Intravenous Infusions

Size: px
Start display at page:

Download "Intravenous Infusions"

Transcription

1 Intravenous Infusions 1) An IV insulin infusion can be used for patients: a) with out of control diabetes b) with DKA (Diabetic Ketoacidosis) c) after a heart attack 2) Hyperglycemia is an adaptive response essential for survival. 3) Diltiazem is used to treat: a) rapid ventricular rate in atrial fibrillation b) rapid ventricular rate in atrial flutter c) a & b d) Wolff-Parkinson White (WPW) syndrome 4) An IV Dopamine infusion is compatible with : a) insulin b) heparin c) norepinephrine d) all other IV infusions 5) Heparin infusions are used to prevent the formation of blood clots but cannot decrease the size of those that have already formed. 6) Medication errors cause over 7000 deaths in the US each year. 7) The onset of action of Regular Insulin is: a) between 0.5 and one hour b) between 2 and 3 hours c) between five and ten minutes d) between one and two hours 8) Milrinone is indicated for patients with: b) hypertension c) atrial fibrillation d) acute decompensated heart failure 9) An IV Nicardipine infusion is typically initiated at: a) 1.0 mg/hr b) 2.75 mg/hr c) 5.0 mg/hr d) 10 mg/hr

2 10) The primary side effect of heparin is: b) hypoglycemia c) thrombocytopenia d) hemorrhage 11) The lab value used to measure patients coagulation when receiving a Heparin IV infusion is the protime (PT/INR.) 12) Cardiac irregularities are a common side effect of Phenylephrine. 13) The primary action of Nitroglycerin is the relaxation of vascular smooth muscle causing dilation of blood vessels. 14) Side effects of Dobutamine include: a) increased heart rate b) increased blood pressure c) decreased heart rate d) a & b 15) Indications for a Dopamine IV infusion include: b) hypertension c) low cardiac output d) a & c 16) Shock is sometimes differentiated as warm or cold. 17) Epinephrine is the first choice of medications for patients with symptomatic bradycardia and hypotension. 18) Lidocaine is a(n): a) vasodilator b) antiarrhythmic c) inotrope d) vasopressor

3 19) Procainamide should not be given to patients with: a) complete heart block b) ventricular tachycardia c) hypertension d) hypoglycemia 20) Before starting any vasopressor infusion, blood volume depletion should be corrected as fully as possible. 21) Norepinephrine is compatible with: a) insulin b) isoproterenol c) heparin d) nitroglycerine 22) Vasodilators can be used to treat: a) hypertension b) heart failure c) angina 23) Esmolol is a(n): a) anti-coagulant b) vasodilator c) vasopressor d) inotrope 24) Milrinone can be used for extended periods of time. 25) There four classes of anti-arrhythmic medications. 26) A medication that must be stored in a glass or hard plastic container is: a) insulin b) heparin c) phenylephrine d) nitroglycerin 27) Cyanide toxicity is the most common adverse effect of: a) nitroprusside b) milrinone c) heparin d) epinephrine

4 28) The typical dose range of Epinephrine is: a) 1-2 mcg/min b) 2-10 mcg/min c) mcg/min d) mcg/min 29) In case of extravasation, the medication to be injected at the site is Phentolamine. 30) Insulin resistance is only found in about 30% of critically ill patients. 31) Heparin is a(n): a) vasopressor b) inotrope c) anti-coagulant d) vasodilator 32) Typical infusion rates of Isoproterenol are: a) 0.5 to 5 mcg/min b) 5 to 10mcg/min c).1 to 0.5 mcg/min d) 10 to 15 mcg/min 33) Norepinephrine is a(n): a) vasopressor b) vasodilator c) anti-coagulant d) anti-arrhythmic 34) All of the following are anti-arrhythmic medications except:: a) amiodarone b) diltiazem c) lidocaine d) phenylephrine 35) Regular insulin is the only type of insulin that should be given intravenously. 36) The typical dose of phentolamine is 1 to 3 mg.

5 37) All of the following are vasodilators except: a) esmolol b) dobutamine c) milrinone d) nicardipine 38) Side effects of esmolol include: b) dizziness c) tachycardia d) a & b 39) Insulin is compatible with: a) esmolol b) heparin c) procainamide 40) A typical infusion rate of heparin is: a) u/hr b) u/hr c) u/hr d) u/hr 41) The most common side effect of Nitroglycerin is: a) headache b) tachycardia c) nausea d) bradycardia 42) Nitroglycerin is indicated for the immediate reduction of blood pressure in patients in hypertensive crisis. 43) Nitroprusside can be used in the treatment of acute congestive heart failure (CHF). 44) All of the following are vasopressors or inotropes except: a) dopamine b) norepinephrine c) epinephrine d) dobutamine

6 45) One of the better diagnostic signs by which adequacy of vital organ perfusion can be monitored is: a) heart rate b) urine flow c) blood pressure d) oxygen saturation 46) Physiologic responses to shock include: a) lactic acidosis b) catecholamine release c) vasodilation 47) The most common side effect of Diltiazem is: b) hypertension c) confusion d) tachycardia 48) Onset of action of IV Lidocaine is: a) 3 to 5 seconds b) 45 to 90 seconds c) 3 to 5 minutes d) 5 to 10 minutes 49) A Procainamide infusion should be stopped if the patient develops persistent conduction disturbances or hypotension. 50) The peak action of Regular Insulin is one to three hours.

