Inf.: 5-20 mg/h (dose should not exceed 1000 mg/day)ĥ0 mg in 100 mL 5% dextrose (500 microgs/mL) Start: 50 microgs/kg/min Adjust every 3-4 mins by repeat load and increase infusion by 50 microgs/kg/min etc.ĥ00 microgs in 50 mL 0.9% saline (10 microgs/mL)īolus: 0.5-1 microgs/kg or aliquots of 25-50 microgs (pain) There is a mythical 2.5 g vial, reconstitute in 250 mL of 0.9% saline (10 mg/mL) Start: 1-2 mg/h, doubling every 90seconds until BP target achieved, then smaller adjustmentsĢ00 microgs in 50 mL 0.9% saline (4 microgs/mL) Neat: 50 mg in 100 mL or 25 mg in 50 mL (0.5 mg/mL) Maint.: 0.5-5 microgs/kg/min titrate to TOF (Train of four) Drugĥ0 units in 50 mL 0.9% saline (1 unit/mL)Ĥ mg in 100 mL 0.9% saline (40 microgs/mL) Route of administration is either via peripheral intravenous access or central intravenous access as indicated below. Please double-check these dosing suggestions in the paediatric population, and adjust doses for elderly, comorbid, or obese patients as required according to local guidelines.ĭISCLAIMER: These are examples from an unnamed adult intensive care unit Institution 1, please check your local infusion protocols and double-check doses - especially with regards to the paediatric patient population.It is the clinician’s responsibility to check that the right medication and the right dose for the right patient is given at the right time.Always refer to local guidelines when prescribing and administering these agents in clinical practice.With proper education, individuals with tree nut allergy can maintain a broad and nutritionally adequate diet, and good quality of life.This page lists common and important drug infusion doses, preparation, and rates used in critical care. Reactions to tree nuts can be severe, including life threatening anaphylaxis, and individuals with a tree nut allergy should have epinephrine available at all times. All oral food challenges should be performed in a medical facility equipped to recognize and treat allergic reactions, with supervision by an allergist. Based on the results of repeat allergy testing, a supervised oral food challenge can be considered if there is a favorable likelihood that the allergy has been outgrown.įood challenges should also be considered if patients show low levels of sensitivity on skin prick or serum IgE testing that may not be considered consistent with true clinical allergy. All individuals with tree nut allergy should discuss these specific dietary considerations with an allergist familiar in the management of food allergy.Īlthough tree nut allergy typically starts in childhood and persists throughout life, approximately 10% of individuals may outgrow tree nut allergy over time. Nutmeg, water chestnut, butternut squash and shea nuts are not tree nuts (the term “nut” does not always indicate a tree nut) and are generally well tolerated by tree nut-allergic individuals. Although the Food and Drug Administration labels coconut as a tree nut, the vast majority of tree nut-allergic individuals also tolerate coconut without difficulty, since coconut is not truly a nut, but rather a fruit. They also usually tolerate macadamia nut and pine nut, which are also both seeds. Individuals with tree nut allergy can also typically consume seeds without difficulty, such as sesame, sunflower and pumpkin. If an individual allergic to certain tree nuts chooses to consume other tree nuts, they should always account for the potential risk of cross contamination (the introduction of trace amounts of the allergenic food during preparation and handling), which may or may not be clinically relevant for all individuals.Īlthough 30% of peanut-allergic individuals are also allergic to tree nuts, having a tree nut allergy does not necessarily mean an individual is allergic to peanuts. This decision must be made after careful discussion with an allergist and should be based on multiple factors, including the age of the individual, results of allergy testing, risk of potential cross reactivity between the nuts, quality of life implications and family preferences. Even though individuals allergic to tree nuts are often allergic to more than one type of tree nut, it may be appropriate and safe to consume certain tree nuts while avoiding others. Tree nuts include almonds, Brazil nuts, cashews, hazelnuts, pecans, pistachios and walnuts.Īn allergy to one tree nut does not necessarily mean an individual is allergic to other tree nuts, but certain tree nuts are closely related, including cashew with pistachio and pecan with walnut. Tree nuts grow on trees, whereas peanuts grow underground and are considered legumes. Tree nut allergy is one of the eight most common food allergies, affecting roughly 0.5 to 1% of the U.S.
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