IV Dose of Some Important Cardiac Drugs

1. Streptokinase
a. Formulation- 1.5 million IU/vial
b. Dose-
i. Myocardial infarction (initiated within 12 hours), by intravenous infusion, 1.5 million units over 60 minutes.
ii. Deep-vein thrombosis, pulmonary embolism, acute arterial thromboembolism, central retinal venous or arterial
thrombosis, by intravenous infusion, 250 000 units over 30 minutes, then 100 000 units every hour for up to 12–72 hours
according to condition with monitoring of clotting parameters
c. Order for use:
 Infusion- 1 vial dissolve in 10 ml N/S & then mix with 90 ml N/S then total 100 ml should be given within 1 hour (@25
drops/min)
 Syringe pump- 1 vial dissolve in 10 ml N/S & then mix with 40 ml N/S then total 50 ml should be given within 1 hour (@
50ml/Hour)

2. Heparin-
a. Formulation- 1 amp= 25000 IU/ 5ml (1ml=5000IU)
b. Dose- 75 units/kg (5000 IU=1ml) I.V. bolus then 15-20 units/kg/hour (20000-25000 IU/day)
c. Order for use: Infusion- 1 vial dissolve in 500 ml N/S & then total 500 ml should be given within 24 hour
(@ 6 drops/min= 24 micro drops /min)
Syringe pump- 1 vial dissolve in 50 ml N/S & then total 50 ml should be given within 24 hour
(@ 2ml/Hour)
S/C inj- Total 5ml (=25000 IU) in 2-3 divided dose.

3. Enoxaparin
a. Formulation: 40-80 mg PFS
b. Dose: DVT-1.5 mg/kg b.i.d; ACS- 1 mg/kg b.i.d.
c. Order for use: 40 – 80 mg S/C with PFS BD.

4. Eftifibatide (Integrilin)
a. Indication
b. Formulation: Bolus- 20mg/10ml vial (2mg/ml); maintenance- 75mg/100ml vial (750 micrograms/ml
c. Dose: initially by intravenous injection, 180 micrograms/kg, then by intravenous infusion, 2 micrograms/kg/minute for up to 72
hours (up to 96 hours if percutaneous coronary intervention during treatment)
d. Order for use: 4-ml iv bolus (bolus dose) then (7200 mcg/hr), without dilution 8-12 ml/hr

5. Lignocaine (2 %= 20mg/ml) :
a. Formulation. 1000 mg/50 ml vial.
b. Dose: IV bolus of 100 to 200 mg (5-10ml) before continuous infusion of 1 to 4 mg/min.
c. Order for use: 4-8 ml iv bolus stat, then 1 vial diluted in 450 ml N/S (1ml=2mg) and give maintenance dose @ 8drops- 30
drops/min (½ ml – 2ml) for 24 hours. Repeat bolus does if necessary.

6. Amiodarone
a. Formulation. 150mg/3ml amp.
b. Dose: via central venous catheter, initially 5 mg/kg over 20–120 minutes
c. Order for use: 2 amp diluted in 10 ml N/S, give IV bolus over ½ to 2 hour. Maintenance: total 400-1200mg over 24 hours. 3-8
amp in N/S to make it 50 ml then give 2ml/hour.

7. Nitrates
a. Formulation: 50mg/10 ml amp (5mg/ml)
 IV Dose of Some Important Cardiac Drugs
b. Dose: 10–200 micrograms/minute
c. Order for use: Syringe pump- 1 amp dissolve in 40 ml N/S then give 0.6-10 ml/hour

8. Dopamine
a. Formulation: 200mg/5ml
b. Dose: 2–5 micrograms/kg/minute
c. Order for use: 2 amp dissolve in 500 cc N/S & give 8-20 micro drops/minute
1 amp dissolve in 500 cc N/S & give 16-40 micro drops/minute

9. Dobutamine
a. Formulation: 250mg/20ml
b. Dose: 2.5–10 micrograms/kg/minute
d. Order for use: 2 amp dissolve in 500 cc N/S & give 8-35 micro drops/min or 1 amp dissolve in 500 cc N/S & give 16-70 micro drops/minute

10. Adrenaline
a. Formulation: 4 mg/2mL amp (equivalent to noradrenaline base 1 mg/mL)
b. Dose: For severe hypotension-Dilute 1 amp with 50 ml N/S (equivalent to noradrenaline base
40 micrograms/mL) & give initial rate of 0.16–0.33 mL/minute (9.6-20 ml/hour)
For cardiac arrest- Dilute 2-3 amp with 50 ml N/S (equivalent to noradrenaline base
80 -120 micrograms/mL) & give initial rate of 0.16–0.33 mL/minute (9.6-20 ml/hour)

11. Isoprenaline
a. Formulation: 1mg/ml (0.2 mg/ml)
b. Dose: Initial: 0.02-0.06 mg via bolus inj. Subsequent dose range: 0.01-0.2 mg. 
For temporary use in 3rd degree atrioventricular block until pacemaker insertion  2-10 mcg/min. Adjust subsequent rate
based on patient's response. 
c. Order for use: Dilute 1 mL (0.2 mg) to 10 mL with 0.9% NaCl, or 5% D/A then 0.02 mg to 0.06 mg (1 mL to 3 mL of diluted
solution) IV stat.
Maintenance: Dilute 5 mL (1 mg) in 500 mL of 5% D/A & give 0.5 mcg to 5 mcg/min. (0.25 mL to 2.5 mL or 3.75- 35 drops of
diluted solution per minute)

12. Atropine
1. Formulation: 0.6 mg/1ml
2. Dose: 0.6-3 mg IV stat.
3. Order for use: 1-5 amp IV stat.

13. Verapamil
a. Formulation: 5mg/2ml
b. Dose: IV bolus of 5 to 20 mg over 2 minutes can be followed by continuous infusion at 5 to 20 mg/h.
c. Order for use: 1-4 amp slow IV stat then, maintenance.

14. Adenosine
a. Formulation: 6mg/2ml ampoule.
b. Dose: Initial dose: 6 mg given as a rapid intravenous bolus (administered over a 1-2 second period).
Repeat administration: If the first dose does not result in elimination of the supraventricular tachycardia within 1-2 minutes, 12
mg should be given as a rapid intravenous bolus. This 12 mg dose may be repeated a second time if required.
c. Order for use: one amp IV stat, if no response 2 amp after few minutes. Not more than two amp.