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Dobutamine
- (Dobutrex) Sympathomimetic
- Des: synthetic catecholamine & beta agent that increases strength of cardiac contraction without appreciably increasing rate
- Ind: increase cardiac output in CHF/cardiogenic shock
- CI: 1)hypersensitivity to Sympathomimetic amines 2)ventricular tachycardia 3)hypovolemia without fluid resuscitation
- PC: 1)atrial fibrillation 2)preexisting hypertension
- Dose: 2-20 mcg/kg/min IV Ped: same
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Dopamine
- (Intropin) Sympathomimetic
- Des: naturally occurring catecholamine that increases cardiac output without appreciably increasing myocardial oxygen consumption. maintains renal & mesenteric blood flow while inducing vasoconstriction & increasing systolic BP
- Ind: Nonhypovolemic hypotension (70 to 100 mmHg) & cardiogenic shock
- CI: 1)hypovolemic hypotension w/out aggressive fluid resuscitation 2) tachydysrhythmias 3) ventricular fibrillation 4)pheochromocytoma
- PC: 1)occlusive vascular disease 2)cold injury 3)arterial embolism 4)ensure adequate fluid resuscitation of the hypovolemic PT
- Dose: 2-5 mcg/kg/min up to 20 mcg/kg/min, titrated to effect. Ped: same
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Isoprotenerol
- (Isuprel) Sympathomimetic
- Des: synthetic sympathomimetic results in increased cardiac output by increasing the strength of cardiac contraction and somewhat increasing rate.
- Ind: bradycardia refractory to atropine when pacing is not available
- CI: cardiogenic shock
- PC: tachydysrhythmias & those associated w/ digitalis & acute myocardial infarction
- Dose: bradycardia: 2-10 mcg/min titrated to cardiac rate. Ped: 0.1 mcg/kg/min titrated to cardiac rate
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Tetracaine
- (Tetracaine) Ophthalmic, Anesthetics
- Des: after topical application to the eye, local anesthetics penetrate to sensory nerve endings in the corneal tissue. these medications block both the initiation & conduction of nerve impulses by decreasing the neuronal membrane's permeability to sodium ions. this reversibly stabilizes the membrane and inhibits depolarization, resulting in the failure of a propagated action potential and subsequent conduction blockade
- Ind: eye injuries or foreign body
- CI: hypersensitivity
- PC: 1)be monitored 2)hyperthyroid disease 3)cardiac diseases
- Dose: 1-2 drops in each eye
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