Create a list of all the drugs used in cardiology in the form of infusion and mention all the preparations in which the concentrations are to be used

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Cardiology Drugs Used as IV Infusions - Complete Reference Guide

Below is a comprehensive list of all major drugs used in cardiology as intravenous infusions, organized by drug class, with their standard preparations, concentrations, and dosing ranges.

1. VASOPRESSORS & VASOCONSTRICTORS

Norepinephrine (Noradrenaline)

Parameter	Details
Preparation	4 mg in 50 mL NS (80 mcg/mL)
	8 mg in 50 mL NS (160 mcg/mL)
	16 mg in 50 mL NS (320 mcg/mL) - concentrated for fluid restriction
	8 mg in 100 mL NS (80 mcg/mL)
	16 mg in 100 mL NS (160 mcg/mL)
Solvent	0.9% NaCl or 5% Dextrose
Dose range	0.01-3 mcg/kg/min (titrate to MAP target)
Indication	Septic shock, cardiogenic shock, distributive shock
Route	Central line preferred

Epinephrine (Adrenaline)

Parameter	Details
Preparation	4 mg in 100 mL NS (40 mcg/mL)
	4 mg in 50 mL NS (80 mcg/mL) - more concentrated option
	8 mg in 50 mL NS (160 mcg/mL) - for high-dose requirements
Solvent	0.9% NaCl (preferred) or 5% Dextrose
Dose range	0.01-1 mcg/kg/min (titrate to effect)
Indication	Cardiogenic shock, anaphylaxis, cardiac arrest post-ROSC
Route	Central line preferred

Phenylephrine

Parameter	Details
Preparation	100 mg in 500 mL NS (200 mcg/mL)
	10 mg in 100 mL NS (100 mcg/mL)
Dose range	0.5-6 mcg/kg/min; bolus 50-100 mcg IV push
Indication	Vasodilatory hypotension (pure alpha agonist, no tachycardia)

Vasopressin (Arginine Vasopressin)

Parameter	Details
Preparation	20 units in 50 mL NS (0.4 units/mL)
	40 units in 100 mL NS (0.4 units/mL)
Dose range	Fixed rate: 0.03-0.04 units/min (cardiogenic/septic shock)
Indication	Vasodilatory shock, adjunct to norepinephrine, post-cardiac surgery vasoplegia
Note	Not titrated by blood pressure response; fixed low dose

Metaraminol

Parameter	Details
Preparation	30 mg in 60 mL NS (0.5 mg/mL)
Dose range	Bolus: 0.5-1 mg q2-5 min; Infusion: 0.5-10 mg/h
Indication	Hypotension; used where norepinephrine not immediately available

2. POSITIVE INOTROPES

Dobutamine

Parameter	Details
Preparation (standard)	250 mg in 100 mL NS (2.5 mg/mL)
	250 mg in 50 mL NS (5 mg/mL)
	500 mg in 100 mL NS (5 mg/mL)
Solvent	0.9% NaCl or 5% Dextrose
Dose range	2.5-20 mcg/kg/min; start at 2-3 mcg/kg/min
Indication	Acute decompensated heart failure, cardiogenic shock, low cardiac output states
Caution	Taper slowly (1 mcg/kg/min per hour); avoid in obstructive cardiomyopathy

Dopamine

Parameter	Details
Preparation (standard)	200 mg in 50 mL NS (4 mg/mL)
	400 mg in 50 mL NS (8 mg/mL)
	250 mg in 1000 mL NS (250 mcg/mL)
Solvent	0.9% NaCl, 5% Dextrose, or Lactated Ringer's
Dose range	Dopaminergic: 1-3 mcg/kg/min; Beta-1: 3-10 mcg/kg/min; Alpha: >10 mcg/kg/min
Indication	Heart failure, cardiogenic shock, low cardiac output, bradycardia

Milrinone

Parameter	Details
Preparation (standard)	20 mg in 100 mL NS (200 mcg/mL)
	10 mg in 50 mL NS (200 mcg/mL)
Solvent	0.9% NaCl, 0.45% NaCl, or 5% Dextrose
Dose range	Loading: 50 mcg/kg over 10 min (often omitted to avoid hypotension); Maintenance: 0.375-0.75 mcg/kg/min
Indication	Acute decompensated heart failure, post-cardiac surgery low output, PVH, bridge to transplant
Route	Central line required; peripheral venous use controversial

