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Sixth Set

Medications

QuestionAnswer
Dobutamine, also known as Dobutrex
Dobutamine Class Adrenergic Agent
Dobutamine Action Acts primarily as an agonist at beta1, adrenergic receptors w/ minor beta2 and alpha1 effects. Consequently, it increases myocardial contractility and stroke volume w/ minor chronotropic effects, resulting in increased cardiac output.
Dobutamine Indications CHF, cardiogenic shock.
Dobutamine Adverse Effects Tachycardia, PVCs, hypertension, hypotension, palpitations, arrhythmias.
Dobutamine Contraindications Suspected or known poisoning/drug-induced shock, systolic blood pressure <100mm Hg w/ signs of shock, idiopthic hypertrophic subaortic stenosis, known sensitivity (including sulfites). Use with caution in hypertension, recent MI, arrhythmias, hypovolem
Dobutamine Dosage: Adult: 2-20mcg/kg/min IV, IO,. At doses >20mcg/kg/min, increases of heart rate of >10%.
Dobutamine Dosage: Pedi: Same as adult dosing.
Dobutamine Special Considerations Half-life 2 minutes. *Pregnancy class C.
Dopamine, also known as Intropin
Dopamine Class Adrenergic agonist, inotrope, vasopressor.
Dopamine Action Stimulates alpha and beta adrenergic receptors. At moderate doses (2-10mcg/kg/min), it stimulates beta1 receptors, resulting in inotropy and increased cardiac output while maintaining dopaminergic-induced vasodilatory effects. At high doses (>10 mcg/k
Dopamine Indications Hypotension and decreased cardiac output associated w/ cardiogenic shock and septic shock, hypotension after return of spontaneous circulation following cardiac arrest, sympotematic bradycardia unresponsive to atropine.
Dopamine Adverse Effects Tachycardia, arrhythmias, skin an dsoft tissue necrosis, severe hypertension from excessive vasoconsstriction, angina, dyspnea, headache, n ausea/vomiting.
Dopamine Contraindications Phechromocytoma, VF, VT, or other ventricular arrhythmias, k nown sensitivity (including sulfites). Correct any h ypovolemia with volume fluid replacement before administering dopamine.
Dopamine Dosage: Adult: 2-20mcg/kg/min IV, IO infusion. Starting dose 5mcg/kg/min; may gradually increase the infusion by 5-10mcg/kg/min to desired effect. Cardiac dose is usually 5-10mcg/kg/min; vasopressor dose is usually 10-20mcg/kg/min. Little benefit is ga
Dopamine Dosage: Pedi: Same as adult dosing.
Dopamine Special Considerations Half-life 2 minutes. *Pregnancy class C.
Heparin, also known as Unfractionated Heparin
Heparin Class Anticoagulant
Heparin Action Acts on antithrombin III to reduce the ability of the blood to form clots, thus preventing clot deposition in the coronary arteries.
Heparin Indications ACS, acute pulmonary embolism, deep venous thrombosis.
Heparin Adverse Effects Bleeding, thrombocytopenia, allergic reactions.
Heparin Contraindications Predisposition to bleeding, aortic aneurysm, peptic ulceration; known sensitivity or history of heparin-induced thrombocytopenia, severe thrombocytopenia, sulfite sensitivity.
Heparin Dosage: Cardiac Indications: Adult: 60U/kg IV (max 4000 units), followed by 12U/kg/hr (max 1000 units). Once in the hospital, addt’l dosing is determined based on lab blood tests.
Heparin Dosage: Cardiac Indications: Pedi: 75U/kg followed by 20U/kg/hr.
Heparin Dosage: Pulmonary Embolism and Deep Vein Thrombosis: Adult: 80U/kg IV, followed by 18U/kg/hr.
Heparin Dosage: Pulmonary Embolism and Deep Vein Thrombosis: Pedi 75U/kg followed by 20U/kg/hr.
