Pediatric Intensive Care Unit Intravenous Push (IVP) Drug List ...

[Pages:11]Generic Name (Brand Names) Adenosine

Amiodarone

Ampicillin

Atropine Sulfate Bumetanide (Bumex)

Pediatric Intensive Care Unit Intravenous Push (IVP) Drug List - Approved for RN Administration

Ventura County Medical Center

Therapeutic Category Antiarrhythmic

Antiarrhythmic (Class III)

Antibiotic Beta-Lactam (Penicillin)

Anticholinergic Agent Loop Diuretic

Typical Pediatric Dose Maximum Pediatric Dose

0.1 mg/kg (max: 6 mg) Max single dose:

Second dose:

12 mg

0.2 mg/kg (max: 12 mg)

5 mg/kg May repeat dose up to 15 mg/kg/DAY.

Max single dose: 300 mg Max daily dose: 15 mg/kg/DAY

100-200 mg/kg/DAY divided every 6 hours

0.02 mg/kg/dose. May repeat once. Minimum dose = 0.1 mg. 0.01-0.1 mg/kg/dose every 6-12 hours

Max single dose: 2000 mg Max daily dose: 400 mg/kg/DAY, up to 12 GM/day for meningitis Max single dose: 0.5 mg

Max single dose: 2 mg

Maximum Concentration Give undiluted (3 mg/mL)

Dilute in D5W only. PIV: 2 mg/mL Central: 6 mg/mL

Neonates/infants: 50 mg/mL Pediatrics: 100 mg/mL

Maximum rate of Administration Adverse Effects/

Administration Considerations Monitoring

Parameters

Rapid IVP over 2- EMERGENCY Monitor for transient

3 seconds.

USE ONLY.

bradycardia, asystole,

Follow dose with and ventricular

rapid 5-10 mL NS arrhythmias.

flush.

PSVT may re-occur.

Monitor EKG, HR, BP

Give over 10 mins. IV PUSH FOR

& RR. HR, BP, EKG.

For perfusing

EMERGENCY For long-term therapy,

tachycardias, give USE ONLY.

consider monitoring

over 20-60 mins. Carefully monitor chest X-ray and lung

for rate-related function.

hypotension.

Black Box Warning:

pulmonary toxicity,

hepatotoxicity, and

proarrhythmic effects. IVP over 3-5 mins. Do not administer Contraindicated in

with gentamicin in patients with a history of

the same tubing or penicillin allergy.

administer

concurrently.

May give undiluted IVP over 1-2

(0.1 mg/mL)

minutes.

May give undiluted IVP over 1-2 (0.25 mg/mL) minutes.

Doses < 0.1 mg may cause paradoxical bradycardia. None

Monitor VS & EKG. Minor side effects: Dry mouth, dizziness & palpitations. Contraindicated in sulfonamide allergy. Black Box Warning: may cause profound diuresis and water/electrolyte depletion.

Page 1 of 11

MEC Approved: 10/9/2012

Pediatric Intensive Care Unit Intravenous Push (IVP) Drug List - Approved for RN Administration

Ventura County Medical Center

Generic Name (Brand Names) Calcium Chloride

Calcium Gluconate

Cefazolin (Ancef, Kefzol) CefoTAXime

CefTAZidime

Therapeutic Category Electrolyte HIGH ALERT

Electrolyte HIGH ALERT

Antibiotic (Cephalosporin, 1st Generation) Antibiotic (Cephalosporin, 3rd Generation)

Antibiotic (Cephalosporin, 3rd Generation)

Typical Pediatric Dose Maximum Pediatric Dose

10-20 mg/kg* *dose expressed in mg of calcium chloride

Max single dose: 1000 mg

50-100 mg/kg/dose* *dose expressed in mg of calcium gluconate

Max daily dose: 500 mg/kg/DAY

25-100 mg/kg/DAY Max daily dose:

divided every 6-8 hours. 100 mg/kg/DAY,

up to 6 gm/day in

children.

50 mg/kg/dose every 8 Max single dose:

hours

2000 mg

Meningitis: 75

mg/kg/dose every 6

hours 50 mg/kg/dose every 8 Max single dose:

hours

2000 mg

Maximum Concentration

For IV push, may give undiluted (100 mg/mL). For IV infusion, dilute to 20 mg/mL.

For IV push, may give undiluted (100 mg/mL). For IV infusion, dilute to 50 mg/mL.

100 mg/mL For IV infusion, dilute to 20 mg/mL. 60 mg/mL

180 mg/mL. For IV infusion, dilute to 40 mg/mL.

Maximum rate of Administration Adverse Effects/

Administration Considerations Monitoring

Parameters

IVP over 3-5

IV PUSH FOR Bradycardia, cardiac

minutes.

EMERGENCY arrhythmias, lethargy,

IV infusion over 1 USE ONLY.

