Med-Surge Drugs

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Med-Surge Drugs
2013-02-18 13:51:49
Med Surge Drugs

med-surge drugs
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  1. Inotropic meds
    • dodutrex/Dopamine - Improve cardiac output w/out ^ heart rate; IV only
    • Digoxin - It can go home with you, also IV, increase cardiac output v heart rate.  Low potassium intensifies digoxin (abd. pain, n/v, halos)
    • Primacor - #1 choice used by physicians.  ^ cardiac output, reduces preload and afterload
    • All increase cardiac output.
  2. Vasopressors
    • Half to make sure tank is full, that they have fluids
    • Dopamine - 3 uses .5-2.0 renal dose, 2-10 affects beta, 10 > alphaABCD - A to C, B to D (alpha constrics beta dilates) raises b/p don't give for tachycardia
    • Levofed - increases b/p without  ^ heart rate, causes shunting.
    • MAP - > 60 for perfusion
    • Neosynephrine - Used as a neuro pressor.  Raises CPP (cerebral pulse pressure)
    • EPI - first drug used in a code, all dead people get epi,
    • Vasopressin - Used in a code, strongest vasoconstrictor, natural occuring hormone, like epi.
  3. Antidisrythmics
    • Amnioderone/Cordarone - favorite works on atrial and ventricular disrythmias. Lowers b/p.
    • Lidocaine - IV only, just for ventricular arrythmias
    • Adenosine - Used for diagnostics, SVT, lowers heart rate, slows heart rate down to diagnose.  Half life is short
    • Atropine - Used for symptomatic bradycardia.  NOT to be used on patients with glaucoma
  4. Ace Inhibitors/ARB's
    • Prevents remodeling after heart failure, MI, etc..  CORE MEASURE (know them all)
    • If you cough on an ACE you get an ARB.

    Watch for angioedema!
  5. Beta Blockers
    • Metropolol - Cardio protective, prevents remodeling in CHF.  v chance of another event.  Anybody who has a stent, MI, CHF, Stemi will get a beta blocker. Slows HR and v B/P.
    • Labetolol - HR > 60 on both beta blockers.  IV only for hypertension crisis.
  6. Corticoid Steroid
    Decadron/Dexamethasone - treat cerebral edema, have to give with a Proton Pump inhibitor.  Watch BS. Used for asthma, allergy, shock.  Mostly used cerebral edema.
  7. Vasodilators
    • Nipride/Nitroglycerine - Lowers b/p, opens coronary arteries.  IV version of nitro is TRIDILE comes in glass bottle (absorbed by plastic, has special IV tubing), used for chest pain, angina, acute MI.
    • Hydralazine/Hydrochloride - Given IV or PO used for patients with b/p 200/120 and low heart rate.  Lowers b/p and raises HR.
  8. Calcium Channel Blockers
    • Cardine - (cardown) acute HTN crisis.  Lowers b/p, IV only.  Not used for arrythmias.
    • Verapamil - IV push, v HR, used for a-fib RVR. 
    • Cardazim - Lowers heart rate, A-fib RVR, given PO or IV.
  9. Diuretic
    • Lasix - loop diuretic, watch potassium and sodium.
    • Bumex - 40 times stronger than lasix
    • Mannitol - osmotic diuretic, used for neuro patients, must have filter, lowers ICP and interoccular pressure, have to have urine production to give it.
  10. Antiplatelets
    • Integrilin - antiplatelet agent, considered a liquid plavix, goes in all stents and all graphs.
    • Plavix - Platelet aggregation inhibitor.  Hold for procedures
    • D50W - Used for hypoglycemia crisis, insulin shock.  Give all 50
  11. Sodium Bicarbonate
    • Sodium Bicarbonate -
    • replace it when its less than -6, and magnesium when its less than 2. 
    • Used for metabolic acidosis, less than -6 or lower, also given for life
    • threatening hyperkalemia.
  12. Morphine
    Reduces preload, pain, and anxiety.
  13. Calcium Gluconate
    Reversal agent for Magnesium sulphate.
  14. Magnesium sulphate
    Used for torsads, which is a lethal heart rythym.  Replace MAG if is falls below 2.  Calcium Gluconate is reversal.
  15. Sedatives
    • Presedex - to wean off of the ventilator. 
    • Propofol - vented only
    • Versad - relaxant
    • Phentanol - 10 x stronger than morphine