FORMULAS

HYPONATREMIA HYPERNATREMIA

Na Deficit = 10/12 x TBW Water Deficit =

ABG
[Actual Na-140] x TBW
TBW = wt (kg) x 0.6 140
I (FiO2 x 713) – pCO2 FM: 5-6 = 40%
0.8 6-7 = 50%
Example: wt = 40 kg TBW = wt (kg) x 0.6 (male)
II PaO2 7-8 = 60%
Na Deficit = (10) (40) (0.6) 0.5 (female)
I
= 240 meqs
III Target FiO2 + pCO2 TP: 6 = 40%
using PNSS 1L, 240 meqs Half-correction: 1/3 D5W
II 0.8 7 = 70%
154 meqs/L 2/3 PNSS
713 x100 8 = 80%
… 1.6 L
9 = 90%
… 1600 mL/24H = 67 cc/hr
10 = 100%
FiO2: RA = 0.21
NP = Lpm x 4 + 20 Target FiO2:
FM = Lpm x 10 – 10 < 60 = 80
RB = Lpm x 10 > 60 = 80 – age above 60 CREATININE CLEARANCE
VR = 100% COPDier = 60
AB = 80 (140-Age) (wt in kg) X 0.85 (F)
CPAP = Lpm x 4 + 20 Expected PF = Age x 5 1 (M)
Crea (mg/dL) x 72

Normal 80-120
Delta H
Impairment 50-80
[H+] = 24 x pCO2
CRI 20-50
HCO3 <0.3 Chronic RF
CRF 5-20
0.3–0.7 Acute on top of
ESRD <5
ΔH = [H+] – 40 Chronic
pCO2 - 40 >0.7 Acute RF, INTUBATE
Stage Description GFR
(mL/min/1.73m2)

1 Kidney Damage w/ Normal or inc GFR ≥ 90

HCO3 DEFICIT 2 Kidney Damage w/ mild dec GFR 60-90
3 Moderate dec GFR 30-59
[Wt (kg) x 0.4] x [Desired - Actual] 4 Severe dec GFR 15-29
5 Kidney Failure < 15 or dialysis
 Desired HCO3:
Normal = 20
CRF = 15
 Give only ½ of the computed deficit
BUN:CREA
 1 amp = 44 meqs NaHCO3 BUN:Crea Ratio = BUN x 2.8 Normal 247.26
Crea Pre-renal > 15
88.4 Renal < 15
Both 15-25

24H Creatinine Clearance (mL/min)

CrCl = Urine Cr (mg/dL) x Volume (mL)

Plasma Cr (mg/dL) x Time (min)
Conversion Factors:
BUN (mg/dL) x 0.357 = __ mmol/L Crea (mg/dL) x 88.4 = __ mmol/L

Reticulocyte Index
Anion Gap Elevated AG:
Ketoacidosis Reticulocyte count x [Hgb x 15]
Na - (Cl + HCO3) Lactic Acidosis 2
RF (GFR < 20-30) or
Normal = 12 ± 4 meqs Methanol & Ethylene Reticulocyte count x [Hct abn] x ½
Intoxication [Hct N]

> 2.5 Hemolysis

< 2.0 Hypoproliferative Anemia or Maturation Disorder
Corrected Ca (mg/dL)

(Calcium x 4) + 0.8 x (4-Albumin)

4 Diabetic Diet
Ideal Body Weight (IBW) x 35 cal/kg = Total cal/day

IBW = [height (in) x 2.54 – 150] – 10% (if female)

Serum Osmolality (mOsm/L)
Example:
[2 (Corrected Na + K)] + RBS (mmol/L) Total Cal Req’t. = 2000 kcal/day
60% CHO = 2000 x 0.60 = 1200/4 = 300 g
Corrected Na = Actual Na + 1.6 [RBS (mg/dL) – 100] 20% CHON = 2000 x 0.20 = 400/4 = 100 g
100 20% Fats = 2000 x 0.20 = 400/9 = 45 g

