The UK NHS Injectable Medicines Guide (IMG) (Medusa) is an electronic resource containing information on the IV preparation and administration of over 200 injectable medicines. In each clinical area a folder containing 83 core monographs is available (entitled NHSGGC Adult Intravenous Medicine Monographs) with further monographs available via the Clinical Info tab on NHSGGC StaffNet (link only active if accessing via NHS network) or http://injmed.wales.nhs.uk/ (username and password available on NHSGGC StaffNet). The monographs available on Medusa are not exhaustive.
It should be noted that monographs will not be available for every drug and it may be necessary to refer to other sources of information for advice on preparation and administration such as:
Specific information regarding intravenous dosing for the following medicines are included in this section:
If intravenous aminophylline is required in a patient who was already taking a theophylline preparation, check the serum theophylline concentration and seek advice before giving a loading dose. If an infusion is required, monitor the patient closely for adverse effects and check the concentration within 12-24 hours, depending on the clinical condition of the patient. Contact your clinical pharmacist or Medicines Information for further advice.
| Aminophylline | Loading dose | Maintenance infusion |
| Dose | 5mg/kg | 0.5mg/kg/hour |
| Preparation | Add dose to 100ml glucose 5% or sodium chloride 0.9% | Add 500mg (20ml) to 500ml glucose 5% or sodium chloride 0.9% |
| Weight (kg) | Dose (volume) of 250mg / 10ml ampoule | Infusion rate |
| 40 | 200mg (8ml) | 20ml/hour |
| 50 | 250mg (10ml) | 25ml/hour |
| 60 | 300mg (12ml) | 30ml/hour |
| 70 | 350mg (14ml) | 35ml/hour |
| 80 | 400mg (16ml) | 40ml/hour |
| 90 | 450mg (18ml) | 45ml/hour |
| ≥100 | 500mg (20ml) | 50ml/hour |
|
Other (<100kg) |
Dose (mg) = 5 x wt (kg) Vol (ml) = (dose / 250) x 10 Maximum 500mg (20ml) |
0.5 x wt (kg) = ml/hour Maximum 50ml/hour |
| Infusion rate | 300ml/hour (over 20 minutes) | Up to 50ml/hour |
Give amiodarone through a central line. If this is not feasible, give the drug through as large a vein as possible (for example median cubital) or via a suitable long-line, inserted peripherally.
| Amiodarone | Loading Dose | Infusion 1 | Infusion 2 |
| Dose | 300mg over 1 hour | 450mg over 12 hours | 450mg over 12 hours |
| Preparation | Add 300mg (6ml) to 250ml glucose 5% | Add 450mg (9ml) to 250ml glucose 5% | Add 450mg (9ml) to 250ml glucose 5% |
| Infusion rate | 250ml/hour for 1 hour | 21ml/hour for 12 hours | 21ml/hour for 12 hours |
N.B. Extravasation may cause tissue damage.
Preparation:
Infusion Rate:
Further increases should be based on clinical response. Systolic blood pressure should be maintained above 90 mmHg.
N.B. There are two formulations of salbutamol available for parenteral use. The infusion formulation, NOT the IV injection formulation, should be used to prepare infusions.
| Salbutamol Dose | Preparation |
|
Initially 5microgram/minute adjusted according to response and heart rate. Usual range 3-20microgram/minute. |
Dilute 5ml of solution with 500ml glucose 5% or sodium chloride 0.9% (concentration = 10microgram/ml) |
| Dose (microgram/minute) | Infusion Rate (ml/hour) |
| 3 | 18 |
| 5 | 30 |
| 8 | 48 |
| 10 | 60 |
| 15 | 90 |
| 20 | 120 |
Guideline reviewed: October 2023
Page last updated: December 2023
