We will double mix it if needed for volume control. But, on our standing orders we have the order to keep the total of IVF, including gtts to 100 cc/hr in the hearts, maybe you could suggest something similar to your MDs. Personally, I've only had 2 patients I can think of need more than 5-7.5 mg/hr, which is 50-75 cc/hr of volume. These two pts ended up getting prns and home meds resumed so we could start working off the cardene.

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