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 dextrose 5% and normal saline 0.9% (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:
  • blood pressure
  • continuous heart rate and ECG rhythm
  • chest pain
  • central or mixed venous oxygen saturation
  • lactate
  • cardiac output if monitored
  • blood gases
  • oxygen saturation (may worsen shunt)
  • urine output
Adult Critical Care Protocol:
  • May be administered by IV infusion by a nurse in Adult Critical Care.
  • May be titrated by a nurse in Adult Critical Care.
  • 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