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ICU > Medications > Flashcards

Medications Flashcards

1
Q

Phenylephrine/Neosynephrine

A
  1. Class: Vasopressor
  2. Use: Hypotension with tachycardia; neurogenic shock.
  3. Starting Dose: 40 mcg/min
  4. Max Dose: 360 mcg/min
  5. Nursing considerations: Preferred in pts with severe tachycardia; provides no inotropic support; max dose may be increased with provider order
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2
Q

Lorazepam/Ativan

A
  1. Class: Benzodiazepines, Sedation
  2. Use: Long term sedation; intermittent therapy
  3. Starting Dose: 1 mg/hr
  4. Max Dose: 8 mg/hr
  5. Nursing considerations: Propylene glycol toxicity (esp.w/ infusion); delirium; preferred BZD in cirrhosis.
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3
Q

Versed/Midazolam

A
  1. Class: Benzodiazepines, Sedation
  2. Use: Short term sedation, frequent Neuro checks
  3. Starting Dose: 1 mg/hr
  4. Max Dose: 10 mg/hr
  5. Nursing considerations: Accumulates in adipose tissue; delirium; unpredictable elimination; less hypotension than propofol and precedex
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4
Q

Propofol/Diprivan

A
  1. Class: Sedative
  2. Use: Short term sedation, frequent Neuro checks
  3. Starting Dose: 5 mcg/kg/minute
  4. Max Dose: 80 mcg/kg/min
  5. Nursing considerations: Hypotension ; change tubing every 12 hours; increases Triglycerides; Propofol related infusion syndrome
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5
Q

Precedex/Dexmedetomidine

A
  1. Class: Sedative
  2. Use: Sedation, Intubation
  3. Starting Dose: 0.2 mcg/kg/hr
  4. Max Dose: 1.5 mcg/kg/hr
  5. Nursing considerations: Avoids common side effects of other sedatives. Has some analgesic effects; can cause hypotension a/o bradycardia; intended for light sedation; expensive
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6
Q

Levophed/Norepinephrine

A
  1. Class: Vasopressor
  2. Use: treats low blood pressure, preferred vasopressor
  3. Starting Dose: 5 mcg/minute
  4. Max Dose: 80 mcg/minute (1 mcg/kg/min)
  5. Nursing considerations: Notify provider at 30 mcg/kg/min. Max dosage may be increased with provider order; may be especially necessary in obese patients.
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7
Q

Vasopressin/Pitressin

A
  1. Class: Vasopressor
  2. Use: Usually added on to norepinephrine (especially in septic shock), Elevates BP
  3. Starting Dose: 0.04 Units/minute
  4. Max Dose: is not titrated/ 0.04 Units/minute
    Diabetes insipidus (2.5 units/hr - 30 units/hr)
  5. Nursing considerations: not used alone initially but can be used alone once catecholamine agent weaned off; risk for Gi ischemia; is typically not titrated (on or off)
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8
Q

Angiotensin II/Giapreza

A
  1. Class: Vasopressor
  2. Use: Elevate BP
  3. Starting Dose: 20 ng/kg/min
  4. Max Dose: 80 ng/kg/min
  5. Nursing considerations: Monitor for thromboembolic events. Observe patients for signs and symptoms of thrombocytopenia
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9
Q

Dopamine/Inotropin

A
  1. Class: Vasopressor
  2. Use: hypotension with bradycardia
  3. Starting Dose: 5 mcg/kg/min
  4. Max Dose: 40 mcg/kg/min
  5. Nursing considerations: High risk for tachyarrhythmias; shown to lead to worse outcomes in cardiogenic shock.
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10
Q

Epinephrine

A
  1. Class: Vasopressors
  2. Use: Cardiogenic shock, anaphylactic shock; 2nd line agent for septic shock; salvage therapy
  3. Starting Dose: 1 mcg/min
  4. Max Dose: 30 mcg/min
  5. Nursing considerations: Least selective vasopressor; causes more Gi hypoperfusion compared to norepinephrine
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11
Q

Amiodarone/Cordarone

A
  1. Class: Antiarrhythmic
  2. Use: atrial and ventricular arrhythmias.
  3. Starting Dose: 1 mg/min x 6 hrs then 0.5 mg/min
  4. Max Dose: 1 mg/min
  5. Nursing considerations: long half life; generally minimal effects on hemodynamics
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12
Q

