Sypathetic Meds

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gmc292008
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60659
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Sypathetic Meds
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2011-01-19 13:57:25
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Sypathetic Meds
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Sypathetic Meds
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  1. Norepinephrine (Levophed)
    Indications
    • Cardiogenic shock
    • Neurogenic shock
    • Inotropic support
    • significant hypotension
  2. Norepinephrine (Levophed)
    Containdications
    Hypotensive Pt's with hypovolemia
  3. Norepinephrine (Levophed)
    Side Effects
    • Dysthythmias
    • tachycardia
    • Reflex Bradycardia
    • Angina
    • Hypertension
  4. Norepinephrine
    Actions
    • • Stimulates alpha-adrenergic receptors located mainly in blood vessels, causing constriction of blood vessels
    • • Also has minor beta effect (myocardial stimulation)
    • Therapeutic Effect(s):
    • • Increased blood pressure
    • • Increased cardiac output
  5. Norepinephrine (Levophed)
    Target sites
    IV continous infusion
  6. Norepinephrine (Levophed)
    Actions
    • Stimulates alpha-receptors located mainly in blood vessels, causing constriction
    • Also has minor beta-adrenergic activity (myocardial stimulation)
    • Therapeutic Effect(s):
    • Increased blood pressure
    • Increased cardiac output
  7. Epinephrine
    Action
    • • Affects both beta1(cardiac)-adrenergic receptors and beta2(pulmonary)-adrenergic receptor sites
    • • Produces bronchodilation
    • • Also has alpha-adrenergic effect which result in vasoconstriction
    • Therapeutic Effect(s):
    • • Bronchodilation
    • • Maintenance of heart rate and blood pressure
  8. Epinephrine (Adrenalin)
    Class
    Sympathomimetic
  9. Epinephrine (Adrenalin)
    Indications
    • asthma
    • Acute allergic reaction (anaphylaxis)
    • Cardiac arrest
    • VF
    • PVT
    • Bradycardia
  10. Epinephrine (Adrenalin)
    Contraindications
    • Hypovolemic shock
    • Cornary artery disease
  11. Epinephrine (Adrenalin)
    side effects
    • Tachydysrhythmias
    • angina
    • HTN
  12. Epinephrine (Adrenalin)
    Dosages
    • Allergic Reaction/Athsma-.3-.5 mg 1;1000 SQ
    • Pedi- .01mg/kg sq to a max of .5 mg
    • Anaphylaxis .3-.5 mg 1;10000 IV
    • Bradycardia/Hypotension 2-10 mg/min/IV
    • Cardiac arrest 1 mg every 3-5 min
    • Alternative doses for CA .2 mg/kg IVP every 3-5 min
    • ET doses 2-2.5 mg every 3-5 min
    • Continous Infusion mix 30 mg in 250 ml of NS or D5W and run@ 100 microdrips/min
  13. Dopeamine (Intropin)
    Class Sympathomimetic
    Indications
    • Asthma
    • Anaphylaxis
    • Cardiac arrest
    • VF
    • PVT
    • Bradycardia
  14. Dopeamine (Intropin)
    Contraindications
    • High HR
    • HTN
    • Low dose to 1/10th for patients on MAOI's
  15. Dopeamine (Intropin)
    Action
    • • Doses greater than 10 mcg/kg/min stimulate alpha-adrenergic receptors and may cause renal vasoconstriction
    • Therapeutic Effect(s):
    • Increased cardiac output
    • increased blood pressure
    • improved renal blood flow
  16. Dopeamine (Intropin)
    Side Effects
    • tachydysrhythmias
    • VF/VT
    • HTN
    • ischemia
    • AMI
  17. Dopeamine (Intropin)
    Dosages
    • Hypotension/Bradycardia
    • 2-20 mcg/min
    • Renal 2-5 mcg/kg/min
    • Inotropic
    • 5-10 mcg/kg/min
    • Pressor
    • >10 mcg/kg/min
    • Max 400 mg in 250 mL of D5W Run @ fallow chart
  18. Albuterol (Proventil, Ventolin)
    Sympathomimetic
    Indications
    • Bronchospasm
    • Asthma
    • hypotension
    • Bradycardia
  19. Albuterol (Proventil, Ventolin)
    Sympathomimetic
    Contraindications
    Tachydysrhythmias
  20. Albuterol (Proventil, Ventolin)Sympathomimetic
    Side Effects
    • Tachydysrhythmias
    • anxiety
    • Nausea/vomit
  21. Albuterol (Proventil, Ventolin)
    Actions
    • Relaxation of airway smooth muscle (bronchodilation)

