Actrapid Sliding Scale

CBG Coverage
CBG ≤200 no coverage
Coverage 201-250 3 units
<160 no coverage 251-300 5
161-200 3 301-350 7
201-249 5 351-400 8
250-299 7 401-450 9
300-349 9 451-500 11
350-399 11 >500 12 & refer
400-449 13
450-499 14
≥500 15 &
refer

Burinex Drip Calcium-Glucose Drip

Burinex 3 amps in 54cc Ca gluconate 4 amps in 500cc
PNSS D5W x 24hr
x 10 cc/hr see to it that the patient has no
beta-blocker

Calcium Gluconate Drip Cordarone Drip

Calcium Gluconate 4 amps Cordarone 4 amps + 500cc PNSS
(10mg/amp) in 500cc D5W x 60 cc/hr x 1st 6 hours
x 24hr Subsequently 25 cc/hr

Cordarone 150 mg IV now

Cordarone 4 amps + 500cc D5W x
Bricanyl Drip 24H
Bricanyl 5 amps in 500cc Cordarone 4 amps + 500cc D5W x
D5W 25 μgtts/min x 6H, then 12 cc/hr
x 24H

Increase to 30-40 cc/hr

Bricanyl 2.5 mg/tab TID

Diazepam Drip
Diazepam 10 mg/100cc D5W
Diazepam 20 mg/100cc D5W

Initial: 50-100 mg IV
Max: 60 mg/day

Diazepam 50 mg in 100cc PNSS x 6 cc/hr to titrate to control

seizure, hold for BP < 90/60 mm Hg

Dormicum Drip
Dormicum 3 amps (1.5 mg/amp) + 500cc PNSS x 2 mg/hr

Epinephrine Drip
Epinephrine 5 amps (5 mg) + 500cc D5W to run for 6 cc/hr

Dobutamine Drip Dopamine Drip

Dobutamine 250 Dopamine 2 amps (400 mg) +
mg/amp + D5W 250cc x 250cc D5W
___ μgtts/min (max: 10-20 mg/kg/min)
(max rate: 60
μgtts/min) Renal Vasocons: 0-5
mg/kg/min
Rate drip: Inotropic: 5-10 mg/kg/min
Drip mcg x kg BW Vasoconstriction: > 10
16.6 mg/kg/min

For patients w/ CHF: Rate (μgtts/min):

Dobutamine 2 amps mg/kg/min x BW
(500 mg) + 13.3 or 26.6
D5W 250 cc
(max rate: 30
μgtts/min)
Fraxiparine Drip
Fraxiparine 2 amps in 1 L D5W or
D5NSS
88 “U”/kg BW or 0.1 cc/kg x 24H
Fraxiparine
85 cc/kg or 0.1 cc/10 kg
Furosemide Drip
Furosemide 3 amps +
54cc PNSS in a soluset x
10 cc/hr
Furosemide 80 mg in
80cc PNSS via soluset x
10 cc/hr

Furosemide Drip Furosemide-Albumin

(Dr. Caro) Drip
25% Albumin 50cc +
In a soluset: Furosemide 3 amps + Furosemide 20mg to run
54cc PNSS x 10cc/hr for 4hrs
Or
D5W 250cc + Furosemide Albumin 50cc + PNSS
250mg/amp x 5-30 μgtts/min 950cc + Furosemide
Conc: 1 mg/mL 100mg x 24hrs
Or
PLR 500cc + 18 amps Furosemide x Albumin 100cc +
18-20 μgtts/min Furosemide 40mg to run
for 4-6hrs

