Intravenous dilution guidelines: Bactrim ,BMX cocktail,bretylium,bumetanide,Bumex . By D.McAuley

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Dilution List [ B ]
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Bactrim Bretylium	Bumetanide (Bumex)
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*Preferred solution is listed first.

Drug	Standard Dilution	Infusion Rate	Diluents*
BACTRIM	0 to 80 mg/ 100 ml 81 to 120 mg/ 150-250 ml 121 to 240 mg/ 250 ml 241 to 450 mg/ 500 ml	60 min 90 min 90 min 2 hours	D5W
Stability/Misc.	EXP: 6 hours (RT)/ 2hrs (minimum dilution). Label: Do not Refrigerate. Minimum dilution: 80 mg TMP/ 75 ml. IV: Usual dose: 8-10mg/kg/day divided q6h, q8h or q12h. PCP: 15-20mg/kg/day in 3 or 4 divided doses. Note: dosages are based on trimethoprim. Oral: UTI: 1 DS tab (160mg TMP/800mg SMX) po q12h. Renal Dosing: >30/ no change \|\| 15-30/ 50% of usual dose q12h-alternatively: 8-10mg/kg/day divided q12h x 1-2 days, then 4-6mg/kg q24h. \|\| <15/ not recommended by manufacturer. Alternatively: 8-10mg/kg/dose q48h or 4-6 mg/kg/day.

BRETYLIUM (BRETYLOL)	500 mg/ 50-100 ml 2 grams/ 250 ml	Titrate	D5W / NS
Stability/Misc.	EXP: 1 Day (RT). Usual continuous infusion rate: 1-2 mg/min (0.5 to 4 mg/min) Dosing: initially 5 mg/kg bolus. IF V-fib persists: 10 mg/kg bolus. Repeat q5-10min up to total (30 to 35 mg/kg). Vtach: 5-10mg/kg diluted in 50ml over 8-10min or longer. May rpt q1-2h if arrhythmia persists. Renal impairment: 10-50/ 50% of dose. <10/ 25% of dose. Side effects: bradycardia/hypotension/ N&V. [Supplied: 500mg/ 10ml syringe] Calculation of drip rate: (code blue: 1 gram/500 ml D5W: 1 mg/min= 30 ml/hr )

BUMETANIDE (BUMEX)	25 mg(100ml)/ empty viaflex	Titrate	D5W / NS
Stability/Misc.	EXP: 1 Day (RT). May add 0 to 25 mg/100 to 250 ml D5W/NSS, Supplied: 2.5mg/ 10 ml vial. Equivalent dosages: [1 mg Bumex] =[40mg Lasix] = [10 to 20mg Demadex]. Higher doses are req'd in renal failure (usually > 10 mg/day). Usual infusion rates: 0.1 to 1 mg/hr.