Bivalirudin (Angiomax) CVDL Diltiazem (Cardizem) Dobutamine (Dobutrex). While the conversion formula has anecdotal clinical effectiveness, it should be taken into consideration that it could be nothing more than a ballpark guess. pharmacy for kit) NA (maintenance drip is optional: 0.40.7 mg/kg/hr) HIT: 2.
Meanwhile, conducting literature searches through PubMed and Google Scholar has yielded no helpful results, and pharmacology and pharmacokinetic textbooks similarly don’t provide any guidance. As a result, the heart beats slower and the blood vessels relax, thus, increasing the supply of blood and oxygen. Diltiazem affects the movement of calcium into the cells of the heart and blood vessels. It belongs to a group of drugs called calcium channel blocking agents. I’ve also attempted (and failed) to derive the formula from the pharmacokinetic parameters of diltiazem, but multiplying the infusion rate in mg/hour by 3, then adding 3, and then multiplying that by 10 appears random. Diltiazem is used to control rapid heartbeats or abnormal heart rhythms. Over the years, I’ve sought the initial description of how these figures came to be. The usual dosage range studied in clinical trials was 240 to 360 mg once daily. Maximum antihypertensive effect is usually observed by 14 days of chronic therapy therefore, schedule dosage adjustments accordingly. By then, the diltiazem should have time to be absorbed and distributed (time to Tmax is approximately 1 to 1.5 hours).ĭespite being cited on some pharmacy practice resource sites, references to the source of this formula are absent. When used as monotherapy, reasonable starting doses are 180 to 240 mg once daily, although some patients may respond to lower doses. After the first hour, slowly titrate down the diltiazem drip by 2.5 mg/hr increments until 0. When actually making the switch, give the first oral dose about 1 hour before you plan to stop the drip. The immediate-release dosage form must be used initially, and rounding will be necessary because it’s only available as 30 mg, 60 mg, 90 mg, and 120 mg. The total daily dose should be divided q6h. The standard rates for diltiazem generally convert as follows:
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