Dobutamine- Chronotropic - Answers Used to treat cardiogenic shock
Cardiac output, preload, and contractility
Venous vasodilator
Inotropic medication
Use when systolic is 70-100
Dopamine- Chronotropic - Answers Used to treat shock
Vasoconstrictor
Cardiac output, afterload, and contractility
Inotropic medication
Use when systolic is <70 and with signs of shock, bradycardia, hypotension
Dose: 2-20 mcg/kg/min infusion
titrated based on clinical response; tapered on/off slowly
,Cautions: extravastion causes tissue damage and necrosis, use caution if giving high doses through IV,
may cause excessive vasoconstriction or tachyarrhythmias, adequate volume resuscitation required
before administration
Epinephrine- Vasoconstrictor - Answers Used to treat shock
Distributive shock
Afterload
Use in cardiac arrest, symptomatic bradycardia, anaphylaxis, severe allergic reactions, severe
hypotension, pulseless v-tach, v-fib
Dose: 1mg, repeat every 3-5 min., IV fluid flush after each dose
Caution: higher doses often needed in overdoses of beta blockers or calcium channel blockers,
continuous infusion may be required. high dose DOES NOT improve survival/neurological outcome, high
dose ceases myocardial dysfunction in post resuscitation period
Norepinephrine- Vasoconstrictor - Answers Used to treat shock
Distributive shock
Afterload and contractility
Inotropic medication
Use for severe cardiogenic shock
Adenosine - Answers Slows conduction in AV node and interrupts AV nodual reentry circuits.
,Use: supreventricular dysrhythmias
rapid IV bolus followed by flush
Side effects: headache, dizziness, facial flushing, dyspnea, bronchospasm, chest pain, may cause asystole
up to 15 sec.
Phenylephrine- Vasoconstrictor - Answers Used to treat shock
Distributive shock
Afterload
Use when BP increases in pt. with septic shock
Vasopressin- Vasoconstrictor - Answers Used to treat shock
Distributive shock
Afterload
Use in vasodilatory shock
Nitroglycerin - Answers Vasodilation
Use for chest pain or MI
Nitroprusside - Answers Reduces afterload
, Use in hypertensive crisis, HF, and acute pulmonary edema
Lidocaine- Antiarrhythmic - Answers Used to treat shock
Cardiac output
Use: v-tach and v-fib
Dose: cardiac arrest from v-tach 1-1.5 mg/kg, Maintenance infusion 1-4 mg/min
Caution: NOT recommended after cardiac arrest
Amiodarone- Antiarrhythmic - Answers Used to treat shock
Cardiac output
Use: pulseless v-tach, v-fib, recurrent hemodynamically unstable v-tach, hypertrophic cardiomyopathy,
supraventricular tachyarrhythmias
Dose: v-tach/v-fib 300mg, may give 150mg after initial dose, tachy/v-tach 150mg over 10min,
continuous infusion of 1mg/min for 6 hours, 0.5mg/min for next 18 hours
Caution: a-fib, hypertrophic cardiomyopathy and supraventricular arrhythmias often treated with oral
form, rapid infusion causes hypotension
IV Fluid to Treat Hypovolemic Shock - Answers 0.9% Normal Saline (NS) and Lactated Ringers (LR)
Anaphylactic Shock - Answers Bronchocontriction
Decrease BP AND O2
Increase HR and RR
Swelling/edema