UTA NURS 4581 Critical Care Exam 2 Meds
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| Diamox (acetazolamide) classification and use | Diuretic, carbonic anhydrase inhibitor, antiglaucoma agent, antiepileptic; used to treat acute altitude sickness; glaucoma; seizures; and edema
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| Propofol (Diprivan) classification and use | anesthetic; used as short-term sedation of patients receiving mechanical ventilation
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| Propofol (Diprivan) side effects | hypotension, bradycardia, and increased triglyceride levels
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| Indications for using propofol and/or neuromuscular blocking agents in ICU | breathing out of synch with vent; Poor compliance with high peak airway pressures; Poor gas exchange/hypoxemia; Severe resp failure; Increased ICP; Tetanus; reduce O2 consumption/CO2 production; PC-IRV; facilitate procedures; postop recovery
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| Atracurium besylate (Tracrium) classification and use | non-depolarizing neuromuscular blocking agent
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| Cisatracurium besylate (Nimbex) classification and use | non-depolarizing neuromuscular blocking agent
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| Doxacurium chloride (Nuromax) classification and use | non-depolarizing neuromuscular blocking agent
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| Pancuronium bromide (Pavulon) classification and use | non-depolarizing neuromuscular blocking agent
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| Vecuronium bromide (Norcuron) classification and use | non-depolarizing neuromuscular blocking agent
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| Succinylcholine Chloride (Anectine) classification and use | depolarizing neuromuscular blocking agent
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| Epinephrine classification and action | alpha and beta adrenergic agonist; Causes vasoconstriction, increasing myocardial and cerebral blood flow during CPR; increases force of ventricular contraction
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| Epinephrine indications | VF (ventricular fibrillation)/VT (ventricular tachycardia), PEA (pulseless electrical activity), Asystole
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| Epinephrine side effects | Palpitations, HTN
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| Epinephrine dosage | 1 mg IV/IO q 3-5 min
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| Atropine classification and action | Anticholinergic; Direct vagolytic action improves automaticity of SA node and conduction of AV node. May raise heart rate, systemic vascular resistance, and blood pressure
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| Atropine indication | Bradycardia
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| Atropine side effects | HA, Dizziness, ↑↓ BP, V Tach, V Fib, A-V Dissociation
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| Adenosine (Adenocard) classification and action | antiarrhythmic, class IA; Depresses activity of SA and AV nodes, interrupting reentry pathway problem common with PSVT. Can cause transient asystole (less than 15 seconds)
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| Adenosine (Adenocard) indication | PSVT (conversion to NSR); second-line in wide QRS complex tachycardia of questionable origin (only after amiodarone)
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| Adenosine (Adenocard) side effects | HA, Dizziness, Transient Facial Flushing, Dyspnea
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| Adenosine dosage | 6-12-12: Initial dose 6 mg over 1-3 seconds followed with 20 ml 9% NACL and Subsequent doses (after 1-2 minutes)of 12 mg over 1-3 seconds. May repeat once.
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| Amiodarone (Cordarone) classification and action | antiarrhythmic class 11A/11B; Blocks sodium channels, causing increase in duration of myocardial cell action potential and refractory period, as well as alpha and beta blockade. IV use reduces vascular resistance (afterload) and increases CI slightly.
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| Amiodarone (Cordarone) indications | Tachyarrhythmias (atrial and ventricular); rate control of rapid atrial dysrhythmias in patients with impaired LV function when digoxin has proven ineffective
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| Amiodarone (Cordarone) side effects | Muscle weakness, fatigue, dizziness, hypotension, corneal microdeposits
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| Amiodarone (Cordarone) contraindications | Cannot use in patients with iodine allergy
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| Vasopressin (Pitressin) classification and action | Potent peripheral vasoconstrictor.
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| Vasopressin (Pitressin) indication | VF/VT, Asystole, PEA, Adult shock
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| Vasopressin (Pitressin) side effects | ↑BP, bradycardia, heart block, N & V, Tremor
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| Lidocaine (Xylocaine) classification and action | antiarrhythmic class IIB; Suppresses ventricular dysrhythmia by reducing automaticity in His Purkinje system and by suppressing spontaneous depolarization of ventricles during diastole.
