This document provides instructions for preparing and administering several intravenous infusions and medications. It includes details on diluting medications to achieve the desired concentrations and infusion rates. Specific medications summarized include adrenaline, atropine, magnesium sulfate, aminophylline, amiodarone, dopamine, fentanyl, glyceryl trinitrate, hydralazine, isosorbide dinitrate, labetalol, midazolam, morphine, and noradrenaline infusions. Dilution volumes and rates are provided to achieve targeted dose ranges.

2. Adrenaline infusion
• Preparation
• 1 amp 1ml (1:1000 = 1mg/ml)
• Dilute 3.0mg (3mls) adrenalin with 47mls of NS in 50mls syringe.
• Rate : 1ml/hr = 1mcg/min
• Dose : 1-10mcg/min. Titrate accordingly to desired BP
• Calculation:
• 50mls = 3mg = 3000mcg
• 1ml = 3000mcg/50mls = 60mcg/ml
• 1ml/hr = 60mcg/hr = 60mcg/60min = 1mcg/min
• 1ml/hr = 1mcg/min

3. Adrenaline infusion (peadiatric)
• Refer Frank Shann
• 0.3mg/kg in 50mls
• Eg 10kg
• 10 x 0.3 = 3mg (add 3mg in D5% to make 50mls
• 10ml/hr = 1mcg/kg/min
• IV infusion 0.05-1mcg/kg/min (ie 0.5-10mls/hr)

4. Atropine infusion
• Preparation 1mg / 1ml
• Dilute 10mg of atropine (10mls = 10ampulse) in 40mls NS  50mls
• 5mls / hr = 1mg / hr to titrate with effect

5. Magnesium sulphate
• For severe asthma
• Preparation : 2.47gm (1amp) / 5mls
• Dilute 2gm (4mls) in 20cc NS
• Give using syringe pump over 20min

6. Aminophyline infusion
• Preparation : 250mg/10mls
• Loading dose : 5mg/kg in 100mls NS over ½ hr
• Eg : 250-500mg in 100ml NS (or 5mg/kg)
• Run over 20-30min
• Do not give bolus to pt already on oral theophylline
• Infusion : 0.5 – 0.9 mg/kg/hr
• Dilute 250mg in 50mls syringe with NS
• 1ml = 250/50 = 5mg
• 1ml/hr = 5mg/hr
• Eg : 70kg
• 0.5mg/kg/hr = 0.5 x 70 = 35mg/hr
• 35mg/hr = 35/5 = 7mls / hr (usual dose at 6-7mls/hr

7. Amiodarone
• Preparation : 150mg / 3mls
• Loading dose
• Dilute 2 amp of amiodarone (300mg / 6mls) in 100mls D5% (not compatibale
with NS)
• Use microchamber run over 1hr
• Maintainance dose
• Dilute 6 amp of amiodarone (900mg / 18mls) in 500mls of D5%
• Run over 24hr ~ 20mls/hr

8. Cocktail regime (for hyperkalemia)
• IV slow bolus 10mls of 10% calcium gluconate
• 1st medication to be given immediately
• Must be given by doctor – given over 2-5min
• Cardiac (ECG) monitoring
• Can be repeated once/twice if necessary – titrate against ECG changes
• Avoid used in hyperK 2ndary to digoxin toxicity
• IV bolus 50mls of D50% (glucose not required in hyperglycemic state)
• IV bolue insulin 10iu
• IV Sodium Bicarb (IV NaHCO3) – consult EP. Given only if pt is acidotic
• IV / Neb salbutamol
• Resonium – orally or rectally every 6hr. Effect take 1-2hr
• HD

9. DIVC regime
• 6 cryoprecipitate
• 4 platelet
• 2 FFP

10. Dopamine
• Preparation : 1 vial = 200mg = 5mls
• Syringe pump : no bolus doses
• Method 1 (dilution dose is adjusted according to pt weight. The rate is
fixed)
• Eg pt weight 60kg
• 3x BW = 3x 60kg
• 180mg in 50mls NS
• 1ml = 180/50 = 3.6mg
• 1ml/hr = 3.6mg/hr = 3.6mg/60min = 3600mcg/60min = 60mcg/min =
1mcg/kg/min
• Rate 1ml/hr = 1mcg/kg/min

11. Dopamine
• Method 2 (dilution dose is fixed, but rate is adjusted according to
weight
• 200mg dopamine in 50mls NS = 200/50 = 4mg/1ml = 4000mcg/ml
• 1ml/hr = 4000mcg/60min = 66.6mcg/min
• 1ml/hr = 66.6mcg/min
• In 70kg person, 1ml/hr = 66.6mcg/min = 66.6mcg/70kg/min =
1mcg/kg/min
• Refer table

