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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.
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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 > 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.
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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
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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!
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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.
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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.
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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.
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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.
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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.
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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
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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.
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Morphine
Reduces preload, pain, and anxiety.
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Calcium Gluconate
Reversal agent for Magnesium sulphate.
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Magnesium sulphate
Used for torsads, which is a lethal heart rythym. Replace MAG if is falls below 2. Calcium Gluconate is reversal.
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Sedatives
- Presedex - to wean off of the ventilator.
- Propofol - vented only
- Versad - relaxant
- Phentanol - 10 x stronger than morphine
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