Term | Definition |
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. |