    • Therapeutic Effect(s):
    • Bronchodilation
  22. Albuterol (Proventil, Ventolin)Sympathomimetic
    Dosage
    • Bronchospasm/COPD/Asthma
    • 1.25-2.5 mg Mixed in 3mL NS In neb
  23. Dobutamine (Dobutrex)
    Sympathomimetic
    Indications
    Inotropic support for PT's with left ventrical dysfunction
  24. Dobutamine (Dobutrex)
    Sympathomimetic
    Contraindications
    • Tachydysrhythmias
    • A Fib/A flutter
    • Hypotension
  25. Dobutamine (Dobutrex)
    Sympathomimetic
    Side Effects
    • tackydysrhythmais
    • hypertension
  26. Dobutamine (Dobutrex)
    Actions
    • Stimulates beta1(myocardial)-adrenergic receptors with relatively minor effect on heart rate or peripheral blood vessels
    • Therapeutic Effect(s):
    • Increased cardiac output without significantly increased heart rate
  27. Isoproterenol (Isuprel)
    Action
    • Alpha 1 and Beta 2
    • Inotropic and chronotropic activity
    • Causes arterial and bronchial dialiation
    • Sometimes delivered by aerosolization
  28. Isoproterenol (Isuprel)
    Indications
    • Bradcardias unresponsive to tcp, dopamine
    • epinephrine Management of torsades
  29. Isoproterenol (Isuprel)
    Contraindications
    VT, VF, Hypotension
  30. Isoproterenol (Isuprel)
    Side Effects
    • Dysrhythmias
    • hypotension
    • angina pectoris
  31. Levalbuterol (Xopenex)
    Actions
    • Therapeutic Effect(s):
    • • Relaxation of airway smooth muscle with subsequent bronchodilation
    • • Relatively selective for beta-2 (pulmonary) receptors
  32. Levalbuterol (Xopenex)
    Indications
    Bronchospasm
  33. Levalbuterol (Xopenex)
    Contraindications
    Hypersensitivity to levalbuterol or albuterol
  34. Levalbuterol (Xopenex)
    Side Effects
    • PARADOXICAL BRONCHOSPASM
    • tachycardia
    • dyspepsia
    • hyperglycemia
    • hypokalemia
  35. Metaproterenol (Alupent)
    Actions
    Relaxes smooth muscles in the bronchial tree and beta 2 receptors
  36. Metaproterenol (Alupent)
    Indications
    • Bronchial asthma
    • Reversiable bronchospasm
    • Bronchitis
    • Emphysema
  37. Metaproterenol (Alupent)
    Contraindications
    • Cardiac dysrhythmias
    • Tachycardia
  38. Metaproterenol (Alupent)
    Side Effects
    • Palpitations
    • Tachycardia
    • Dysrhythmias
    • Hypotension
  39. Isoetharine (Bronkosol)
    Actions
    • Bronchodilation
    • increases heart rate.
  40. Isoetharine (Bronkosol)
    Indications
    Asthma, reversible bronchospasm associated with chronic bronchitis and emphysema
  41. Isoetharine (Bronkolol)
    Contra
    Patients with history of hypersensitivity to the drug
  42. Isoetharine (Bronkosol)
    Side Effects
    Palpitations, tachycardia, anxiety and tremors, headache
  43. Isoetharine (Bronkosol)
    Doseages
    • Adult
    • Hand nebulizer: four inhalations.Small-volume nebulizer: 0.5 ml (1:3 with saline).
    • Pedi
    • 0.25-0.5 ml diluted with 4 ml normal saline

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