EEG. Stop infusion if

hour

Do not use scalp patient complains of

vein or small hand pain at injection site.

or foot vein.

Do NOT give IM

or SQ. IVP over 3-5 min, IV PUSH FOR Bradycardia, cardiac

not to exceed 50- EMERGENCY arrhythmias, lethargy,

100 mg/per min. USE ONLY.

EEG. Stop infusion if

IV infusion over 1 Do not use scalp patient complains of

hour.

vein or small hand pain at injection site.

or foot vein.

Do NOT give IM

IVP over 3-5

or SQ. None

Caution in patients with

minutes.

a history of penicillin

IV infusion over

allergy.

10-60 minutes.

IVP over 5

Fast IVP (5

mcg/kg, slow IVP

over 5-10 minutes.

Antidote: GABA receptor antagonist

0.01 mg/kg (max: 0.2 Max single dose:

mg); may repeat dose 0.2 mg

every minute up to

Max total dose:

maximum of 0.05 mg/kg 1 mg

or 1 mg total

May give undiluted Infuse over 15 to

(0.1 mg/mL)

30 seconds via a

freely running IV

infusion into a

large vein.

EMERGENCY Black Box Warning:

USE ONLY.

administration has been

Do not exceed 0.2 associated with

mg/min.

seizures.

Page 4 of 11

MEC Approved: 10/9/2012

Pediatric Intensive Care Unit Intravenous Push (IVP) Drug List - Approved for RN Administration

Ventura County Medical Center

Generic Name (Brand Names) Furosemide (Lasix)

Glycopyrrolate (Robinul)

Haloperidol Lactate (Haldol)

Therapeutic Category Loop Diuretic

Anticholinergic Agent

Antipsychotic

Typical Pediatric Dose Maximum

Maximum

Maximum rate of Administration Adverse Effects/

Pediatric Dose Concentration Administration Considerations Monitoring

Parameters

0.5-1 mg/kg/dose every Do not exceed May give undiluted IVP over 1-2

Rapid & high dose Contraindicated in

6-12 hours

10mg/kg total for a (10 mg/mL)

minutes.

administration can sulfonamide allergy.

24-hour period.

cause irreversible Hypotension, headache

hearing loss.

& dizziness. Monitor for

hearing loss.

Black Box Warning:

may cause profound

diuresis and

water/electrolyte

depletion.

Control of secretions: Max single dose:

4-10 mcg/kg every 6-8 100 mcg

hours.

(May exceed max

Neuromuscular blockade single dose when

reversal:

used with

0.2 mg for every 1mg neostigmine

neostigmine used 0.01-0.2 mg/kg/dose

reversal). 0.1 mg/kg/dose,

not to exceed 5

mg.

May give undiluted IVP over 1-2

(0.2 mg/mL)

minutes.

May give undiluted Slow IVP (5 mg/mL)

Dysrhythmias have Blurred vision, dry been reported with mouth, N/V, urinary administration. hesitancy & retention.

Do NOT inject haloperidol decanoate. QT-prolongation and torsades de pointes have been reported with IV administration.

Hypotension, extrapyramidal symptoms, dystonic reactions, QTprolongation, torsades de pointes. ECG should be monitored. Black Box Warning: increased risk of death in elderly patients with dementia

Page 5 of 11

MEC Approved: 10/9/2012

Generic Name (Brand Names) HydrALAZINE

Hydrocortisone Succinate (Solu-Cortef) Hydromorphone (Dilaudid)

Insulin

Pediatric Intensive Care Unit Intravenous Push (IVP) Drug List - Approved for RN Administration

Ventura County Medical Center

Therapeutic Category

Typical Pediatric Dose Maximum Pediatric Dose

Antihypertensive: 0.1-0.2 mg/kg/dose

Vasodilator

every 4-6 hours

Max single dose: 20 mg

Maximum Concentration

Maximum rate of Administration Administration Considerations

May give undiluted IVP over 1-2

(20 mg/mL)

minutes, not to

exceed 0.2

mg/kg/minute.

May cause reflex tachycardia.

Adverse Effects/ Monitoring Parameters Palpitations, flushing, tachycardia, hypotension, arthralgias. Monitor heart rate, BP.

Anti-inflammatory 1-5 mg/kg/DAY every 6- None

Agent:

8 hours

Corticosteroid

Opioid analgesic HIGH ALERT

Initial dose: 5-15 mcg/kg/dose

None

50 mg/mL

IVP over 30 seconds

May give undiluted IVP over 2-3

(2 mg/mL)

minutes

Medication is

Hypertension,

usually placed hyperglycemia,

inline, but may be insomnia, nervousness

pushed.

Reversal agent ? Respiratory rate,

naloxone (Narcan) hypotension.

Black Box Warning:

risk of respiratory

depression, drug

interactions with other

CNS depressants, abuse

and medication errors.

