WESTERN MARYLAND HEALTH SYSTEM
DRUG

Amiodarone

Diltiazem
BOLUS
IV TITRATION PROTOCOLS
INITIAL RATE
TITRATE BY
MAX RATE
150mg over 1 mg/minute for 0.5 mg/minute for
10min
6 hrs
18 hrs
5 mg/hr every
15 mg/hr for
5 mg/hr
15min
24 hr

Dobutamine
5 mcg/kg/min

Dopamine
2 mcg/kg/min

Epinephrine

Esmolol

Fenoldopam

Isoproterenol

Labetalol

Lorazepam

Milrinone

Nesiritide

1 mcg/kg/min
every 15 min
1 mcg/kg/min
every 10 min
0.05 mcg/kg/min
0.05mcg/kg/min
every 1 minutes
(For SVT)
500mcg/kg 25 mcg/kg/min
over 1min
25 mcg/kg/min
every 4 min
40 mcg/kg/min
20 mcg/kg/min
1 mcg/kg/min
300 mcg/kg/min
GOAL (unless ordered otherwise)
HR between 60-120 BPM
HR between 80 to 100 BPM
MAP greater than or equal to 65
mmHG or Cardiac Index greater
than or equal to 2.2L/min
MAP greater than or equal to 65
mmHG
MAP greater than or equal to 65
mmHG
MAP greater than or equal to 65
mmHG or HR between 60-120 BPM
0.1 mcg/kg/min
0.05 mcg/kg/min
every 15 min
1.6 mcg/kg/min
MAP between 65-100 mmHG
for up to 48 hrs
MAP greater than or equal to 65
1 mcg/min every 5
1 mcg/min
10 mcg/min
mmHG or HR greater than or equal
min
to 50 BPM
0.5 mg/min every
MAP between 100-120 mmHG or
1 mg/min
300 mg/ 24 hrs
15 min
HR between 50-120 BPM
0.5 mg/hr every 15
1 mg/hr
Maintain RASS of -1
min
Cardiac Index greater than or equal
0.125mcg/kg/min
0.375mcg/kg/min
0.75 mcg/kg/min to 2.2L/min or MAP greater than or
every 15 min
equal to 65 mmHG
0.01 mcg/kg/min
0.005mcg/kg/min
every 3 hrs
Nicardipine
5 mg/hr
2.5 mg/hr every 15
15 mg/hr
min
MAP between 100-120 mmHG

Nitroglycerin
10 mcg/min
10 mcg/min every
200 mcg/min
5 min
MAP between 70-100 mmHG

Nitroprusside
0.25 mcg/kg/min
0.5 mcg/kg/min
every 5 min
MAP between 70-100 mmHG

Norepinephrine
2 mcg/min
2 mcg/min every 1
30 mcg/min
min
MAP greater than or equal to 65
mmHG

Phenylephrine
0.2 mcg/kg/min
0.1 mcg/kg/min
every 1 min
1.5 mcg/kg/min
MAP greater than or equal to 65
mmHG

VasopressinSeptic Shock
0.01 units/min
0.01 units/min
every 30 min
0.04 units/min
MAP greater than or equal to 65
mmHG
2 mcg/kg
over 1min
0.03 mcg/kg/min
10 mcg/kg/min
MAP greater than or equal to 65
mmHG
Nurse/Date/Time:
Secretary/Date/Time:
___________________________
_____________________________
Protocol requires only one nurse and one clerical signature
Original to Patient’s Chart
Fax to Pharmacy
Original 04/13
Form # 1.0-007
.