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3 Cards in this Set
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Dopamine (Intropin) |
Classification: Adrenergic agonist, inotropic, vasopressor Action: Stimulates alpha and beta adrenergic receptors. At moderate doses (2-10 mcg/kg/min), dopamine stimulates beta1 receptors, resulting in inotropy and increased cardiac output while maintaining dopaminergic-induced vasodilatory effects. At high doses (>10 mcg/kg/min), alpha adrenergic agonism predominates, and increased peripheral vascular resistance and vasoconstriction result. Indications: Hypotension and decreased cardiac output associated with cardiogenic shock and septic shock, hypotension after return of spontaneous circulation following cardiac arrest, symptomatic bradycardia unresponsive to atropine. Adverse effects: Tachycardia, arrhythmias, skin and soft tissue necrosis, severe hypertension from excessive vasoconstriction, angina, dyspnea, headache, nausea/vomiting. Contraindications: Pheochromocytoma, VF, VT, or other ventricular arrhythmias, known sensitivity (including sulfites). Correct any hypovolemia with volume fluid replacement before administering dopamine. Dosage: Adult: 2 to 20 mcg/kg/min IV, IO infusion. Starting dose 5 mcg/kg/min; may gradually increase the infusion by 5 to 10 mcg/kg/min to desired effect. Cardiac dose is usually 5 to 10 mcg/kg/min; vasopressor dude is usually 10 to 20 mcg/kg/min. Little benefit is gained beyond 20 mcg/kg/min. Pediatric: Same as adult dosing. Special Considerations: Half-life 2 minutes Pregnancy class C |
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Norepinephrine (Levophed) |
Classification: Adrenergic agonist, inotropic, vasopressor Action: Norepinephrine is an alpha1, alpha2, and a beta1 agonist. Alpha-mediated peripheral vasoconstriction is the predominant clinical result of administration, resulting in increasing blood pressure and coronary blood flow. Beta adrenergic action produced inotropic stimulation of the heart and dilates the coronary arteries. Indications: Cardiogenic shock, septic shock, severe hypotenion. Adverse effects: Dizziness, anxiety, cardiac arrhythmias, dyspnea, exacerbation of asthma. Dosage: Adult: Add 4 mg to 250 mL of D5W or D5NS, but not normal saline alone. 0.5 to 1 mcg/min as IV, IO, titrated to maintain blood pressure of >80 mmHg. Refractory shock may require doses as high as 30 mcg/min. Pediatric: 0.05 to 2 mcg/kg/min IV, IO infusion, to a maximum dose of 2 mcg/kg/min. Special Considerations: Do not administer in same IV line as alkaline solutions.Half-life 1 minutesPregnancy class C |
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Dobutamine (Dobutrex) |
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