[Drug] Midazolam

Midazolam 5mg/ml

Loading: 0.03 - 0.3 mg/kg

Maintenance: 0.03 - 0.2 mg/kg/hr

Pump泡法:  10 amps + NS 90 ml  ---> 0.5 mg/ml

[60 kg] Titrate from 3 ml/hr ~ 24 ml/hr

[Drugs] Nitroglycerin

Nitroglycerin

(Millisrol)    5 mg/10ml     è 0.5 mg/ml
Starting from 10 mcg/min (1.2 ml/hr);
Titrate by 5 mcg/min (0.6 ml/hr) every 3~5 min up to 20 mcg/min (2.4 ml/hr);
If still no response, Titrate by 10 mcg/min (1.2 ml/hr) up to 200 mcg/min (24 ml/hr)

(Nitrostat)   0.6 mg/tab

[Drugs] Antipsychotic for Sedation

1. Haloperidol (Haldol)  1-5mg IM/PO q1h  (Max: 20-30mg/24h) 

    [SKH] HALDOL 5mg/amp; 5mg/tab

2. Droperidol (Dropel)  2.5-5mg IM/IV        Note black box regarding arrhythmias 

    [SKH] DROPEL 2.5mg/amp

3. Olanzapine (Zyprexa)  5-10mg IM/ 10-20mg PO (Max: 20mg/24h) 

    [SKH] ZYPREXA 10mg/vial; 5mg/tab

4. Risperidone (Risperdal) 25 mg IM Q2W/ 1-2mg PO (Max: 6mg/24h) 

    [SKH] RISPERDAL 37.5mg/vial; 2mg/tab; 1mg/ml

    (NOT used in ER) 

5. Ziprasidone (Geodon) 20mg IM q4h/ 10mg q2h (< 40mg/24h) 

   [SKH] GEODON 60mg/cap

[Drugs] Treatment of EPS

1. Diphenhydramine 50mg q4-5h
    [SKH] DIPHENHYDRAMINE  30mg/1ml/amp

2. Trihexyphenidyl (Artane) 2mg/day ~ 5-15mg/day
    [SKH] ARTANE 2mg/tab

3. Biperiden (Akineton) 2.5-5mg IM or 2mg PO

    [SKH] BIPIDEN 5MG/1ML

4. Benztropine (Cogentin) 1-2mg PO or IM q 8-12h

[Drug] Vasopressor, Inotropics

Dopamine     (Dopamine)    (400mg/250ml/bag)             è   1.6 mg/ml

mcg/kg/min		2		10		20
mcg/kg/hr		120		600		1200
mg/kg/hr		0.12		0.6		1.2
40	mg/hr mg/ml	4.8	3	24	15	48	30
50		6	4	30	19	60	38
60		7.2	4.5	36	23	72	45
70		8.4	5	42	26	84	53
80		9.6	6	48	30	96	60

Dobutamine   (Easydobu)     (250mg/250ml/bag)               è   1 mg/ml

mcg/kg/min		2.5	5	10	20
mcg/kg/hr		150	300	600	1200
mg/kg/hr		0.15	0.3	0.6	1.2
40	mg/ml	6	12	24	48
50		7.5	15	30	60
60		9	18	36	72
70		10.5	21	42	84
80		12	24	48	96

Epinephrine   (Adrenaline)   (1mg/ml/amp)                        è    1 mg/ml

                        (Bosmin)         (0.1%/500ml/bot)           è    0.5 mg/ml

1 %         = 10 mg/ml     (1:1000   = 1 mg/ml)

Norepinephrine (Levophed) (4mg/4ml/amp)

泡：2 amp in D5W 250 mlè0.03 mg/ml

mcg/min	0.5	1	2	5	10	20	30
mcg/hr	30	60	120	300	600	1200	1800
mg/hr	0.03	0.06	0.12	0.3	0.6	1.2	1.8
ml/hr	1	2	4	10	20	40	60

[Drug] Herpes Zoster (Shingles) & Varicella (ChickenPox)

Shingles

1.    Devirus       OINT         PID                            (Acyclovir 3%, for rash (esp. V1))
                                                                                (痊癒後，必須再繼續治療3天)

2.   Valtrex         2#              PO       TID  *7D        (Valacicovir 500mg)

                     or

Famvir         2#             PO       TID                 (Famciclovir 250mg) 

                     or

Acyclovir    2#              PO       TID                 (Acyclovir 400mg)

Varicella：
Acyclovir    20mg/kg/dose (max: 800mg)   PO   QID *5D

注意事項：
1. High risk group才用藥
(a) Tintinalli：Children >12 yo, adults, chronic skin or pulmonary disease, long-term salicylate therapy, immunocompromised
(b) 健保給付：
2. US-FDA沒有批准famvir或valtrex使用在varicella

Immunocompromised or CNS or Disseminated(>3 dermatome or cross midline)
Acyclovir    500 mg      IVD      Q8H                 (10~15 mg/kg/dose)