Indications
Drug of choice: Hypovolemic Shock
Dopamine
Class III Anti-Arhythmic Prototype
Amiodarone: Potassium-channel Blocker Prototype
This drug, used in renal failure, must be pushed slowly to avoid ototoxicity
Furosemide: loop diuretic
Activation of this adenergic receptor results in a vasopressor effect
Alpha1 Receptors
Beta2 Receptor activation causes…
Bronchodilation and vasodilation
Drug of choice: Cardiogenic Shock
Dobutamine
This drug, indicated for supraventricular tachycardia, must be pushed in less than 10 seconds
Adenosine
Black Box Warning: Amiodrone
Fatal Pulmonary Toxicity: diminished breath sounds, crackles, and pain on inspiration are all warning signs
This adrenergic increases the analgesia effect of local anesthetics
Epinepherine
Indication for Vasopressors
Hypotension
Drug of choice: Sepsis
Norepinepherine
Atrial fibrillation is most commonly treated with one of these two drugs
Digoxin, a cardiac glycoside
Cardizem, a calcium-channel blocker
Digoxin is contraindicated in these dysrhythmias
V-tach + V-fib
Patients with diabetes mellitus undergoing adrenergic therapy should anticipate this potential adverse reaction
Hyperglycemia
This diuretic is incompatible with renal impairment
Thiazide diuretics: hydrochlorothiazide
Drug of choice: V-tach, V-fib
Amiodarone
Therapeutic Range of the prototype Class 1A Sodium Blocker
Quinidine’s therapeutic range is 2-5 mcg/mL. Toxicity is seen at >8 mcg/mL
These anti-arrhythmics have a lack box warning against abrupt discontinuation, and are also discouraged in conjunction with asthma, COPD, and sinus bradycardia.
Beta-blockers
Adverse Effects of Norepinepherine
HTN, Hypokalemia, dysrhythmias (including reflex bradycardia), and EXTRAVASATION.
Must be pushed via a large vein or central line
Vasodilator: for MI, stable angina, HTN w/ FVO. Cannot be administered in the presence of tachycardia or other vasodilators
Nitroglycerin
Drug of choice: Asystole
Epinepherine (also, atropine)
Blue-grey skin is a known adverse effect after drug therapy with this dysrhythmic drug
Amiodarone
A 62yo heart failure patient with managed a-fib is presenting as nauseous, diaphoretic, and refusing to eat. His output is diminished, with edema +3 bilaterally. He complains of dizziness, fatigue, and green-tinged visual halos. What is the priority assessment for the nurse?
Assess for digoxin toxicity: Digoxin is indicated in the mgmt of both HF and a-fib. Therapeutic range of Digoxin is 0.8-2.0 ng/mL, but is narrower in HF: 0.5-0.8 ng/mL. Digoxin toxicity can occur at any level, especially in older patients with impaired excretion.
This drug class is not recommended in conjunction with adrenergics (including those in OTC cold medicine), due to the risk of hypertensive crisis.
MAO Inhibitors
Peripheral edema is a common adverse effect of this anti-hypertensive and anti-dysrhythmic drug class
Calcium channel blockers