| MAGNESIUM
SULFATE |
1 gram/ 50 ml
2 grams/ 100 ml
3 grams/ 100 ml
4 grams/ 250 ml
5 grams/ 250 ml |
30 min
60 min
2 hours
3 hours
4 hours |
D5W / NS |
Stability/Misc.
|
1 gram = 8.12
meq.
Maximum rate: 1 gram/ 7 minutes. Normal range:1.5 to 2.5 meq/L or 1.7 to 2.6 mg/dl.
Magnesium
content: Mag Oxide: 49.6 meq/gram || Mag Gluconate: 4.5 meq/gram || MOM: @ 13.4
meq/5 ml |
|
| MANNITOL |
12.5 grams/ 33 ml (15%)
25 grams/ 67 ml (15%)
50 grams/ 133 ml (15%)
12.5 to 100 grams/ empty viaflex |
As directed |
D5W |
Stability/Misc.
|
Label: Do not
Refrigerate. Note: Diluted solutions of mannitol are less likely to
crystallize, especially if the final concentration is less than 15%. An
administration set with a filter should be used for infusions containing
20% or more of mannitol. At concentrations of 15% or greater, mannitol may
crystallize at low temperatures. Dosing: Oliguria: 50 to 100 grams (15 to
25% solution) over 90 min to several hours. Test dose may be given: 12.5 g over
3 to 5 minutes. May repeat. Usual adult dosage ranges (50 to 200 g/ 24hrs). |
|
MEROPENEM
(MERREM) |
[0.5
- 1 gram] [100 ml] [30 min]
(Minimum volume= 50 ml) |
30 min |
NS,
D5W |
Stability/Misc.
|
EXP:
2 hr (RT)/18 hours (REF) in saline. vs 8 hr stability in D5W. Label:
Refrigerate.
Reconstitute 500mg vial with 10 ml; 1 gram vial with 20ml. |
|
| MESNA
(MESNEX) |
Usual dose / 100 ml
D5W or
NS (over 15 min.)
(Concentration range: 1-20 mg/ml) |
15-30 min |
D5W / NS |
Stability/Misc.
|
Dosing: usual dose=20% of
ifosfamide dose given just before and 4 and 8 hours after ifosfamide (total=60%).
May also be given as a continuous IV infusion concurrently with ifosfamide. Total daily dose=
60% to 160% of ifosfamide dose or 60% to 200% of cyclophosphamide dose.
May give 20% W/W 15min prior, and then q3hrs x 3-6 doses. Administration:
IVPB in 50 ml or more of D5W or normal saline over 5 minutes or longer. Also by continuous IV
infusion. Storage/stability: Vials stored at RT. Diluted
solutions (1-20 mg/ml)-24
hrs (REF). 20 mg/ml (D5W)-48hrs RT; 1-mg/ml (D5W)-24 hours RT.
Preparation:
May be further diluted in D5W, NS, D5/.45NS, or LR to a final concentration of 1-20
mg/ml. Availability: 2-,4-,10-ml ampules (100mg/ml) |
|
| METHYLDOPATE
(ALDOMET) |
0 to 500 mg/ 100 ml
over 500 mg/ 250 ml |
60 min |
D5W |
Stability/Misc.
|
EXP: 1 DAY (RT) |
|
METHYLPRED-
NISOLONE
(SOLU MEDROL) |
60 to 100 mg/ 50 ml
101 to 500 mg/ 100 ml
501 to 1250 mg/ 250 ml
(Spinal cord injury) Bolus dose (30mg/kg)/ 50 ml D5W over 15
min, pause 45min. Maintenance dose: 5.4 mg/kg/hr x 23. Dilute to 230ml (total
volume)
D5W. Infuse at 10 ml/hr x 23 hours.