Dr. Caro:
Furosemide 60mg +
PNSS 54cc x 10cc/hr
SD: Plasbumin 25%
100cc to run for
6 hrs
Glucose-Insulin-HCO3 Drip
D5W 150cc + D50W 1 vial +
NaHCO3 1 amp + Actrapid 8
units to run for 6 or 8 or 12
hrs
Repeat K post-drip
Glucose
HGT < 60 – D50W 1 amp
HGT < 40 – D50W 2 amps
Target FBS 60-90, RBS 80-
120
Heparin Drip
D5W 250cc + Heparin 10,000
units x 10-20 μgtts/min via
infusion pump
Conc.: 50 U/mL
Drip of 500-1000 ‘U’ ~ 10-20
μgtts/min
OR
In a soluset, Heparin 4cc in
36cc D5W (Heparin 1000
IU/cc)
OR
Heparin 5000 ‘U’ IV initially,
then 4000 ‘U’ in 36cc PNSS via
soluset x 1000 ‘U’/hr
LD: 3000-5000 ‘U’ slow IV
LD = 80 U/kg
MD = 18 U/kg
APTT det’n q6h
APTT 1.5-2x the baseline
Glucose-Insulin Drip
(Hyperkalemia ≥ 6)
In a soluset, 50cc D50W + Actrapid
8-10 units x 1hr x 3 cycles
CBG monitoring qHourly while on
drip
Repeat K 1 hr after the last cycle
Heparin for Flushing
> 500 ‘U’ Heparin in 100 mL PNSS
Hepamerz Drip
< 4 amps in 500cc D5W x 12hrs BID
IVIG
LD: 2 g/kg given in 5-6hrs in 3-5
days
MD: 400 mg/kg or 0.4g/kg
Insulin Drip
PNSS 250cc + Humulin R 50 ‘u’
Conc.: 0.2 ‘U’/mL
Drip of 5-50 μgtts/min ~ 1-10 ‘u’
Humulin
Isoket Drip
Isoket 10mg/amp (1amp) + Toradol Drip
PNSS 90cc x 10 μgtts/min (1 Toradol 30mg + PNSS 80cc via
mg/hr) soluset x 8H
Toradol 100mg + PNSS 80cc x
10cc/H
Miacalcic Drip
Miacalcic 2 amps (200 IU) + Tramadol Drip
D5W 250 cc x 15H Tramadol 100mg + PNSS 80cc x 10
μgtts/min

NaHCO3 Drip Trental Drip

NaHCO3 2 amps (50cc/amp) in Trental 4amps in PNSS 500cc x 24H
D5W x 24H
or Zantac Drip
NaHCO3 3 amps in 100cc D5W Zantac 5amps in D5W 500cc x 16H
x 24H
Zithromax Drip
Zithromax 500mg in 90cc IVF via
soluset to run for 5H

Nicardipine Drip
- 5mg/10ml
Mannitol (prep 20%) Mannitol-
Dose: Amt given (cc)x0.2/kBW Furosemide Drip:
- Nicardipine
LD: 1-2 g/kg 10mg in 90cc PNSS Mannitol
or D5W in250cc
a soluset
+
to run
MD: forg/kg
0.5-1 10cc/hr, titrate by increments of 5 μgtts/min
Furo 100mg x 10
to maintain BP at ____ mmHg μgtts/min
Action: 30mins OR
- Max
Peak: of 150 cc/hr at 15mg/hr (0.5
2hrs mk/BW),
Mannitol give
36cc +
initial bolus of 2mg IVTT, titrate to BP ___
Furo 240mg (24mL)
Complications: x 6H
Lidocaine
- rebound Drip in ICP
increase
-give
- IV 50 asexpansion
volume blous, then start drip as follows:
1 g in 250cc
pulmonary D5W at 15cc/hr (1mg/h)
edema MgSO4 Drip
increase by increments of 15
CHF D5W 250cc +
- DHN MgSO4 2g x
LD: 1mg/H
- Hypernatremia 20 cc/H
Conc: 4mg/cc
Drip: 1-4mg/min
 Conc: 250mg/mL x
10 amps
(2.5 g/amp)

