CVICU required drugs Exam Questions with
Correct Answers
ADMINISTER: Continuous: • Infusion rate is based on body weight.• Infusion rate and
guidelines for adjusting rate relative changes in blood pressure are prescribed by physician.•
Microdrip and other reliable metering device should be used for accuracy of flow rate.
INCOMPATIBILITIES Solution/additive: Sodium bicarbonate, aminophylline, amphotericin B,
ampicillin, cephalothin, penicillin G. Y-site: Acyclovir, aminophylline, amphotericin B, sodium
bicarbonate.
Correct hypovolemia, if possible, with either whole blood or plasma before initiation of
dopamine therapy.
Monitor infusion continuously for free flow, and take care to avoid extravasation, which can
result in tissue sloughing and gangrene. Use a large ve
Fentanyl-CNS agent, analgesic, narcotic (opiate) agonist
(Sublimazine) Actions-is quicker but short
,Synthetic, potent narcotic agonist analgesic with pharmacologic actions qualitatively similar to
those of morphine and meperidine, but action is more prompt and less prolonged. Principal
actions: analgesia and sedation. Drug-induced alterations in respiratory rate and alveolar
ventilation may persist beyond the analgesic effect. Emetic effect is less than with either
morphine or meperidine.
Therapeutic Effects
Provides analgesia and sedation.
Uses
Short-acting analgesic during operative and perioperative periods, as a narcotic analgesic
supplement in general and regional anesthesia, and with droperidol or with diazepam to produce
neuroleptoanalgesia. Also given with oxygen and a skeletal muscle relaxant
(neuroleptoanesthesia) to selected high-risk patients (e.g., those undergoing open heart surgery)
when attenuation of the response to surgical stress without use of additional anesthesia agents is
important.
Contraindications
Route & Dosage
Premedication
,Adult: IM 50-100 mcg 30-60 min before surgery PO Suck on 400-mcg lozenge until sedated
Adjunct for Regional Anesthesia
Adult: IM 50-100 mcg IV 2-20 mcg/kg over 1-2 min up to 50 mcg/kg
General Anesthesia
Adult: IV up to 150 mcg/kg as required
Postoperative Pain
Adult: IM 50-100 mcg q1-2h prn
Child: IM 1.7-3.3 mcg/kg q1-2h prn
Chronic Pain
Adult: Transdermal Individualize and regularly reassess doses of transdermal fentanyl; for
patient not already receiving an opioid, the initial dose is 25 mcg/h patch q3d; for patients
already on opioids, see package insert for conversions Stick lozenge (Actiq) Place in mouth
between cheek and lower gum and suck on lozenge; should be consumed over 15-min period
Administration
Intravascular
, PREPARE: Direct: Give parenteral doses undiluted or diluted in 5 mL sterile water or NS.
ADMINISTER: Direct:
Metoprolol-ANS agent, beta-adrenergic antagonist (Sympatholytic) antihypertensize
Actions
Beta-adrenergic blocking agent with preferential effect on beta1 adrenoreceptors located
primarily on cardiac muscle. At higher doses, metoprolol also inhibits beta2 receptors located
chiefly on bronchial and vascular musculature. Antihypertensive action may be due to
competitive antagonism of catecholamines at cardiac adrenergic neuron sites, drug-induced
reduction of sympathetic outflow to the periphery, and to suppression of renin activity.
Therapeutic Effects
Reduces heart rate and cardiac output at rest and during exercise; lowers both supine and
standing BP, slows sinus rate and decreases myocardial automaticity. Antianginal effect is like
that of propranolol.
Uses
Correct Answers
ADMINISTER: Continuous: • Infusion rate is based on body weight.• Infusion rate and
guidelines for adjusting rate relative changes in blood pressure are prescribed by physician.•
Microdrip and other reliable metering device should be used for accuracy of flow rate.
INCOMPATIBILITIES Solution/additive: Sodium bicarbonate, aminophylline, amphotericin B,
ampicillin, cephalothin, penicillin G. Y-site: Acyclovir, aminophylline, amphotericin B, sodium
bicarbonate.
Correct hypovolemia, if possible, with either whole blood or plasma before initiation of
dopamine therapy.
Monitor infusion continuously for free flow, and take care to avoid extravasation, which can
result in tissue sloughing and gangrene. Use a large ve
Fentanyl-CNS agent, analgesic, narcotic (opiate) agonist
(Sublimazine) Actions-is quicker but short
,Synthetic, potent narcotic agonist analgesic with pharmacologic actions qualitatively similar to
those of morphine and meperidine, but action is more prompt and less prolonged. Principal
actions: analgesia and sedation. Drug-induced alterations in respiratory rate and alveolar
ventilation may persist beyond the analgesic effect. Emetic effect is less than with either
morphine or meperidine.
Therapeutic Effects
Provides analgesia and sedation.
Uses
Short-acting analgesic during operative and perioperative periods, as a narcotic analgesic
supplement in general and regional anesthesia, and with droperidol or with diazepam to produce
neuroleptoanalgesia. Also given with oxygen and a skeletal muscle relaxant
(neuroleptoanesthesia) to selected high-risk patients (e.g., those undergoing open heart surgery)
when attenuation of the response to surgical stress without use of additional anesthesia agents is
important.
Contraindications
Route & Dosage
Premedication
,Adult: IM 50-100 mcg 30-60 min before surgery PO Suck on 400-mcg lozenge until sedated
Adjunct for Regional Anesthesia
Adult: IM 50-100 mcg IV 2-20 mcg/kg over 1-2 min up to 50 mcg/kg
General Anesthesia
Adult: IV up to 150 mcg/kg as required
Postoperative Pain
Adult: IM 50-100 mcg q1-2h prn
Child: IM 1.7-3.3 mcg/kg q1-2h prn
Chronic Pain
Adult: Transdermal Individualize and regularly reassess doses of transdermal fentanyl; for
patient not already receiving an opioid, the initial dose is 25 mcg/h patch q3d; for patients
already on opioids, see package insert for conversions Stick lozenge (Actiq) Place in mouth
between cheek and lower gum and suck on lozenge; should be consumed over 15-min period
Administration
Intravascular
, PREPARE: Direct: Give parenteral doses undiluted or diluted in 5 mL sterile water or NS.
ADMINISTER: Direct:
Metoprolol-ANS agent, beta-adrenergic antagonist (Sympatholytic) antihypertensize
Actions
Beta-adrenergic blocking agent with preferential effect on beta1 adrenoreceptors located
primarily on cardiac muscle. At higher doses, metoprolol also inhibits beta2 receptors located
chiefly on bronchial and vascular musculature. Antihypertensive action may be due to
competitive antagonism of catecholamines at cardiac adrenergic neuron sites, drug-induced
reduction of sympathetic outflow to the periphery, and to suppression of renin activity.
Therapeutic Effects
Reduces heart rate and cardiac output at rest and during exercise; lowers both supine and
standing BP, slows sinus rate and decreases myocardial automaticity. Antianginal effect is like
that of propranolol.
Uses