Levosimendan

Parameter	Details
Preparation	Dilute to 0.025 mg/mL (add 10 mL concentrate [12.5 mg] to 500 mL 5% Dextrose)
	Or 10 mL concentrate (12.5 mg) in 250 mL D5W = 0.05 mg/mL
Solvent	5% Dextrose only
Dose range	Loading: 6-12 mcg/kg over 10 min (omit in hypotension); Maintenance: 0.1 mcg/kg/min; range 0.05-0.2 mcg/kg/min
Duration	Single 24-hour infusion
Indication	Acutely decompensated severe chronic heart failure, cardiogenic shock, post-cardiac surgery low output
Note	Effects persist for days-weeks due to active metabolite OR-1896 (half-life 70-80 hours)

3. ANTIARRHYTHMICS

Amiodarone

Parameter	Details
Loading dose preparation	300 mg in 100 mL D5W (3 mg/mL)
	300 mg in 50 mL D5W (6 mg/mL)
Maintenance infusion	900 mg in 500 mL D5W (1.8 mg/mL) - run over 24 hours
	600 mg in 500 mL D5W (1.2 mg/mL)
	900 mg in 50 mL D5W (18 mg/mL) - concentrated via central line
Solvent	5% Dextrose only (incompatible with NS)
Dose range	Load (AF/VT): 150-300 mg IV over 10-20 min; Maintenance: 1 mg/min x 6 h, then 0.5 mg/min x 18 h (= 1080 mg over 24 h)
Indication	AF with rapid ventricular response, VT/VF, chemical cardioversion
Route	Central line for concentrations >2 mg/mL (phlebitis risk)

Lidocaine (Lignocaine)

Parameter	Details
Preparation	1 g in 500 mL NS or D5W (2 mg/mL) - standard
	2 g in 500 mL NS or D5W (4 mg/mL)
Dose range	Loading: 1-1.5 mg/kg IV push over 2-3 min (max 3 mg/kg); Maintenance: 1-4 mg/min (20-50 mcg/kg/min)
Indication	VT, VF post-defibrillation, ventricular arrhythmias, post-MI arrhythmias

Procainamide

Parameter	Details
Preparation	1 g in 250 mL NS or D5W (4 mg/mL)
	2 g in 500 mL (4 mg/mL)
Dose range	Load: 20-50 mg/min IV until arrhythmia suppression, hypotension, or max 17 mg/kg; Maintenance: 1-4 mg/min
Indication	AF, WPW with AF, VT, SVT

Esmolol

Parameter	Details
Preparation	2500 mg in 250 mL NS (10 mg/mL) - standard
	600 mg in 60 mL (neat, 10 mg/mL) - from 10 mg/mL vials
Dose range	Load: 500 mcg/kg over 1 min; Maintenance: 50-200 mcg/kg/min; titrate by 50 mcg/kg/min q3-4 min
Indication	AF/flutter rate control, SVT, perioperative hypertension/tachycardia, thyroid storm
Note	Ultra-short acting (half-life ~9 min); titrateable

Diltiazem

Parameter	Details
Preparation	100 mg in 50 mL NS or D5W (2 mg/mL) - standard
	125 mg in 100 mL (1.25 mg/mL)
Dose range	Load: 0.15 mg/kg IV over 2 min (repeat 0.35 mg/kg in 15 min if needed); Maintenance: 5-15 mg/h
Indication	AF/flutter rate control, SVT, Angina
Caution	Do not run infusions >24 h (metabolite accumulation)

Adenosine

Parameter	Details
Preparation	Undiluted: 6 mg in 2 mL (3 mg/mL) - from pre-filled syringe
Administration	IV bolus only: 6 mg rapid push (over 1-2 sec) into large proximal vein; flush immediately with 20 mL NS; repeat 12 mg if no response
Indication	SVT (AVNRT, AVRT) - diagnostic and therapeutic; Wolff-Parkinson-White
Note	Half-life <10 seconds; must be given rapidly into antecubital or central vein

