Question

Your patient in the ICU has been admitted with a diagnosis of uncontrolled hypertension with end organ damage. He is a 195 lb. male with symptoms of renal failure. His BP on admission to the ER was 220/110. An arterial line has been placed in his right radial artery. He is currently on a Nipride drip 12 ml/hr ( you titrated to this level 5 minutes ago). The MD order reads, "Nipride drip to maintain systolic BP at 140 mmHg. May titrate 0.4 mcg/kg/min q 5 minutes". The pharmacy has sent you a bag label Nipride 100 mg/250 ml D5W wrapped in a brown bag. You just looked at the arterial line reading and it says 180/100 mmHg. How many mcg/kg/min is the Nipride drip currently infusing?

Answer 1

To know the mcg /kg/ min Nipridedrip in 12 ml/ hour drip we must know the dose of infusion.

The amount of medication in 1 ml = 100 mg $\div$ 250 ml

                                                      = 0.4 mg

The current infusion is 12 ml / hr = 0.4 mg $\times$ 12 ml

                                                    = 4.8 mg/ hr

Convert mg to mcg by multiplying with 1000. That is 4.8$\times$ 1000 = 4800 mcg per hour

To know dose per minute 4800$\div$60 = 80 mcg per minute

To know the dose per kg body weight per minute 80 $\div$88 (weight in kgs) = 0.9 mcg

Nipride drip currently infusing 0.9 mcg/ kg/min