(Methylpred dose/ 0.8 )=prednisone dose |
30 min
UD
|
D5W |
Stability/Misc.
|
EXP: 1 DAY
(RT) Label:
Do not Refrigerate. May be given IM, IVpush, or
IVPB. High dose: 30 mg/kg over 30 min (may rpt q4-6h) in a 48hr
period. Asthma: 2 mg/ kg q4 -6h until severe symptoms controlled, then
reduce dose. MS acute exacerbation: 500 mg once daily x 5 days. PCP:
40 to 60 mg every 6 hours or pulse dosing: 250 to 1000mg once daily x 3 to 5 days. Spinal
cord injury: 30 mg/kg (over 15 to 30 minutes) then 5.4 mg/kg/hr x 23
hours. (higher doses possible).
Dilution (Upjohn): 125,250,500
mg/100ml D5W [ 1-1.25g/ 250ml D5W] [1.5 to 3g/50ml NS] [ 3 to 6g/100ml NS] [6 to 12g/200 ml
normal saline--total
volume] [7.5 to 15g/ 250 ml NS]
Medrol dose
pack: (4mg tab # 21): Day#1: 2 tabs before breakfast, 1 tab after lunch
& dinner, and 2 tabs at bedtime. (Total=6 tabs) If received later in
the day, may take all
6 tablets at once or in divided doses. Day#2: 1 tab before breakfast, 1
tab after
lunch & dinner, and 2 tablets at bedtime. Day#3: Same as day#2 except 1 tab at
bedtime. Day#4: 1 tab before breakfast, after lunch and at bedtime. Day#5: 1 tab after
breakfast and at bedtime. Day#6: 1 tab after breakfast. |
|
| METOCLOPRAMIDE
(REGLAN) |
All doses / 50 ml |
30 min |
D5W |
Stability/Misc.
|
EXP: 1 DAY
(RT).
Dosing: GI hypomotility: 10mg (PO/IM/IV) 30min AC & hs.
Antiemetic:
1-2 mg/kg IV 30min prior to chemo, then q2-4hr.
Crcl [10-40]- decrease dose by
50%. [<10]--75% decrease |
|
| METOPROLOL
(LOPRESSOR) |
0 to 20 mg/ 50 ml
21 to 40 mg/ 100 ml |
30 min
60 min |
D5W / NS |
Stability/Misc.
|
EXP: 1 DAY
(RT).
The dilutions listed are conservative guidelines that can be used in
non-acute conditions. The infusion times were formulated to mimic the
onset of an oral formulation. (@ onset-oral= 45-60min).
Oral to IV
conversion (2.5 to 1) : eg 50mg oral=20mg IV (equivalent beta-blockade).
Lopressor may be given by IV bolus (HR, BP, and EKG should be carefully
monitored). IV therapy permits rapid control of HR and contractility. Post MI
(early tx): 5 mg IV bolus x 3 doses q2 minutes. In patients who tolerate full
15 mg
dose, oral lopressor 50mg po q6h should be started 15 min after last IV
dose x 48 hours. Unstable angina: 5 mg IV bolus x3 q2min f/b 2 to 5 mg
hourly titrated to min HR of 55 to 60 BPM or min systolic BP of 80 . May
switch to oral dosing (50 to 100mg po q6h) after IV bolus therapy.
Supraventricular tachycardias(PAT, A-fib/flutter): 5 to 15 mg (usually 5 mg)
over 2.5 min at 7.5min intervals-usually a high response rate. |
|
| METRONIDAZOLE
(FLAGYL) |
500 mg/ 100 ml
Over 500 mg/ 250 ml |
60 min |
NS |
Stability/Misc.
|
Label: Do not
Refrigerate. Reconstituted vials must be neutralized with 5 meq sodium
bicarbonate for each 500 mg used. IV: 500mg or 7.5 mg/kg q6h (range: q6-12h
--long T ½ ). Oral: 250-750mg orally three times daily. (occasionally
twice daily). Max 4g/day. Renal Dosing: > 10/ no change || <10/ 500mg ivpb q12h. |
|
| MICAFUNGIN
(MYCAMINE) |
| Usual
Diluents |
| NS or D5W |
| Standard
Dilutions [Amount of drug] [Infusion volume]
[Infusion rate] |
[ 50 mg ] [ 100 ml] [ 1
hour]
[ 150 mg ] [100 ml] [1 hour]
Reconstitute each 50mg vial with 5 ml 0.9% Sodium Chloride
Injection, USP (without a bacteriostatic agent). |
|
Stability/Misc.
|
Stability:
24 hours room temperature. Label: Protect from light.
