-
-
morphine dose
not used in cath lab, used on floor
mostly used in ambulance & ER
great analgesic
decreases pain, HR
dilates blood vessels so it decreases BP
- 4-10 mg on floor
- 2-5 mg in cath lab
- onset 5-30 min
-
fentanyl
mostly used in cath lab for pain
don't have BP effects like morphine does
works quicker, stays shorter in blood stream
- 25mcg-50mcg
- redose 1/2 the 1st dosage every 5-10 min
-
demerol
not used in cath lab
triggers n/v
not as strong as morphine
25-50mg
-
Benzodiazepines include:
the mostly used in cath lab
-
valium
used for anxiety
given on floor as pre-op
increases respiratory depression
5-10 mg IV
-
versed
used for anxiety
mostly used in cath lab
hits hard, wears off quickly
0.5-1.5 mg
1mg usually 1st dose given
-
Vasodilators mostly used in cath lab include:
- nitroglycerine
- nitroprusside
-
nitorglycerine
drops BP ALOT!!
increases blood flow to heart by dilating blood vessels
good for controlling spasms
easily triggers migraines
- sublingual/spray/tablet: 150-600mcg
- IV: 5-20mcg titrate low to high, BP below 110 stop nitro.
- IC: 200-400mcg for spasms
-
nitroprusside
extremely potent and powerful
given to relax vessels that spasm closed
onset very fast
watch doses can turn into cyanide
- IV: 0.3-10mg/min
- IC: 200-400mcg/dose
-
Beta Blockers used mostly in cath lab include:
Specific: metropolol(lopressor)
- Non-specific: propanolol
- lobatalol
-
Specific beta blockers---metropolol(lopressor)
decrease HR, decreasing contractility there fore decreasing BP
given to pt w/ fast HR and high BP
5mg bolus via IV every 5 min
-
Non-specific beta blockers
propanolol(inderal)
lobatolol
given to pt with fast HR and low to normal BP
propanolol: 1-3 mg IV every 5 min
lobatolol: 20 mg IV over 2 min
-
Calcium Channel Blockers includes
used to control HR and contractility
not given for MI's
decrease HR and decrease vasotone therefore decreasing contractility
-
diltiazem
may decrease HR
causes blood vessels to dilate some and decreases BP
for really high BP
- IV: 0.25mg/kg over 2 min
- IV drip: 0.5mg/hr
-
Verapamil
decreases HR
decreases vaso constriction
decreases contractility
No Flow phenomenon: no flow occurance
- IV: 2.5-10mg max dose 20mg
- IC: 50-200mcg
-
Antithrombins used in cath lab include
- heparin
- low molecular wt heparins: enoxaprin
- angiomax
-
heparin
used for angioplasty
reversal is protamine
- 25 units/kg for diagnostic procedures
- 50 units/kg for interventional procedures
-
protamine reversal for heparin
1 mg of protamine for every 100 units of heparin
-
enoxaprin(lovenox)
low wt molecular heparin
most commonly used
may cause HITS
bleeding complications for diabetics
CANNOT REVERSE!!!
- not good for diabetics
- good for MI's
- injection into IM/SQ
-
Bivalirudin(angiomax)
low wt molecular heparin
doesn't cause HITS as much
Given to Diabetics
- 0.75mg//kg IV bolus
- 1.75 mg/kg/hr IV drip
-
antiplatelets used in cath lab include
- aspirin
- super aspirin: ticlid
- plavix
-
aspirin
decreases ability for platelets to activate
doesn't break up previously formed clots but further keeps platelets from sticking together
can cause ulcers
81-325mg
-
super asprin--ticlid
used on acute/urgent/ER patients
limits hardness of clots
keeps platelets from sticking together,
put on right before angioplasty
or right after stent
- before procedure: 500mg
- after procedure: 250mg b.i.d for 2-6 weeks
-
clipidogrel---Plavix
used most in cath lab, most common
- before procedure: 300mg
- after procedure: 75mg per day for 6 months or longer, depends on type of stent used
-
anticoagulations used most in cath lab
- IIbIIIa
- reopro
- integrellin
- aggrestat
-
reopro
antibody
attachs to platelet so clotting doesnt take effect
used for stents and MI's
CAN'T REVERSE, FRESH FROZEN PLASMA GIVEN BEFORE SURGERY
-
integrellin
aggrestat
drug
- attached to platelet
- last for 2 hr
- hold equipment for 2 hrs
-
Emetics used in cath lab include
-
phenergan
for n/v
has sedative effect
monitor vital signs
25-50 mg
-
zofran
mostly used in cath lab
has no sedative effects
4mg IV
-
Benadryl
for allergy reaction
has sedative effects
10-50mg
-
-
benozo reversal
romazicon
0.2mg
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