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Norepinephrine (Levophed)
Indications
- Cardiogenic shock
- Neurogenic shock
- Inotropic support
- significant hypotension
-
Norepinephrine (Levophed)
Containdications
Hypotensive Pt's with hypovolemia
-
Norepinephrine (Levophed)
Side Effects
- Dysthythmias
- tachycardia
- Reflex Bradycardia
- Angina
- Hypertension
-
Norepinephrine
Actions
- • Stimulates alpha-adrenergic receptors located mainly in blood vessels, causing constriction of blood vessels
- • Also has minor beta effect (myocardial stimulation)
- Therapeutic Effect(s):
- • Increased blood pressure
- • Increased cardiac output
-
Norepinephrine (Levophed)
Target sites
IV continous infusion
-
Norepinephrine (Levophed)
Actions
- Stimulates alpha-receptors located mainly in blood vessels, causing constriction
- Also has minor beta-adrenergic activity (myocardial stimulation)
- Therapeutic Effect(s):
- Increased blood pressure
- Increased cardiac output
-
Epinephrine
Action
- • Affects both beta1(cardiac)-adrenergic receptors and beta2(pulmonary)-adrenergic receptor sites
- • Produces bronchodilation
- • Also has alpha-adrenergic effect which result in vasoconstriction
- Therapeutic Effect(s):
- • Bronchodilation
- • Maintenance of heart rate and blood pressure
-
Epinephrine (Adrenalin)
Class
Sympathomimetic
-
Epinephrine (Adrenalin)
Indications
- asthma
- Acute allergic reaction (anaphylaxis)
- Cardiac arrest
- VF
- PVT
- Bradycardia
-
Epinephrine (Adrenalin)
Contraindications
- Hypovolemic shock
- Cornary artery disease
-
Epinephrine (Adrenalin)
side effects
- Tachydysrhythmias
- angina
- HTN
-
Epinephrine (Adrenalin)
Dosages
- Allergic Reaction/Athsma-.3-.5 mg 1;1000 SQ
- Pedi- .01mg/kg sq to a max of .5 mg
- Anaphylaxis .3-.5 mg 1;10000 IV
- Bradycardia/Hypotension 2-10 mg/min/IV
- Cardiac arrest 1 mg every 3-5 min
- Alternative doses for CA .2 mg/kg IVP every 3-5 min
- ET doses 2-2.5 mg every 3-5 min
- Continous Infusion mix 30 mg in 250 ml of NS or D5W and run@ 100 microdrips/min
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Dopeamine (Intropin)
Class Sympathomimetic
Indications
- Asthma
- Anaphylaxis
- Cardiac arrest
- VF
- PVT
- Bradycardia
-
Dopeamine (Intropin)
Contraindications
- High HR
- HTN
- Low dose to 1/10th for patients on MAOI's
-
Dopeamine (Intropin)
Action
- • Doses greater than 10 mcg/kg/min stimulate alpha-adrenergic receptors and may cause renal vasoconstriction
- Therapeutic Effect(s):
- Increased cardiac output
- increased blood pressure
- improved renal blood flow
-
Dopeamine (Intropin)
Side Effects
- tachydysrhythmias
- VF/VT
- HTN
- ischemia
- AMI
-
Dopeamine (Intropin)
Dosages
- Hypotension/Bradycardia
- 2-20 mcg/min
- Renal 2-5 mcg/kg/min
- Inotropic
- 5-10 mcg/kg/min
- Pressor
- >10 mcg/kg/min
- Max 400 mg in 250 mL of D5W Run @ fallow chart
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Albuterol (Proventil, Ventolin)
Sympathomimetic
Indications
- Bronchospasm
- Asthma
- hypotension
- Bradycardia
-
Albuterol (Proventil, Ventolin)
Sympathomimetic
Contraindications
Tachydysrhythmias
-
Albuterol (Proventil, Ventolin)Sympathomimetic
Side Effects
- Tachydysrhythmias
- anxiety
- Nausea/vomit
-
Albuterol (Proventil, Ventolin)
Actions
• Relaxation of airway smooth muscle (bronchodilation)
- Therapeutic Effect(s):
- Bronchodilation
-
Albuterol (Proventil, Ventolin)Sympathomimetic
Dosage
- Bronchospasm/COPD/Asthma
- 1.25-2.5 mg Mixed in 3mL NS In neb
-
Dobutamine (Dobutrex)
Sympathomimetic
Indications
Inotropic support for PT's with left ventrical dysfunction
-
Dobutamine (Dobutrex)
Sympathomimetic
Contraindications
- Tachydysrhythmias
- A Fib/A flutter
- Hypotension
-
Dobutamine (Dobutrex)
Sympathomimetic
Side Effects
- tackydysrhythmais
- hypertension
-
Dobutamine (Dobutrex)
Actions
- Stimulates beta1(myocardial)-adrenergic receptors with relatively minor effect on heart rate or peripheral blood vessels
- Therapeutic Effect(s):
- Increased cardiac output without significantly increased heart rate
-
Isoproterenol (Isuprel)
Action
- Alpha 1 and Beta 2
- Inotropic and chronotropic activity
- Causes arterial and bronchial dialiation
- Sometimes delivered by aerosolization
-
Isoproterenol (Isuprel)
Indications
- Bradcardias unresponsive to tcp, dopamine
- epinephrine Management of torsades
-
Isoproterenol (Isuprel)
Contraindications
VT, VF, Hypotension
-
Isoproterenol (Isuprel)
Side Effects
- Dysrhythmias
- hypotension
- angina pectoris
-
Levalbuterol (Xopenex)
Actions
- Therapeutic Effect(s):
- • Relaxation of airway smooth muscle with subsequent bronchodilation
- • Relatively selective for beta-2 (pulmonary) receptors
-
Levalbuterol (Xopenex)
Indications
Bronchospasm
-
Levalbuterol (Xopenex)
Contraindications
Hypersensitivity to levalbuterol or albuterol
-
Levalbuterol (Xopenex)
Side Effects
- PARADOXICAL BRONCHOSPASM
- tachycardia
- dyspepsia
- hyperglycemia
- hypokalemia
-
Metaproterenol (Alupent)
Actions
Relaxes smooth muscles in the bronchial tree and beta 2 receptors
-
Metaproterenol (Alupent)
Indications
- Bronchial asthma
- Reversiable bronchospasm
- Bronchitis
- Emphysema
-
Metaproterenol (Alupent)
Contraindications
- Cardiac dysrhythmias
- Tachycardia
-
Metaproterenol (Alupent)
Side Effects
- Palpitations
- Tachycardia
- Dysrhythmias
- Hypotension
-
Isoetharine (Bronkosol)
Actions
- Bronchodilation
- increases heart rate.
-
Isoetharine (Bronkosol)
Indications
Asthma, reversible bronchospasm associated with chronic bronchitis and emphysema
-
Isoetharine (Bronkolol)
Contra
Patients with history of hypersensitivity to the drug
-
Isoetharine (Bronkosol)
Side Effects
Palpitations, tachycardia, anxiety and tremors, headache
-
Isoetharine (Bronkosol)
Doseages
- Adult
- Hand nebulizer: four inhalations.Small-volume nebulizer: 0.5 ml (1:3 with saline).
- Pedi
- 0.25-0.5 ml diluted with 4 ml normal saline
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