relaxes arterial and venous smooth muscle to decrease preload with mild afterload reduction; venous effect > arterial
decreases pulmonary vascular resistance
improves ventricular compliance
5mcg/min as initial dose
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)
pulmonary vasodilation may worsen pulmonary shunt
continuous heart rate and ECG rhythm
central or mixed venous oxygen saturation
cardiac output if monitored
oxygen saturation (may worsen shunt)
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