Adult Critical Care Intravenous Infusions Titration Protocol

Adult Critical Care Intravenous Infusions Titration Protocol Adult Critical Care Intravenous Infusions Protocol Nursing staff to titrate drip to achieve goal ordered by provider in assigned time intervals. Amiodarone (Pacerone ) Argatroban Non-heparin anticoagulant

More information

Chapter 9. Learning Objectives. Learning Objectives 9/11/2012. Cardiac Arrhythmias. Define electrical therapy

Chapter 9. Learning Objectives. Learning Objectives 9/11/2012. Cardiac Arrhythmias. Define electrical therapy Chapter 9 Cardiac Arrhythmias Learning Objectives Define electrical therapy Explain why electrical therapy is preferred initial therapy over drug administration for cardiac arrest and some arrhythmias

More information

Adenosine. poison/drug induced. flushing, chest pain, transient asystole. Precautions: tachycardia. fibrillation, atrial flutter. Indications: or VT

Adenosine. poison/drug induced. flushing, chest pain, transient asystole. Precautions: tachycardia. fibrillation, atrial flutter. Indications: or VT Adenosine Indications: 1. Narrow complex PSVT 2. Does not convert atrial fibrillation, atrial flutter or VT 1. Side effects include flushing, chest pain, transient asystole 2. May deteriorate widecomplex

More information

Titrating Critical Care Medications

Titrating Critical Care Medications Titrating Critical Care Medications Chad Johnson, MSN (NED), RN, CNCC(C), CNS-cc Clinical Nurse Specialist: Critical Care and Neurosurgical Services E-mail: johnsoc@tbh.net Copyright 2017 1 Learning Objectives

More information

Vasoactive Medications. Matthew J. Korobey Pharm.D., BCCCP Critical Care Clinical Specialist Mercy St. Louis

Vasoactive Medications. Matthew J. Korobey Pharm.D., BCCCP Critical Care Clinical Specialist Mercy St. Louis Vasoactive Medications Matthew J. Korobey Pharm.D., BCCCP Critical Care Clinical Specialist Mercy St. Louis Objectives List components of physiology involved in blood pressure Review terminology related

More information

Blanchard Valley Hospital Pharmacy Code Blue Overview

Blanchard Valley Hospital Pharmacy Code Blue Overview Blanchard Valley Hospital Pharmacy Code Blue Overview Adapted from Gary Spanik, RPh Edited by Kate Reeves, Pharm D, RPh Jon Manocchio, Pharm D, RPh Pharmacist Responsibilities Be aware of basic ACLS tenets

More information

ANTI - ARRHYTHMIC DRUGS

ANTI - ARRHYTHMIC DRUGS ANTI - ARRHYTHMIC DRUGS CARDIAC ACTION POTENTIAL K Out Balance Ca in/k out Na in K Out GENERATION OF ARRHYTHMIAS Four mechanisms of arrhythmia generation; Increased normal automaticity Abnormal automaticity

More information

6 th Floor and 7 East Nurses Guide Intravenous Drip List Approved for RN Administration University of Kentucky Chandler Medical Center

6 th Floor and 7 East Nurses Guide Intravenous Drip List Approved for RN Administration University of Kentucky Chandler Medical Center RATE Abciximab (Reopro) Alteplase (tpa, Activase) All units 6S and 6W ONLY Platelet aggregation inhibitor Thrombolytic agent Bolus: 0.25 mg/kg IV over 5 min Infusion: 0.125 0.9 mg/kg (max 90 mg); 10% of

More information

The Pharmacology of Hypotension: Vasopressor Choices for HIE patients. Keliana O Mara, PharmD August 4, 2018

The Pharmacology of Hypotension: Vasopressor Choices for HIE patients. Keliana O Mara, PharmD August 4, 2018 The Pharmacology of Hypotension: Vasopressor Choices for HIE patients Keliana O Mara, PharmD August 4, 2018 Objectives Review the pathophysiology of hypotension in neonates Discuss the role of vasopressors

More information

Systemic Pharmacology Lecture 7: Neuropharmacology

Systemic Pharmacology Lecture 7: Neuropharmacology Systemic Pharmacology Lecture 7: Neuropharmacology Drugs act on Sympathetic NS (adrenergic system) Adrenergic Drugs (Sympathomimetics), adrenergic agonists, or alpha- and beta-adrenergic agonists Antiadrenergic

More information

ANESTHESIA DRUG REVIEW

ANESTHESIA DRUG REVIEW ANESTHESIA REVIEW CAPA S 39 TH ANNUAL CONFERENCE PALM SPRINGS OCTOBER 10, 2015 ROBERT F. KOPEL, MD, FACP, FCCP HOAG HOSPITAL CARDIAC ANESTHESIOLOGIST ASSISTANT CLINICAL PROFESSOR UCLA SCHOOL OF MEDICINE

More information

7/21/2017. Learning Objectives. Current Cardiovascular Pharmacology. Epinephrine. Cardiotonic Agents. Epinephrine. Epinephrine. Arthur Jones, EdD, RRT

7/21/2017. Learning Objectives. Current Cardiovascular Pharmacology. Epinephrine. Cardiotonic Agents. Epinephrine. Epinephrine. Arthur Jones, EdD, RRT Learning Objectives Current Cardiovascular Pharmacology Arthur Jones, EdD, RRT Explain the actions, effects, indications, adverse effects, & precautions for agents from the following drug categories Cardiotonic

More information

Nitroglycerin and Heparin Drip Interfacility Protocols

Nitroglycerin and Heparin Drip Interfacility Protocols Nitroglycerin and Heparin Drip Interfacility Protocols EMS Protocol This protocol applies to nitroglycerin and Heparin drips that are initiated at the transferring facility prior to transport and are not

More information

Critical Care Medication Administration

Critical Care Medication Administration Critical Care Medication Administration 1. HEPARIN (units/hour): Given in LII, LI, HG, ER, HCHA, PACU, Cath Lab, MSONT Purpose: Anticoagulation. Used to treat Acute MI, CVA, DVT, etc. Identify concentration

More information

DIAGNOSIS AND MANAGEMENT OF ACUTE HEART FAILURE

DIAGNOSIS AND MANAGEMENT OF ACUTE HEART FAILURE DIAGNOSIS AND MANAGEMENT OF ACUTE HEART FAILURE Mefri Yanni, MD Bagian Kardiologi dan Kedokteran Vaskular RS.DR.M.Djamil Padang The 3rd Symcard Padang, Mei 2013 Outline Diagnosis Diagnosis Treatment options

More information

Introduction. Invasive Hemodynamic Monitoring. Determinants of Cardiovascular Function. Cardiovascular System. Hemodynamic Monitoring

Introduction. Invasive Hemodynamic Monitoring. Determinants of Cardiovascular Function. Cardiovascular System. Hemodynamic Monitoring Introduction Invasive Hemodynamic Monitoring Audis Bethea, Pharm.D. Assistant Professor Therapeutics IV January 21, 2004 Hemodynamic monitoring is necessary to assess and manage shock Information obtained

More information

IV Medication Drip Chart

IV Medication Drip Chart IV Medication Drip Chart Index Summary chart 2 IV Medication drip chart Amiodarone 2 Atracurium 2, 5 Cisatracurium 2, 5 Dexmedetomidine 2 Dobutamine 2, 6 Dopamine 2, 6 Epinephrine 2, 7 Esmolol 2, 7 Etomidate

More information

LESSON ASSIGNMENT Given the trade and/or generic name of an adrenergic blocking agent, classify that agent as either an alpha or beta blocker.