 RBS (mmol/L) x 18 = ___ mg/dL

 Normal 280-300 mOsm/L OTF Feeding kcal/scoop

DKA 300-320 Weight (kg) x 35 kcal = ___ kcal/day Nutren = 35
HHS 330-380 x 60% CHO/4 Isocal = 83
x 20% CHON/4 Ensure = 42-43
x20% Fats/9 Glucerna = 36-37

Urine Osmolality

Specific Gravity – 1 x 40,000 IV Fluids

D5W D10W PNSS D5LR D5NM D5NMK D5IMB
Gluc 50g/L Gluc 100g/L Na Na Na Gluc Na-
154 130 40 50 5
Mean Arterial Pressure (MAP; mmHg) Cl Cl Cl Na Cl
154 109 40 40 22
K K Cl K
Systolic BP + 2Diastolic BP 4 13 40 20
3 Ca K Mg
3 30 3
HCO3 Acetate
Body Mass Index (BMI) 28 23
Normal <18.5 PO4
weight (kg) Underweight 18.5-24.9 3
height (m)2 Overweight 25-29.9
Obese >30
 Actrapid Sliding Scale CBG Coverage
DRIPS ≤200 no coverage
CBG Coverage 201-250 3 units
<160 no coverage 251-300 5
CA Drip Clonidine Drip 161-200 3 units 301-350 7
201-249 5 351-400 8
Clonidine 2 amps (150 mg/amp) + Apresoline Clonidine 2 amps in 500cc 250-299 7 401-450 9
2 amps (20 mg/amp) in 500cc PNSS or D5W x PNSS 300-349 9 451-500 11
___ μgtts/min 350-399 11 >500 12 & refer
Systolic BP Dose 400-449 13
Titrate by increments of __ μgtts to maintain (μgtts/min) 450-499 14
BP ___ mm Hg (up to 60 μgtts/min) <160 close ≥500 15 & refer
160-180 20
180-200 25
Apresoline Drip >200 30 Burinex Drip Calcium-Glucose Drip
Burinex 3 amps in 54cc PNSS Ca gluconate 4 amps in 500cc
Apresoline 2 amps (20 mg/amp) in PNSS Aminophylline Drip x 10 cc/hr D5W x 24hr
250cc
Aminophylline 4 amps in see to it that the patient has
Max: 400 mg/day 500cc D5W x ___ μgtts/min Calcium Gluconate Drip no beta-blocker
Calcium Gluconate 4 amps (10mg/amp) in
LD: 5-6 mg/kg BW 500cc D5W x 24hr
MD: 0.2-0.5 mL/hr

