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30 Cards in this Set
- Front
- Back
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Oxygen |
Trade Name:Oxygen
Class:Gas MOA:Enters thru respiratory system and is transported to the cells by Hemaglobin. Also required for the breakdown of glucose into energy, and it increases the O2 in the Alveoli which then increases O2 sats in Hemoglobin Indications:Any hypoxic situation Contra:None but use with caution with COPD pt's. Also high dose may damage a Neonate's eyes Adverse:Dried mucous membranes and irritation of upper respiratory tract Onset/Duration:Immediate, peak within 1min, duration <2 min Dose:Per device being used Route:Oral or Nasal Interactions:May increase toxicity of certain herbicides in pt's that ingested the poisons |
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D5W
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Trade Name:5% Dextrose in Water
Class:Hypotonic dextrose-containing solution MOA:Provides nutrients in the form of Dextrose for IV infusion Indications:IV access for drugs and for dilution of concentrated drugs for IV infusion Contra:Not for fluid replacement in Hypovolemic states Adverse:Local veinous irritation and tissue necrosis. Watch for circulatory overload Onset:Immediate Dose:Usually with a microdrip set at TKO Route:IV infusion Interactions:Should not be used with Dilantin or Inocor |
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Lactated Ringers
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Trade Name:Lactated Ringers
Class:Isotonic Crystalloid Solution MOA:Replaces water and electrolytes Indications:Hypovolemic shock and KVO Contra:CHF or Renal Failure Adverse:Monitor for circulatory overload Onset:Immediate Dose:Generally replace 1L of lost blood with 3-4L of LR. In severe hypovolemic shock use large bore catheters and leave "Wide" open until Systolic BP is 100 or higher. Then adjust as needed Route:IV infusion Interactions:Few in the emergency setting |
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0.9% NS
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Trade Name:Normal Saline
Class:Isotonic Crystalloid solution MOA:Replaces water and electrolytes Indications:Heat-related, fresh water drowning, hypovolemia, diabetic ketoacidosis, and KVO Contra:CHF Adverse:In large amts other physiological electrolytes may be depleted Onset:Immediate Dose:Dictated by situation Route:IV infusion Interactions:Few in the emergency setting |
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Epinephrine 1:10,000
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Trade Name:Adrenalin, Epinephrine
Class:Sympathomimetic MOA:Increases HR & automaticity, cardiac contractile force, myocardial electrical activity, systemic vascular resistance, and BP. Also causes bronchodilation Indications:Cardiac Arrest, Anaphylactic Shock, and severe reactive airway disease Contra:Pt's who require extensive resuscitative efforts Adverse:Palpitations, Anxiety, Tremulousness, N/V Onset:IV <2mins, SC 3-10 mins, <1min ET. Peak <5min IV/ET, 20min SC Duration:5-10min IV/ET, 20-30 min SC Adult Dose:CPR .5-1.0mg, repeated every 3-5min, Severe Anaphylaxis .3-.5mg Ped Dose:.01mg/kg initially, with subsequent dosages 1;1000 should be used at .1mg/kg. Route:IV, IV drip, ET Interactions:May increase hypotension in circulatory collapse or caused by phenothiazines. Additive toxicities with other sympathomimetics. Alpha & Beta adrenergic blocking agents antagonize the effects. It is PH dependent and can be deactivated when given with high alkaline solutions |
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Atropine Sulfate
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Trade Name:Atropine
Class:Parasympatholytic MOA:Increases HR. Blocks ACh receptors, increasing SA node discharge, enhancing conduction thru the AV junction, & increases cardiac output. It is a bronchodilator and is an antidote in organophosphate poisonings Indications:Bradycardia & Asystole Contra:None Adverse:Headache, ataxia, dizziness, excitement, irritability, convulsions, drowsiness, fatigue, weakness, mental depression, confusion,disorientation,Hyper-tension or Hypotension, VTach, palpitations, pardoixical bradycardia, AV dissociation, AVib, VFib Onset/Duration: Well aborbed from all admin sites, peak is 20-60mins IM, 2-4mins IV. Duration is 4hrs, 1/2 life is 2-3hrs. Adult Dose: .5-1.0mg/IV, 2mg ET, repeat every 3-5mins up to 3.0 mg. Ped Dose: .02mg/kg IV, .04 mg/kg ET. Minimum is .1mg, repeat every 5mins up to 1 mg. Route: IV or ET Interactions: Amantadine, antihistamines, tricyclic antidepressants, quinidine, disopyramide, procainamide can add to the anticholinergic effects. |