LESSON ASSIGNMENT Given the trade and/or generic name of an adrenergic blocking agent, classify that agent as either an alpha or beta blocker. LESSON ASSIGNMENT LESSON 8 Adrenergic Blocking Agents. TEXT ASSIGNMENT Paragraphs 8-1 through 8-5. LESSON OBJECTIVES 8-1. Given a group of statements, select the statement that best describes one of the

More information

Medical Management of Acute Heart Failure

Medical Management of Acute Heart Failure Critical Care Medicine and Trauma Medical Management of Acute Heart Failure Mary O. Gray, MD, FAHA Associate Professor of Medicine University of California, San Francisco Staff Cardiologist and Training

More information

Heart Failure (HF) Treatment

Heart Failure (HF) Treatment Heart Failure (HF) Treatment Heart Failure (HF) Complex, progressive disorder. The heart is unable to pump sufficient blood to meet the needs of the body. Its cardinal symptoms are dyspnea, fatigue, and

More information

Arrhythmias. 1. beat too slowly (sinus bradycardia). Like in heart block

Arrhythmias. 1. beat too slowly (sinus bradycardia). Like in heart block Arrhythmias It is a simple-dysfunction caused by abnormalities in impulse formation and conduction in the myocardium. The heart is designed in such a way that allows it to generate from the SA node electrical

More information

The Art and Science of Infusion Nursing John M. Allen, PharmD, BCPS. Understanding Vasoactive Medications

The Art and Science of Infusion Nursing John M. Allen, PharmD, BCPS. Understanding Vasoactive Medications The Art and Science of Infusion Nursing John M. Allen, PharmD, BCPS Understanding Vasoactive Medications Focus on Pharmacology and Effective Titration ABSTRACT In the care of the critically ill patient,

More information

Chapter (9) Calcium Antagonists

Chapter (9) Calcium Antagonists Chapter (9) Calcium Antagonists (CALCIUM CHANNEL BLOCKERS) Classification Mechanism of Anti-ischemic Actions Indications Drug Interaction with Verapamil Contraindications Adverse Effects Treatment of Drug

More information

Swans and Pressors. Vanderbilt Surgery Summer School Ricky Shinall

Swans and Pressors. Vanderbilt Surgery Summer School Ricky Shinall Swans and Pressors Vanderbilt Surgery Summer School Ricky Shinall SHOCK Hypotension SHOCK Hypotension SHOCK=Reduction of systemic tissue perfusion, resulting in decreased oxygen delivery to the tissues.

More information

Medical Management of Acutely Decompensated Heart Failure. William T. Abraham, MD Director, Division of Cardiovascular Medicine

Medical Management of Acutely Decompensated Heart Failure. William T. Abraham, MD Director, Division of Cardiovascular Medicine Medical Management of Acutely Decompensated Heart Failure William T. Abraham, MD Director, Division of Cardiovascular Medicine Orlando, Florida October 7-9, 2011 Goals of Acute Heart Failure Therapy Alleviate

More information

Swans and Pressors. Vanderbilt Surgery Summer School Ricky Shinall

Swans and Pressors. Vanderbilt Surgery Summer School Ricky Shinall Swans and Pressors Vanderbilt Surgery Summer School Ricky Shinall Shock, Swans, Pressors in 15 minutes 4 Reasons for Shock 4 Swan numbers to know 7 Pressors =15 things to know 4 Reasons for Shock Not enough

More information

Advanced Cardiac Life Support

Advanced Cardiac Life Support Advanced Cardiac Life Support Algorithm Drugs Class I: definitely helpful, excellent Class II: Class II a -probably helpful; good to very good Class II b -possibly helpful; fair to good Class

More information

Nothing to Disclose. Severe Pulmonary Hypertension

Nothing to Disclose. Severe Pulmonary Hypertension Severe Ronald Pearl, MD, PhD Professor and Chair Department of Anesthesiology Stanford University Rpearl@stanford.edu Nothing to Disclose 65 year old female Elective knee surgery NYHA Class 3 Aortic stenosis

More information

Based on the Guidelines 2000 for Cardiopulmonary Resuscitation & Emergency Cardiovascular Care EMERGENCY PHARMACOLOGY I & II. ADENOSINE (Adenocard)

Based on the Guidelines 2000 for Cardiopulmonary Resuscitation & Emergency Cardiovascular Care EMERGENCY PHARMACOLOGY I & II. ADENOSINE (Adenocard) EMERGENCY PHARMACOLOGY I & II Advanced Cardiac Life Support Seminole Community College Based on the Guidelines 2000 for Cardiopulmonary Resuscitation & Emergency Cardiovascular Care International Consensus

More information

Atrial fibrillation in the ICU

Atrial fibrillation in the ICU Atrial fibrillation in the ICU Atrial fibrillation Preexisting or incident (new onset) among nearly one in three critically ill patients Formation of arrhythogenic substrate usually fibrosis (CHF, hypertension,

More information

Jeopardy Tip Sheets. 12 Lead EKG Review. Leads affected. Coronary artery involved. Area of myocardium INFERIOR RCA II, III, AVF SEPTAL LAD V1 & V2

