Adrenergic Drugs Flashcards
Dobutamine
Functional Classification
Adrenergic direct-acting Beta1-agonist, cardiac stimulant
Dobutamine
Mechanism of Action
Causes increased contractility, increased cardiac output without marked increase in heart rate by acting on Beta1-receptors in heart; minor alpha and beta2 effects
Dobutamine
Uses
Cardiac decompensation due to organic heart disease or cardiac surgery
Dobutamine
Contraindications
Hypersensitivity, idiopathic hypertrophic subaortic stenosis
Dobutamine
Side Effects
CNS: Anxiety, headache, dizziness, fatigue
CV: palpitations, tachycardia, hyper/hypotension, PVCs, angina
ENDO: hypokalemia
GI: heartburn, nausea, vomiting
MS: muscle cramps (leg)
RESP: dyspnea
Dobutamine
Nursing Considerations
ASSESS:
- HYPOVOLEMIA; if present, correct first; administer cardiac glycoside before DOBUTamine
- OXYGENATION/PERFUSION DEFICIT: check BP, chest pain, dizziness, loss of consciousness
- HEART FAILURE: S3 gallop, dyspnea, neck venous distention, bibasilar crackles in patients with CHF, cardiomyopathy, palpate peripheral pulses; report if extremities become cold or mottled or if peripheral pulses decrease
- ECG during administration continuously; if BP increases, product is decreased; CVP or PCWP, cardiac output during inf; report changes
- Serum electrolytes, urine output
- SULFITE SENSITIVITY, which may be life threatening
Dobutamine
Overdose Treatment
Administer a Beta1-adrenergic blocker; reduce IV or discontinue, ensure oxygenation/ventilation; for severe tachydysrhythmias (ventricular), give lidocaine or propranolol
Dopamine
Functional Classification
Adrenergic
Dopamine
Chemical Classification
Catecholamine
Dopamine
Mechanism of Action
Causes increased cardiac output; acts on beta1- and alpha-receptors, causing vasoconstriction in blood vessels; low dose causes renal and mesenteric vasodilation; beta1 stimulation produces inotropic effects with increased cardiac output
Dopamine
Uses
Shock, increased perfusion, hypotension, cardiogenic/septic shock
Dopamine
Contraindications
Hypersensitivity, ventricular fibrillation, tachydysrhythmias, pheochromocytoma, hypovolemia
Dopamine
Side Effects
CNS: Headache, anxiety
CV: Palpitations, Tachycardia, Hypertension, Ectopic Beats, Angina, Wide QRS Complex, peripheral vasoconstriction, hypotension
GI: Nausea, Vomiting, Diarrhea
INTEG: necrosis, tissue sloughing with extravasation, GANGRENE
RESP: dyspnea
Dopamine
Nursing Considerations
ASSESS:
- Hypovolemia; if present, correct first
- OXYGENATION/PERFUSION DEFICIT: check BP, chest pain, dizziness, loss of consciousness
- HEART FAILURE: S3 gallop, dyspnea, neck venous distention, bibasilar crackles in patients with CHF, cardiomyopathy, palpate peripheral pulses
- I&O ratio: if urine output decreases without decrease in BP, product may need to be reduced
- ECG during administration continuously; if BP increases, product should be decreased; PCWP, CVP during inf
- BP, pulse q5min
- Paresthesias and coldness of extremities; peripheral blood flow may decrease
- Inj site: tissue sloughing; if this occurs, administer phentolamine mixed with NS
Dopamine
Overdose Treatment
Discontinue IV, may give a short-acting alpha-adrenergic blocker