Vasodilators Flashcards
Nipride MOA
Decreases Preload, Afterload and Peripheral vascular resistance by metabolism to Nitric Oxide
Nipride Dose
Starting Dose: 0.5 mcg/kg/min
Rarely exceeds 3 mcg /kg/min
Max 10 mcg/kg/min for no more then 10-15 min
Nipride
May Increase Dead Space R/T decrease pulmonary artery pressure
Nipride
Mixed in D5
Protected from light R/T decomposition
Always use a pump and have an A line
Nipride Duration
1-3 min after drug termination
Nipride Uses
Emergent BP control
Hypotensive techniques
Treatment of pulmonary edema
Nipride Onset
Seconds
Nipride can cause??
Cyanide Toxicity: Tachyphylaxis
Methemoglobinemia
Increased ICP
Metabolic Acidosis
Cyanide Toxicity Treatment?
3% Sodium Nitrate– 5 mg/kg over 5 min
Methylene Blue 1-2 mg/kg of 1% solution over 5 min (SPO2 will not work while administering)
Sodium Thiosulfate 150 mg/ kg over 15 min
Nitroglycerine use to treat?
Angina, HTN, MI ischemia,
Nitroglycerine MOA?
Relaxes vascular smooth muscle with venous pooling
Nitroglycerine metabolized to?
NO (Nitric Oxide) a potent vasodilator
Nitroglycerine cardiac effects
Decreases Preload
Decreases L end-diastolic pressure
Decreases myocardial O2 demand
Increases endocardial perfusion
Nitroglycerine other effects
Relaxes bronchial smooth muscle, uterine relaxation, and relaxation of the sphincter of oddi
Nitroglycerine special concerns
Glass bottle, special tubing and can cause headaches.
Not as potent as Nipride
Nitroglycerine Dose
0.5-10 mcg/kg/min
Small boluses of 50 mcg if BP is high
SL dose 0.4 mg peaks in 4 min
Hydralazine MOA
Actually unknown it may work on Nitric Oxide or K+ Channels causing arterial smooth muscle relaxation
Hydralazine Side Effects
Tachycardia (good choice for hypertensive bradycardic Pts
Hydralazine Dose
5-20 mg
Hydralazine Onset
up to 15 min
Hydralazine Duration
2-4 hours
Hydralazine
Used in Pregnancy Induce HTN
Mixing Hydralazine
20 mg per cc. mix with 3 cc NS in a 5 cc syringe. Each cc = 5 mg
Adenosine
Potent vasodilator effecting the afterload
Adenosine
Used for controlled hypotension at a dose of 60-120 mcg/kg/min
Adenosine is approved by the FDA for_____ only
SVT
Adenosine SVT dosing
1st dose 6mg
2nd Dose 12 mg
NO 3rd dose anymore
Adenosine can cause
Coronary steal in CAD
Adenosine is competitively antagonized by?
Aminophylline
Choosing an Antihypertensive consider
Preload Afterload Contractility HR Heart Rhythm BP ( specifically MAP)