Jeopardy Tip Sheets. 12 Lead EKG Review. Leads affected. Coronary artery involved. Area of myocardium INFERIOR RCA II, III, AVF SEPTAL LAD V1 & V2 12 Lead EKG Review Jeopardy Tip Sheets Area of myocardium Coronary artery involved Leads affected INFERIOR RCA II, III, AVF SEPTAL LAD V1 & V2 ANTERIOR LAD V3 & V4 LATERAL Circumflex I, AVL, V5, V6 Normal

More information

Treatment of Arrhythmias in the Emergency Setting

Treatment of Arrhythmias in the Emergency Setting Treatment of Arrhythmias in the Emergency Setting Zian H. Tseng, M.D. Assistant Professor of Medicine Cardiac Electrophysiology Section Cardiology Division University of California, San Francisco There

More information

Professional Development Presents. May 2016 Medication of the Month. Milrinone Drip IN2731

Professional Development Presents. May 2016 Medication of the Month. Milrinone Drip IN2731 Med of the Month For any question regarding May 2016 Med of the Month: Milrinone Drip You may contact: Sherr Ann Arabit MSN, RN-BC, CCRN/Professional Development Department Ext 4196 Professional Development

More information

Medical Treatment for acute Decompensated Heart Failure. Vlasis Ninios Cardiologist St. Luke s s Hospital Thessaloniki 2011

Medical Treatment for acute Decompensated Heart Failure. Vlasis Ninios Cardiologist St. Luke s s Hospital Thessaloniki 2011 Medical Treatment for acute Decompensated Heart Failure Vlasis Ninios Cardiologist St. Luke s s Hospital Thessaloniki 2011 2010 HFSA guidelines for ADHF 2009 focused update of the 2005 American College

More information

Characterization of Intravenous Medication Administration in an Intensive Care Unit. Catherine A. Thorn. B.S., Electrical Engineering

Characterization of Intravenous Medication Administration in an Intensive Care Unit. Catherine A. Thorn. B.S., Electrical Engineering Characterization of Intravenous Medication Administration in an Intensive Care Unit by Catherine A. Thorn B.S., Electrical Engineering Georgia Institute of Technology Submitted to the Department of Electrical

More information

Krittin Bunditanukul Pharm.D, BCPS Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Chulalongkorn University

Krittin Bunditanukul Pharm.D, BCPS Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Chulalongkorn University Krittin Bunditanukul Pharm.D, BCPS Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Chulalongkorn University Cardiac arrest Cardiac arrest can be caused by 4 rhythms: Ventricular fibrillation

More information

Pulse 110/min beats per min + 20 Systolic blood pressure <100 mmhg Respiratory rate 30 breaths per min + 20

Pulse 110/min beats per min + 20 Systolic blood pressure <100 mmhg Respiratory rate 30 breaths per min + 20 Online Supplement Impact of Relative Contraindications to Home Management in Emergency Department Patients with Low-Risk Pulmonary Embolism David R. Vinson, Carrieann E. Drenten, Jie Huang, J. Eileen Morley,

More information

Heart Failure. Dr. Alia Shatanawi

Heart Failure. Dr. Alia Shatanawi Heart Failure Dr. Alia Shatanawi Left systolic dysfunction secondary to coronary artery disease is the most common cause, account to 70% of all cases. Heart Failure Heart is unable to pump sufficient blood

More information

Instruct patient and caregivers: Need for constant monitoring Potential complications of drug therapy

Instruct patient and caregivers: Need for constant monitoring Potential complications of drug therapy Assessment Prior to administration: Assess patient for chest pain, dysrhythmias, and vital signs (initially and throughout therapy) Obtain complete medical history, including allergies, especially heart

More information

The most common. hospitalized patients. hypotension due to. filling time Rate control in ICU patients may be difficult as many drugs cause hypotension

The most common. hospitalized patients. hypotension due to. filling time Rate control in ICU patients may be difficult as many drugs cause hypotension Arrhythmias in the critically ill ICU patients: Approach for rapid recognition & management Objectives Be able to identify and manage: Atrial fibrillation with a rapid ventricular response Atrial flutter

More information

HOW LOW CAN YOU GO? HYPOTENSION AND THE ANESTHETIZED PATIENT.

HOW LOW CAN YOU GO? HYPOTENSION AND THE ANESTHETIZED PATIENT. HOW LOW CAN YOU GO? HYPOTENSION AND THE ANESTHETIZED PATIENT. Donna M. Sisak, CVT, LVT, VTS (Anesthesia/Analgesia) Seattle Veterinary Specialists Kirkland, WA dsisak@svsvet.com THE ANESTHETIZED PATIENT

More information

Antihypertensive Agents Part-2. Assistant Prof. Dr. Najlaa Saadi PhD Pharmacology Faculty of Pharmacy University of Philadelphia

Antihypertensive Agents Part-2. Assistant Prof. Dr. Najlaa Saadi PhD Pharmacology Faculty of Pharmacy University of Philadelphia Antihypertensive Agents Part-2 Assistant Prof. Dr. Najlaa Saadi PhD Pharmacology Faculty of Pharmacy University of Philadelphia Agents that block production or action of angiotensin Angiotensin-converting

More information

MAT vs AFIB. Henry Clemo. Fast & Easy ECGs, 2E 2013 The McGraw-Hill Companies, Inc. All rights reserved.

MAT vs AFIB. Henry Clemo. Fast & Easy ECGs, 2E 2013 The McGraw-Hill Companies, Inc. All rights reserved. MAT vs AFIB Henry Clemo 1 Multifocal Atrial Tachycardia (MAT) > 3 P wave morphologies HR > 100 HR < 100 wandering pacemaker I 2 Multifocal Atrial Tachycardia 3 Multifocal Atrial Tachycardia 4 Multifocal

More information

Critical Thinking Tip Sheets

Critical Thinking Tip Sheets 12 Lead EKG Review Critical Thinking Tip Sheets Area of myocardium Coronary artery involved Leads affected INFERIOR RCA II, III, AVF SEPTAL LAD V1 & V2 ANTERIOR LAD V3 & V4 LATERAL Circumflex I, AVL, V5,

More information

DOBUTamine INJECTION, USP R x only

DOBUTamine INJECTION, USP R x only DOBUTamine INJECTION, USP R x only DESCRIPTION Dobutamine Injection, USP is 1,2-benzenediol, 4-[2-[[3-(4-hydro-xyphenyl)-1- methylpropyl]amino]ethyl]-hydrochloride, (±). It is a synthetic catecholamine.

