/reference/drips

Drips

Mixing, concentrations, dose ranges for 16common perioperative infusions. Always confirm against your facility's standardized concentrations — these are common patterns, not protocol.

vasopressors

Norepinephrine

vasopressor

Dose

0.01–0.5 mcg/kg/min (typically 0.03–0.3)

Mix

4 mg in 250 mL D5W or NS

Concentration

16 mcg/mL

First-line for septic shock; α1 + β1; central line preferred. Extravasation: phentolamine.

Phenylephrine

vasopressor

Dose

0.1–5 mcg/kg/min (often 25–200 mcg/min for adults)

Mix

10 mg in 100 mL NS

Concentration

100 mcg/mL

Pure α1; reflex bradycardia common. Useful for OB spinal-induced hypotension.

Vasopressin

vasopressor

Dose

0.01–0.04 U/min (fixed, usually 0.04)

Mix

20 U in 100 mL NS

Concentration

0.2 U/mL

V1 receptor agonist; second-line in septic shock. No β effect — useful in catecholamine-resistant.

Epinephrine

vasopressor

Dose

0.01–1 mcg/kg/min (codes, anaphylaxis); inotrope dose 0.02–0.1

Mix

4 mg in 250 mL D5W (mix matches NE)

Concentration

16 mcg/mL

Dose-dependent: low → β; high → α dominates. Anaphylaxis bolus 10–100 mcg IV.

inotropes

Dobutamine

inotrope

Dose

2–20 mcg/kg/min

Mix

250 mg in 250 mL D5W

Concentration

1 mg/mL = 1000 mcg/mL

β1 > β2; ↑contractility, mild ↓SVR. Good for HF with adequate preload.

Milrinone

inotrope

Dose

0.125–0.75 mcg/kg/min (no bolus in HF)

Mix

20 mg in 100 mL D5W

Concentration

200 mcg/mL

PDE3 inhibitor → ↑contractility + pulmonary vasodilator. Useful in RV failure.

Dopamine

inotrope

Dose

1–20 mcg/kg/min (low/mid/high dose effects)

Mix

400 mg in 250 mL D5W

Concentration

1.6 mg/mL = 1600 mcg/mL

Falling out of favor for shock — NE preferred. Dose: 1–3 dopaminergic, 3–10 β, >10 α.

vasodilators

Nicardipine

vasodilator

Dose

5–15 mg/h

Mix

25 mg in 250 mL D5W or NS

Concentration

100 mcg/mL

Calcium channel blocker; arterial vasodilator. Smooth titration; preferred for HTN urgency in OR/ICU.

Nitroprusside

vasodilator

Dose

0.25–10 mcg/kg/min

Mix

50 mg in 250 mL D5W (light-protected)

Concentration

200 mcg/mL

Arterial + venous; cyanide toxicity risk if >2 mcg/kg/min × hours. Light-protect tubing + bag.

Nitroglycerin

vasodilator

Dose

5–200 mcg/min

Mix

50 mg in 250 mL D5W

Concentration

200 mcg/mL

Venous > arterial (preload reduction). Adsorbs to PVC — use non-PVC tubing.

Esmolol

vasodilator

Dose

50–300 mcg/kg/min (bolus 0.5 mg/kg)

Mix

2.5 g in 250 mL D5W

Concentration

10 mg/mL

Selective β1; ultrashort half-life (~9 min). Good for tachy + HTN of intubation/extubation.

antiarrhythmics

Amiodarone

antiarrhythmic

Dose

150 mg load over 10 min, then 1 mg/min × 6h, then 0.5 mg/min × 18h

Mix

Use premix or 900 mg in 500 mL D5W

Concentration

1.8 mg/mL

VT/VF + rate control. Caution: hypotension on bolus. Long-term: thyroid, pulm, hepatic toxicity.

Lidocaine

antiarrhythmic

Dose

1–4 mg/min infusion (1.5 mg/kg load)

Mix

2 g in 250 mL D5W

Concentration

8 mg/mL

Class IB; alternative to amio for VT. Toxicity: seizure, arrhythmia, CV collapse.

sedatives

Propofol (sedation infusion)

sedative

Dose

25–75 mcg/kg/min (sedation); 100–200 (anesthesia)

Mix

Direct from vial 10 mg/mL

Concentration

10 mg/mL

Egg/soy allergy caution. PRIS at >4 mg/kg/h × >48h. Hypotension common.

Dexmedetomidine

sedative

Dose

0.2–1.4 mcg/kg/h (load 1 mcg/kg over 10 min, optional)

Mix

200 mcg in 50 mL NS

Concentration

4 mcg/mL

α2 agonist; sedation without resp depression. Bradycardia + hypotension. Good ICU sedation.

anticoagulants

Heparin (UFH)

anticoagulant

Dose

Bolus 80 U/kg, infusion 18 U/kg/h (titrate to PTT 60–90)

Mix

25,000 U in 500 mL D5W or NS

Concentration

50 U/mL

Reverse with protamine 1 mg per 100 U recent heparin. HIT risk after 5–10d.

Verify before dosing.Your institution's concentrations may differ. Check pump library standardization. Education only.

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