Download DILTIAZEM (CARDIZEM) MEDICATION

r*PHYSORDE*r
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HALIFAX HEALTH
303 N. Clyde Morris Blvd., Daytona Beach, FL 32114
1041 Dunlawton Ave., Port Orange, FL 32127
"X" IN BOX
FOR STAT MED
PHYSICIAN’S ORDERS
Patient Name
Adm. Date
Date of Birth
MR #
Dr.
Age
Visit #
DILTIAZEM (CARDIZEM) MEDICATION
(NDOSCARDIZ)
ALLERGIES:
Page 1 of 1
HIGH RISK / DO NOT USE ABBREVIATIONS: U, IU, MS, MSO4, MgSO4, QD, QOD.
ALWAYS WRITE OUT INTENDED MEANING AND USE METRIC. DO NOT USE A ZERO AFTER A DECIMAL; ALWAYS USE A ZERO BEFORE A DECIMAL.
DATE
TIME
CK’D
(✔)
X CHECK BOX TO INITIATE ORDER
❑
Patient Status: (select only one)
❑ Admit to Inpatient. I certify that inpatient services are necessary.
❑ Place in Observation
❑ Case Management Protocol
Attending Physician is________________________________________________________
1. X
❑ Bolus 0.25 mg/kg undiluted Cardizem IV over 2 minutes
2. X
❑ If response is inadequate after 15 minutes:
Rebolus with 0.35 mg/kg Cardizem IV
X
3. ❑ Start infusion: 5 mg/hour (5 ml/hour) for 24 hours
May titrate to 15 mg/hour to maintain the desired heart rate and continue for up to 24 hours
Requires physician order to titrate OFF
4. X
❑ IV infusion of Diltiazem (Cardizem) in 0.9% Normal Saline for a final concentration of 1 mg/ml
5. Cardizem Guidelines:
1.) Contraindicated in patients with hypotension, sick sinus syndrome, second and complete
AV block, and in patients with acute myocardial infarction and pulmonary edema
2.) Continuous ECG and blood pressure monitoring
3.) Multiple drug incompatibilities include: (do not give through the same IV line)
Furosemide (Lasix)
Phenytoin
Insulin
Methylprednisolone
Diazepam
Sodium Bicarbonate
4.) Most common drug interactions:
• Beta−blockers − decreased heart rate, cardiac index and prolonged PR interval
• Digoxin − increased digoxin plasma concentrations
• Cyclosporin − increased cyclosporin plasma concentrations
• Amiodarone − increased diltiazem plasma concentrations
5.) Monitoring Therapy:
• Vital Signs: blood pressure, pulse, and respirations should be documented a minimum
of every 15 minutes x 4 after initial bolus, then every 4 hours during continuous infusion
• Posting and interpretation of rhythm strip before administration and with any significant
rhythm and/or hemodynamic change
6.) If the patient has symptomatic hypotension and/or displays signs of changes, STOP
the infusion and notify physician
7.) Conversion from IV to oral:
3 mg/hour = 120 mg/day
5 mg/hour = 180 mg/day
7 mg/hour = 240 mg/day
11 mg/hour = 360 mg/day
Physician Signature:__________________________________________ Dictation #:__________________
PHYSICIANS: PLEASE REMEMBER TO USE YOUR DICTATION NUMBER WITH YOUR SIGNATURE.
PHYS ORDER
ALL ORDERS TO PHARMACY
HMC − 1564 − 2/10