Cardiac Misc Flashcards
Norepinephrine Bitartrate (Levophed)
Class
Sympathomimetic, vasopressor
Norepinephrine Bitartrate (Levophed)
Description
Potent alpha-agonist resulting in intense peripheral vasoconstriction, positive chronotropic and increased inotropic effect (from 10% beta effect) with increased cardiac output. Alpha-adrenergic activity resulting in peripheral vasoconstriction and beta-adrenergic activity leading to inotropic stimulation of the heart and coronary artery vasodilation
Norepinephrine Bitartrate (Levophed)
Indication
Cardiogenic shock, unresponsive to fluid resuscitation, significant hypotension (<70mmHg)
Norepinephrine Bitartrate (Levophed)
Contraindication
Hypotensive patients with hypovolemia, pregnency (relative)
Norepinephrine Bitartrate (Levophed)
Precautions
Bradycardia, HTN, dysrhythmias, chest pain, peripheral cyanosis, tissue necrosis from extravasation
Norepinephrine Bitartrate (Levophed)
Dosage
Adult: 0.1-0.5 ug/kg/min titrated to response (average dose for 70kg patient 7-35 ug/min)
Pedi: Begin at 0.1-2 ug/kg/min IV infusion, adjust rate to achieve desire change in blood pressure and systemic perfusion. Titrated to patient response.
Vasopressin (Pitressin)
Class
Hormone, Vasopressor
Vasopressin (Pitressin)
Description
Hormone with a strong vasopressive and antidiuretic properties but that may precipitate angina and/or AMI
Vasopressin (Pitressin)
Indication
To increase peripheal vascular resistance in arrest (CPR) or to control bleeding from esophageal varices
Vasopressin (Pitressin)
Contraindication
PVCs or 1st stage of labor
Vasopressin (Pitressin)
Precaution
Epilepsy, migraine, heart failure, angina, vascular disease, hepatic impairment, elderly, and children
Vasopressin (Pitressin)
Dosage
Cardiac arrest: 40 units IV
Esophageal varices: 0.2-0.4 units/min IV drip
