Drugs required during stress echocardiography5
| Type of drug | Drug name | Dose |
|---|---|---|
| Stressors | Dobutamine | Low dose: Incremental dosage every 5 min 5 μg/kg/min then 10 and 20 μg/kg/min (in case of rapid HR elevation 15 μg/kg/min can be considered) High dose Incremental dose every 3 min 5 μg/kg/min then 10, 20, 30 and 40 μg/kg/min |
| Adenosine (Adenoscan) | 140 μg/kg/min for 6 min | |
| Dipyridamole | 0.56 mg/kg over 4 min If no adverse effects: additional 0.28 mg/kg over last 2 min thus overall 0.84 mg/kg | |
| Atropine sulfate | 300–600 μg boluses until THR achieved, keep minimum effective dose (<1200 μg) | |
| Contrast agent | SonoVue | Prepare by mixing prepacked solution 10 mL at 0.9 mL/min infusion via infusion pump |
| Optison | Gently shake to prepare solution 0.5 mL at 1 mL/s slow intravenous bolus followed by 10 mL saline flush 1–2 mL with 8 mL of saline as infusion Not to exceed 5 mL in 10 min or 8.7 mL/patient | |
| Luminity | Agitate for 45 s to activate Bolus: 0.3 mL up to 1.3 mL Infusion: 1.3 mL in 50 mL of 0.9% normal saline/5% glucose at a rate of 4 mL/min not exceeding 10 mL/min | |
| Antiallergic | Chlorpheniramine | 10 mg intravenous/intramuscular |
| Hydrocortisone | 200 mg intravenous/intramuscular | |
| Adrenaline 1/1000 | 1 mL intramuscular repeat after 5 min if no better | |
| Antiemetic | Metoclopramide | 10 mg intravenous |
| B-blocker | Metoprolol | 1 mg/mL intravenous dose as required |
| Esmolol | 0.5 mg/kg as a bolus then 0.2 mg/kg as required | |
| Aminophylline | 240 mg intravenous for adverse dipyridamole-related events | |
| Nitrate | GTN spray/tablet | Sublingual use 1–2 spray/1 tablet as required |
| Intravenous fluids | Glucose | 25% solution 25 mL intravenous infusion as required |
| Normal saline (0.9%) | 250 mL and 500 mL bags intravenous infusion as required | |
| Dextrose 5% | 250 mL bags intravenous infusion as required |
GTN, nitroglycerine; THR, target heart rate.