Agents to treat Shock, Cardiac Arrest, and Anaphylaxis

Question 1

Norepinephrine

Answer 1

Non-Selective Adrenergic Agonist:
Vasoconstrictor: increase cardiac output and blood pressure
may cause reflex bradycardia
monitor bp and urinary output (not hr?)
protect medication from light! infuse with DEXTROSE SOLUTION ONLY

Side effects: headache, palpitations, nervousness, epigastric distress, angina, hypertension, TISSUE NECROSIS WITH EXTRAVASATION SO BE CAREFUL

Question 2

Dopamine

Answer 2

low-dose: dilates renal and coronary arteries
high-dose: vasoconstrictor, increases myocardial oxygen consumption
HEADACHE = EARLY S/S OF DOPAMINE TOXICITY
Monitor bp, peripheral pulses, urinary output

Side effects: INCREASED OCULAR PRESSURE, Ectopic beats, nausea, tachycardia, chest pain, dysrhythmias.

Question 3

Epinephrine

Answer 3

Non-Selective alpha and beta adrenergic receptors
ASPIRATE SYRINGE BEFORE IM AND SQ DOSES
1:1000 parenteral; 1:100 inhaled
MUST BE HYDRATED
monitor bp

Side Effects: nervousness, restlessness, dizziness, local necrosis of skin

Question 4

Isoproterenol

Answer 4

Stimulates beta-1 and beta-2 adrenergic receptors
Used for heart block, ventricular arrhythmias, and bradycardia
bronchodilator for asthma and bronchospasm
DON’T GIVE HS-INTERRUPTS SLEEP.
monitor bp and pulse;

Side effects: headache, palpitations, tachycardia, bp changes, angina, bronchial asthma, pulmonary edema

Question 5

phenylephrine

Answer 5

for hypotension- POTENT alpha-1 agonist

palpitations, tachycardia, hypertension, dysrhythmia, angina, TISSUE NECROSIS WITH EXTRAVASATION

Question 6

dobutamine hydrochloride

Answer 6

Beta-1 Receptor agonist:
INCOMPATIBLE WITH ALKALINE SOLUTIONS (SODIUM BICARB)
ADMINISTER THROUGH CVC OR LARGE VEIN
INCOMPATIBLE THROUGH LINE WITH OTHER MEDS
monitor EKG, i/o, bp, serum K

Side effects: hypertension, PVCs, Asthmatic episodes, headache

Question 7

Milrinone

Answer 7

Positive INOTROPE + smooth ms relaxant- used to treat severe heart failure

Side effects: dysrhythmia, THROMBOCYTOPENIA, JAUNDICE

Question 8

Sodium nitroprusside

NITRO

Answer 8

Vasodilator:
Dilates cardiac veins and arteries
Decreases preload and afterload 
increases myocardial perfusion
KEEP MED IN DARK AFTER FIXED-?

side effects: hypotension, INCREASED ICP

Question 9

Diphenhydramine HCl

Answer 9

Blocks effects of HISTAMINE (inflammatory response) on Bronchioles, GI tract, blood vessels

Side effects: drowsiness, confusion, insomnia, headache, vertigo, photosensitivity

Question 10

General Considerations..

Answer 10

assess for extravasation and observe extremities for color and perfusion