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Karteikarten
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EPINEPHRINE
Name/Class: EPINEPHRINE (Adrenalin)/Sympathomimetic
Description: Epinephrine is a naturally occurring catecholamine that increases heart rate, cardiac contractile
force myocardial electrical activity, systemic vascular resistance, and systolic blood pressure and
decreases overall airway resistance and automaticity. It also, through bronchial artery constriction, may
reduce pulmonary congestion and increase tidal volume and vital capacity.
Indications: To restore rhythm in cardiac arrest and severe allergic reactions.
Contraindications: Hypersensitivity to sympathomimetic amines, narrow angle glaucoma; hemorrhagic,
traumatic, or cardiac shock; coronary insufficiency; dysrhythmias; organic brain or heart disease; or
during labor.
Precautions: Elderly, debilitated patients, hypertension, diabetes, hyperthyroidism, Parkinson’s disease,
tuberculosis, asthma, emphysema, and in children < 6 years.
Dosage/Route: Arrest: 1 mg of 1:10,000 IV/3 to 5 min (ET: 2 to 2.5 mg 1:1,000).
Allergic reactions: 0.3 to 0.5 mg of 1:1,000 subcutaneously/5 to 15 min as needed or 0.5 to
1 mg of 1:10,000 IV if subcutaneous dose ineffective or severe reaction.
AMIODARONE
Name/Class: AMIODARONE (Cordarone, Pacerone)/Antidysrhythmic
Description: Amiodarone is an antidysrhythmic that prolongs the duration of the action potential and
refractory period and relaxes smooth muscles, reducing peripheral vascular resistance and increasing
coronary blood flow.
Indications: Life-threatening ventricular and supraventricular dysrhythmias, frequently atrial fibrillation.
Contraindications: Hypersensitivity, cardiogenic shock, severe sinus bradycardia, or advanced heart block.
Precautions: Hepatic impairment, pregnancy, nursing mothers, children.
Dosage/Route: 150 to 300 mg IV over 10 min, then 1 mg/min over next 6 hours.
ATROPINE
Name/Class: ATROPINE/Parasympatholytic
Description: Atropine blocks the parasympathetic nervous system, specifically the vagal effects on heart rate.
It does not increase contractility but may increase myocardial oxygen demand. Decreases airway
secretions.
Indications: Hemodynamically significant bradycardia, bradyasystolic arrest, and organophosphate
poisoning.
Contraindications: None in the emergency setting.
Precautions: AMI, glaucoma.
Dosage/Route: Symptomatic bradycardia: 0.5 to 1 mg IV/2 mg ET. Repeat 3 to 5 min to 0.04 mg/kg.
Asystole: 1 mg IV or 2 mg ET, may
repeat 3 to 5 min up to 0.04 mg/kg.
Organophosphate poisoning: 2 to 5 mg IV/IM/IO/10 to 15 min.
ADENOSINE
Name/Class: ADENOSINE (Adenocard)/Antidysrhythmic
Description: Adenosine is a naturally occurring agent that can “chemically cardiovert” PSVT to a normal
sinus rhythm. It has a half-life of 10 seconds and does not cause hypotension.
Indications: Narrow, complex paroxysmal supraventricular tachycardia refractory to vagal
maneuvers.
Contraindications: Hypersensitivity, 2nd- and 3rd-degree heart block, sinus node disease, or asthma.
Precautions: It may cause transient dysrhythmias. COPD.
Dosage/Route: 6 mg rapidly (over 1 to 2 sec) IV, then flush the line rapidly with saline. If
ineffective, 12 mg in 1 to 2 min, may be repeated.
LABETALOL
Name/Class: LABETALOL (Trandate, Normodyne)/Beta Blocker
Description: Labetalol is a beta blocker with some alpha blocker characteristics. It induces vasodilation,
reduces peripheral vascular resistance, and lowers blood pressure.
Indications: Acute hypertensive crisis.
Contraindications: Asthma, CHF, 2nd- and 3rd-degree heart block, severe bradycardia, or cardiogenic
shock.
Precautions: COPD, heart failure, hepatic impairment, diabetes, peripheral vascular disease.
Dosage/Route: 20 mg slow IV, then 40 to 80 mg/10 min as needed, up to 300 mg OR a continuous drip
2 mg/min up to 300 mg
NOREPINEPHRINE
Name/Class: NOREPINEPHRINE (Levophed)/Sympathomimetic Agent
Description: Norepinephrine is a naturally occurring catecholamine and causes vasoconstriction, cardiac
stimulation, and increased blood pressure, myocardial oxygen demand, and coronary blood flow.