Diltiazem/ Cardizem

A
  1. Class: Antiarrhythmic
  2. Use: Atrial fibrillation
  3. Starting Dose: 5 mg/hr
  4. Max Dose: 15 mg/hr
  5. Nursing considerations: Contraindicated in acute decompensated heart failure.
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13
Q

Isoproterenol/Isoprenaline

A
  1. Class: Antiarrhythmic
  2. Use: Heart block (bridge for pacer)
  3. Starting Dose: 2 mcg/min
  4. Max Dose: 10 mcg/min
  5. Nursing considerations: Very Expensive
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14
Q

Brevibloc/ Esmolol

A
  1. Class: Antiarrhythmic
  2. Use: Tachyarrhythmias (usually SVT or Thyroid storm)
  3. Starting Dose: 50 mcg/kg/min
  4. Max Dose: 200 mcg/kg/min
  5. Nursing considerations: Quick onset/offset; commonly accompanied by high infusion rate
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15
Q

Milrinone/ Primacor

A
  1. Class: Intropes
  2. Use: Heart failure exacerbation or other myocardial dysfunction(sepsis, post CABG, ect.)
  3. Starting Dose: 0.375 mcg/kg/min
  4. Max Dose: 0.75 mcg/kg/min
  5. Nursing considerations: Can be used in patients receiving beta-blockers; more hypotension than dobutamine; should be adjusted for renal dysfunction; can cause thrombocytopenia, generally not titrated
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16
Q

Dobutamine/Dobutre

A
  1. Class: Intropes
  2. Use: heart failure exacerbation or other myocardial dysfunction(sepsis, post CABG, ect.)
  3. Starting Dose: 2.5 mcg/kg/min
  4. Max Dose: 20 mcg/kg/min
  5. Nursing considerations: Should NOT be used in patients receiving beta-blockers; may cause hypotension w/ sepsis pts, generally not titrated
17
Q

Labetolol

A
  1. Class: Vasodilator
  2. Use: Acute CVA; aortic dissection; pregnancy
  3. Starting Dose: 1 mg/min
  4. Max Dose: 6 mg/min
  5. Nursing considerations: Long half life - titrate slowly to avoid overdose use caution in patients with bronchospastic lung disease, contraindicated in acute HF
18
Q

Nitroglycerine

A
  1. Class: Vasodilators
  2. Use: Acute coronary syndromes; pulmonary edema
  3. Starting Dose: 5 mcg/min
  4. Max Dose: 200 mcg/min
  5. Nursing considerations: can cause headache - titrate slowly to decrease incidence; contraindicated with right ventricular failure.
19
Q

Nicardipine/ Cardene

A
  1. Class: Vasodilators
  2. Use: Acute CVA; hypertensive emergencies
  3. Starting Dose: 5 mg/hr
  4. Max Dose: 15 mg/hr
  5. Nursing considerations: rebound tachycardia; contraindicated in advanced aortic stenosis; commonly accompanied by high infusion rate; peripheral infusion site changed every 12 hours.
20
Q

Cisatracuruim/Nimbex

A
  1. Class: Paralytic agent
  2. Use:Typically used for ventilator dyssynchrony (especially in ARDS) or to facilitate short procedures
  3. Starting Dose: 3 mcg/kg/min
  4. Max Dose: 10 mcg/kg/min
  5. Nursing considerations: Ensure adequate ventilatory support, ensure adequate analgesia and sedation prior to use and do not wean analgesia/sedation while the patient is paralyzed.
21
Q

Ketamine

A
  1. Class: Analgesic AND sedative
  2. Use: Pain/ sedation, inability to tolerate traditional agents due to hypotension
  3. Starting Dose: (Nonintubated: 0.1 mg/kg/hr) Intubated: 0.5 mg/kg/hr
  4. Max Dose: Nonintubated: 0.5 mg/kg/hr to 2 mg/kg/hr Intubated: up to 4 mg/kg/hr
  5. Nursing considerations: Sympathomimetic effects (increase BP/HR) Psychotropic effects, respiratory depression with high doses, hypersalivation.
22
Q

Fentanyl

A
  1. Class: Analgesic
  2. Use: Rapid onset pain or Bronchospasm
  3. Starting Dose: 25 mcg/hr
  4. Max Dose: 200 mcg/hr
  5. Nursing considerations: Least hemodynamic effects; most respiratory depression.

ICU (1 decks)

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