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D50W
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Trade Name:50% Dextrose in water
Class:Carbohydrate MOA:Supplies supplemental glucose. Indications:Hypoglycemia & coma of unknown origin. Contra:Use with caution in pt's with increased intracranial pressure. Adverse:Warmth, pain, burning @ site of injection. Can cause tissue necrosis, plebitis, sclerosis, or thrombosis @ the site. Can cause severe neurologic symptoms if pt is Thiamine deficient Onset:<1min. Duration:Peak effect & duration dependent upon degree of hypoglycemeia Adult dose:25g IV. If ineffective, 2nd dose of 25g IV Ped dose:Dilute 1:1 with water. .5 to 1.0g/kg by slow IV bolus Route:IV Interactions:None |
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Naloxone
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Trade Name:Narcan
Class:Narcotic Antagonist MOA:Competes for opiate receptors in the brain Displaces narcotic molecules from the receptors. Reverses respiratory depression associated with narcotic overdose Indications:Depression caused by narcotics or synthetic narcotics, and also for use with comas of unknown origin Contra:Hx of hypersensitivity to the drug. Adverse:Hypotension, hypertension, ventricular dysrhythmias, nausea, vomiting Onset:<2mins IV and 2-10mins IM/ET including peak effects Duration:20-120mins, 1/2 life is 60-90mins. Adult Dose:.4-2mg IV/IM, 2.0-2.5 times dose ET, may be repeated every 2-3mins up to 10 mg. Ped dose:.01mg/kg IV/IM, 2.0-2.5 times dose ET, may be repeated every 2-3mins up to mg Route:IV, IM, ET Interactions: May cause narcotic withdrawal. Use only the amt necessary |
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Epinephrine 1:1000
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Trade Name:Adrenalin, Epinephrine
Class:Sympathomimetic MOA:Bronchodilation Indications:Bronchial Asthma, exacerbation of COPD, allergic reactions, pediatric cardiac arrest Contra:Cardiovascular disease, HTN, Pregnancy, tachydysrhythmias. Adverse:Palpitations, anxiousness, headache, tremors. Onset:<2mins IV, 3-10mins SC, <1min ET. Duration:5-10mins IV/ET, 20-30mins SC Adult dose:.3-.5mg Ped dose:.01mg/kg up to .3mg Route: IV, IM, ET Interactions: Hypotension in circulatory collapse, hypotension by phenothiazines, antagonized by alpha & beta receptors, additive toxicities with other sympathomimetics, and is PH dependent & can be deactivated when given with high alkaline solutions |
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Albuterol
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Trade Name:Asmol, Proventil, Respolin, Ventolin
Class:Sympathomimetic Action:Bronchodilator Indications:Asthma, reversible bronchospasm associated with COPD. Contra:Hypersensitivity to the drug, symptomatic tachycardia Adverse:Palpitations, anxiety, headache, dizziness, sweating Onset:5-15mins Duration:3-6hrs, peak effect is 1-1.5hrs. Adult dose:.5ml in 2.5ml NS over 5-15mins Ped dose:.15mg/kg in 2.5ml NS Route:Inhaled with Nebulizer or Inhaler Interactions:Not for use with other inhalers. Use with caution on pt's using MAO's or tricyclic antidepressants. Also with pt's using meds to lower their serum potassium. |
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Diphenhydramine
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Trade Name:Benadryl
Class:Antihistamine MOA:Blocks histamine receptors & has some sedative effects Indications:Anaphylaxis, allergic reactions, & dystonic reactions due to phenothiazines Contra:Asthma & nursing mothers Adverse:Sedation, dries bronchial secretions, blurred vision, headache, palpitations Onset:15-30mins Duration:<10mins Adult dose:25-50mg IV/IM Ped dose:2-5mg/kg IV/IM Route:Slow IV push, deep IM Interactions:Alcohol, other CNS depressants, MAO inhibitors |
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Midazolam
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Trade Name:Versed, Hypnovel
