Updated July 2026 · 10 min read
Part of the ICU Emergencies Hub — browse every related guide in one place.
| Medication | Typical IV Push Dose | Administration Rate | Key Monitoring |
|---|---|---|---|
| Adenosine | 6 mg → 12 mg | Rapid bolus (1–2 sec) + immediate NS flush | Continuous cardiac monitor, crash cart ready |
| Atropine | 0.5–1 mg | Rapid IV push | Heart rate response within 1–2 min |
| Calcium gluconate | 1–2 g | Over 10 minutes (slow) | BP, ECG — bradycardia if given too fast |
| Furosemide (Lasix) | 20–200 mg | No faster than 4 mg/min (ototoxicity risk) | Urine output, electrolytes, hearing |
| Hydralazine | 10–20 mg | Over 1–5 minutes | BP q5–15min for 1 hour post-dose |
| Labetalol | 5–20 mg | Over 2 minutes | BP and HR q5min |
| Lorazepam (Ativan) | 1–4 mg | No faster than 2 mg/min | Respiratory rate, sedation level |
| Magnesium sulfate (MgSO4) | 1–4 g | Over 5–20 minutes (eclampsia load: 4g over 15–20 min) | BP, DTRs, RR, urine output |
| Metoprolol | 2.5–5 mg | Over 2 minutes | HR, BP, PR interval |
| Morphine | 2–10 mg | Over 4–5 minutes | RR, SpO2, pain level |
| Naloxone (Narcan) | 0.4–2 mg | Over 15–30 seconds (emergency) or 2–3 min (careful titration) | Respiratory effort, withdrawal signs |
| Ondansetron (Zofran) | 4 mg | Over 2–5 minutes | QT — caution in patients on QT-prolonging drugs |
| Phenytoin (loaded as fosphenytoin IV) | Per weight in PE units | No faster than 50 mg PE/min (fosphenytoin); 50 mg/min (phenytoin) — cardiac monitoring required | Continuous ECG, BP every 5 min |
| Potassium (KCl peripheral) | 10 mEq in 100 mL | Over 60 min (NOT IV push — included to prevent errors) | Never give KCl undiluted IV push — cardiac arrest |
| Vancomycin | Weight-based dose | No faster than 500 mg/30 min (Red Man Syndrome) | Skin flushing, BP, slow rate if reaction |
When two drugs infuse through the same IV line (Y-site coadministration), physical incompatibility can cause precipitation, inactivation, or patient harm. Key incompatible pairs to memorize: vancomycin + ceftriaxone (precipitates — flush between), piperacillin-tazobactam + aminoglycosides (inactivation — separate lines), phenytoin + anything in saline (precipitates — use dedicated line with D5W).
For all compatibility questions: use Lexicomp IV compatibility tool, or your facility's pharmacy consult — this is faster and safer than guessing.
High-alert IV push checklist: Confirmed allergy check → Correct concentration → Administration rate calculated → Monitoring parameters set up (continuous cardiac, SpO2, BP cuff cycling) → Crash cart/reversal agents available (naloxone, calcium gluconate) → Informed patient → Documentation ready for post-administration assessment.
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