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Discussion

Diltiazem

HI everyone,

I have the following question. How fast do you push 10 mg of Diltiazem for a pt with AFib with rapid ventricular response? Also, how often can you give Diltiazem IVP if the pt's HR does not decrease less than 100 bpm?

Thanks.

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    • Featured Replies

    Push it slow like lasix, over 2 minutes. If the 1st dose doesn't have an effect after 15 minutes, we give another round. Anything beyond that is dependant on the individual pt.

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    i agree, slow push. hopefully they will get the bolus and gtt ordered. a lot of times if that doesn't break them with the first bolus or 2- they order labetalol ivp.

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    • Experts

    As above. We push over 2 minutes and get a drip running.

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    We can bolus dilt through out pumps...the bolus runs in fast (i.e. 10 mg in a few seconds).

    As for how ofen you can repeat this--the depends on the physician's order. They may originially order a 2nd bolus if the first does not lower this below a certain rate. Most often though, I have seen doctors order bolus doses one at a time. Also, if they plan on using a gtt, HR of 100 is not their goal with a bolus. For example, if a pt has a HR of 140 (EKG: A fib with RVR), the will order a bolus dose of 10mg and a gtt at 10 mg/h. After the bolus, if the HR comes down to 110 they will often just go with the gtt. If HR is still 130, they will go with another bolus. Regardless, an order is needed for another bolus.

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    • Experts
    @esme12 that link was pretty cool how did you do that ?

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