Class:Sedative MOA:Hypnotic, sedative Indications:Premedication before cardioversion, acute anxiety state Contra:Hx of hypersensitivity to the drug, narrol-angle glaucoma, shock Adverse:Drowsiness, Hypotension, Amnesia Onset:3-5mins IV, 15mins IM, 6-12mins intranasal Duration:<2hrs IV, 1-6hrs IM, half-life is 1-4hrs, peak effect is 20-60mins Adult dose:1.0-2.5mg slow IV, .07-.08mg/kg IM Ped dose:.05-.20mg/kg IV, .10-.15mg/kg IM, 3mg Intranasal Route:IV, IM, Oral, Intranasal Interactions: Alcohol, CNS depressants, & anti-seizure potentiate CNS depression, may decrease antiparkinsonism effects of levodopa, may decrease phenytoin levels, & smoking decreases its sedative & antianxiety effects |
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Fentanyl
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Trade Name:Sublimaze
Class:Narcotic Analgesic MOA:CNS depressant, decreases sensitivity to pain Indications:Severe pain, adjunct to rapid-sequence induction or sedation, maintenance of analgesia Contra:Shock, severe hemorrhage, undiagnosed abdominal pain, hx of hypersensitivity to the drug Adverse:Dizziness, altered LOC, bradycardia Onset:Immediate Duration:30-60mins, peak effect is 3-5mins IV Adult dose:25-100mcg slow IV Ped dose:2.0mcg/kg slow IV/IM Interactions:Alcohol & other CNS depressants, MAO inhibitors |
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Etomidate
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Trade Name:Amidate
Class:Sedative/Hypnotic MOA:Creates an ultra-short-acting sedative/hypnotic effect Indications:Induction agent for rapid-sequence induction Contra:Hypersensitivity to the drug Adverse:Myoclonic skeletal muscle movements, tonic movements, apnea, hyperventilation or hypoventilation, laryngospasm, HTN, hypotension, tachycardia, bradycardia, dysrhythmias, N/V, eye movements, hiccups, snoring Onset:10-20sec Duration:3-5mins, half-life 30-74mins, peak effect is within 1min Adult dose:.1-.3mg/kg IV over 15-30sec Ped dose:>10yrs, same as adult Route:IV Interactions:None |
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Vecuronium
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Trade Name:Norcuron
Class:Neuromuscular-blocking agent(nondepolarizing) MOA:Skeletal muscle relaxant, paralyzes skeletal muscles including respiratory muscles Indications:To achieve paralysis to facilitate ET intubation Contra:Hypersensitivity to the drug Adverse:Prolonged paralysis, hypotension, bradycardia Onset:<1 min Duration:25-40mins, half-life 30-80mins, peak effect in 3-5 mins Adult dose:.08-.10mg/kg IV Ped dose:>1 yr same as adult Route:IV Interactions:General anesthetics increase neuromuscular blockade & duration of action. Diurectics may increase or decrease the blockade while Lithium prolongs the duration of the blockade. Narcotic analgesics increase the possibility of additive respiratory depression and Succinylcholine increases onset & depth of the blockade. Phenytoin may cause resistance to or reversal of the blockade |
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NTG
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Trade Name:Nitroglycerin
Class:Antianginal MOA:Smooth muscle relaxant, reduces cardiac output, dialtes coronary & systemic arteries Indications:Angina pectoris, CP with MI Contra:<12 YOA, hypotension Adverse:Headache, dizziness, hypotension Onset:1-3mins SL, 30mins transdermal Duration:20-30mins SL, 3-6hrs transdermal, peak effect 5-10 mins Adult dose:.4mg SL, repeat every 3-5mins up to 3 tablets, .5-1in ointment, .4 mg SL spray up to 3 sprays. Ped dose:None Route:Orally, topically Interactions:Alcohol & antihypertensive may compound effects. May cause hypotension when used with beta blockers |
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ASA
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Trade Name:Aspirin, Alka-Seltzer, Aspergum, Bayer, Cosprin, Easprin, Ecotrin, Empirin, Halfprin, Measurin, St. Joseph Children's
Class:Anti-inflammatory, analgesic, antipyretic, platelet inhibitor MOA:Blocks formation of thromboxone A2, inhibits formation of prostaglandins & their synthesis, acts upon the PNS with limited action on the CNS, causes centrally mediated peripheral vasodilation & sweating. Indications:New CP suggestive of acute MI, CVA Contra:Hypersensitivity to the drug, ulcers, asthma Adverse:Heartburn, N/V, wheezing Onset:5-30mins Duration:1-4hrs, half-life 15-20mins, peak effects 15mins-2 hrs. Adult dose:160-325mg Route:Orally Interactions:Anticoagulants increase risk of bleeding |
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Morphine Sulfate
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Trade Names:Astramorph, Duramorph, Infumorph, Kadian, Morphine, Roxanol, Statex
