12: Doses of Parenteral Medications Commonly Used in the ICU and Their Modifications in Renal Failure

Drug Class Usual Dosage Route of Adjustment Elimination∗ in Moderate Renal Failure Analgesics Fentanyl 50–100 μg IV → H No change 50–200 μg/h Ketorolac 30–60 mg IV q6h (×72 h) R Reduce Meperidine 50–100 mg IM q3h H Use with caution Morphine 2–10 mg IV/IM q2–4h H No change Antacids Pantoprazole 40 mg IV over 15 min H No change (Protonix) Ranitidine 50 mg IV q8h or R Reduce (Zantac) 6.25 mg/h Antianginals Esmolol 0.25–0.5 mg/kg IV → M No change 0.05–0.2 mg/kg/min IV Metoprolol 5 mg IV q15 min × 3 H No change (continued )