Medications

Labetalol – a1, B1, B2 blockade

• 10 – 80 mg IV bolus q 10 min (double dose at 10 min intervals up to max 300 mg)
• or 0.5-8 mg/min gtt (titrate 0.5 mg/min q 10 min)
• Onset: 5-10 min; Duration: 2-4hrs

Clevidipine

• Infusion 1 mg/hr then double rate q 90 sec util close to goal; titrate by 1-2 mg/hr q 5-10 min prn; Max 21 mg/hr
• Onset: 2-4 min; Duration: 5-15 min

Nicardipine – dihydropyridine CCB

• Infusion: start 5 mg/hr, titrate 2.5 mg/hr q5 min
•  Onset: 5-15 minutes; Duration: 4-6 hrs

Nitroglycerin

• Loading infusion 50-100 mcg/min for 1-5 min
• Infusion: 50-200 mcg/min; titrate by 40 mcg/min q3-5 min
• Extreme load: Can draw up 200 mcg/ml in 10 ml syringe, give 1 or even 2 mg IV bolus as a loading dose prior to starting infusion (Strayer)
• Onset: 2-5 min; Duration: 3-5 min

Esmolol – B1 blockade – 500 mcg load then 50-300 mcg/kg/min gtt – onset 1-2 min