Always follow your institution’s specific protocols. Dosage adjustments depend heavily on the patient’s response and condition. Typical starting doses range from 5-15 mcg/kg/min, titrated to effect. Careful monitoring is paramount.
Monitoring Vital Signs
- Continuously monitor ECG for bradycardia, hypotension, and conduction abnormalities. Frequently assess blood pressure, heart rate, and rhythm. Regularly check oxygen saturation levels.
Closely observe the patient for adverse effects. Slow the infusion rate or temporarily stop it if hypotension or bradycardia develops.
Potential Adverse Effects and Management
Hypotension: Reduce infusion rate or temporarily discontinue. Consider fluid boluses if necessary. May require vasopressors in severe cases. Bradycardia: Reduce infusion rate or stop the drip. Atropine may be needed. Pacemaker may be necessary. AV Block: Immediately stop the infusion. Treat underlying cause and potential need for pacemaker. Headache: May require slowing the drip or alternate medication. Nausea/Vomiting: May require antiemetics. Reduce infusion rate if severe.
Precautions and Contraindications
- Avoid administering Cardizem to patients with sick sinus syndrome or second – or third-degree AV block (unless a pacemaker is in place). Use caution in patients with severe heart failure, impaired hepatic function, or hypotension. Monitor serum calcium and potassium levels during prolonged infusion. Be aware of potential drug interactions, particularly with other negative inotropic agents or beta-blockers.
Documentation
Meticulous documentation is critical. Record the infusion rate, patient response, any adverse effects, and all adjustments made to the dosage.
Emergency Preparedness
Have emergency equipment readily available, including atropine, epinephrine, and a pacemaker. Be prepared to manage potential complications promptly and effectively.