Sotalol

Parameter	Details
Preparation	75-150 mg diluted in 250-500 mL NS (variable)
Dose range	0.2-1.5 mg/kg IV over 5-10 min; typical 75 mg over 5 min
Indication	AF, atrial flutter, ventricular arrhythmias (oral loading strategy via IV)

4. VASODILATORS & ANTIHYPERTENSIVES

Glyceryl Trinitrate (Nitroglycerin / GTN)

Parameter	Details
Preparation	50 mg in 50 mL D5W (1 mg/mL) - standard
	25 mg in 250 mL D5W (100 mcg/mL)
	50 mg in 250 mL D5W (200 mcg/mL)
Solvent	5% Dextrose (preferred) or NS; use glass bottles/polyethylene-lined tubing (adsorbs to PVC)
Dose range	Start: 5-10 mcg/min; titrate by 5-10 mcg/min q3-5 min; usual range 20-200 mcg/min; max 400 mcg/min
Indication	Unstable angina/NSTEMI, ACS, acute LVF/pulmonary edema, hypertensive emergency with ACS

Sodium Nitroprusside (SNiP)

Parameter	Details
Preparation	50 mg in 100 mL D5W (500 mcg/mL) - central line (concentrated)
	50-100 mg in 500 mL D5W (100-200 mcg/mL) - peripheral
Solvent	5% Dextrose only; protect from light
Dose range	Start: 0.3-0.5 mcg/kg/min; titrate every 2-3 min; usual range 0.5-5 mcg/kg/min; max 10 mcg/kg/min
Indication	Hypertensive emergency, acute aortic dissection, acute severe heart failure (afterload reduction)
Caution	Cyanide/thiocyanate toxicity at high doses or prolonged use (>72 h); monitor thiocyanate levels

Nicardipine

Parameter	Details
Preparation	25 mg in 250 mL NS or D5W (0.1 mg/mL) - standard
	40 mg in 250 mL (0.2 mg/mL) - less common
Dose range	Start: 5 mg/h; increase by 2.5 mg/h q15 min; max 15 mg/h
Indication	Hypertensive emergency, perioperative hypertension, SAH (prevents vasospasm)

Clevidipine

Parameter	Details
Preparation	Neat: 50 mg in 100 mL (0.5 mg/mL) - premixed lipid emulsion
	25 mg in 50 mL (0.5 mg/mL)
Dose range	Start: 1-2 mg/h; double every 90 sec until target BP; maintenance 4-6 mg/h; max 16 mg/h (500 mg/day max)
Indication	Acute hypertension (surgical, perioperative, ICU)
Note	Lipid emulsion; use within 4 h of opening; contraindicated in lipid metabolism disorders

Hydralazine

Parameter	Details
Preparation	20 mg in 20 mL NS (1 mg/mL) for bolus; or 40-80 mg in 100 mL for infusion
Dose range	5-20 mg IV bolus q4-6h; infusion 0.5-2 mg/h
Indication	Hypertensive emergency in pregnancy (eclampsia), chronic hypertension IV

Labetalol

Parameter	Details
Preparation	200 mg in 200 mL NS (1 mg/mL) - standard infusion
	5 mg/mL undiluted for bolus
Dose range	Bolus: 20 mg IV over 2 min (repeat 40-80 mg q10 min; max 300 mg); Infusion: 2 mg/min titrating to response
Indication	Hypertensive emergency, aortic dissection (combined alpha+beta block), pheochromocytoma crisis

5. ANTICOAGULANTS

Unfractionated Heparin (UFH)

Parameter	Details
Preparation	25,000 units in 25 mL NS (1,000 units/mL) - neat/standard
	25,000 units in 500 mL NS (50 units/mL) - diluted
	20,000 units in 20 mL NS (1,000 units/mL)
Dose range	ACS: 60 units/kg bolus (max 4,000 units); then 12 units/kg/h (max 1,000 units/h); titrate per aPTT
	DVT/PE: 80 units/kg bolus; then 18 units/kg/h
	Cardiopulmonary bypass: 300-400 units/kg bolus
Indication	ACS (NSTEMI/STEMI), DVT/PE, AF cardioversion, mechanical heart valves, CPB