More information

Introductory Clinical Pharmacology Chapter 41 Antihypertensive Drugs

Introductory Clinical Pharmacology Chapter 41 Antihypertensive Drugs Introductory Clinical Pharmacology Chapter 41 Antihypertensive Drugs Blood Pressure Normal = sys

More information

Inventory of paediatric therapeutic needs

Inventory of paediatric therapeutic needs 24 April 2013 EMA/PDCO/246339/2013 Human Medicines Development and Evaluation Cardiovascular therapeutic area Agreed by PDCO August 2012 Adopted by PDCO for release for consultation 15-17 August 2012 Start

More information

Intravenous Inotropic Support an Overview

Intravenous Inotropic Support an Overview Intravenous Inotropic Support an Overview Shaul Atar, MD Western Galilee Medical Center, Nahariya Affiliated with the Faculty of Medicine of the Galilee, Safed, Israel INOTROPES in Acute HF (not vasopressors)

More information

Cardiac Drugs: Chapter 9 Worksheet Cardiac Agents. 1. drugs affect the rate of the heart and can either increase its rate or decrease its rate.

Cardiac Drugs: Chapter 9 Worksheet Cardiac Agents. 1. drugs affect the rate of the heart and can either increase its rate or decrease its rate. Complete the following. 1. drugs affect the rate of the heart and can either increase its rate or decrease its rate. 2. drugs affect the force of contraction and can be either positive or negative. 3.

More information

HYPOTENSION IS DANGEROUS C. R Y A N K E A Y, M D, F A C E P 1 6 M A R C H

HYPOTENSION IS DANGEROUS C. R Y A N K E A Y, M D, F A C E P 1 6 M A R C H HYPOTENSION IS DANGEROUS C. R Y A N K E A Y, M D, F A C E P 1 6 M A R C H 2 0 1 8 OBJECTIVES Case-based overview of pressors Debunking pressor myths Utilizing push-dose pressors CASE 1 82-year old male,

More information

Evidence for Lidocaine and Amiodarone in Cardiac Arrest Due to VF/Pulseless VT

Evidence for Lidocaine and Amiodarone in Cardiac Arrest Due to VF/Pulseless VT Evidence for Lidocaine and Amiodarone in Cardiac Arrest Due to VF/Pulseless VT Introduction Evidence supporting the use of lidocaine and amiodarone for advanced cardiac life support was considered by international

More information

Don t Forget the Basics

Don t Forget the Basics Scary Arrhythmias in the Hospital Gregory M Marcus, MD, MAS Assistant Professor of Medicine Division of Cardiology University of California, San Francisc Don t Forget the Basics 79 yo man with a history

More information

Arrhythmias. Simple-dysfunction cause abnormalities in impulse formation and conduction in the myocardium.

Arrhythmias. Simple-dysfunction cause abnormalities in impulse formation and conduction in the myocardium. Arrhythmias Simple-dysfunction cause abnormalities in impulse formation and conduction in the myocardium. However, in clinic it present as a complex family of disorders that show variety of symptoms, for

More information

1. Normal sinus rhythm 2. SINUS BRADYCARDIA

1. Normal sinus rhythm 2. SINUS BRADYCARDIA 1. Normal sinus rhythm 2. SINUS BRADYCARDIA No signs and symptoms observe There are severe signs or symptoms o What are the signs and symptom Hypotension

More information

WHAT DO YOU SEE WHEN YOU STIMULATE BETA

WHAT DO YOU SEE WHEN YOU STIMULATE BETA CARDIAC DRUG REVIEW WHAT DO YOU SEE WHEN YOU STIMULATE BETA VASODILATE BRONCHODILATE +CHRONOTROPE +INOTROPE EPI S OTHER NAME? ADRENALIN WHAT DOES EPI DO THAT NOREPI AND DOPAMINE DO NOT DO? BETA 2 BRONCHODILATOR

More information

These drugs produce effects similar to the sympathetic nervous system

These drugs produce effects similar to the sympathetic nervous system Terms adrenergic Drugs mydriasis sympathetic nervous system adrenergic drugs adrenergic mechanism of action positive inotropic effect positive chronotropic effect positive dromotropic effect adrenergic

More information

Drugs Used in Heart Failure. Assistant Prof. Dr. Najlaa Saadi PhD pharmacology Faculty of Pharmacy University of Philadelphia

Drugs Used in Heart Failure. Assistant Prof. Dr. Najlaa Saadi PhD pharmacology Faculty of Pharmacy University of Philadelphia Drugs Used in Heart Failure Assistant Prof. Dr. Najlaa Saadi PhD pharmacology Faculty of Pharmacy University of Philadelphia Heart Failure Heart failure (HF), occurs when cardiac output is inadequate to

More information

WRITER TRISTAN WALKER TABLE OF CONTENTS. The Basics of cardiac pharmacology 2007

WRITER TRISTAN WALKER TABLE OF CONTENTS. The Basics of cardiac pharmacology 2007 WRITER TRISTAN WALKER TABLE OF CONTENTS 1. WHAT ARE THE MAJOR CLASSES OF CARDIAC DRUGS?...2 2. HOW DO THEY WORK?...3 3. CONSIDERATIONS FOR THE PEDIATRIC PATIENT...7 4. SUMMARY TABLE...10 REFERENCES...14

More information

Shock and Vasopressors. Nina E. Glass, MD TACS Fellow SICU Didactic Curriculum 9/24/14

Shock and Vasopressors. Nina E. Glass, MD TACS Fellow SICU Didactic Curriculum 9/24/14 Shock and Vasopressors Nina E. Glass, MD TACS Fellow SICU Didactic Curriculum 9/24/14 Review Question Unilaterally diminished breath sounds A. Figure 1 B. Figure 2 C. Both D. Neither Related Specialties

