Dopamine (Intropin)

Class:Sympathomimetic

Mechanism of Action: precourser to norepi, increases vascular resistance

Indications: Cardiogenic, septic or spinal shock, hypotension w/ low cardiac output

Contraindications: hypovolemic shock, v-fib, tachyarrhythmias

Side Effects: cardiac arrhythmias, hypertension, increased myocardial O2 demand

How Supplied: 200mg/5mL or 400mg/5mL prefilled syringe or 400mg in 250mL D5W for IV

Dosage: Adult and Ped 2-20mcg/kg/min titrate to response 

Duration of Action: Onset 1-4 min, Peak 5-10 min Duration effects cease immediatly after infusion shut off

Special Considerations: Effects dose dependant,  2-4mcg/kg/min dialate vessels in kidneys 4-10mcg/kg/min +chrono and inotropic response 10-20mcg/kg/min alpha stimulant vasoconstrict

Furosemide (Lasix)

Class: Loop diuretic

Mechanism of Action:  inhibits electrolyte reabsorption promotes excretion of potassium sodium and chloride

Indications: CHF, pulmonary edema, hypertensive crisis

Contraindications: hypovolemia, hypertension, hypersensitivity, hepatic coma

Side Effects: hypokalemia, ECG changes, hyperglycemia

How Supplied: 100mg/5mL, 20mg/2mL, 40mg/4mL vials

Dosage: Adult 0.5-1mg/kg injrcted IV over 1-2 min if no response, 2mg/kg Ped 1mg/kg IV/IO MAX 80mg

Duration: onset 5min, Peak 20-60min, Duration 4-6 hr

Special Considerfations: Preg C Ototoxicity and deafness with rapid admin. protect from light

Morphine Sulfate (Astramorph/PF)

Class: Opioid Analgesic (schedule II narcotic)

Mechanism of Action:Alievates pain thru CNS action, supresses fear and anxiety,

Indications: severe CHF, pulmonary edema, chest pain asssociated with acute MI,moderate to severe acute and chronic pain

Contraindications:head injury, exacerbated COPD, hypotension, depressed respiratory dec LOC

Side Effects: respiratory depression, hypotension, decreased LOC, nausea, vomiting bradycardia, tachycardia, syncope,bronchospasms

How Supplied: 10mg/mL of solution ampules and tubex syringes

Dosage: Adult initial dose 2-4mg IV (over 1-5min) every 5-30 min repeat dose 2-8mg 5-15min intervals Peds 0.1-0.2mg/kg per dose IV/IO IM, SC Max dose 5mg

Duration of Action: Onset immediate, Peak 20min, Duration 2-7 hr

Special Considerations: use caution with geriatric, asthma, COPD, Naloxone should be readily available as antidode

Metoprolol (Lopressor)

Class: Beta blocker

Mechanism of Action: reduced heart rate and cardiac output, lowers BP slows sinus rate

Indications: v-fib and other complications in pts with recent MI

Contraindications: BP <100, sinus bradycardia (<45), asthma, COPD

Side Effects: Dizziness, bradycardia, palpitations, cold extremeties, nausea, heartburn, diarrhea

How Supplied: 5mg/5mL ampule

Dosage: 5mg slow IV every 5min up to 3 times(15mg max) peds not used

Duration of Action: Onset immediate, Peak 20 min, Duration, 13-19 hr half-life 3-4 hr

Special Considerations: protect from heat light and moisture,monitor HR and BP

Calcium Chloride

Class: Electrolyte

Mechanism of Action: increase cardiac contractile state (posative inotropic effect)

Indications: hypocalcemia, hyperkalemia, magnesium sulfate OD, calcium channel blocker OD

Contraindications: Hypercalcemia, V-fib, digitalis toxicity

Side Effects: bradycardia, asystole, hypotension. vasodialation, nausea, vomiting

How Supplied: prefilled syringes containing 10% solution in 10 ML (100mg/mL)

Dosage: Adult 500-1000mg IV/IO push Peds 20mg/kg slow IV/IO push max 1g dose

Duration of Action: Onset 5-15min Peak 3-5min Duration 15-30 min (up to 4hr dose dependant)

Special Considerations: Preg C, do not use routinely in cardiac arrest.