Heparin Special Considerataions Half-life approx 90 minutes. *Pregnancy class C.
Insulin, Regular...also known as Humulin R, Novolin R
Insulin, Regular Class Hormone
Insulin, Regular Action Binds to a receptor on the membrane of cells and facilitates the transport of glucose into cells.
Insulin, Regular Indications Hyperglycemia, insulin-dependent diabetes mellitus, hyperkalemia.
Insulin, Regular Adverse Effects Hypoglycemia, tachycardia, palpitations, diaphoresis, anxiety, confusion, blurred vision, weakness, depression, seizures, coma, insulin shock, hypokalemia.
Insulin, Regular Contraindications Hypoglycemia, known sensitivity.
Insulin, Regular Dosage: Ketoacidosis: Adult: 0.1U/kg IV, IO, or subQ. Because of poor perfusion of the peripheral tissues, subQ admin. is much less effective than the IV, IO route. IV, IO insulin has very short half-life, therefore IV, IO insulin w/o an infusion is not that effective. Rate for
Insulin, Regular Dosage: Ketoacidosis: Pedi: None listed in book.
Insulin, Regular Dosage: Hyperkalemia: Adult: 10U IV, IO of regular insulin (Insulin R), coadministered with 50ml of D50W over 5 minutes.
Insulin, Regular Dosage: Hyperkalemia: Pedi: 0.1U/kg Insulin R IV, IO.
Insulin, Regular Special Considerations Only regular Insulin can be given IV, IO. *Pregnancy class B.
(Humulin R, Novolin R)
Class Hormone
Adverse Effects Hypoglycemia, tachycardia, palpitations, diaphoresis, anxiety, confusion, blurred vision, weakness, depression, seizures, coma, insulin shock, hypokalemia.
Contraindications
Dosage Ketoacidosis
0.1U/kg IV, IO, or subQ. Because of poor perfusion of the peripheral tissues, subQ admin. is much less effective than the IV, IO route. IV, IO insulin has very short half-life, therefore IV, IO insulin w/o an infusion is not that effective. Rate for
Pedi 0.1U/kg Insulin R IV, IO.
Special Considerations
Mannitol, also known as (Osmitrol)
Class Osmotic diuretic
Mannitol Action Facilitates the flow of fluid out of tissues (including the brain) and into interstitial fluid and blood, thereby dehydrating the brain and reducing swelling. Re-absorption by the kidney is minimal, consequently increasing urine output.
Mannitol Indications Increased ICP.
Mannitol Adverse Effects Pulmonary edema, headache, blurred vision, dizziness, seizures, hypovolemia, nausea/vomiting, diarrhea, electrolyte imbalances, hypotension, hypertension, sinus tach, PVCs, angina phlebitis.
Contraindications Active intracranial bleeding, CHF, pulmonary edema, severe dehydration. Use w/ caution in hypovolemia, renal failure.
Mannitol Dosag:e Adult: 0.5-2g/kg IV, IO followed by 0.25-1g/kg admin’d every 4 hrs.
Mannitol Dosage: Pedi: 0.25-1g/kg IV, IO followed by 0.25-0.5g/kg every 4 hrs.
Mannitol Special Considerations Mannitol should not be given in the same IV, IO line as blood. *Pregnancy class C.
Propofol, also known as Diprivan
Propofol Class Anesthetic
Propofol Action Produces rapid and brief state of general anesthesia.
Propofol Indications Anesthesia induction.
Propofol Adverse Effects Apnea, cardiac arrhythmias, asystole, hypotension, hypertension, pain at injection site.
Propofol Contraindications Hypovolemia, known sensitivity (including soybean oil, eggs).
Propofol Dosage: Adult and Pedi: A general induction dose used to produce a state of unconsciousness rapidly is 1.5-3mg/kg IV, IO.
Propofol Special Considerations None listed in book.
Created by: 1300311346