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| Lidocaine (Xylocaine) indication | VF/VT; second line drug after amiodarone; Tachycardia (VT, questionable wide complex)
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| Lidocaine (Xylocaine) side effects | Confusion, Difficulty breathing/swallowing
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| Procainamide (Pronestyl) classification and action | antiarrhythmic class IIA; Suppresses automaticity in His Purkinje system. Slows conduction in atria, ventricles, and His-Purkinje system, and may slow conduction through AV node.
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| Procainamide (Pronestyl) indications | Tachycardia (PSVT, VT). Alternate second-line drug for VT (after amiodarone)
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| Procainamide (Pronestyl) side effects | Agranulocytosis with repeated use. V Fib, Hypotension
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| Magnesium sulfate classification and action | electrolyte; Regulates movement of calcium in and out of cells, controlling calcium- dependent functions such as cardiac contraction. Deficiency can lead to cardiac dysrhythmias, including refractory VF and torsades de pointes.
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| Magnesium sulfate indications | VF/VT; Torsades de Pointes
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| Magnesium sulfate side effects | 3° heart block, respiratory paralysis
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| Diltiazem (Cardizem) classification and action | calcium channel blocker; Inhibits calcium ions from flowing into myocardial and vascular smooth muscle cells. Slows conduction and raises refractoriness in AV node. Decreases myocardial contractility.
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| Diltiazem (Cardizem) indications | Ventricular rate control in at atrial fibrillation and flutter; conversion of PSVT to NSR (after adenosine); narrow QRS complex tachycardias
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| Diltiazem (Cardizem) side effects | HA, ↓BP, Constipation
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| Dopamine (Intropin) classification and action | Produces inotropic effect on myocardium, increasing cardiac output, blood pressure, and renal blood flow; May enhance myocardial automaticity, causing ventricular dysrhythmias
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| Dopamine (Intropin) indications | Low Dose: Hypotension; Intermediate to high dose: Hypotension (except when caused by hypovolemia), Symptomatic bradycardia (after Atropine trial)
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| Dopamine (Intropin) side effects | Hypertension, Tachycardia, Severe tissue damage with extravasation/IV infiltration
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| Dobutamine (Dobutrex) classification and action | Increases myocardial contractility without increasing myocardial oxygen demand. Decreases left ventricular diastolic pressure
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| Dobutamine (Dobutrex) indications | CHF, Low C.O. Syndrome, Cardiogenic shock
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| Dobutamine (Dobutrex) side effects | ↑HR, ↑BP, Anginal pain
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| Calcium Chloride classification and action | May enhance ventricular automaticity in asystole and myocardial contractility in PEA
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| Calcium Chloride indications | Recommended only for asystole or PEA caused by: Toxicity from calcium channel blockers, open-heart surgery, hyperkalemia, hypermagnesemia, hypocalcemia
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| Calcium Chloride side effects | ↓BP, Bradycardia, Cardiac arrest with rapid infusion.
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| Isoproterenol (Isuprel) classification and action | Beta-Adrenergic Agonist; Enhances automaticity and accelerates conduction, Increases HR and contractility, but exacerbates ischemia and dysrhythmias in patients with ischemic heart disease, Raises BP by increasing CO, and Promotes bronchodilation
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| Isoproterenol (Isuprel) indications | Rarely used for temporary control of severe bradycardia unresponsive to other treatment modalities. Not indicated for cardiac arrest.
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| Isoproterenol (Isuprel) side effects | Ventricular arrhythmias, severe tissue damage with extravasation.
