Med-Surge Drugs

• 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.

• Half to make sure tank is full, that they have fluids
• Dopamine - 3 uses .5-2.0 renal dose, 2-10 affects beta, 10 > alpha.  ABCD - 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.

• 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

• 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!

• 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.

Decadron/Dexamethasone - treat cerebral edema, have to give with a Proton Pump inhibitor.  Watch BS. Used for asthma, allergy, shock.  Mostly used cerebral edema.

• 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.

• 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.

• 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.

• 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

• 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.

Reduces preload, pain, and anxiety.

Reversal agent for Magnesium sulphate.

Used for torsads, which is a lethal heart rythym.  Replace MAG if is falls below 2.  Calcium Gluconate is reversal.

• Presedex - to wean off of the ventilator. 
• Propofol - vented only
• Versad - relaxant
• Phentanol - 10 x stronger than morphine