Dobutrex

2-20 mcg/kg/min IV

-vasopressor used for decreased CO and heart failure

MOA =β-1 agonist

-↑ contractility and SV  → ↑ CO

- decreases systemic vascular resistance (Afterload) 

-decreases ventricular pressure (Preload)

DI

-beta blockers 

-atomoxetine

ADR

-premature ventricular contractions

-Angina

-dyspnea

-nervousness

-HTN

Adrenaline

Caridac Dosing:

1 mg IV 

MR q3-5 min

Anaphylaxis:

0.3-0.5 mg SC or IM

MR q10-15 min

-catecholemine used as a cardiac stimulant

(as a bronchodilator for anaphylactic shock)

MOA = potent non-selective α and β adrenergic agonist

α stimulation = arteriolar vasocontriction

β1 stimulation = induces + chronotropic and inotropic response

β2  stimulation = arteriolar vasodilation, bronchial smooth muscle relaxation, and increased glycogenolysis 

chronotropic - heart rate

inotropic - muscle contractility

DI

-MAOIs 

-α/β blockers or agonists

-atomoxetine

ADR

-nervousness

-excitability

-n/v

-diaphoresis

-cardiac arrythmias

Levophed

2-4 mcg/min IV

-vasporessor used for tx of acute hypotension and septic shock

MOA= acts mostly on α adrenergic receptors

-causing vasoconstriction and ↑ BP and coronary artery blood flow

DI

-MAOIs

-alpha/beta blockers or agonists

-atomoxetine

ADR

-nervousness

-excitability

-n/v

-diaphoresis

-cardiac arrythmias

Neo-Synephrine

0.5 mg - 1 mg IV

-vasopressor used in tx of paroxysmal supraventricular tachycardia

MOA = potent vasoconstrictor - α adrenergic agonist

-leads to ↓ HR

DI

-MAOIs

-bromocriptine

-alpha/beta blockers

ADR

-HTN

-Angina

-reflux sinus bradycardia

-increased risk for heart failure

Activase

15 mg IV bolus

followed by 0.75 mg/kg IV infused over 30 min

then 0.5 g/kg IV over next 60 min 

-thrombolytic agent used in acute MI and acute ischemic stroke

MOA = plasminogen activator that cleaves Arg-Val bone plasminogen

-results in formation of plasmin (enzyme responsible for clot dissolution)

-requires fibrin as a cofactor for activation of plasminogen 

DI

-NSAIDs

-anticoagulants 

-cephalosporins

-nitroglycerin

ADR

-bleeding

-arrythmias

-angiodema

Cordarone

150 mg rapid IV for first 10 min

then slow IV infusion of 1 mg/min for next 6 hrs

then 0.5 mg/min for the next 18 hrs

-class III antiarrhythmic - used for tx of life threatening ventricular arrhythmias

MOA = acts directly on the myocardium to

-delay repolarizaton

-↑ AP duration

-IV no longer than 3 weeks (not for maintenance)

DI

-inhibits 1A2, 2C9, 2D6, and P-glycoprotein

ADR

-pulmonary reactions

-GI disturbances

-rare fatal hepatotoxicity

-hematological effects

Bumex

0.5-1 mg IV or IM

MDD = 10 mg/day

-diuretic - used for management of edema associated with CHF, cirrhosis, and renal disease

-MOA = loop diuretic

-inhibits reabsorbtion of Na and Cl in ascending loop of henle

-DI

-glucocorticoids

-lithium

-salicylates

ADR

-muscle cramps

-hypotension

-hypokalemia

-hyponatremia

-rare renal failure

Lovenox

1 mg/kg SC q12h 

or

1.5 mg/kg SC q24h

for a min of 5 days

- low MW heparin - used in prophylaxis and tx of deep vein thrombosis (DVT) and tx of STEMI

-MOA = binds and accelerates activity of antithrombin III

-therefore inhibits coagulation factor Xa and factor IIa (thrombin)

-ultimately preventing the formation of fibrin clots

DI

-antigcoagulants

-cephalosporins

-NSAIDs

-protamine

ADR

-bleeding

-anemia

-fever

-peripheral edea

80 IU/kg IV bolu

then maintenance: 18 IU/kg/hour IV continuous infusion for min of 5 days

-adjust dose based on aPTT

-anticoagulant used to treat and prevent blood clots

MOA = accelerates activity of antithrombin III to inactivate factor IIa (thrombin)

-however, heparin does not lyse existing lots and can't inactivate fibrin-bound thrombin

DI

-anticoagulants

-cephalosporins

-NSAIDs

-protamine

ADR

-bleeding

-thrombocytopenia

-hyperkalemia

-osteoperosis (long term use)

Brevibloc

loading dose: 500 mcg/kg IV over 1 min

maintenance: 50-200 mcg/kg/min IV

class II antiarrhythmic and cardioselective Beta-1 blocker used in the treatment of HTN and supraventricular arrhythmias

MOA = blocks sympathetic stimulation medicated by Beta-1 receptors in the heart and vascular smooth muscle

-effects are limited to the myocardium

DI

-digoxin

-diltiazem

-verapamil

ADR

-hypotension

-sinus bradycardia

-AV block

Primacor

0.375- 0.5 mcg/kg/min IV infusion

MDD = 1.13 mg/kg

-alnotropic/vasodilator agent used in tx of CHF

MOA = inhibits cAMP PDE in cardiac and vascular muscle

-improves diastolic function and myocardial contractility

no DI

ADR

-hypotension

-ventricular arrythmias

-torsades de pointes (rare)

AquaMephyton

2-25 mg IM or SC

-MR PRN - depending on pt response/severity

-synthetic compound that is chemically the same as natural vitamin K

-indicated for tx or prevention of hypoprothrombinemia due to vitamin K deficiency or oral anticoagulant therapy

MOA = promotes liver synthesis of lotting factors II, VII, IX, and X

DI

-warfarin and any other anticoagulant

ADR

-hypersensitivity rxns

-injection site rxn