Class:Narcotic analgesic MOA:Depresses CNS, causes peripheral vasodilation, decreases sensitivity to pain Indications:Severe pain, pulmonary edema Contra:Head injury, volume depletion, undiagnosed abdominal pain, hypersensitivity to the drug Adverse:Pruritus, rash, urticaria, edema, hemorrhagic urticaria, respiratory depression, euphoria, insomia, disorientation, visual, pediatric convulsions, bradycardia, syncope Onset:Immediate IV, 15-30mins IM/SC Duration:2-7hrs, peak effect 20mins IV, 30-60mins IM/SC Adult dose:2.5-15mg IV, 5-20mg IM/SC Ped dose:.05-.1mg/kg IV, .1-.2mg/kg IM/SC Route:IM, IV Interactions:CNS depressants, sedatives, barbiturates, alcohol, benzodiazepines, & tricyclic antidepressants may potentiate the CNS depressant effects. MAO's may precipitate HTN crisis |
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Meperidine
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Trade name:Demerol
Class:Narcotic analgesic MOA:CNS depressant, decreases sensitivity to pain Indications:Moderate to severe pain Contra:MOI's, undiagnose abdominal pain, hypersensitivity to the drug Adverse:Dizziness, altered LOC. Onset:5mins IV, 10mins IM Duration:2hrs IV, 2-4hrs IM, peak effects 1hr Adult dose: 25-50mg IV, 50-100mg IM Ped dose:1mg/kg IV/IM Route:IV/IM Interactions:Alcohol, CNS depressants cause additive sedation & CNS depression. MAO's, selegiline, & furazolidone may cause excessive & prolonged CNS depression, seizures, & cardiovascular collapse |
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Diazepam
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Trade Name:Valium, Zetran,
Class:Tranquilizer(Benzodiazepine) MOA:Antiseizure, skeletal muscle relaxant, sedative Indications:Major motor seizures, status epilepticus, premed before cardioversion, skeletal muscle relaxant, acute anxiety Contra:Hypersensitivity to the drug Adverse:Drowsiness, hypotension, respiratory depression & apnea Onset:1-5mins IV, 15-30mins IM Duration:15-60mins, peak effect 15mins IV, 30-45mins IM Adult dose:For seizure 5-10mg IV/IM Ped dose:.5-2mg IV/IM Adult dose:For anxiety 2-5mg IM Ped dose:.5-2mg IM Adult dose:For premed for cardioversion 5-15mg IV Ped dose:.2-.5mg/kg IV Route:IV/IM Interactions:Alcohol, CNS depressants, & antiseizures can potentiate CNS depression. Cimetidine increases diazepam plasma levels & toxicity. May decrease the antiparkinson effects of levodopa & increase phenytoin levels. Smoking decreases its sedative & antianxiety effects |
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DIVISION ONE DRUGS
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OXYGEN
D5W LACTATED RINGERS 0.9% NORMAL SALINE EPINEPHRINE ATROPINE SULFATE D50W NALOXONE ALBUTEROL DIPHENHYDRAMINE MIDAZOLAM FENTANYL ETOMIDATE VECURONIUM SUCCINOCHOLINE LIDOCAINE NITROGLYCERIN ASPIRIN MORPHINE SULFATE MEPERIDINE DIAZEPAM GLUCAGON THIAMINE TETANUS TOXOID |
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GLUCAGON
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Trade Name:GlucaGen
Class:Hormone(antihypoglycemic agent) MOI:Causes breakdown of glycogen to glucose,inhibits glycogen synthesis,elevates glucose level, increases cardiac contractile force & HR Indications:Hypolglycemia, beta-blocker overdose Contra:Hypersensitivity to the drug Adverse:Dizziness, headache, hypotension, N/V, hyperglycemia, hypokalemia Onset:5-20mins, peak in 30 mins Duration:1-1.5hrs Adult dose:IV .25-.5 unit, IM 1mg Ped dose:.03mg/kg Route:IV, IM Interactions:None |
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FUROSEMIDE
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Trade Name:Lasix
Class:Diuretic MOA:Inhibits sodium & chloride reabsorption in the kidneys and causes venous dilation Indications:CHF & Pulmonary Edema Contra:Pregnancy except in life-threatening situations, allergy to sulfa drugs Adverse:Headache,dizziness,hypotension,volume depletion,potassium depletion,dysrhythmias,diarrhea,N/V Onset/Duration:5-10mins, lasts 2hrs Dose:40mg slow IV, 80-120mg severe cases Route:IV Interactions:Do not use if pt uses amrinone(Inocor),caution with other diuretics |
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CLOPIDOGREL
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Trade Name:Plavix
