Indication
Refractory bradycardia awaiting pacing, torsades (bridge), β-blocker toxicity.
Preparation
2 mg in 500 mL D5W.
Dilution
4 mcg/mL
Rate
Start 2 mcg/min IV, titrate to HR target 60–80 (usual 2–10 mcg/min).
Monitoring
- • Continuous ECG
- • BP
- • K+
- • Angina symptoms
Common errors
- • Precipitates ischaemia in coronary disease
- • May cause hypotension via β2 vasodilation
Pearls
- • Bridge to transcutaneous/transvenous pacing
- • Useful in complete heart block after inferior MI
