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Terms in this set (13)
Vasopressin (20 units/100ml NS)
Antidiuretic hormone, Vasopressor
Range: 0.01-0.04 units/min (usually a set rate of 0.04)
Action: Increases BP in hypotensive pts. CLAMPS DOWN VEINS, HOLDS ONTO FLUID.
An alternative to Epinephrine.
V1 receptors in the vasculature - increase vasocasular tone to increase BP.
V2 receptors in the kidneys - release ADH to increase renal fluid reabsorption - increasing blood volume and BP.
Epinephrine/Adrenalin (2mg/250ml D5W)
Cadiac stimulant, Vasopressor
Range: 1-4 mcg/min (no max)
Stimulates both alpa and beta adrenergic receptors. Strengthens the myocardial contraction and increase cardiac rate. INCREASES CONTRACTION & HR. WORKS ON ALPHA & BETA RECEPTORS. + INOTROPE +CHRONTROPE.
-1st line drug of choice in CPR
-Drug of choice for anaphylactic shock
High doses will increases acidosis and blood sugars.
Levophed/Norepinephrine (8mg/250ml D5)
+Inotrope and Vasoconstrictor (beta 1 & alpha)
Range: 0.5-30 mcg/min
Action: Drug of choice for septic shock. Dilates the coronary arteries more than twice as much as Epi. Will increase O2 demand.ONSET OF ACTION IS 1-2 MIN.
Side Effects: Necrosis caused bt extravasations 'levophed-leave'em dead'
NORMALLY 1ST DRIP USED IN HYPOTENSIVE TRAUMA PTS!!!
Fentanyl (2500 mcg/250 ml)
For Pain - If you titrate up or down you must chart a RASS Score.
Range: 25-400 mcg/hr
IV push should be over 3-5 min or else can cause chest wall rigidity if given to fast.
100x more potent then morphine mg for mg.
Propofol (1000 mg/ 100 ml)
range: 5-80 mcg/kg/min
decreases BP - hypotension common during the first 60 min
No analgesic priperties
Must monitor triglycerides Q3D with long term use. Can cause acute pancreatitis
IMPORTANT: RN IS NOT ALLOWED TO BOLUS OR ADMINISTER ONE TIME DOSES UNLESS DURING RSI (RAPID SEQUENICE INTUBATION)
Side effects: decreases BP, green tent to urine
Must change IV tubing and bottle Q12H
Positive inotrope, vasopressor, and cardiac stimulant. Range: 1-20mcg/kg/min (increase by 5 mcg/kg/min) Action: DOSE RELATED. 2.5-5 mcg/kg/min provides inotropic support and increases renal perfusion. 5-15mcg/kg/min increases cardiac output and peripheral resistance. Use central line to avoid extravasation. (Normally not used in tramua patients unless underlying cardiac disease.)
Influences the force of contractility.
Positive inotrope - increases contractility
Negative inotrope - decrease contractility
Influences the heart rate
Positive chronotrope- increases the rate
Negative chronotrope - decreases the rate.
cardiac tissue- increased heart rate, conduction, and contractility.
Vascular and bronchial smooth muscle- vasodilation of peripheral arterioles, bronchodilation.
Benzodiazepine, sedative-hypnotic, amnestic
Range: Per physician order-usually 1-4mg IV push. 1-14 mg/hr in gtt form (per sedation protocol)
Actions: short acting benzodiazepine (3-4x as potent as diazepam)
Reversal Agent: Romazicon/Flumazenil 0.2mg IV.
Vasopressor (pure alpha)
Range: 50-300 mcg/min OR 50-400mcg/min (severe head protocol)
Action: acts on alpha-adrenergic receptors to decrease HR, and increase stroke volume. Used for tx of hypotension secondary to vasodilator reaction.
Range: 1 bolus 150 mg over 10 min
2 - 1mg/min for 6 hrs (34ml/hr)
3- 0.5mg/min continuous (17ml/hr)
Action: prolongs phase 3 of the cardiac action potential. Decreases conduction velocity, decreases cardiac workload and myocardial o2 consumpton.
Calcium channel blocker, anti-arhythmic
Range: 5-25 mg/hr
Actions: decreases HR, BP, SVR, pulmonary artery BP and coronary cascular resistance with no effect on contractility.
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