12. • Dopamine (200mg in 5mls)
Wt (kg)
Mcg/kg
/min
45kg 50 55 60 65 70 75 80 85 90
2.5 1.6ml/hr 1.8 2.0 2.2 2.4 2.6 2.8 3.0 3.2 3.4
5.0 3.3 3.7 4.1 4.5 4.9 5.3 5.7 6.1 6.5 6.9
7.5 5.0 5.6 6.1 6.7 7.3 7.8 8.4 9.0 9.6 10.1
10.0 6.7 7.5 8.2 9.0 9.7 10.5 11.2 12.0 12.8 13.5
12.5 8.4 9.3 10.3 11.2 12.1 13.1 14.0 15.0 16.0 16.9
15.0 10.1 11.2 12.3 13.5 14.6 15.7 16.8 18.0 19.1 20.3
17.5 11.8 13.1 14.4 15.7 17.0 18.3 19.7 20.1 22.3 23.6
20.0 13.5 15.0 16.5 18.0 19.5 21.0 22.5 24.0 25.5 27.0

13. Hydralazine
• For preeclampsia / eclampsia
• Method 1 :
• Dilute 50mg in 50cc NS (1mg = 1ml)
• Start 5ml/hr
• Increase 1ml/hr every 15-20min
• Max infusion rate – 10ml/hr
• Method 2 :
• Dilute 50mg in 500ml NS
• 10ml = 1mg/hr
• Start infusion at 15ml/hr (1.5mg/hr)
• Increase 15ml/hr every 15min
• Aim decrease diastolic BP 90-100
• Caution when hydralazine if given together with Mgso4 -> BP may drop

14. Fentanyl infusion (for sedation)
• Preparation : 100mcg / 2mls
• Dilute 200mcg (2amp) of fentanyl with NS to become 20ml
• 200mcg = 20ml
• 1ml = 10mcg
• Dose infusion
• Start with 2ml/hr (20mcg/hr)
• Titrate to desired BP

15. GTN infusion
• Preparation : 50mg/10ml
• Syringe pump 50ml
• Method 1 :
• Dilute 50mg (10ml) of nitrobid with 50ml NS
• Rate 0.3mls/hr = 5mcg/min
• Method 2 :
• Dilute 30mg nitrobid (6ml) with NS to become 50ml
• Rate 1ml/hr = 10mcg/min
• Startting dose infusion 10-20mcg/min
• Can increase up to 100mcg/min
• Monitor BP every 5min

16. Isoket (isosorbide dinitrate)
• Preparation 10mg / 10mls
• Dilute 10mg (10ml) of isoket in 40ml NS
• 5ml = 1mg
• Dose 1-5mg/hr
Isoket (mg/hr) Infusion rate (ml/hr)
1.0 5.0
1.5 7.5
2.0 10.0
2.5 12.5
3.0 15.0
3.5 17.5
4.0 20.0
4.5 22.5
5.0 25.0

17. Labetalol
• Preparation: 1amp : 25mg / 5ml
• Bolus dose : IV 5-20mg bolus injected over 2min (max 200mg)
• Infusion dose :
• Dose 20-160mg/hr
• Dilute in D5% or DS
• Method 1 – infusion
• Dilute 200mg (8amp) IV labetalol in NS to make 50cc (1ml = 4mg)
• Start at 5ml / hr = 20mg/hr
• Dose 20 – 160mg /hr
• Double every ½ hr to max 160mg/hr
• Method 2 – infusion
• Dilute 100mg (4amp) IV labetalol in 30ml NS to make 50ml solution
• 50ml  100mg = 1ml  2mg

18. Midazolam morphine sedation
• Preparation
• Morphine 30mg (3ml) + midazolam (dormicum) 30mg (6ml)
• Dilute with 21ml NS in 50ml syringe
• Rate : 1ml/hr = 1mg of midazolam and morphine
• Dose
• Bolus dose may be required for faster effect, followed by infusion dose
• Infusion dose : 3mg / hr (3ml/hr)
• To titrate to desired effect
• Paeds dose :
• Mida : 3mg/kg in 50ml NS ; Morphine : 1mg/kg
• Morphine 30mg + midazolam 90mg dilute in 29ml NS in 50ml syringe

19. Noradrenaline infusion
• Preparation : 4mg/4ml (1 amp)
• Dilute 4mg (4ml) with 46ml NS in 50ml syringe
• Rate : 1ml/hr = 1mcg/min
• Dose : 2-20mcg/min. titrate accordingly to desired effect
• Calculation
• 4mg (4ml) Norad in 50ml NS
• 50m  4mg  4000mcg
• 1ml  4000mcg/50ml  80mcg
• 1ml/hr  80mcg/hr  80mcg/60min  1.3mcg/min
• 1ml /hr = 1.3mcg/min