Indications: Refractory hypotension and neurogenic shock.
Contraindications: Hypotension due to hypovolemia.
Precautions: Hypertension, hyperthyroidism, severe heart disease, elderly, MAO inhibitor therapy, patients receiving tricyclic antidepressants. Monitor blood pressure frequently and infuse the drug through the
largest vein available as it may cause tissue necrosis.
Dosage/Route: 0.5 to 30 mcg/min IV, titrated to BP.
SODIUM BICARBONATE
Name/Class: SODIUM BICARBONATE (NaHCO3)/Alkalizing Agent
Description: Sodium bicarbonate provides vascular bicarbonate to assist the buffer system in reducing the effects of metabolic acidosis and in the treatment of some overdoses.
Indications: Tricyclic antidepressant and barbiturate overdose, refractory acidosis, or hyperkalemia.
Contraindications: None when used in severe hypoxia or late cardiac arrest.
Precautions: May cause alkalosis if given in too large a quantity. It may also deactivate vasopressors and may precipitate with calcium chloride.
Dosage/Route: 1 mEq/kg IV, then 0.5 mEq/kg/10 min.
DOPAMINE
Name/Class: DOPAMINE (Intropin)/Sympathomimetic
Description: Dopamine is a naturally occurring catecholamine that increases cardiac output without
appreciably increasing myocardial oxygen consumption. It maintains renal and mesenteric blood flow
while inducing vasoconstriction and increasing systolic blood pressure.
Indications: Nonhypovolemic hypotension (70 to 100 mmHg) and cardiogenic shock.
Contraindications: Hypovolemic hypotension without aggressive fluid resuscitation, tachydysrhythmias,
ventricular fibrillation, and pheochromocytoma.
Precautions: Occlusive vascular disease, cold injury, arterial embolism. Ensure adequate fluid resuscitation
of the hypovolemic patient.
Dosage/Route: 2 to 5 mcg/kg/min up to 20 mcg/kg/min, titrated to effect.
NITROGLYCERIN
Name/Class: NITROGLYCERIN (Nitrostat)/Nitrate
Description: Nitroglycerin is a rapid smooth muscle relaxant that reduces peripheral vascular resistance,
blood pressure, venous return, and cardiac workload.
Indications: Chest pain associated with angina and acute myocardial infarction, and acute pulmonary
edema.
Contraindications: Hypersensitivity, tolerance to nitrates, severe anemia, head trauma, hypotension,
increased ICP, patients taking sildenafil, glaucoma, and shock.
Precautions: May induce headache that is sometimes severe. Nitroglycerin is light sensitive and will lose
potency when exposed to the air.
Dosage/Route: 1 tablet (0.4 mg) SL. May be repeated/3 to 5 min up to 3 tablets, or 1⁄2 inch of topical
ointment, or 0.4 mg (one spray)SL up to 3 sprays/25 min.
VASOPRESSIN
Name/Class: VASOPRESSIN (Pitressin)/Hormone, Vasopressor
Description: Vasopressin is a hormone with strong vasopressive and antidiuretic properties but that may
precipitate angina and/or AMI.
Indications: To increase peripheral vascular resistance in arrest (CPR) or to control bleeding from
esophageal varices.
Contraindications: Chronic nephritis with nitrogen retention, ischemic heart disease, PVCs, advanced
arteriosclerosis, or 1st stage of labor.
Precautions: Epilepsy, migraine, heart failure, angina, vascular disease, hepatic impairment, elderly, and
children.
Dosage/Route: Arrest: 40 units IV.
Esophageal varices: 0.2 to 0.4 units/min IV drip.
Digoxin
Name/Class: digoxin [lanoxin]
Description: derived from foxglove . increases intracellular calcium to improve myocardial contractility. Decreases sa rate, av node conduction; sodium loss may cause increased automaticity.
Indications: atrial flutter and atrial fibrillation
Contraindications: v-fib, v-tach, av blocks, digitalis toxicity, 2nd or 3rd degree blocks without pacing
Dosage/Route: .004-.006 mg/kg (4-6 mcg/kg]
Dilitiazem
Name/Class: Dilitiazem ( Cardizem) Anti-dysrhythmic
Description: calcium channel blocker that slows conduction; causes coronary and peripheral vasodilation. Used to control a-fib, a-flutter
Indications: control rate in a-fib and a-flutter
Contraindications: wide qrs or unknown origin; sick sinus syndrome; av blocks; hypotension, cardiogenic shock; wpw, v-tach or ami
Dosage/Route: 25 mg or 50 mg [don’t give with Lasix]
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