Bivalirudin

Parameter	Details
Preparation	250 mg in 50 mL NS or D5W (5 mg/mL)
Dose range	PCI: 0.75 mg/kg bolus then 1.75 mg/kg/h during procedure; post-PCI: 0.2 mg/kg/h x 4-12 h
Indication	Percutaneous coronary intervention (PCI), HIT type II, ACS

6. THROMBOLYTICS (Fibrinolytics)

Alteplase (tPA)

Parameter	Details
Preparation	Reconstitute 50 mg vial with 50 mL SWFI = 1 mg/mL (standard concentration)
	May further dilute 1:1 with NS or D5W = 0.5 mg/mL
	Post-procedure infusion: 10 mg in 1000 mL NS = 0.01 mg/mL
STEMI (accelerated)	<67 kg: weight-based; ≥67 kg: 15 mg bolus, then 50 mg over 30 min, then 35 mg over 60 min (total ≤100 mg)
STEMI (3-hr infusion)	<65 kg: 0.075 mg/kg bolus, then 0.675 mg/kg over 60 min, then 0.5 mg/kg over 120 min
Massive PE	100 mg IV over 2 hours
Indication	STEMI (no PCI available), massive PE, large thrombus burden

Tenecteplase (TNKase)

Parameter	Details
Preparation	Reconstitute with 10 mL SWFI; concentration 5 mg/mL
Dose	Single IV bolus (weight-based): <60 kg: 30 mg; 60-70 kg: 35 mg; 70-80 kg: 40 mg; 80-90 kg: 45 mg; >90 kg: 50 mg
Indication	STEMI (fibrinolysis when primary PCI unavailable within 120 min)

Streptokinase

Parameter	Details
Preparation	1.5 million units diluted in 100-250 mL NS or D5W
Dose range	STEMI: 1.5 million units IV over 60 min; DVT/PE: 250,000 units loading over 30 min, then 100,000 units/h
Indication	STEMI (where alteplase unavailable), DVT, PE

7. DIURETICS

Furosemide (Frusemide)

Parameter	Details
Preparation	250 mg in 250 mL NS (1 mg/mL) - standard infusion
	500 mg in 500 mL NS (1 mg/mL) - 24-h infusion in severe heart failure
	10-40 mg IV bolus (undiluted, 10 mg/mL)
Dose range	Bolus: 20-200 mg; Infusion: 5-20 mg/h (continuous preferred in acute HF for better diuresis)
Indication	Acute decompensated heart failure, pulmonary edema
Max infusion rate	Do not exceed 4 mg/min (ototoxicity risk)

8. ELECTROLYTES (Used in Cardiac Context)

Magnesium Sulfate

Parameter	Details
Preparation	20 mmol in 100 mL NS (0.2 mmol/mL)
	20 mmol in 50 mL NS (0.4 mmol/mL)
Dose range	Torsades de Pointes/hypomagnesemia: 1-2 g (4-8 mmol) IV over 10-15 min; Infusion: 0.5-1 g/h
Indication	Torsades de pointes, refractory VF/VT, hypomagnesemia, pre-eclampsia

Potassium Chloride (KCl)

Parameter	Details
Preparation	40 mmol in 1000 mL NS (40 mmol/L) - standard
	20 mmol in 100 mL NS via controlled infusion
Dose range	Max peripheral infusion rate: 10 mmol/h; Central line: up to 20-40 mmol/h in emergency
Indication	Hypokalemia with arrhythmia risk, pre-operative cardiac preparation

9. VASODILATORS FOR PULMONARY HYPERTENSION

Epoprostenol (Prostacyclin, PGI2)

Parameter	Details
Preparation	100,000 ng in 50 mL NS (2,000 ng/mL)
	Diluted to 10-60 ng/mL for certain pump systems
Dose range	Start: 2 ng/kg/min; titrate up by 2 ng/kg/min q15 min; maintenance typically 20-80 ng/kg/min
Indication	Pulmonary arterial hypertension, right heart failure
Note	Requires continuous central infusion; half-life 2-3 min; never interrupt abruptly

