Group 4A Flashcards
Atropine Sulfate
Class
-Anticholingeric/parasympatholytic agent
-organophosphate antidote
-antimuscarinic
Atropine Sulfate
MOA
-CV: increased chronotropic, inotropic and dromotropic effects; increases cardiac output
-Resp: increased bronchial smooth muscle relaxation (bronchodilation), decreased mucous production
-GI: decreased GI secretions and motility
-GU: decreased urinary bladder tone
-Other: Mydriasis (pupil dilation); decreased sweat and saliva production
Atropine Sulfate
Indications
-Symptomatic bradycardia
-Acetylcholinesterase inhibitor poisoning (organophosphates, carbamate cholingeric poisoning)
Atropine Sulfate
Adult Dose & Route
-Symptomatic bradycardia
1 mg IV/IO push every 3-5 min. (Max dose 3 mg)
-Organophosphate poisoning
2-6 mg IV/IO, double the dose every 3-5 min. Until S.L.U.D.G.E.M. Signs are gone.
Atropine Sulfate
Onset, Peak, Duration
Onset of Action- immediate
Peak Effect- 2-4 min.
Duration of Action- 4 hr.
Dopamine
Class
-Inotropic Sympathomimetic (increases contraction strength)
-vasopressor (shunts peripheral blood to the core)
Dopamine
MOA
-Cerebral, renal, mesenteric vasodilation @ 1-2 mcg/kg/min.
-Primarily B1 stimulation (increased cardiac output) @ 5-10 mcg/kg/min.
-Primarily A stimulation (increased preload and afterload) @ 10-20 mcg/kg/min.
-Similar effects to norepinephrine, increases myocardial oxygen demand @ >20 mcg/kg/min.
Dopamine
Indications
-Symptomatic bradycardia refractory (unresponsive) to Atropine
-Non-hypovolemic hypotension (cardiogenic or septic shock unresponsive to fluid bolus)
-Hypotension following return of spontaneous circulation (ROSC) following cardiac arrest
Dopamine
Adult Dose & Route
-Bradycardic hypotension:
2-20 mcg/kg/min IV/IO infusion, titrated for proper response
-Shock: cardiogenic or septic shock unresponsive to fluid bolus (non-hypovolemic):
5 mcg/kg/min to start for systolic BP < 70
2.5 mcg/kg/min to start for systolic BP > 70
-Dopamine Drip:
400 mg added to 250 mL of D5W, makes 1600 mcg/mL
Dopamine
Onset, Peak, Duration
Onset of Action: immediate
Peak Effect: 5-10 min.
Duration of Action: ceases almost immediately after drug is stopped
Phenylephrine Nasal Spray 0.5% (Neo-synephrine)
Class
-Topical vasoconstrictor
Phenylephrine Nasal Spray 0.5% (Neo-synephrine)
MOA
-stimulates a-receptors in the blood vessels of the nasal mucosa, decreases chances of nasal bleeding during nasal intubation
Phenylephrine Nasal Spray 0.5% (Neo-synephrine)
Indications
-Facilitation of nasotracheal intubation
Phenylephrine Nasal Spray 0.5% (Neo-synephrine)
Adult Dose & Route
- 2-4 sprays in each nostril (before attempting nasal intubation)
Phenylephrine Nasal Spray 0.5% (Neo-synephrine)
Onset, Peak, Duration
Onset of Action: seconds
Peak Effect: 30 min.
Duration of Action: 30 min. To 4 hrs.
