Among the craziness of residency is the learning of medications. Below is a list of standard dilutions used. This should not be a substitute to understanding the process of dilution
Pressors
Phenylephrine
- Mix (2) 10 mg vials into a 250 mL bag
- Final concentration: 80 mcg/mL
Ephedrine
- Draw up 1 mL (50 mg/mL) ephedrine
- Add 9 mL normal saline
- Final concentration: 5 mg/mL
Norepinephrine
- Add 4 mg to a 250 mL bag
- Final concentration: 16 mcg/mL
Optional dilution:
- Take 5 mL of the 16 mcg/mL solution + 5 mL NS
- Final concentration: 8 mcg/mL
Epinephrine
- 1 mg (1 mL) into a 100 mL bag
- Final concentration: 10 mcg/mL
Infusion example:
- 4 mg in 250 mL → 16 mcg/mL
- Typical starting rate: ~0.02 mcg/kg/min (titrate to effect)
Vasopressin
- Add 20 units to a 100 mL bag
- Typical infusion: 0.03–0.04 units/min
- Bolus: 1–2 mL (based on concentration)
Hypnotics
Dexmedetomidine (Precedex)
- Standard concentration: 4 mcg/mL
- Common preparations:
- 200 mcg in 50 mL NS
- 400 mcg in 100 mL NS
Opioids
Sufentanil
- 100 mcg in 100 mL NS
- Final concentration: 1 mcg/mL
Remifentanil
Common preparations:
- 2 mg in 50 mL NS → 40 mcg/mL
- 8 mg in 250 mL NS → 32 mcg/mL
Notes:
- Supplied as powder (typically 1 mg or 2 mg vials)
- Scale proportionally as needed (e.g., 4 mg in 100 mL)
Antihypertensives
Nicardipine
- 25 mg in 250 mL
- Final concentration: 0.1 mg/mL