More information

Shock. Shao Mian Emergency Department,Zhongshan Hospital

Shock. Shao Mian Emergency Department,Zhongshan Hospital Shock Shao Mian Emergency Department,Zhongshan Hospital What is shock THE BEGINNINGS OF UNDERSTANDING: THE LATE 19TH CENTURY THE AGE OF REASON: 1890 1925 THE MODERN ERA: BLALOCK S EPIPHANY POSTMODERNISM:

More information

Disclosures. Objectives 10/11/17. Short Term Mechanical Circulatory Support for Advanced Cardiogenic Shock. I have no disclosures to report

Disclosures. Objectives 10/11/17. Short Term Mechanical Circulatory Support for Advanced Cardiogenic Shock. I have no disclosures to report Short Term Mechanical Circulatory Support for Advanced Cardiogenic Shock Christopher K. Gordon MSN, ACNP-BC Disclosures I have no disclosures to report 1. Pathophysiology 2. Epidemiology 3. Assessment

More information

Case Scenario 3: Shock and Sepsis

Case Scenario 3: Shock and Sepsis Name: Molly Boyle 1. Define the term shock (Lewis textbook): Shock is a syndrome characterized by decreased perfusion and impaired metabolism. Shock can have a number of causes that result in damage to

More information

Requirements to successfully complete PALS:

Requirements to successfully complete PALS: The American Heart Association released new resuscitation science and treatment guidelines on October 19, 2010. The new AHA Handbook of Emergency Cardiac Care (ECC) contains these 2010 Guidelines.The 2010

More information

The ARREST Trial: Amiodarone for Resuscitation After Out-of-Hospital Cardiac Arrest Due to Ventricular Fibrillation

The ARREST Trial: Amiodarone for Resuscitation After Out-of-Hospital Cardiac Arrest Due to Ventricular Fibrillation The ARREST Trial: Amiodarone for Resuscitation After Out-of-Hospital Cardiac Arrest Due to Ventricular Fibrillation Introduction The ARREST (Amiodarone in out-of-hospital Resuscitation of REfractory Sustained

More information

Evaluation and Management of Acute Decompensated Heart Failure (HF) with Reduced Ejection Fraction Systolic Heart Failure (HFrEF)(EF<40%

Evaluation and Management of Acute Decompensated Heart Failure (HF) with Reduced Ejection Fraction Systolic Heart Failure (HFrEF)(EF<40% Evaluation and Management of Acute Decompensated Heart Failure (HF) with Reduced Ejection Fraction Systolic Heart Failure (HFrEF)(EF

More information

ANGINA PECTORIS. angina pectoris is a symptom of myocardial ischemia in the absence of infarction

ANGINA PECTORIS. angina pectoris is a symptom of myocardial ischemia in the absence of infarction Pharmacology Ezra Levy, Pharm.D. ANGINA PECTORIS A. Definition angina pectoris is a symptom of myocardial ischemia in the absence of infarction angina usually implies severe chest pain or discomfort during

More information

SHOCK. May 12, 2011 Body and Disease

SHOCK. May 12, 2011 Body and Disease SHOCK May 12, 2011 Body and Disease Shock Definition of shock Pathophysiology Types of shock Management of shock Shock Definition? Shock What the Duke Community would have experienced if Gordon Hayward

More information

Acute Arrhythmias in the Hospitalized Patient

Acute Arrhythmias in the Hospitalized Patient Acute Arrhythmias in the Hospitalized Patient Gregory M Marcus, MD, MAS Associate Professor of Medicine Division of Cardiology University of California, San Francisc Disclosures Medtronic: Research Support

More information

7/4/2015. Titrating Vasoactive Drips

7/4/2015. Titrating Vasoactive Drips Leanna R. Miller RN, MN, CCRN-CMC, PCCN-CSC, CEN, NP LRM Consulting Vasoactive medications are indicated when the SBP has a decrease of > 30mmHg from the baseline or a MAP < 60mmHg and when either condition

More information

Fundamentals of Pharmacology for Veterinary Technicians Chapter 8

Fundamentals of Pharmacology for Veterinary Technicians Chapter 8 Figure 8-1 Figure 8-2 Figure 8-3 Figure 8-4 Figure 8-5 Figure 8-7 Figure 8-8 Figure 8-9 TABLE 8-1 Blood Flow Through the Heart The right atrium receives blood from all tissues, except the lungs, through

More information

ACLS Review. Pulse Oximetry to be between 94 99% to avoid hyperoxia (high oxygen tension can lead to tissue death

ACLS Review. Pulse Oximetry to be between 94 99% to avoid hyperoxia (high oxygen tension can lead to tissue death ACLS Review BLS CPR BLS CPR changed in 2010. The primary change is from the ABC format to CAB. After establishing unresponsiveness and calling for a code, check for a pulse less than 10 seconds then begin

More information

Prehospital Care Monograph

Prehospital Care Monograph Prehospital Care Monograph Amiodarone (Cordarone) City of Pittsburgh Bureau of Emergency Medical Services And Medical Direction Committee Center for Emergency Medicine Of Western Pennsylvania 1 This monograph

More information

Mr. Eknath Kole M.S. Pharm (NIPER Mohali)

Mr. Eknath Kole M.S. Pharm (NIPER Mohali) M.S. Pharm (NIPER Mohali) Drug Class Actions Therapeutic Uses Pharmacokinetics Adverse Effects Other Quinidine IA -Binds to open and inactivated Na+ -Decreases the slope of Phase 4 spontaneous depolarization

More information

Optimal preload. Objectives. Preload RV: RAP LV: LAP (PAOP) 3/11/2015. Effects of CV Drugs on Hemodynamics: Which Drug When?