10. MISCELLANEOUS CARDIOLOGY INFUSIONS

Digoxin

Parameter	Details
Preparation	500 mcg (0.5 mg) in 50 mL NS (10 mcg/mL)
	250 mcg (0.25 mg) undiluted or diluted in 10-50 mL NS
Dose range	Load: 500-1000 mcg in divided doses over 24 h; each dose given IV over 30-60 min
Indication	AF rate control, heart failure with reduced EF

Atropine

Parameter	Details
Preparation	1 mg undiluted (0.5 mg/mL) for IV push
Dose range	0.5-1 mg IV bolus; repeat every 3-5 min; max 3 mg
Indication	Symptomatic bradycardia, asystole, heart block

Quick Reference Summary Table

Drug	Standard Preparation	Concentration	Primary Indication
Norepinephrine	4 mg in 50 mL NS	80 mcg/mL	Vasodilatory/cardiogenic shock
Epinephrine	4 mg in 100 mL NS	40 mcg/mL	Cardiogenic shock, cardiac arrest
Vasopressin	20 units in 50 mL NS	0.4 units/mL	Refractory vasodilatory shock
Dobutamine	250 mg in 100 mL NS	2.5 mg/mL	Low cardiac output, acute HF
Dopamine	200 mg in 50 mL NS	4 mg/mL	Shock, bradycardia, low CO
Milrinone	20 mg in 100 mL NS	200 mcg/mL	ADHF, post-cardiac surgery
Levosimendan	12.5 mg in 500 mL D5W	0.025 mg/mL	Decompensated severe HF
Amiodarone (load)	300 mg in 100 mL D5W	3 mg/mL	VT/VF, AF
Amiodarone (maint.)	900 mg in 500 mL D5W	1.8 mg/mL	Post-conversion maintenance
Lidocaine	1 g in 500 mL NS	2 mg/mL	Ventricular arrhythmias
Esmolol	2500 mg in 250 mL NS	10 mg/mL	AF rate control, SVT
Diltiazem	100 mg in 50 mL NS	2 mg/mL	AF rate control
Nitroglycerin (GTN)	50 mg in 50 mL D5W	1 mg/mL	ACS, LVF, hypertensive emergency
Sodium Nitroprusside	50 mg in 100 mL D5W	500 mcg/mL	Hypertensive emergency, aortic dissection
Nicardipine	25 mg in 250 mL NS	0.1 mg/mL	Hypertensive emergency
Labetalol	200 mg in 200 mL NS	1 mg/mL	Aortic dissection, hypertensive emergency
Heparin (UFH)	25,000 units in 25 mL NS	1,000 units/mL	ACS, DVT/PE anticoagulation
Bivalirudin	250 mg in 50 mL NS	5 mg/mL	PCI, HIT
Alteplase	50 mg in 50 mL SWFI	1 mg/mL	STEMI, massive PE
Furosemide	250 mg in 250 mL NS	1 mg/mL	Acute HF, pulmonary edema
Magnesium Sulfate	20 mmol in 100 mL NS	0.2 mmol/mL	Torsades de Pointes
Epoprostenol	100,000 ng in 50 mL NS	2,000 ng/mL	Pulmonary arterial hypertension

Key Practical Notes:

Drugs marked for central line (norepinephrine, epinephrine, dopamine, dobutamine, milrinone, amiodarone at high concentrations, potassium >40 mmol/L) should not be administered peripherally due to vesicant/vasoconstrictor properties.
Amiodarone and nitroglycerin adsorb to PVC - use polyethylene or glass containers.
Sodium nitroprusside must be protected from light (wrap in foil) - degrades to cyanide on exposure.
Levosimendan must only be diluted in D5W - not compatible with NS.
All weight-based infusions should be recalculated if there is a significant change in patient weight.

Sources: LITFL Critical Care Compendium; Lancashire & South Cumbria Critical Care Drug Monographs (2024); UBC Critical Care ICU Drug Reference; ICS Infusion Concentration Standards; StatPearls (Alteplase); ECR Journal (Levosimendan 2024).

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