Varies among protocols. Check local protocols. Typically administered for rate control of sustained uncontrolled (rate>100) atrial fibrillation/flutter and sustained SVT, JT, MAT.
Ventricular rhythm/pacemaker, Sick sinus syndrome, 2nd or 3rd degree block, SBP <90, acute MI, pulmonary congestion.
Edema, nausea, headache, fatigue, drowsiness, rash, constipation.
Potentially Lethal Side Effects:
Dysrhythmia, CHF, AV block, acute renal failure
All indications:
Dose 1: Slow IV push: 0.25mg/kg/2 min, to Max first dose 20mg
Dose 2: Slow IV push: 0.35mg/kg/2 min, to Max second dose 25mg
Maintenence Infusion:
5-15mg/hr, titrated to heart rate <100
Not recommended by AHA/AACN in PALS Guidelines
- Rapid administration of Diltiazem may result in profound hypotension.
- Increases effects of beta blockers, digoxin, lithium, carbamazepine, cyclosporine, anesthetics.
Using 60gtt/ml set:
If adding 20mg to 500ml NaCl, OR 40mg to 1L,
Then 125gtt/min=5mg/hr; 250gtt/min=10mg/hr.
Using 15 gtt/ml set:
If adding 20mg to 500ml NaCl, OR 40mg to 1L,
Then 31gtt/min=5mg/hr; 62gtt/min=10mg/hr; 93gtt/min=15mg/hr.
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Using 60gtt/ml set:
If adding 20mg to 250ml NaCl, OR 40mg to 500ml
Then 60gtt/min= ~5mg/hr; 120gtt/min= ~10mg/hr, 180gtt/min= ~15mg/hr
Using 15gtt/ml set:
If adding 20mg to 250ml NaCl, OR 40mg to 500ml
Then 15gtt/min= ~5mg/hr; 30gtt/min= ~10mg/hr, 45gtt/min= ~15mg/hr
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Using 60gtt/ml set:
If adding 20mg to 50ml NaCl,
Then 5gtt/min=5mg/hr; 10gtt/min=10mg/hr, 15gtt/min=15mg/hr