Prescribing Inotropes

Discussion in 'Cardiology' started by callofthewild, Aug 15, 2015.

  1. callofthewild

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    Hello everyone,

    I am on my cardiology rotation and am having trouble coming to grips to prescribing inotropes. Can someone help me with the following:

    1. Dobutamine
    - What is meant by singe, double triple strength
    e.g. consultant asks to prescribe single strength dobutamine, is this 5mcg/kg/hr? and is double strength 10mcg/kg/hr?
    - How do you calculate the rate e.g. mg/hr, mg/min

    2. Dopamine
    - What is meant by singe, double triple strength
    e.g. consultant asks to prescribe single strength dobutamine, is this 5mcg/kg/hr? and is double strength 10mcg/kg/hr?
    - How do you calculate the rate e.g. mg/hr, mg/min

    Ive been looking online for a 'dummies' guide to this like in the form of weight of patient, conentration to give and rate to run but am unable to find one - if you know of any good one please let me know.

    Thanks.
     
  2. P Diddy

    P Diddy california lover
    10+ Year Member

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    I am not familiar with the terminology single, double, and triple strength. Where I practice (in the US) we prescribe based upon mcg/kg/min for both dopamine and dobutamine.

    I would term dopamine <= 5 mcg/kg/min low dose, >5 and < 10 moderate, and > 15 high, but that is arbitrary.

    I would term dobutamine <= 2.5 mcg/kg/min low, > 2.5 < 10 moderate, and > 10 high, but that is even more arbitrary.

    Are you in a commonwealth country?

    p diddy
     
  3. IMreshopeful

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    Usually as a resident when prescribing inotropes inpatient I specify the exact dose
     
  4. Sillyme1986RB

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  5. Sillyme1986RB

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    1. Dobutamine
    - What is meant by singe, double triple strength -

    250mg/250mL single strength
    500mg/250mL double
    750mg/250mL triple strength

    e.g. consultant asks to prescribe single strength dobutamine, is this 5mcg/kg/hr? and is double strength 10mcg/kg/hr?
    - How do you calculate the rate e.g. mg/hr, mg/min

    > Using the available drug concentration
    > patient's weight (Kg) x dose (mcg/kg/min) × 60 = mcg/hr
    > use; 1000mc = 1 mg to derive to your desired dose

    Example. MD's order: Start dopamine infusion at 5 mcg/kg/min. Patient's wt = 100 kg

    Solution

    100kg × 5mcg/kg/min × 60 min/hr = 30kmcg/hr

    30k mcg/hour / 1000 mcg/mg = 30 mg/hr

    For single strength program the pump to run for 30 mL/hr; double strength - 15 mL/hr. ..



    2. Dopamine
    - What is meant by singe, double triple strength

    Single strength = 200 mg/250mL
    Double = 400 mg /250mL
    Triple = 600 mg/250mL

    e.g. consultant asks to prescribe single strength dobutamine, is this 5mcg/kg/hr? and is double strength 10mcg/kg/hr?
    - How do you calculate the rate e.g. mg/hr, mg/min

    Same procedure as that of dobu.
     

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