Morphine Drip
MoSO4 10 mg/amp (1 amp) + PNSS 60cc in a soluset x
10 μgtts/min

MoSO4 1 amp (16mg/amp) + PNSS 50cc x 6 μgtts/min

Midazolam Drip ( Dr. Beltran )
(2mg/H)
0.3mcg per kg per minute.
30 mg
PRN: midazolam
1-3mg in 50 cc D5W to run at 3 ugtts per
MoSO4 SQ
min. Titrate by increments of 1 ugtts every 15 minutes
as needed.
Nimotop Drip
Nimotop ½ vial + D5W 500cc x 24H
Noradrenaline (Levophed) Drip
- 2mg Noradrenaline/2ml amp
- D5W 250cc
Nootropil Drip+ Levophed 1amp x 15-60 μgtts/min
- conc: 12g
Nootropil 8mcginNoradrenaline/ml
60cc x 24H
- drip of 2-8 mcg Noradrenaline ~ 15-60 μgtts/min

Levophed 2 amps (2 mg/mL/amp) in D5W 250cc x 10

μgtts/min

Levophed 4 amps in D5W 500cc x ___ μgtts/min

Pantoloc Drip
- maintain GI acidity to stabilize clot
- Pantoloc 80mg IV bolus then 5 amps in PNSS 1L x
24H for 3 days
 Octreotide (Sandostatin) Drip
- prep: 0.5 mg/mL
- 0.2 mg/mL IV bolus, give for 1 min, then start drip as ff: 4
amps + remaining 0.03 mg in 500cc PNSS x 24H

Sandostatin Drip
- sandostatin 0.5mg/amp 0.2mL now then drip as ff: 0.8mL in
D5W 500cc x 8H
- ff by 2 amps sandostatin 0.5mg/amp + D5W or D5NSS 1L x
24H

Solumedrol Drip
Solumedrol 2g + D5W 500cc x 20 μgtts/min

Somatostatin Drip
Somatostatin 250mcg IV bolus then 2amps (3mg/amp) + PNSS
1L x 24H for 5 days w/o interruption

Streptokinase Drip Terbutaline (Bicanyl)

Streptokinase 1.5M units + D5W Drip
90cc x 100cc/H (1H running rate) D5W 250cc + Bricanyl
via soluset 5amps x 10-30
μgtts/min
Give prior: Benadryl 50mg ivtt
Solucortef 250mg ivtt
Thiamine Drip:
APTT monitoring q6H 50-100mg IV (for 40-50
y.o.)
Burn Replacement:
4 ml/kg in 1st 24H: ½ 1st 8 H
½ next 16 H
Start initially w D5LR--- D5NSS
Prednisone Tapering
Prednisone 20 mg/tab 1 tab p BF
1 tab p lunch x 3 days
1 tab p BF, ½ tab p lunch x 3 days
1 tab p BF x 3 days
Then DC

Dilantin Drip 500 mg IVTT as LD via slow IVTT c PNSS as

mainline to be given at 110 mg/min then 300 mg IV Q6H

RHD Prophylaxis Ampicillin 2 g + Gentamycin 2 mg/kg

RITUXIMAB 90-120 meqs/kg

1st infusion, 50 mg/hr—100mg/hr
Max 400 mg/H
SE: pulmonary events, rapid tumor lysis
MOA: Binds to CD20 in pre B and mature B Lymp

Myoclonic seizure
Clonazepam – 0.02 mg/KBW

Lumbar Puncture
Send CSF for exam
1 Sugar, protein
2 centrifuge x 1 H at 1000 cpm
Sediment AFB, india ink, GS, CS
3 Cell Ct/Diff
4 save specimen: centrifuge x 1 H at 1000 cpm then exam
supernantant for CALAS

Flat on bed x 6H
NPO x 4H
Monitor Vs Q4H

Prepare materials
Spinal needle gauge 23
LP set
Manometer
Sterile test tube # 4
OS
Betadine
Lidocaine 2 %
Syringe 3 cc with guage 23 needle #2
Plaster

POST LP ORDERS (Dr Beltran)

Flat on bed x 6H
Monitor NVS Q30 mins x 4H until stable
NPO x 4H
For RBS
Include Na, K, Ca

Send CSF for analysis

tt1 sugar protein
tt2 centrifuge at 1000 cpm x 1 H
a. Sediment- gs, cs, afb, india ink, sabouraud
b. Supernatant- CALAS if avail
tt3 cell ct, diff ct
tt4 cell cytology