Cardiology Corner: Updates in SVT

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Nurses Edition Commentary

Kathy Garvin, RN and Lisa Chavez, RN
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chris r. -

What is your maximum dose of Cardizem patient (in mg/kg)? For morbidly obese patients, do you use total body weight or ideal body weight? Same question with metoprolol.

Amal M. -

Personally I really don't have a max dose, as long as the BP is ok. I think the most common reason that dilt or metop don't work is because they are not given aggressively enough. Almost always, I start with a dose of 10-15 mg based on body habitus, then I give an additional 10-15 mg IV every 10 min and eventually it pretty much always works. But when things are busy and the patient doesn't get the dosing this frequently, it sometimes will not work.

Dilt only lasts for around an hour so if you are not dosing it frequently enough, the first dose will wear off before the 2nd dose, etc. So be aggressive in terms of the frequency of dosing and it will work!

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