Class:Anti-Platelet MOA:Inhibits ability of platelets to clump together Indications:Prevention of strokes and heart attacks in high risk pts. Contra:Pt's with recent stroke or heart attack Adverse:Diarrhea,rash,itching,abdominal pain Onset/Duration: Dose:300mg Route:Orally Interactions:May cause stomach & intestinal bleeding if used with NSAIDS |
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RETAPLASE
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Trade Name:Retavase
Class:Fibrinolytic MOA:Increases formation of plasmin and degrades the fibrin matrix of a clot Indications:Acute Coronary Syndrome Contra:Active internal bleeding,suspected aortic dissection,traumatic CPR,Severe HTN,recent head trauma or intracranial tumor, CVA within past 6 months,pregnancy Adverse:Bleeding,allergic reactions,anaphylaxis,fever,N/V Onset/Duration:<5mins,lasting effect varies Dose:10units IV over 2mins, repeat same in 30mins Route:IV Interactions:None |
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ATENOLOL
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Trade Name:Tenormin
Class:Antidysrhythmic,Antihypertensive MOA:Beta blocker for B1-adrenergic receptors in cardiac muscle,reduces rate & force of cardiac contraction,cardiac output,& BP, increases peripheral vascular resistance Indications:Acute Coronary Syndromes,VFib Contra:Sinus Brady,>than 1st degree blocks,CHF,Cardiogenic Shock.Caution with Asthma,COPD,CHF controlled by Digitalis & diuretics Adverse:Dizziness,vertigo,syncope,fatigue,weakness,lethargy,insomnia,depression,Bradycardia,hypotension,N/V,Pulmonary Edema,dyspnea,bronchospasm Onset/Duration:2-4hrs PO,5mins IV.Lasts 24hrs Dose:5mg slow IV over 5mins,wait 10mins,repeat 5mg is tolerated Route:IV,Orally Interactions:Absorption increased if used with Atropine & other anticholinergics,NSAIDS can dcrease hypotensive effects,mas mask symptoms of hypoglycemia |
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HEPARIN
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Trade Name:Heparin
Class:Anticoagulant MOA:Enhances inhibitory actions of antithrombin III-thrombin complex,blocking conversion of prothrombin to thrombin & preventing conversion of fibrinogen to fibrin Indications:Unstable angina & non-Q-wave MI,to prevent PE & DVT Contra:Allergy to med,pork products,& to beef products Adverse:Confusion,dizziness,edema,CP,irregular heart beat,irriation,pain,erythema Onset/Duration:Immediate,lasts 2-6hrs Dose:5000units followed by infusion Route:IV Interactions:NSAIDS,warfarin, & antiplatelet agents, IV Nitro,Protamine |
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INTEGRELLIN
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Trade Name:Eptifibatide
Class:IIb-IIIa glycoprotein inhibitor,antithrombotic,antiplatelet MOA:Binds to IIb-IIIa glycoprotein receptors found in platelets & vessel wall endothelial & smooth muscle cells.Inhibits platelet aggregation Indications:Acute Coronary Syndromes, pts undergoing percutaneous coronary interventions Contra:Active internal bleeding,recent GI or GU bleed, CVA within past 2yrs,recent major surgery or trauma,aneurysm Adverse:Intracranial bleed,GI/GU bleed,anemia Onset/Duration:Immediate,lasts 6-8hrs Dose:180mcg/kg bolus,infuse 2mcg/kg up to 72 hrs Route:IV Interactions:Oral Anticoagulants,NSAIDS,Dipyridamole,Ticlopidine,Dextran |
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NOREPINEPHRINE
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Trade Name:Levophed
Class:Sympathetic Agonist MOA:Peripheral Vasoconstrictor,increases BP in Cardiogenic Shock & other hypotensive crisis Indications:Hypotension <70, not related to hypovolemia, and in Neurogenic Shock Contra:Pts who are hypotensive due to hypovolemia Adverse:Anxiety,Headache,Dizziness,N/V,Bradycardia Onset/Duration:Immediate,lasts 1-2mins Dose:.5-1.0ug/min Route:IV Interactions:Diluted by Alkaline solutions, BP increases if used with Beta Blockers |
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DOBUTAMINE
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Trade Name:Dobutrex
Class:Sympathetic Agonist MOA:Increases the force of systolic contraction,useful in CHF when increase in HR is not desired. Indications:Short term mgt of CHF when an increased COutput without an increased CRate is desired Contra:Not to be used alone in hypovolemic shock unless fluid resusc. is under way Adverse:Nervousness,headache,HTN,dysrhythmias,palpitations,CP,N/V Onset/Duration:2-10mins, duratation varies Dose:2-20ug/kg/min, diluted in D5W Route:IV Interactions:Ineffective if used with Beta blockers,risk of HTN with TCA's |