Actrapid Drip Actrapid Drip for GDM Bricanyl Drip Cordarone Drip
20 “u” Actrapid + 100cc PNSS 10 “u” Actrapid + 100cc PNSS Bricanyl 5 amps in 500cc D5W Cordarone 4 amps + 500cc
x 24H PNSS x 60 cc/hr x 1st 6 hours
HGT Actrapid HGT Actrapid Subsequently 25 cc/hr
< 160 close < 120 close Increase to 30-40 cc/hr
160-199 3 cc/hr 121-140 6 cc/hr Cordarone 150 mg IV now
200-249 8 141-160 8 Bricanyl 2.5 mg/tab TID Cordarone 4 amps + 500cc
250-299 10 161-180 10 D5W x 24H
300-349 15 181-220 14 Cordarone 4 amps + 500cc
350-399 20 221-240 16 D5W x 25 μgtts/min x 6H,
400-499 25 241-260 18 then 12 cc/hr
≥ 500 30 & refer 261-280 20
281-300 22
> 300 refer Diazepam Drip
Diazepam 10 mg/100cc D5W
< 200 close Diazepam 20 mg/100cc D5W
200-249 15
250-299 20 Initial: 50-100 mg IV
300-349 25 Max: 60 mg/day
350-399 30
400-449 35 Diazepam 50 mg in 100cc PNSS x 6 cc/hr to titrate to control seizure, hold for
450-499 40 BP < 90/60 mm Hg
> 500 45 & refer
Dormicum Drip
Dormicum 3 amps (1.5 mg/amp) + 500cc PNSS x 2 mg/hr
Epinephrine Drip
Epinephrine 5 amps (5 mg) + 500cc D5W to run for 6 cc/hr Glucose-Insulin-HCO3 Drip Glucose-Insulin Drip
D5W 150cc + D50W 1 vial + NaHCO3 1 amp + (Hyperkalemia ≥ 6)
Actrapid 8 units to run for 6 or 8 or 12 hrs
In a soluset, 50cc D50W +
Dobutamine Drip Dopamine Drip Repeat K post-drip Actrapid 8-10 units x 1hr x 3
Dobutamine 250 mg/amp + D5W 250cc x ___ Dopamine 2 amps (400 mg) cycles
μgtts/min + 250cc D5W Glucose
(max rate: 60 μgtts/min) (max: 10-20 mg/kg/min) HGT < 60 – D50W 1 amp CBG monitoring qHourly while
HGT < 40 – D50W 2 amps on drip
Rate drip: Renal Vasocons: 0-5
Drip mcg x kg BW mg/kg/min Target FBS 60-90, RBS 80-120 Repeat K 1 hr after the last
16.6 Inotropic: 5-10 mg/kg/min cycle
Vasoconstriction: > 10
For patients w/ CHF: mg/kg/min
Dobutamine 2 amps (500 mg) +
D5W 250 cc Rate (μgtts/min): Heparin Drip Heparin for Flushing
(max rate: 30 μgtts/min) mg/kg/min x BW D5W 250cc + Heparin 10,000 units x 10-20 > 500 ‘U’ Heparin in 100 mL
13.3 or 26.6 μgtts/min via infusion pump PNSS

Conc.: 50 U/mL
Drip of 500-1000 ‘U’ ~ 10-20 μgtts/min Hepamerz Drip
OR < 4 amps in 500cc D5W x
Fraxiparine Drip Furosemide Drip In a soluset, Heparin 4cc in 36cc D5W 12hrs BID
Fraxiparine 2 amps in 1 L D5W or D5NSS Furosemide 3 amps + 54cc (Heparin 1000 IU/cc)
PNSS in a soluset x 10 cc/hr OR
88 “U”/kg BW or 0.1 cc/kg x 24H Heparin 5000 ‘U’ IV initially, then 4000 ‘U’ in IVIG
Furosemide 80 mg in 80cc 36cc PNSS via soluset x 1000 ‘U’/hr LD: 2 g/kg given in 5-6hrs in
Fraxiparine PNSS via soluset x 10 cc/hr 3-5 days
85 cc/kg or 0.1 cc/10 kg LD: 3000-5000 ‘U’ slow IV MD: 400 mg/kg or 0.4g/kg

LD = 80 U/kg
MD = 18 U/kg Insulin Drip
Furosemide Drip Furosemide-Albumin Drip PNSS 250cc + Humulin R 50
(Dr. Caro) 25% Albumin 50cc + APTT det’n q6h ‘u’
Furosemide 20mg to run for APTT 1.5-2x the baseline
In a soluset: Furosemide 3 amps + 54cc PNSS 4hrs Conc.: 0.2 ‘U’/mL
x 10cc/hr
Or Albumin 50cc + PNSS 950cc Drip of 5-50 μgtts/min ~ 1-
D5W 250cc + Furosemide 250mg/amp x 5-30 + Furosemide 100mg x 24hrs 10 ‘u’ Humulin
μgtts/min
Conc: 1 mg/mL Albumin 100cc + Furosemide
Or 40mg to run for 4-6hrs Isoket Drip NaHCO3 Drip
PLR 500cc + 18 amps Furosemide x 18-20 Isoket 10mg/amp (1amp) + PNSS 90cc x 10 NaHCO3 2 amps (50cc/amp)
μgtts/min Dr. Caro: μgtts/min (1 mg/hr) in D5W x 24H
Furosemide 60mg + PNSS or
54cc x 10cc/hr NaHCO3 3 amps in 100cc
SD: Plasbumin 25% 100cc to Miacalcic Drip D5W x 24H
run for Miacalcic 2 amps (200 IU) + D5W 250 cc x
6 hrs 15H
Nicardipine Drip Noradrenaline (Levophed) Drip
- 5mg/10ml - 2mg Noradrenaline/2ml amp
- D5W 250cc + Levophed 1amp x 15-60 μgtts/min
- Nicardipine 10mg in 90cc PNSS or D5W in a soluset to run for 10cc/hr, titrate - conc: 8mcg Noradrenaline/ml
by increments of 5 μgtts/min to maintain BP at ____ mmHg - drip of 2-8 mcg Noradrenaline ~ 15-60 μgtts/min

