ICU Drips

Question 1

What medication causes vasoconstriction, increasing systemic vascular resistance, without impacting the heart rate much?

Answer 1

Norepinephrine (nor-epi) / Levophen (levo)

Question 2

What does SVR stand for?

Answer 2

Systemic vascular resistance

Question 3

Why is norepinephrine frequently a first-line treatment for hypotension?

Answer 3

Because it can raise the blood pressure with minimal impact to heart rate.

Question 4

What anti-diuretic hormone is used as adjuct therapy to raise blood pressure?

Answer 4

Vasopressin (vaso)

Question 5

When is vasopressin used?

Answer 5

Usually combined with norepinephrine to increase efficacy of norepinephrine.

Question 6

What drug causes vasoconstriction, increasing SVR, often increases the heart rate, but does not impact the heart rhythm?

Answer 6

Phenylephrine (neo-synephrine) (neo)

Question 7

When is phenylephrine used?

Answer 7

Neurocritical care, rarely in cardiac critical care due to impact on heart rate

Question 8

What are two drugs that are positive inotropes that also cause vasoconstriction?

Answer 8

Epinephrine (epi) and Dopamine (dope)

Question 9

What are some conditions that epinephrine drips are frequently used for?

Answer 9

Anaphylaxis, asthma, cardiac arrest

Question 10

What drug is second-line treatment for hypotension in sepsis?

Answer 10

Dopamine (dope)

Question 11

What are two medications that cause vasodilation?

Answer 11

Nicardipine (cardene) and Nitroprusside sodium (Nipride)

Question 12

What are some considerations when administering nicardipine?

Answer 12

Can be given through central or peripheral line, but if giving through a peripheral line, the site must be changed every 12 hours.

Question 13

What medication causes vasodilation and is also a negative inotrope?

Answer 13

Esmolol (Brevibloc)

Question 14

What are some considerations when using esmolol?

Answer 14

It can cause hypoglycemia but mask the symptoms, and med needs to be titrated off instead of stopping abruptly.

Question 15

What are some common uses for nitroprusside?

Answer 15

Hypertensive crisis, acute heart failure, cerebral vasospasms

Question 16

What is diprivan (propofol)?

Answer 16

Sedative

Question 17

Does propofol help with pain relief?

Answer 17

No

Question 18

What are some considerations for propofol?

Answer 18

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.

Question 19

What is dexmedetomidine (precedex)?

Answer 19

Sedative

Question 20

What are some considerations when giving precedex?

Answer 20

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.

Question 21

What class of medis is diltiazem (cardizem)?

Answer 21

Calcium channel blocker

Question 22

When is cardizem used?

Answer 22

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.

Question 23

What is amiodarone?

Answer 23

Antiarrhythmic

Question 24

What are some considerations for amiodarone?

Answer 24

Potent, interacts with a lot of medications, and has a lot of side effects.

Question 25

When is amiodarone typically used?

Answer 25

For ventricular arrhythmias or afib with RVR.

Question 26

How is amiodarone typically given?

Answer 26

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.