Classification: vasodilator
  • relaxes arterial and venous smooth muscle to decrease preload with mild afterload reduction; venous effect > arterial
  • decreases pulmonary vascular resistance
  • coronary vasodilation
  • improves ventricular compliance
Dose: Infusions:
  • 5mcg/min as initial dose
Administration: IV Infusion:
50mg/250 mL D5W or NS (maximum concentration: 200mg/250 mL)
  • mix in glass bottle (adsorbed onto polyvinyl chloride)
  • hypovolemia should be corrected concurrently with initiation of therapy
  • drug should be weaned off (abrupt discontinuation may cause rebound coronary artery spasm)
Adverse Effects:
  • headache, flushing
  • tachycardia
  • hypovolemia
  • hypotension
  • pulmonary vasodilation may worsen pulmonary shunt
Monitoring Therapy:
  • BP
  • chest pain
  • cardiac index
  • blood gases, Sp02, pulmonary secretions
  • HR, ECG rhythm
  • arterial lactate
  • urine output
CCTC Protocol:
  • May be administered by IV infusion by an approved nurse in CCTC.
  • May be titrated by an approved nurse in CCTC.
  • Continuous infusion must be administered via an infusion pump.
  • Should not be infused into the proximal injectate port (blue) of the Swan Ganz catheter.
  • Patient requires placement of an arterial line to monitor BP.

Lynne Kelly, Pharmacist, CCTC
Brenda Morgan, Clinical Nurse Specialist, CCTC
Last Update: August 7, 2006, October 25, 2011

LHSCHealth Professionals

Last Updated October 25, 2011 | © 2007, LHSC, London Ontario Canada