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ICU Pharmacology

Critical Care Pharmacology

TermDefinition
Norepinephrine (Levophed) Vasopressor. Increases BP. 1st choice in septic shock.
Phenylephrine (Neosynephrine) Vasopressor. Increases BP. Increases contractility. Increase in HR.
Low Dose Dopamine Renal dose causes renal dilatation and improved renal blood flow
Low Dose Dopamine (mcg/kg/min) 1-3 mcg/kg/min
Moderate Dose Dopamine Contractility. Stimulates beta 1 receptors in the heart. Increases BP
Moderate Dose Dopamine (mcg/kg/min) 4-10 mcg/kg/min
High Dose Dopamine Vasopressor. Stimulates alpha receptors in the peripheral vasculature. Causes Vasoconstriction, Increase SVR, Increase BP.
High Dose Dopamine (mcg/kg/min) 10 mcg/kg/min
Dobutamine + Inotrope. Increases Contractility. Might increase heart rate.
Primacor + Inotrope. Increases Contractility. Decreases BP due to vasodilation.
Nicardipine (Cardene) Vasodilator. Decreases BP
Nitroprusside (Nipride) Vasodilator. Decreases BP
Lasix Diuretic
Nitroglycerin Vasodilator. Decreases Chest Pain. Decreases BP. Decreases Preload. Decreases Afterload.
Vasopressin Antidiuretic Hormone. Increases BP. NOT the 1st line pressor.
Amiodarone Antiarrythmic. Used best with afib and aflutter. Not useful in PSVT. Can control rate, convert to SR and maintain SR.
Lidocaine Antiarrythmic
Epinephrine Vasopressor. Increases BP
Nitric Oxide Selective vasodilator. Decreases PA Pressure. Inhaled
Starting and Titrating Dose for Dopamine start 4-5mcg/kg/min, titrate 1-4mcg/kg/min every 3-5mins
Maximum Dose for Dopamine 20mcg/kg/min
Adverse effects of Dopamine Tachyarrythmias, Ventricular arrhythmias, tissue necrosis and sloughing with infiltration into subcutaneous tissue.
Epinephrine (alpha) Vasconstriction. Increases coronary perfusion pressure. Increases BP.
Epinephrine (beta) Myocardial contraction. Increase HR.
Epinephrine (during code dose) 1mg IVP may repeat every 3-5mins
Epinephrine (during code use) PEA, VFib, Asystole
Epinephrine (nursing considerations) check blood sugars.
Starting and titrating dose for Levophed start 5 mcg/min. titrate 5 mcg/min every 5 minutes.
Maximum dose for Levophed 199 mcg/min
Adverse effects of Levophed Tachyarrhythmias, HTN, MI
Levophed (nursing considerations) Infuse in central line always. Monitor every 5 minutes during titration.
Starting and titrating dose for Phenylephrine/Neo start 40mcg/min. titrate 25-50mcg/min every 10-15 minutes.
Maximum dose for Phenylephrine/Neo 400mcg/min
Phenylephrine/Neo (nursing considerations) decrease organ perfusion may occur due to increased vasoconstriction.
Vasopressin(during code dose) 40 units IVP (1 dose only)
Vasopressin dose 0.03 units/min
Starting and titrating dose for Nicardipine(Cardene) Start 5mg/hr. Titrate 2.5mg/hr every 10-15 minutes.
Maximum dose for Nicardipine(Cardene) 15mg/hour
Nicardipine(Cardene) (nursing considerations) If peripherally administered, change site every 12 hours. Transition to oral therapy ASAP.
Starting and titrating dose for Nitroprusside (Nipride) Start 0.1mcg/kg/min for heart failure, 0.25-0.35mcg/kg/min for hypertension. Titrate every 5-10 by 0.125 to 0.25mcg/kg/min
Maximum dose for Nitroprusside (Nipride) 0.25 to 10 mcg/kg/min but prolonged infusion greater than 2mcg/kg/min is more likely to result in cyanide toxicity.
Starting and titrating dose for Nitroglycerin Start 10-40mcg/min. Titrate 10-20mcg/min every 3-5mins. >200mcg might be used for arterial vasodilation
Maximum dose for Nitroglycerin >100mcg/min consider another dilator. No specific maximum dose.
Starting and titrating dose for Dobutamine Start 2.5-5mcg/kg/min. Titrate 2.5-5mcg/kg/min.
Maximum dose for Dobutamine 20mcg/kg/min
Dosing for Milrinone (Primacor) 0.125, 0.25, 0.375, 0.50 mcg/kg/min
Amiodarone (nursing considerations) Assess K and Mg levels. Monitor for arrhythmias. Hold for HR < 60 bpm.
Adverse effects of Lidocaine Tinnitus. change in LOC, confusion, restlessness, slurred speech, depression, paresthesia, muscle twitching, seizures.
Created by: mlwest130