| Medication |
Bolus Dose | Infusion Rate | Note |
|---|---|---|---|
| Nondihydropyridine Calcium Channel Blockers | |||
| Diltiazem | 0.25 mg/kg IV bolus over 2 min | 5–10 mg/h | Avoid in hypotension, heart failure, cardiomyopathy, and acute coronary syndromes |
| Verapamil | 0.075-0.15 mg/kg IV bolus over 2 min; may give an additional dose after 30 min if no response | 0.005 mg/kg per min | Avoid in hypotension, heart failure, cardiomyopathy, acute and coronary syndromes |
| β-Adrenergic Blockers | |||
| Metoprolol | 2.5-5 mg over 2 min, up to 3 doses | Avoid in decompensated heart failure | |
| Esmolol | 500 μg/kg IV over 1 min | 50–300 μg/kg per min | Short duration of action; avoid in decompensated heart failure |
| Propranolol | 1 mg IV over 1 min, up to 3 doses | Avoid in decompensated heart failure | |
| Other Medications | |||
| Amiodarone | 300 mg IV over 1 h | 10-50 mg/h over 24 h | Multiple dosing schemes exist for amiodarone |
| Digoxin | 0.25 mg IV, repeated to maximum dose 1.5 mg over 24 h | Typically used as adjunctive therapy with another option from above; caution in patients with renal impairment | |
IV indicates intravenous.