Optimal preload. Objectives. Preload RV: RAP LV: LAP (PAOP) 3/11/2015. Effects of CV Drugs on Hemodynamics: Which Drug When? Objectives Effects of CV Drugs on Hemodynamics: Which Drug When? Robin Donohoe Dennison, DNP, APRN, CCNS, CNE describe the hemodynamic effects of select CV drugs select the appropriate CV drug in a clinical

More information

Case year old female nursing home resident with a hx CAD, PUD, recent hip fracture Transferred to ED with decreased mental status BP in ED 80/50

Case year old female nursing home resident with a hx CAD, PUD, recent hip fracture Transferred to ED with decreased mental status BP in ED 80/50 Case 1 65 year old female nursing home resident with a hx CAD, PUD, recent hip fracture Transferred to ED with decreased mental status BP in ED 80/50 Case 1 65 year old female nursing home resident with

More information

a)-catecholamines // these are compounds which have the catechol nucleus as adrenaline, noradrenaline, isoprenaline, dopamine, dobutamine

a)-catecholamines // these are compounds which have the catechol nucleus as adrenaline, noradrenaline, isoprenaline, dopamine, dobutamine 1 Adrenergic or sympathetic agonist: Are classified according to: I)- according to the chemical structure a)-catecholamines // these are compounds which have the catechol nucleus as adrenaline, noradrenaline,

More information

ADULT DRUG REFERENCE Drug Indication Adult Dosage Precautions / Comments

ADULT DRUG REFERENCE Drug Indication Adult Dosage Precautions / Comments ADENOSINE Paroxysmal SVT 1 st Dose 6 mg rapid IV 2 nd & 3 rd Doses 12 mg rapid IV push Follow each dose with rapid bolus of 20 ml NS May cause transient heart block or asystole. Side effects include chest

More information

PHENTOLAMINE MESYLATE INJECTION SANDOZ STANDARD 5 mg/ ml THERAPEUTIC CLASSIFICATION Alpha-adrenoreceptor Blocker

PHENTOLAMINE MESYLATE INJECTION SANDOZ STANDARD 5 mg/ ml THERAPEUTIC CLASSIFICATION Alpha-adrenoreceptor Blocker PACKAGE INSERT Pr PHENTOLAMINE MESYLATE INJECTION SANDOZ STANDARD 5 mg/ ml THERAPEUTIC CLASSIFICATION Alpha-adrenoreceptor Blocker ACTIONS AND CLINICAL PHARMACOLOGY Phentolamine produces an alpha-adrenergic

More information

CHAPTER-I MYOCARDIAL INFARCTION

CHAPTER-I MYOCARDIAL INFARCTION CHAPTER-I MYOCARDIAL INFARCTION Definition A myocardial infarction, more commonly known as MI or acute myocardial infarction (AMI) or heart attack is a condition where there is interruption of blood supply

More information

BETALOL Esmolol hydrochloride HIKMA PHARMACEUTICALS

BETALOL Esmolol hydrochloride HIKMA PHARMACEUTICALS 09-15 BETALOL Esmolol hydrochloride HIKMA PHARMACEUTICALS ACTION Esmolol hydrochloride is a beta 1-selective (cardioselective) adrenergic receptor blocking agent with rapid onset, a very short duration

More information

Core Safety Profile. Pharmaceutical form(s)/strength: Film-coated tablets 1.25 mg, 2.5 mg, 3.75 mg, 5 mg, 7.5 mg and 10 mg. Date of FAR:

Core Safety Profile. Pharmaceutical form(s)/strength: Film-coated tablets 1.25 mg, 2.5 mg, 3.75 mg, 5 mg, 7.5 mg and 10 mg. Date of FAR: Core Safety Profile Active substance: Bisoprolol Pharmaceutical form(s)/strength: Film-coated tablets 1.25 mg, 2.5 mg, 3.75 mg, 5 mg, 7.5 mg and 10 mg P - RMS: FI/H/PSUR/0002/002 Date of FAR: 13.12.2011

More information

Post-Cardiac Surgery Evaluation

Post-Cardiac Surgery Evaluation Post-Cardiac Surgery Evaluation 20th Annual Heart Conference October 15, 2016 Gary A Mayman PROFESSOR PEDIATRICS UNIVERSITY OF NEVADA Look Touch Listen Temperature, pulse, respiratory rate, & blood pressure

More information

Management Of Medical Emergencies. Zakaria S. Messieha, DDS

Management Of Medical Emergencies. Zakaria S. Messieha, DDS Management Of Medical Emergencies Zakaria S. Messieha, DDS Z.S. Messieha Associate Professor, Anesthesiology University Of Illinois At Chicago Necessity Of Emergency Protocol Aging patient population.

More information

Post Resuscitation Care

Post Resuscitation Care Princess Margaret Hospital f Children PAEDIATRIC ACUTE CARE GUIDELINE Post Resuscitation Care Scope (Staff): Scope (Area): All Emergency Department Clinicians Emergency Department This document should

More information

HYPERTENSION. Background for understanding the Hypertension literature. Case presentation. Approach to Treatment. Jeffrey J. Kaufhold, MD Nephrology

HYPERTENSION. Background for understanding the Hypertension literature. Case presentation. Approach to Treatment. Jeffrey J. Kaufhold, MD Nephrology HYPERTENSION Background for understanding the Hypertension literature. Case presentation Approach to Treatment Jeffrey J. Kaufhold, MD Nephrology 2009 HYPERTENSION SUMMARY Background for understanding

More information

Dr. Vishaal Bhat. anti-adrenergic drugs

Dr. Vishaal Bhat. anti-adrenergic drugs Dr. Vishaal Bhat anti-adrenergic drugs Divisions of human nervous system Human Nervous system Central Nervous System Peripheral Nervous System Autonomic Nervous System Nervous system Includes neurons and

More information

WHY ADMINISTER CARDIOTONIC AGENTS?

