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# Inotropic Calculations M.

Michelle Piper, MSN, RN

    Inotropic medications are given to support blood pressure & maintain cardiac output Medications are given via continuous IV drip and must be titrated to patient’s body weight very carefully Other drugs. such as sedatives. & antiarrythmics may be given via continuous drip Pumps may or may not be available to calculate drips for the nurse ◦ And the nurse still needs to check pump anyway! . insulin.

the patient needs to receive 4 mcg EVERY minute. or 240 mcg/hr For 4 mcg/kg/min. or 16.800 mcg/hr .   Most drips calculated as mcg/min or mcg/kg/min This means that for 4 mcg/min. the a 70 kg patient needs 280 mcg EVERY minute.

   Remember ordered ? available The same rule applies for drip calculations Patient needs 5 mcg/min.05 mL/min O/A = 5 mcg/min 100 mcg/mL . Concentration of nitroglycerin is 100 mcg/mL = 0.

   Pumps are set in mL/hr.05 mL/min x 60 min/hr = 3 mL/hr . not mL/min How many minutes are there in an hour? Rate (mL/min) x 60 (min/hr) = Rate (mL/hr) 0.

 mcg/min Formula: Rate = Dose (mcg/min) x 60 min/hr Concentration (mcg/mL)  mcg/kg/min Formula: Rate = Dose (mcg/kg/min) x Weight (kg) x 60 min/hr Concentration (mcg/mL)  mcg/kg/hr Formula: Rate = Dose (mcg/kg/hr) x Weight (kg) Concentration (mcg/mL) .

8 mL/hr .A 63 kg patient needs dopamine 5 mcg/kg/min.6 mg/mL = 1600 mcg/mL  Rate = Dose (mcg/kg/min) x Weight (kg) x 60 min/hr Concentration (mcg/mL) Rate = 5 mcg/kg/min x 63 kg x 60 min/hr 1600 mcg/mL Rate = 11. Bag hanging has 400 mg/250 mL.  What is concentration of drug?    What rate should the pump run? ◦ 400 mg/250 mL = 1.

What should the pump rate be? Rate = 0. A 50 kg mechanically ventilated patient needs an infusion of midazolam 0. Versed is available at a concentration of 5 mg/mL.5 mL/hr .05 mg/kg/hr.05 mg/kg/hr x 50 kg 5 mg/mL  = 0.

The patient should be receiving norepinephrine 6 mcg/min. The pump is currently running at 50 mL/hr.    A critical care nurse is coming on shift at 0700. The nurse notes that the bag has 800 mcg in 100 mL. Is the pump set correctly? Correct Rate = 6 mcg/min x 60 min/hr 8 mcg/mL Correct Rate = 45 mL/hr Should the RN decrease the rate? .

 How much drug is the patient actually getting? Rate = Dose (mcg/min) x 60 min/hr Concentration (mcg/mL) 50 mL/hr = Dose x 60 min/hr 8 mcg/mL Dose = 6.7 mcg/min .

5 mL/hr = Volume/4 hours Volume = 2 mL 2 mL x 20 Units/mL = 40 Units .   A 75 kg patient received Insulin drip at 0. How much insulin did he receive? What other information do you need? Concentration is 20 Units/mL Pump rate = Volume/Time 0.5 mL/hr for the last 4 hours.