Merck & Co., Inc., Kenilworth, NJ, USA is a global healthcare leader working to help the world be well. From developing new therapies that treat and prevent disease to helping people in need, we are committed to improving health and well-being around the world. The Merck Manual was first published in 1899 as a service to the community. The legacy of this great resource continues as the Merck Manual in the US and Canada and the MSD Manual outside of North America. Learn more about our commitment to Global Medical Knowledge.
This is a powerful drug for the control of atrial and ventricular arrhythmias.
The dosage regime is as follows (via a central line):-
300 mgs in 100mls 5 % Dextrose over 1 hour
then 900 mgs in 250 mls 5% Dextrose over 23 hours
The initial oral dose is then 200 mgs tds for 1 week reduced thereafter to bd followed by maintenance od.
( Note. Some has a preference not to use this agent first line and prefers Digoxin)
A DC shock applied to the chest is an effective way of restoring sinus rhythm, particularly supraventricular tachycardia. This is usually carried out by the Cardiologist.
3. Ventricular Arrhythmias
VF\VT - See cardiac arrest
mg/m2 PO/IM daily for 4 to 6 weeks or until remission occurs; followed by twice weekly maintenance therapy with a total weekly dose of 30 mg/m2 PO/IM. Children receiving doses of 20 to 30 mg/m2/week ( to 1 mg/kg/week) may have better absorption and fewer GI side effects if methotrexate is administered either IM or subcutaneous. Several different combination chemotherapy regimens have been used for both induction and maintenance therapy in acute lymphoblastic leukemia. The prescriber should be familiar with new advances in antileukemic therapy.