reduces systemic vascular resistance by direct relaxation of vascular smooth muscle
reduces pulmonary vascular resistance
dilates renal arterioles
1 mg-5 mg/hr
5 mg-25 mg/hr (titrated to effect)
5-40 mg IV direct
maximum rate of injection 5 mg/min
50 mg/500 mL NS, RL
hypovolemia should be corrected concurrently with therapy
should be weaned off
increased myocardial oxygen consumption
peripheral neuritis as evidenced by numbness, tremor, agitation, anxiety
rheumatoid syndrome---systemic lupus erythematosus like syndrome
risk of hemorrhage in patients with cerebral or abdominal aneurysms due to speed of blood flow
may worsen a pulmonary shunt
continuous heart rate and ECG rhythm
joint appearance and mobility
Adult Critical Care Protocol:
May be administered by IV infusion by a nurse in Adult Critical Care.
May be administered IV direct by an approved nurse in the CCTC at a rate < 5mg/min.
May be titrated by a nurse in Adult Critical Care.
Central line is preferred.
Patient requires placement of an arterial line to monitor BP.
Continuous infusions must be administered by infusion device and the pump library must be enabled.
Should not be infused via the proximal injectate port (blue) of a pulmonary artery catheter. If this is the only available central venous line, it may be administered through the proximal injectate port but thermodilution cardiac output measurements must not be measured during infusion).
Lynne Kelly, Pharmacist, CCTC
Brenda Morgan, Clinical Nurse Specialist, CCTC Last Update: September 17, 2018