Term
| Norepinephrine (Levophed) |
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Definition
Alpha-1 agonist
Classification: Vasopressor (both arterial & venous)
2-ICU Purpose: Increase BP
Concentration: 4mg/250ml or MAX 16mg/250ml
Dosage/Titration: Start 0.02-0.03 mcg/kg/min, Titrate ↑ or ↓ q1 by 0.01-.03 – CVICU MAX: 0.3 (Hospital MAX: 3)
Notes: Need to protect from light. Will ↑ SVR (afterload) also b/c it stimulates alpha (more) & beta (less) receptors also has some contractility properties. Half life: 1 minute |
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Term
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Definition
Synthetic ADH
Classification: Powerful Vasopressor
Purpose: Hypotension not responsive to Levo. Septic Shock, GI Bleed.
Concentration: 100 units/ 100ml
Dosage/Titration: Range for dose is 0.02- 0.04 units/min
Notes: May give 40 units IVP X 1 in V-fib or PEA during CPR.
Half life: 10-20 minutes |
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Term
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Definition
Classification:
Antihypertensive)
Purpose:
Short term treatment of Hypertension (especially post op).
Concentration: 20mg/200ml or 40mg/200ml or MAX 125mg/250ml
Dosage/Titration: Start 2.5-5mg/hr, Titrate ↑or↓ by 2.5 or 5 to a MAX of 15mg/hr.
Notes: Will ↓ SVR. Halflife: 2 min. Only 20/200 can be run through peripheral IV. |
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Term
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Definition
Arterial Vasodilator
Classification: Potent Vasodilator (affects more arterial than venous vessels)
2-ICU Purpose: Decrease BP and SVR
Concentration: 50mg/250ml or 100mg/250ml
Dosage/Titration: Start 0.2-0.5 mcg/kg/min, Titrate ↑or↓ by 0.5 – MAX 10 mcg
Notes: Need to protect from Light. Will ↓ CVP & ↓ SVR (afterload); Not for long term use 2/2 cyanide toxicity. Halflife: 2 min |
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Term
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Definition
Venous Vasodilator
Classification: Vasodilator (affects coronary arteries & venous vessels only)
2-ICU Purpose: Decrease BP and preload
Concentration: 50mg/250ml
Dosage/Titration: Start at 5 ml/hr, Titrate ↑or↓ by 5ml/hr. MAX is 50 ml/hr
Notes: Will ↓ CVP and ↓ MAP (b/c venopooling). On postop CABG with radial graft NTG is used to prevent arterial spasms. CAREFUL with Valve patients. Half life: 2 min |
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Term
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Definition
(Cordarone)
Classification: Antiarrhythmic- Class III
2-ICU Purpose: To treat Atrial & Ventricular Tachyarrhythmias(A-fib/VTach)
Concentration:
Bolus: 150mg/100ml D5W infused over 10 minutes.
Drip: 450mg/250ml . Max 900mg/250ml
Dosage/Titration: Maintenance dose is 1mg/min X 6 hrs, then 0.5mg/min.
Notes: Will ↓ HR & BP. Need to use a filter when infusing. Increases QT interval, have pacer at bedside!
Half life: 58 days. Use central line only. |
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Term
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Definition
Alpha-1 & Beta-1 & 2 agonist
Classification:
+ Inotrope (small doses), Vasopressor (high doses)
Purpose:
Increase Contractility and Cardiac Index.
Concentration:
4mg/250 ml or MAX 16mg/250ml
Dosage/Titration:
Start 0.02-0.03 mcg/kg/min, Titrate ↑or↓ by 0.01. MAX is .1
Notes:
Will cause ↑ HR, ↑ BP, ↑ CO, ↑ SVR, ↑ myocardial oxygen consumption, ↑ DFS & ↑ lactate . Half life: 2 minutes |
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Term
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Definition
Beta-1 agonist
Classification: + Inotrope
2-ICU Purpose: Increase Contractility and Cardiac Index. Used post-CPB for myocardial stunning.
Concentration: 250mg/250ml or 1000mg/250ml
Dosage/Titration: Start at 2.5-5 mcg/kg/min. MAX is 15.
Notes: Will ↑↑ HR. Also has mild vasodilator effect (so will ↓ SVR slightly), but does not affect BP. Half life: 2 minutes |
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Term
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Definition
PDI (phosphodiesterase 3 inhibitor) - pulmonary vasodilator
Classification: + Inotrope
2-ICU Purpose: Increase Contractility and Cardiac Index.
Concentration: 20mg/100ml or 40mg/100ml
Dosage/Titration: Start 0.375mcg/kg/min. MAX dose is 0.75mcg/kg/min.
Notes: Has vasodilator effect (so will ↓↓ SVR and BP) but doesn’t affect HR. Used to treat CHF exacerbations, pulmonary edema and bridge to transplant.
Half-life: 2-3 hours… wean slowly! |
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Term
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Definition
Classification: Sedative (general anesthetic)
Purpose: Sedation for Mechanical Ventilation
Concentration: 1000mg/100ml
Dosage/Titration: Start 10 mcg/kg/min, Titrate ↓or↑ by 10 to a MAX of 50mcg.
Notes: Will ↓ BP. Not an analgesic-no pain relief! Half life 2 minutes. |
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Term
| Dexmedetomidine (Precedex) |
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Definition
Classification: Sedative (analgesic)
Purpose: Post-op extubation, bridge off propofol, potentiates narcotics.
Concentration: 400mcg/100ml
Dosage/Titration: Start 0.2 mcg/kg/hr, Titrate ↑or↓ by 0.1 to a MAX of 0.7
Notes: Will ↓BP and HR. Potentiates the effects of Morphine.
Therapeutic half life: 6 minutes. |
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Term
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Definition
Classification: Narcotic opioid analgesic
Purpose: Pain control. IVP when extubated, gtt for intubated patients
Concentration: 2,500mcg/250ml or 5,000mcg/100ml
Dosage/Titration: Gtt: Start at 50 mcg /hr. Titrate ↑or↓ by 25-50 to a MAX of 300 mcg/hr. IVP: 25-100mcg q1-2 for pain
Notes: Onset is immediate, Duration: 30-60 minutes. Will ↓HR and BP
Often used in conjunction with versed for pain mgmt and sedation of mechanically vented patients. |
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Term
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Definition
Classification: Benzodiazepine Sedative (general anesthetic), anxiolytic
Purpose: Sedation for Mechanical Ventilation
Concentration: 100mg/100ml
Dosage/Titration: Start 1 mg/hr, Titrate ↓or↑ by 1 to a MAX of 10mg/hr.
Notes: Will ↓ BP. Used as gtt in ICU. May be given IVP for intubation or induction of anesthesia. Has amnesic properties
Half life: 1-4 hours |
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