ICU Drips Flashcards
What medication causes vasoconstriction, increasing systemic vascular resistance, without impacting the heart rate much?
Norepinephrine (nor-epi) / Levophen (levo)
What does SVR stand for?
Systemic vascular resistance
Why is norepinephrine frequently a first-line treatment for hypotension?
Because it can raise the blood pressure with minimal impact to heart rate.
What anti-diuretic hormone is used as adjuct therapy to raise blood pressure?
Vasopressin (vaso)
When is vasopressin used?
Usually combined with norepinephrine to increase efficacy of norepinephrine.
What drug causes vasoconstriction, increasing SVR, often increases the heart rate, but does not impact the heart rhythm?
Phenylephrine (neo-synephrine) (neo)
When is phenylephrine used?
Neurocritical care, rarely in cardiac critical care due to impact on heart rate
What are two drugs that are positive inotropes that also cause vasoconstriction?
Epinephrine (epi) and Dopamine (dope)
What are some conditions that epinephrine drips are frequently used for?
Anaphylaxis, asthma, cardiac arrest
What drug is second-line treatment for hypotension in sepsis?
Dopamine (dope)
What are two medications that cause vasodilation?
Nicardipine (cardene) and Nitroprusside sodium (Nipride)
What are some considerations when administering nicardipine?
Can be given through central or peripheral line, but if giving through a peripheral line, the site must be changed every 12 hours.
What medication causes vasodilation and is also a negative inotrope?
Esmolol (Brevibloc)
What are some considerations when using esmolol?
It can cause hypoglycemia but mask the symptoms, and med needs to be titrated off instead of stopping abruptly.
What are some common uses for nitroprusside?
Hypertensive crisis, acute heart failure, cerebral vasospasms
What is diprivan (propofol)?
Sedative
Does propofol help with pain relief?
No
What are some considerations for propofol?
Works quickly and can also titrate up or down quickly. Has high fat content- important consideration with tube feedings and labs. Patient must be on a ventilator or they will become to sedated to protect their own airway.
What is dexmedetomidine (precedex)?
Sedative
What are some considerations when giving precedex?
Do not always need to be on a ventilator, but does work as fast or wean off as fast as propofol, sometimes a loading dose us ordered.
What class of medis is diltiazem (cardizem)?
Calcium channel blocker
When is cardizem used?
Typically if patient flips into atrial fibrillation with rapid ventricular response or supraventricular tachycardia. The goal is for the med to convert patient back to sinus rhythm, or at least slow down the rhythm.
What is amiodarone?
Antiarrhythmic
What are some considerations for amiodarone?
Potent, interacts with a lot of medications, and has a lot of side effects.
When is amiodarone typically used?
For ventricular arrhythmias or afib with RVR.
How is amiodarone typically given?
Bolus bag 1, give bag two at a slower rate, give bag 3 even slower for about 24-48 hours. May need to transition to oral for maintenance.