Indications: Treatment of patients with esophageal candidiasis: 150mg qd.
Prophylaxis of Candida infections in patients undergoing hematopoietic
stem cell transplantation: 50 mg qd.
The diluent to be used for reconstitution and dilution is 0.9% Sodium
Chloride Injection, USP (without a bacteriostatic agent). Alternatively,
5% Dextrose Injection, USP, may be used for reconstitution and dilution of
MYCAMINE. Do not mix or co-infuse MYCAMINE with other medications.
Reconstitution: MYCAMINE 50 mg vial:
Aseptically add 5 mL of 0.9% Sodium Chloride Injection, USP (without a
bacteriostatic agent) to each 50 mg vial to yield a preparation containing
approximately 10 mg micafungin/mL.
Dissolution: To minimize excessive foaming, GENTLY dissolve the MYCAMINE
powder by swirling the vial. DO NOT VIGOROUSLY SHAKE THE VIAL.Visually
inspect the vial for particulate matter. MYCAMINE is preservative-free.
Discard partially used vials.
MYCAMINE is a trademark of Astellas Pharma, Inc., Tokyo , Japan. |
|
| MIDAZOLAM (VERSED) |
100 mg/ 100 ml
(0 to 100 mg/ 100 ml)
Usual dose requested: 1 to 5
mg/hr
|
Titrate |
D5W / NS |
Stability/Misc.
|
EXP: 1 DAY
(RT). Premedication: usually 5mg (70 to 80 mcg/kg) IM 30-60min before
surgery.
Anesthesia induction: 0.3 to.35 mg/kg over 20-30 seconds (range: 0.15 to 0.6).
Status epilepticus: 0.1 to 0.35 mg/kg load, followed by continuous infusion: 0.05 to 1.08
mg/kg/hr (possibly up to 2? Based on EEG). Mechanical ventilator
patient: usually 0.05 to
0.2 mg/kg/hr for sedation. Maximum dose: In isolated reports, midazolam
has been given in doses ranging from 0.3 to 0.85 mg/kg/hr (20 to 55 mg/hr)
without respiratory depression or decreased BP. Decrease dose by 50% for
patients
with renal failure. [Little support for doses > 0.35 mg/kg/hr-disregarding limited case
studies.] |
|
| MILRINONE
(PRIMACOR) |
50 mg/ 200 ml (final
volume = 250 ml) |
Titrate |
D5W / NS |
Stability/Misc.
|
EXP: 3 DAYS
(RT).
Remove 50 ml from 250ml bag. Dosing: initially give loading dose: 50
mcg/kg IV over 10 minutes, followed by continuous infusion: 0.375 to
0.75 mcg/kg/min (usually 0.5 mcg/kg/min). Lower doses are required in
renal failure (0.2 to 0.23 mcg/kg/min for crcl <10 ml/min, crcl
10-30 ml/min-0.23 to 0.33 mcg/kg/min). Venodilator: 0
Arterial dilator: ++ Inotropic effect: +++ Calculation
of drip rate: 50 mg/250ml (ml/hr) = wt (kg) x 0.3 x mcg/kg/min
| Recommended
infusion rates: renal insufficiency
|
Creatinine Clearance
(mL/min/1.73 m 2 )
|
Infusion Rate
(mcg/kg/min) |
| 5 |
0.20 |
| 10 |
0.23 |
| 20 |
0.28 |
| 30 |
0.33 |
| 40 |
0.38 |
| 50 |
0.43
|
|