Insulin

0.1 unit/kg

N/A

HIGH ALERT

100 units/mL

For life-threatening Use only regular

hyperkalemia: insulin for IV

give over 10

administration

seconds after

dextrose 25%.

For non-life-

threatening

hyperkalemia:

Give over 15-30

minutes with

dextrose 25%.

Monitor blood sugars, signs/symptoms of hypoglycemia

Page 6 of 11

MEC Approved: 10/9/2012

Generic Name (Brand Names) Ketoralac (Toradol)

Labetalol

Levothyroxine (Synthroid) Lidocaine

LORazepam (Ativan)

Pediatric Intensive Care Unit Intravenous Push (IVP) Drug List - Approved for RN Administration

Ventura County Medical Center

Therapeutic Category

Typical Pediatric Dose Maximum

Maximum

Pediatric Dose Concentration

Non-steroidal anti- Loading dose:

Age 16 years &

0.5 mg/kg/dose every 6- >50 kg:

8 hours

30 mg

30 mg/mL

Maximum rate of Administration Adverse Effects/

Administration Considerations Monitoring

Parameters

Give over >15 Requires dose Edema, drowsiness,

seconds.

adjustment in renal renal toxicity.

dysfunction.

Contraindicated in pts

with active or recent

bleeds, or taking aspirin

or other NSAIDs.

Black Box Warning:

Increased risk of

bleeding,

nephrotoxicity, and

cardiovascular

thrombotic events.

Antihypertensive: 0.2-0.5 mg/kg/dose Mixed alpha-beta blocker Thyroid Product 2-8 mcg/kg/dose

Antiarrhythmic 1 mg/kg

Benzodiazepine 0.05-0.1 mg/kg/dose

Max single dose: May give undiluted IVP over 2-3

Medication is

BP, HR, EKG

20 mg

(5 mg/mL)

minutes; not to usually placed

exceed 2

inline, but may be

mg/minute

pushed.

Not established. 100 mcg/mL;

Give over 2-3 Use immediately Palpitations,

dilute in NS only minutes.

after

tachycardia, cardiac

reconstitution. arrhythmias,

nervousness, tremor.

Max single dose: 20 mg/mL

IVP over 5-10 min, EMERGENCY Contraindicated in

100 mg/dose

not to exceed 0.7 USE ONLY.

patients with severe

Max cumulative

mg/kg/min or 50 Can be given via heart block.

dose:

mg/min.

ETT at 2-2.5 times

5 mg/kg Max single dose: 4 1 mg/mL

the normal dose.

0.05 mg/kg over 2- Can cause

Sedation, hypotension,

mg

5 minutes, not to infiltration with dizziness, headache, HR,

not exceed 2

IVP.

RR

mg/min.

Page 7 of 11

MEC Approved: 10/9/2012

Pediatric Intensive Care Unit Intravenous Push (IVP) Drug List - Approved for RN Administration

Ventura County Medical Center

Generic Name (Brand Names)

Magnesium Sulfate

Therapeutic Category

Electrolyte

HIGH ALERT

Typical Pediatric Dose Maximum

Maximum

Pediatric Dose Concentration

25-50 mg/kg/dose

100 mg/kg/dose Max single dose: 2 GM

200 mg/mL

Meperidine (Demerol)

Opioid Analgesic 1-1.5 mg/kg/dose HIGH ALERT

Max single dose: 100 mg, not to exceed 2 mg/kg

10 mg/mL

MethylpredniSOLON E Sodium Succinate (Solu-Medrol)

Anti-inflammatory Varies by indication:

Agent:

Asthma:

Corticosteroid 2-4 mg/kg/DAY

Pulse dose:

15-30mg/kg/DAY x 3

days

30 mg/kg/dose

125 mg/mL

Metoclopramide (Reglan)

Antiemetic Prokinetic gastrointestinal agent

0.1-0.2 mg/kg/dose every 6-8 hours

Max single dose: 5 mg/mL 10 mg

Maximum rate of Administration Administration Considerations

Slow IVP over at IV PUSH FOR least 5 minutes in EMERGENCY emergencies only. USE ONLY. IV infusion over 24 hours.

Adverse Effects/ Monitoring Parameters Hypotension, CNS depression, loss of deep tendon reflexes, heart block.

IVP over at least 5 Dilute to 10mg/mL Sedation, hypotension,

minutes.

with NS.

dizziness, constipation,

RR

Dose 15 mg/kg, Rapid

infuse over 30 administration of

minutes

doses 15 mg/kg

can cause cardiac

arrhythmias &

IVP over >2

cardiac arrest. Too rapid rate may Hypotension, sedation,

minutes.

cause intense

dizziness, rash,

If dose is >10mg, anxiety and/or dystonias & other

give IVPB over 15- drowsiness.

extrapyramidal effects.

30 minutes.

Medication usually Black Box Warning:

placed in the line, tardive dyskinesia

but may be pushed.

Page 8 of 11

MEC Approved: 10/9/2012

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