Cardene (Nicardipine) Continuous Infusion Protocol

Pharmacy Code (if one is required): Diagnosis: _________________________________ Weight (kg): ____________________ Allergies: _________________________________ Height (cm): ____________________ 1. Initiate Physician Preference Order Set as Outlined below. 2. Continuous cardiac monitoring 3. Vital Signs (blood pressure and pulse)- follow below orders for monitoring during continuous IV infusion. Initial vital signs every 15 minutes x 2, then Every 30 minutes x 2, then Every 60 minutes x2, then Every 2 hours x 2, then Every 4 hours while on continuous IV infusion If dose adjusted, repeat above protocol for vital signs. 4. In patients experiencing a hypertensive emergency It is recommended that resting mean arterial pressure (MAP) not be reduced >25%. It is recommended that DBP initially be decreased by 10% to 15%, or to approximately 110 mm Hg over 30 to 60 minutes. In patients with aortic dissection, the BP should be reduced rapidly (within 5 to 10 minutes), targeting a SBP of <120 mm Hg and MAP <80 mm Hg. 5. Cardene continuous IV infusion: Initiate therapy at 5mg/hr or _____ increased by 2.5 mg/hr every 5 minutes (for rapid titration) to every 15 minutes (for gradual titration) up to a maximum of 15 mg/hr. 6. For rapidly titrated patients a reduction to 3 mg/hr or _____ after response is achieved. 8. All patients should be titrated to lowest dose necessary to maintain stable blood pressure. 9. If no response from above, notify physician. 10. Administer using safety limits on infusion pump for infusion. 11. Physician to evaluate need for Cardene (Nicardipine) drip after response is achieved. If transitioning to oral anti-hypertensive start 1 hour prior to IV discontinuation.

______________________________________ Physician Signature Date/Time Pharm Code:

Originated: 1/11 Revised: __ Copy sent to pharmacy SUBSEQUENT ORDERS TO BE SUBMITTED ON NCR PHYSICIAN'S ORDER SHEET