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Diuretics
Pengenceran :
syringe pump : 100 mg (5 amp) /50 cc NaCl 0,9%
1 cc = 2 mg
Infus
90 cc NaCl 0,9% + 100 mg (5 amp) 100 cc= 100 mg
1cc = 1 mg
Misal dosis furosemid yang diinginkan 5 mg /jam
mikrodrip (5 cc/jam) = 300/60 menit = 5 tts/menit
Morphine and its analogues
Morphine induces
• Venodilatation
• Mild arterial dilatation
• Reduce heart rate
Infus
1 amp (10 mg) dalam 100 cc NaCl 0,9%
100 cc = 10 mg
1 cc = 0,1 mg
Misal : dosis yang diinginkan 2 mg/jam
20 cc/jam
Makrodrip 20 tts x 20 = 400 tts/jam = 7 tts/menit
Role of Inotropic Therapy in
Acute Heart Failure
Infus
200 cc +200 mg dopamin 1 cc = 1 mg = 1000 mikrogram
Dobutamine
Clinical action is dose dependent positive
inotropic and chronotropic effects.
In low dose induce arterial vasodilatation
and in higher induce arterial
vasoconstriction
Infus
250 cc NaCl 0,9% + 250 mg dobutamin
1 cc = 1 mg
Misal : pasien dengan BB 50 kg memerlukan drip dobutamin 5 mikro/KgBB/menit
Kebutuhan 5 x 50 kg = 250 mikrogram/menit 0,25 cc/menit
Mikrodrip : 0,25 x 60 = 15 tts/menit
Nor ephinefrine
Sediaan
4 ml = 4 mg
Syringe pump
50 cc = 4 mg
1 cc = 0,08 mg = 80 mikro
Infus
1 ampul dilarutkan dalam 200 cc NaCl 0,9%
200 cc = 4 mg
1cc = 0,02 mg = 20 mikro
Misal pasien dengan BB 50 kg membutuhkan Norephinefrin 0.1 mikro/kgBB/menit
50 x 0.1 = 5 mikro/menit
= 0,25 cc
Tetesan = 60 x 0,25 = 15 tts mikro
Inotropic Agents
Phosphodiesterase inhibitors
Block the breakdown of cyclic AMP into
AMP (milrinone, enoximone)
In advance HF, associated with inotropic,
lusitropic, vasodilating effects
Intermediate between vasodilator and
predominant inotrope