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Acute decomp HF
Stack #28571
| Question | Answer |
|---|---|
| s/s of Left Ventricular HF | Dyspnea on Exertion, Orthopnea, Pulmonary Edema, Rales |
| s/s of Right Ventricular HF | Abdominal pain, Anorexia, Bloating, peripheral edema, ascites |
| Hemodynamic subset I | No specific intervention |
| Hemodynamic subset II | Dobutamine and/or loop or NTG |
| Hemodynamic subset III PAOP <15 | First give IV fluids then if PAOP is between 15-18 dobutamine and /or nitroprusside |
| Hemodynamic subset III PAOP 15-18 | nitroprusside or dobutamine or milirone and nitroprusside or NTG |
| Hemodynamic subset IV | Nitroprusside or Dobutamine+ milrinone |
| Dopamine MOA | Directly stimulates adrenergic receptors as well as release CCA's |
| Dopamine SE | Arrhythmias, Angina. Long term use increase mortality |
| Dobutamine MOA | Racemic mixture:+dobutamine, is a B1 and 2 agonist and partial alpha agonist |
| Dobutamine Administration | infusion pump;2.5-20 mcg/kg/min titrate at 5mcg/kg/min |
| Dobutamine Benefits | Less mycardial o2 demand and great post MI. WIll last 3-7 days |
| Dobutamine SE | Tachycardia, arrhythmias, angina, long term use increase mortality |
| Milrinone MOA | PDE inhibitor will increase intracellular cAMP and thus increase intracellular Ca, increase contraction |
| Milirinone Administration | infusion pump; 5-10 mcg/kg/min |
| Milirinone Benefit | Decrease SVR, increase CO, and decrease PCWP, onset in 10 minutes |
| Milirinone SE | Hypotension, thrombocytopenia, increase HR, arrhythmias, fever, LFT increase. |
| Milirinone monitor | Renal adjust, HR, MAP, SVR, BP, CO, Scr |
| Nitroprusside MOA | Mixed arterial/venous dialator, produced NO |
| Nitroprusside Administration | infusion pump, 0.25-3mcg/kg/min |
| Nitroprusside benefits | Decrease SVR, PCWP, increase CO onset is in 10 minutes |
| Nitroprusside SE | Hypotension, thiocyniate/cyanide toxcity |
| Nitroprusside Monitor | BP, MAP, SVR (triple cath), LFT, renal function |
| Nitroglycerine MOA | PRimary venousdialator, mild arterial dialator |
| Nitroglycerine Administration | infusion pump, 5-200mcg/kg/min |
| Nitroglycerine benefit | Decrease PCWP, SVR |
| Nitroglycerine SE | Hypotension, Increase HR, nitrate tolerance |
| Nitroglycerine Monitor | PCWP(Catheter) BP, MAP, Chest pain |
| Nesiritide MOA | Human b peptide, increases Cyclic GMP |
| NesiritideAdministration | 2mcg/kg bolus, then 0.01 mcg/kg/min continus infusion |
| Nesiritide benefit | Decrease PVR, SVR, PCWP, aldosterone, EPI |
| Nesiritide SE | Hypotension, and long t1/2 (3-4 hrs), reflex tachycardia |
| Nesiritide Monitor | Urine out/input, Na, BP, MAP |
| Vasopressin MOA | Dialate renal mesinteric arteries of kidney, and increase ANP |
| Vasopressin Asministration | 0.01-0.04 U/min continous infusion |
| Vasopressin Benefits | Improve renal profusion |
| Vasopressin SE | Ischemia, metabolic acidosis, cramping, hyponatremia, sweating, tremor |
| Vasopressin Monitor | Urine out/in put, BUN/Scr |
| Furosemide MOA | Decrease Na/water reabsorption |
| Furosemide Administration | 20-80 mg IV repeated every 4-6 times per day |
| Furosemide Benefit | Decrease PCWP, intravascular volume, preload, and pulmonary congestion. |
| Furosemide SE | Volume depletion, electrolyte imbalance, azeotemia( overdiuresis), otoxcity (3mg/min) |
| Furosemide Monitor | Urine in/output, Clcr, Scr |
Created by:
liza001
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