PGY3 - Vasotropic/Inotropic Drugs Flashcards
Norepinephrine
2-20 mcg/min IV
0.02-2 mcg/kg/min IV
1st line for sepsis/vasodilartory shock
Epinephrine (Drip)
2-20 mcg/min
0.05-0.5 mcg/kg/min
A1, B1/2
Cardiogenic, Vasodilatory, ACLS
Dirty Epi Drip
10 mL of 1:10K in 1 L NS
–> 1 mcg/mL
Run at 2-10 mcg/min
Wide open in 18ga IV is ~30 mcg/min
Push Dose Epi
1 mL of 1:10K + 9 mL NS
–> 10 mcg/mL
Push 0.5-2 mL q2-5 minutes (5-20 mcg)
Vasopressin
0.01-0.04 units/min
V1, V2
Sepsis adjunct
Dopamine
2-20 mcg/kg/min (Low dose)
D1/2 at low dose, A1/B1 at high dose
Vasodilatory Shock, Cardiogenic Shock
Dobutamine
2-20 mcg/kg/min
B1 and 2
ADHF, Cargiogenic SHock, Vasodilatory Shock
Phenylephrine
0.02-2 mcg/kg/min
A1
Vasodilatory shock, obstructive shock
Milrinone
Load: 50 mcg/kg
Drip: 0.25-0.75 mcg/kg/min
PDE Inhibitor
ADHF
Hypertension Tx - Dissection
- First Line - Esmolol
- Second Line (BB Contraindication)
- Dilt First –> Decrease HR
- Nitroprusside Second –> Decrease BP
Goals
HR 60
SBP 100-140
Hypertension Tx - Pulmonary Edema
Nitroglycerin
Goal reduce by 20%
Hypertension Tx - ACS
Treat if SBP > 160, goal reduce by 20%
Nitroglycerin or Metoprolol
Hypertension Tx - Renal Failure/Enceph
Treat > 180/110, Reduce by 20%
Labetalol or Cardene
Hypertension Tx - Pre E
Treat if > 160/110
Labetalol or Hydralazine
Hypertension Tx - ICH
- Cardene or Esmolol or Labetalol
- Goals:
- No Inc ICP - SBP < 160, MAP < 130
- Inc ICP - MAP < 110
Hypertension Tx - CVA
- Cardene or Nitro or Labetalol
- Goals:
- tPA - < 180/110
- If no tPA - < 220/120
Diltiazem
- aka
- Dose
Cardizem
0.25 mg/kg bolus (usually 20mg), can repeat at 0.35 mg/kg
Drip at 10-15 mg/hr
Esmolol
500 mcg/kg IV
then 50-200 mcg/kg/min
Hydralazine
5-10mg q 20 min
Labetalol
0.25-1 mg/kg (10-20 mg)
Double q 10 min
Max 300 mg total
Drip = 1-2 mg/kg/hr
Nicardipine
5-15 mg/hr
Nitroglycerin
- SL = 0.4 mg x 3 doses
- Topical - 1-2 inches paste
- 20-80 mcg/min IV
Nitroprusside
0.25-10 mcg/kg/min