- Max of 150 cc/hr at 15mg/hr (0.5 mk/BW), give initial bolus of 2mg IVTT, Levophed 2 amps (2 mg/mL/amp) in D5W 250cc x 10 μgtts/min
titrate to BP ___
Levophed 4 amps in D5W 500cc x ___ μgtts/min
Lidocaine Drip
-give 50 as blous, then start drip as follows:
1 g in 250cc D5W at 15cc/hr (1mg/h) Pantoloc Drip
increase by increments of 15 - maintain GI acidity to stabilize clot
- Pantoloc 80mg IV bolus then 5 amps in PNSS 1L x 24H for 3 days
LD: 1mg/H
Conc: 4mg/cc
Drip: 1-4mg/min Octreotide (Sandostatin) Drip
- prep: 0.5 mg/mL
- 0.2 mg/mL IV bolus, give for 1 min, then start drip as ff: 4 amps +
Mannitol (prep 20%) Mannitol-Furosemide Drip: remaining 0.03 mg in 500cc PNSS x 24H
Dose: Amt given (cc)x0.2/kBW Mannitol 250cc + Furo 100mg
LD: 1-2 g/kg x 10 μgtts/min Sandostatin Drip
MD: 0.5-1 g/kg OR - sandostatin 0.5mg/amp 0.2mL now then drip as ff: 0.8mL in D5W 500cc x
Mannitol 36cc + Furo 240mg 8H
Action: 30mins (24mL) x 6H - ff by 2 amps sandostatin 0.5mg/amp + D5W or D5NSS 1L x 24H
Peak: 2hrs
Solumedrol Drip
Complications: MgSO4 Drip Solumedrol 2g + D5W 500cc x 20 μgtts/min
- rebound increase in ICP D5W 250cc + MgSO4 2g x
- IV volume expansion 20 cc/H Somatostatin Drip
pulmonary edema Somatostatin 250mcg IV bolus then 2amps (3mg/amp) + PNSS 1L x 24H for 5
CHF Conc: 250mg/mL x 10 amps days w/o interruption
- DHN (2.5 g/amp)
- Hypernatremia
Streptokinase Drip Terbutaline (Bicanyl) Drip
Streptokinase 1.5M units + D5W 90cc x D5W 250cc + Bricanyl 5amps
Morphine Drip 100cc/H (1H running rate) via soluset x 10-30 μgtts/min
MoSO4 10 mg/amp (1 amp) + PNSS 60cc in a soluset x 10 μgtts/min
Give prior: Benadryl 50mg ivtt
MoSO4 1 amp (16mg/amp) + PNSS 50cc x 6 μgtts/min (2mg/H) Solucortef 250mg ivtt Thiamine Drip:
50-100mg IV (for 40-50 y.o.)
PRN: 1-3mg MoSO4 SQ APTT monitoring q6H

Nimotop Drip
Nimotop ½ vial + D5W 500cc x 24H

Nootropil Drip
Nootropil 12g in 60cc x 24H
Toradol Drip
Toradol 30mg + PNSS 80cc via soluset x 8H
Toradol 100mg + PNSS 80cc x 10cc/H

Tramadol Drip
Tramadol 100mg + PNSS 80cc x 10 μgtts/min

Trental Drip
Trental 4amps in PNSS 500cc x 24H

Zantac Drip
Zantac 5amps in D5W 500cc x 16H

Zithromax Drip
Zithromax 500mg in 90cc IVF via soluset to run for 5H