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| Propranolol (Inderal) classification and action | Beta adrenergic blocker; Decreases HR, CO, myocardial contractility; Decreases portal HTN; can potentiate effects of calcium channel blockers
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| Propranolol (Inderal) indications | Control hypertension, suppress rapid supraventricular tachycardias
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| Propranolol (Inderal) side effects | confusion, fatigue, drowsiness, bradycardia
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| Digoxin (Lanoxin) classification and action | Increases myocardial contractility. Slows HR; toxicity can cause wide variety of dysrhythmias; must monitor K+ and digoxin levels
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| Digoxin (Lanoxin) indications | Acute supraventricular tachydysrhythmia with hemodynamic instability
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| Digoxin (Lanoxin) side effects | N & V, AV Block, visual disturbances
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| Furosemide (Lasix) classification and action | Rapid diuresis, venous vasodilatation
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| Furosemide (Lasix) indications | Edema of CHF Renal failure
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| Furosemide (Lasix) side effects | ↓BP, circulatory collapse, hypo K
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| Nitroglycerin (Tridil) classification and action | Relaxes vascular smooth muscle, promotes vasodilatation
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| Nitroglycerin (Tridil) indications | Acute angina pectoris
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| Nitroglycerin (Tridil) side effects | HA, Postural hypotension, anaphylactoid reaction
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| Sodium Nitroprusside (Nipride) classification and action | Relaxes vascular smooth muscle, promotes vasodilatation, reduces BP. Reduces preload and afterload. ↓ SVR
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| Sodium Nitroprusside (Nipride) indications | Rapid reduction of BP in hypertensive crises; CHF
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| Sodium Nitroprusside (Nipride) side effects | Thiocyanate toxicity (profound hypotension, tinnitus, blurred vision)
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| Norepinephrine (Levophed) classification and action | Potent peripheral venous/arterial vasoconstriction
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| Norepinephrine (Levophed) indications | Treat severe hypotension
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| Norepinephrine (Levophed) side effects | Hepatic or renal necrosis, fatal arrhythmias, cerebral hemorrhage, severe tissue damage with extravasation (treated with phentolamine (Regitine)
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| Oxygen action | Increases arterial oxygen tension and hemoglobin saturation. Improves tissue oxygenation.
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| Oxygen indications | cardiac arrest
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| Milrinone (Primacor) classification and action | Rapid-acting positive inotrope. Increases myocardial contractility. Vasodilates
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| Milrinone (Primacor) indications | Short term relief of CHF unresponsive to cardiac glycosides, vasodilators and diuretics
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| Milrinone (Primacor) side effects | Ventricular ectopics, possible ↓BP
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| Sodium Bicarbonate classification and action | Short-acting, potent systemic alkalinizer. Rapidly neutralizes acid to form sodium chloride, carbon dioxide and water. Given only after first line drugs therapy, effective resuscitation begun, and ABG’s have been assessed.
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| Sodium Bicarbonate indications | known preexisting hyperkalemia; known bicarbonate-responsive acidosis or overdose; prolonged resuscitation with effective ventilation; upon return of spontaneous circulation
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| Sodium Bicarbonate side effects | M. Alkalosis, Na overload, severe tissue damage with extravasation.
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| Nicardipine (Cardene) classification and action | Calcium channel blocker; Inhibits influx of calcium ions into smooth muscle without altering serum calcium. Dilates coronary and peripheral blood vessels; reduces SVR.
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| Nicardipine (Cardene) indications | Antihypertensive; short-term use for gradual or rapid reduction of BP
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| Lorazepam (Ativan) classification and action | Benzodiazepine; sedative-hypnotic; Interacts with GABA-benzodiazepine receptors in brain. Acts in 15-30 min. Use cautious dosing in elderly.
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| Lorazepam (Ativan) indication | Status epilepticus; control of acute agitation; sedation
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| Drug given for Torsades de Pointes | Magnesium sulfate
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| Drug that provides rapid BP reduction in HTN crisis | Sodium Nitroprusside (Nipride)
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| Drug that dilates coronary and peripheral blood vessels, causing reduced BP | Nicardipine (Cardene)
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| First drug given for SVT | Adenosine (Adenocard)
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| Drug given to help raise BP and increase myocardial contractility | Dobutamine (Dobutrex)
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| First drug given for pulseless rhythms | Epinephrine
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| First drug given for Vtach with a pulse | Amiodarone (Cordarone)
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| Drug given for acute angina | Nitroglycerin (Tridil)
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| Drug given for bradycardia | Atropine
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| Drugs used to treat tachycardia | Beta blockers
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| Beta blockers suffix | "OLOL"
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| ACE inhibitor suffix | "PRIL"
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