WHY ADMINISTER CARDIOTONIC AGENTS? Cardiac Pharmacology: Ideas For Advancing Your Clinical Practice The image cannot be displayed. Your computer may not have enough memory to open the image, or Roberta L. Hines, M.D. Nicholas M. Greene

More information

Objectives. Management of Septic Shock. Definitions Progression of sepsis. Epidemiology of severe sepsis. Major goals of therapy

Objectives. Management of Septic Shock. Definitions Progression of sepsis. Epidemiology of severe sepsis. Major goals of therapy Objectives Management of Septic Shock Review of the Evidence and Implementation of Pediatric Guidelines at Christus Santa Rosa Manish Desai, M.D. PL 5 2 nd year Pediatric Critical Care Fellow Review of

More information

SARASOTA MEMORIAL HOSPITAL DEPARTMENT POLICY

SARASOTA MEMORIAL HOSPITAL DEPARTMENT POLICY PS1006 SARASOTA MEMORIAL HOSPITAL DEPARTMENT POLICY TITLE: PHARMACEUTICALS FOR CRITICAL CARE AREAS, HEMODIALYSIS, PACU, EMERGENCY CARE CENTER, CARDIAC CARE AREAS, NEURO PROGRESSIVE CARE, AND THE MECKLER

More information

Rhythm Control: Is There a Role for the PCP? Blake Norris, MD, FACC BHHI Primary Care Symposium February 28, 2014

Rhythm Control: Is There a Role for the PCP? Blake Norris, MD, FACC BHHI Primary Care Symposium February 28, 2014 Rhythm Control: Is There a Role for the PCP? Blake Norris, MD, FACC BHHI Primary Care Symposium February 28, 2014 Financial disclosures Consultant Medtronic 3 reasons to evaluate and treat arrhythmias

More information

UTMB-Galveston SURGICAL INTENSIVE CARE UNIT ORGAN PROCUREMENT PROTOCOL

UTMB-Galveston SURGICAL INTENSIVE CARE UNIT ORGAN PROCUREMENT PROTOCOL UTMB-Galveston SURGICAL INTENSIVE CARE UNIT ORGAN PROCUREMENT PROTOCOL For questions call: Eugene J. Lian, MD, Marc O. Maybauer, MD, PhD, EDIC, FCCP Department of Anesthesiology Division of Critical Care

More information

Cardiovascular Diseases and Diabetes

Cardiovascular Diseases and Diabetes Cardiovascular Diseases and Diabetes LEARNING OBJECTIVES Ø Identify the components of the cardiovascular system and the various types of cardiovascular disease Ø Discuss ways of promoting cardiovascular

More information

ACLS Emergency Cardiac Drug Therapy (bolded = changes based on 2005 AHA ACLS Guidelines) revised 01/18/07

ACLS Emergency Cardiac Drug Therapy (bolded = changes based on 2005 AHA ACLS Guidelines) revised 01/18/07 Oxygen Acute Chest Pain Suspected hypoxemia of any cause or c/o SOB Cardiopulmonary Arrest correct hypoxemia by O2 tension O2 content tissue oxygenation O2 Toxicity with high FIO2s May cause CO2 if a CO2

More information

Chapter 26. Media Directory. Dysrhythmias. Diagnosis/Treatment of Dysrhythmias. Frequency in Population Difficult to Predict

Chapter 26. Media Directory. Dysrhythmias. Diagnosis/Treatment of Dysrhythmias. Frequency in Population Difficult to Predict Chapter 26 Drugs for Dysrythmias Slide 33 Slide 35 Media Directory Propranolol Animation Amiodarone Animation Upper Saddle River, New Jersey 07458 All rights reserved. Dysrhythmias Abnormalities of electrical

More information

DBL DOBUTAMINE HYDROCHLORIDE INJECTION

DBL DOBUTAMINE HYDROCHLORIDE INJECTION Name of medicine Dobutamine Hydrochloride DBL DOBUTAMINE HYDROCHLORIDE INJECTION Data Sheet New Zealand Presentation DBL Dobutamine Hydrochloride Injection is a sterile solution containing in each 20 ml

More information

Adrenergic Agonists 1

Adrenergic Agonists 1 Adrenergic Agonists 1 THE ADRENERGIC NEURON Adrenergic neurons release norepinephrine as the primary neurotransmitter. These neurons are found in the central nervous system (CNS) and also in the sympathetic

More information

Adult Drug Reference. Dopamine Drip Chart. Pediatric Drug Reference. Pediatric Drug Dosage Charts DRUG REFERENCES

Adult Drug Reference. Dopamine Drip Chart. Pediatric Drug Reference. Pediatric Drug Dosage Charts DRUG REFERENCES Adult Drug Reference Dopamine Drip Chart Pediatric Drug Reference Pediatric Drug Dosage Charts DRUG REFERENCES ADULT DRUG REFERENCE Drug Indication Adult Dosage Precautions / Comments ADENOSINE Paroxysmal

More information

CSI Skills Lab #5: Arrhythmia Interpretation and Treatment

CSI Skills Lab #5: Arrhythmia Interpretation and Treatment CSI 202 - Skills Lab #5: Arrhythmia Interpretation and Treatment Origins of the ACLS Approach: CSI 202 - Skills Lab 5 Notes ACLS training originated in Nebraska in the early 1970 s. Its purpose was to

More information

MEDICATIONS CARDIOVASCULAR URGENCIES & EMERGENCIES 12/29/14. Cardiovascular Emergency Medications. Cardiovascular Emergency Medications

MEDICATIONS CARDIOVASCULAR URGENCIES & EMERGENCIES 12/29/14. Cardiovascular Emergency Medications. Cardiovascular Emergency Medications CARDIOVASCULAR URGENCIES & EMERGENCIES Steven Ganzberg, DMD, MS Director of Anesthesiology, Century City Outpatient Surgery Center Clinical Professor of Anesthesiology, UCLA School of Dentistry sganzberg@ucla.edu

More information

SHOCK. Emergency pediatric PICU division Pediatric Department Medical Faculty, University of Sumatera Utara H. Adam Malik Hospital

SHOCK. Emergency pediatric PICU division Pediatric Department Medical Faculty, University of Sumatera Utara H. Adam Malik Hospital SHOCK Emergency pediatric PICU division Pediatric Department Medical Faculty, University of Sumatera Utara H. Adam Malik Hospital 1 Definition Shock is an acute, complex state of circulatory dysfunction

More information