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11 Cards in this Set
- Front
- Back
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(C)ardene - Nicardipine
C-25mg D-250mg E-2.5g |
Cardene
-medication blocks the movement of calcium into the smooth muscle cells surrounding the arteries of the body and the heart -Since calcium promotes contraction of muscle, blocking calcium entry into the muscle cells relaxes the arterial muscles and causes the arteries to become larger. -This lowers blood pressure, which reduces the work that the heart must do to pump blood to the body. Reducing the work of the heart -also it leads to decreased myocardial contractility and decreased myocardial oxygen demand -mix 25mg/250ml D5W -initiate 5mg/hr -titrate q 10min -increments of 2.5mg/hr to desired MAP -max dose 15mg/hr |
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(D)obutamine
C-25mg D-250mg E-2.5g |
Dobutamine
-Dobutamine is predominantly a β1-adrenergic agonist -Dobutamine also has mild β2 agonist activity, which makes it useful as a vasodilator. -βeta agonist- inc cardiac output, by raising heart rate (positive chronotropic effect) and increasing impulse conduction and increasing contraction thus increasing the volume expelled with each beat (increased ejection fraction). -while Alpha 1 receptors mediate vasoconstriction, Beta 2 receptors induce vasodilation in vascular smooth muscle -Inodilator, used to stimulate beta receptors located in the blood vessels to cause vasodilation -Systemic vascular resistance is usually decreased with administration of dobutamine. -SBP 70-100mmHg with s/s of HF and pulmonary edema -mix 250mg in 250ml D5W (1000mcg/ml) -2-20mcg/kg/min, increase in 5-10mcg, up to 40mcg/kg/min |
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(E)smolol-E-3
C-25mg D-250mg E-2.5g |
Esmolol
-a beta1-selective (cardioselective) adrenergic receptor blocking agent (beta blocker) -activation of beta1 receptors in the SA node by norepi results in depolarization of the SA node and inc HR and contraction -esmolol slows down HR and dec contraction -has a very short duration of action -mix 2.5g in 250ml D5W, initiate at 50mcg/kg/min q 5min -increase at: 50, 100, 200, 300mcg/kg/min -end point is max dose 300mcg/kg/min, HR<60 or MAP <80 (E - 3)00, 200, 100, 50mcg/kg/min Es = 2 letters molol = 5 letters --------- 2.5g in 250ml |
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Sodium Nitroprusside
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-Nitroprusside acts on vascular smooth muscle to reduce afterload
-Sodium nitroprusside (SNP) has potent vasodilating effects in arterioles and venules (arterioles more than venules). -Mix 50mg in 250ml D5W -Initiate at 0.2mcg/kg/min, titrate 0.1mcg/kg/min -Titrate at 1mcg/kg/min once 1mcg is reached -Max dose is 10mcg/kg/min |
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Nitrogylcerin
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-Nitrates are venodilators, and primary effect is to dec preload
-Nitrates decrease the preload and mediate the volume of blood presented to the left ventricle -direct smooth muscle relaxation of the coronary arteries, improves coronary blood flow and increasing myocardial oxygen supply -dec myocardial oxygen demand by reducing preload -Nitro gtt 50mg/250ml D5W -Infuse 10mcg/min inc q 5min by 10mcg/min |
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Dopamine
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-Dopamine is also an excellent inotrope, it is also a vasoconstrictor, it increases afterload in pt with HF and will decrease stroke volume
-doses of 5-10mcg/kg/min dopamine inc inotropy with significant chronotropy -at high doses > 10mcg/kg/min alpha effects cause peripheral vasoconstriction -smooth muscles of the arteries and veins have mostly alpha1 and alpha2 receptors (A for Arteries & A for Alpha) -activation of alpha1 and alpha2 receptors in the arteries results in inc contraction by arteriolar smooth muscle and an inc BP -dopamine inc inotropy with significant chronotropy -at high doses > 10mcg/kg/min alpha effects cause peripheral vasoconstriction -400mg/250ml D5W, begin 5mcg/kg/min |
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Mannitol
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-Mannitol is an osmotic diuretic, it elevates blood plasma osmolality, and results in enhanced flow of water from tissues to plasma, as a result of osmosis (water flow from high to low concentration)
-contraindicated in renal failure, pulmonary edema, CHF, shock -Plasma osmolality- a measure of the concentration of substances, Na, Cl, K, urea, glucose in the blood -Osmolality of blood inc with dehydration -Osmolality of blood dec with overhydration -1gm/kg over 5-10min |
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Cardizem
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-Calcium Channel Blocker
-These drugs exert a strong negative inotropic effect without the long term benefits of beta blockers decrease myocardial oxygen demand by decreasing afterload, contractility, and HR -Calcium ions regulate contraction in smooth and cardiac muscle -CCB inhibit the movement of Ca ions across myocardial and vascular smooth muscle -this leads to decreased myocardial contractility and decreased myocardial oxygen demand -CCB also improve coronary blood flow via direct smooth muscle relaxation -they also cause peripheral vasodilation from direct smooth muscle relaxation -initial bolus of 0.25mg/kg IV over 2min -followed by infusion of 10mg/hr |
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Amiodarone
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150mg IV over 10 min for Atrial dysrhythmias
300mg IV ACLS, repeat 150mg IV x1, infusion 1mg/min Mix 450mg/250ml D5W -Contra: cardiogenic shock, bradycardia, 2nd and 3rd degree blocks, dont use with meds that prolong the QT interval -SE: vasodilation, dec BP, dec HR, AV blocks, inc QT interval, VF and VT -pedi, 5mg/kg |
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Ca Chloride
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-Reverse the membrane potential effects of the elevated ECF K by administering calcium, which can immediately reverse the membrane excitability
-Calcium chloride – 10mg/kg, administer slowly at less than 100mg/min, it has triple the free Ca available than what Ca gluconate provides, do not administer in same line as NaHC03 -Calcium gluconate – 10mg/kg, administer slowly at less than 100mg/min ] |
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Magnesium sulfate
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Preterm labor
-initial dose: 4gm in 100ml LR or NS over 15-30min -infusion: 2gm/hr ACLS -1-2gm over 2min -infusion 1gm/hr |
