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Inotropic Calculations

M. Michelle Piper, MSN, RN

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Inotropic medications are given to supportblood pressure & maintain cardiac outputMedications are given via continuous IV dripand must be titrated to patients body weightvery carefullyOther drugs, such as sedatives, insulin, &antiarrythmics may be given via continuous

dripPumps may or may not be available tocalculate drips for the nurse And the nurse still needs to check pump anyway!

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Most drips calculated as mcg/min ormcg/kg/minThis means that for 4 mcg/min, the patientneeds to receive 4 mcg EVERY minute, or

240 mcg/hrFor 4 mcg/kg/min, the a 70 kg patient needs280 mcg EVERY minute, or 16,800 mcg/hr

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Remember ordered ?available

The same rule applies for drip calculations

Patient needs 5 mcg/min. Concentration ofnitroglycerin is 100 mcg/mL

O/A = 5 mcg/min100 mcg/mL

= 0.05 mL/min

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Pumps are set in mL/hr, not mL/minHow many minutes are there in an hour?Rate (mL/min) x 60 (min/hr) = Rate (mL/hr)

0.05 mL/min x 60 min/hr = 3 mL/hr

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m cg/min Form ula:

Rate = Dose (mcg/min) x 60 min/hrConcentration (mcg/mL)

m cg/kg/m in Formula :

Rate = Dose (mcg/kg/min) x Weight (kg) x 60 min/hrConcentration (mcg/mL)

m cg/kg/hr Formula :

Rate = Dose (mcg/kg/hr) x Weight (kg)Concentration (mcg/mL)

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A 50 kg mechanically ventilated patient needsan infusion of midazolam 0.05 mg/kg/hr.Versed is available at a concentration of 5mg/mL. What should the pump rate be?

Rate = 0.05 mg/kg/hr x 50 kg5 mg/mL

= 0.5 mL/hr

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A critical care nurse is coming on shift at0700. The patient should be receivingnorepinephrine 6 mcg/min. The nurse notesthat the bag has 800 mcg in 100 mL. Thepump is currently running at 50 mL/hr. Isthe pump set correctly?Correct Rate = 6 mcg/min x 60 min/hr

8 mcg/mLCorrect Rate = 45 mL/hrShould the RN decrease the rate?

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How much drug is the patient actuallygetting?

Rate = Dose (mcg/min) x 60 min/hrConcentration (mcg/mL)

Dose x 60 min/hr8 mcg/mL

Dose = 6.7 mcg/min

50 mL/hr =

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A 75 kg patient received Insulin drip at0.5 mL/hr for the last 4 hours. How muchinsulin did he receive?What other information do you need?Concentration is 20 Units/mL

Pump rate = Volume/Time0.5 mL/hr = Volume/4 hours

Volume = 2 mL2 mL x 20 Units/mL = 40 Units