Sedation/Analgesics
This medication is known to be a Hypnotic that has no analgesic effects and can cause mortality with continuous infusion
Etomidate
This medication is given to individuals who have unstable angina, Left sided MIs, and HTN crisis. Could be given via SL, patch, or spray.
SE include: Hypotension, tachycardia, HA, and tachyphylaxis
Nitroglycerin
This medication is used for cardiovascular collapse and anaphylaxis.
Adverse effects include: HTN, tachycardia, tremors, tissue ischemia due to IV infiltration, acidosis, dysrhythmias/arrhythmias
Epinephrine
Reversal agent of Fentanyl and other opioids
Naloxone
Reverses sedation, paradoxical agitation, return of respiratory depression, cessation of amnesia. Known to cause seizures but works as an excellent reversal agent for benzodiazepines.
Flumazenil
Adverse effects of this medication include: Decrease Respiratory drive, apnea, histamine release (hypotension, bradycardia, bronchospasm), and chest wall/glottal rigidity
Fentanyl
This catecholamine is first line therapy for hemodynamic support in sepsis. Increases vascular tone in about 2 minutes. Known to cause tissue ischemia/necrosis if used at high doses (adverse effect is hypoperfusion to microvasculature). Central IV access is preferred.
Norepinephrine
This medication speeds up the conduction from the SA to the AV node and helps symptomatic bradycardia.
Adverse effects include: Arrhythmias, tachycardia, dilated pupils, and anticholinergic effects
Atropine
Excessive salivation is a known side effect of Ketamine and can be treated with _______.
HINT: It is a very strong Anticholinergic
Atropine
You should be cautious when using this medication with the elderly as they may not be able to metabolize as fast but also might hold on to the opioid in their tissue potentially causing a significant effect on the respiratory drive once it is released from the adipose tissue.
Fentanyl
This long acting barbiturate is used for agitation/seizure management and sedation.
Phenobarbital
This medication has Alpha adrenergic agonist effects and no Beta adrenergic effects. It is used for Hypotension, shock, and nasal congestion.
Adverse effects: HTN, reflex bradycardia (caused by abrupt cessation or going up on the rate too quickly)
Phenylephrine
This medication slows conduction through the AV node and slows down HR from the SA to the AV node (Negative inotrope and chronotrope). What is its onset? half-life? Adverse effects?
HINT: It is the only drug outside a code situation that should be given rapidly through an IV
Adenosine
Onset is immediate, half-life is 5-7 seconds
transient arrhythmia, chest pain, diaphoresis, N/V, feeling horrible! Causes heart to go into Asystole (STOPS HR)
This selective PDE3 inhibitor treats CHF by increasing cardiac contractility
Milrinone
This medication is used for hypotension, shock, and impaired renal perfusion. What are the 3 different types of doses and what happens during each one?
Dopamine
Low dose (1-5): improves renal/mesenteric perfusion
Intermediate dose (5-10): positive chronotrope and vasoconstriction
High dose (>10): More vasoconstriction
This medication is a Benzodiazepine. It provides sedation, amnesia, anxiolytic, and anticonvulsant properties but NOT pain control.
Versed (Midazolam)
This vasodilator is known to be more efficient in lowering the BP, in contrast can cause hypotension more quickly than Nitroglycerin. Can produce cyanide, cause coronary steal, CNS dysfunctions, seizures, and AMS.
HINT: Keep away from the sun as it can cause potential cyanide buildup in the body
Nitroprusside
This medication is a positive inotrope, used in HF, and known to cause ventricular arrhythmia and dysrhythmias, could increase UOP secondary to improved CO.
HINT: It is a synthetic catecholamine
Dobutamine
This medication causes hypotension, loss of protective reflexes-high risk for aspiration, and will stop ability to breathe so have advanced airway ready! It also has a short half-life so no reversal agent is needed.
HINT: Josy was given this before her transesophageal echocardiography (TEE). It is given for intubation in the ICU/ER :)
Propofol
This medication blocks acetylcholine from binding receptors on motor endplate inhibiting depolarization. This is used as continuous infusion for someone who needs to be paralyzed on a ventilator.
Name some adverse effects:
Caution with which population:
What is the reversal agent for paralytic agents:
Vecuronium
Histamine release (Bradycardia, hypotension, bronchospasm)
Myasthenia Gravis
Neostigmine (prostigmin)
This medication is used for sedation, amnesia, and analgesia. Known to not cause cardiovascular compromise (No effect on HR or BP or RR)
Ketamine
This calcium channel blocker is known to relax smooth muscle of arteries and cause smooth muscle dilation. Adverse effects include HA, bradycardia, dysrhythmias, ischemia, and infiltration (tissue ischemia, and very painful phlebitis)- Central IV access is preferred
This is the Depolarizing neuromuscular blocker that makes the body use all the acetylcholine and then relaxes.
Name the adverse effects:
Bradycardia, hypotension, arrhythmias, Hyperkalemia, fasciculations, and malignant hyperthermia
This medication is known to act on the kidneys to stimulate the reabsorption of water from the collecting ducts back into the bloodstream. Used for hypotension, sepsis, and diabetes insipidus.
What is its drug class?
HINT: This is a maintained ordered dose, DO NOT titrate this medication!
Vasopressin (ADH)
This Alpha 2 agonist is used for both analgesia and sedation, has no impact on respiratory drive, and can also be used for ETOH withdrawals!
HINT: This medication also has a synergistic effect with narcotics and benzodiazepines
Dexmedetomidine