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    Emergency Drugs

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    Audi Kyle Saydoven
    This document provides information on emergency drugs used to treat cardiac conditions including epinephrine, lidocaine, atropine, adenosine, bretylium, dobutamine, dopamine, magnesium, and procainamide. It lists the indications, dosages, and nursing considerations for each drug. Torsades de pointes is defined as a specific type of ventricular tachycardia characterized by rotation of the heart's electrical axis by at least 180 degrees on ECG and preceded by irregular heartbeats.

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    Emergency Drugs

    Uploaded by

    Audi Kyle Saydoven
    191 views19 pages
    This document provides information on emergency drugs used to treat cardiac conditions including epinephrine, lidocaine, atropine, adenosine, bretylium, dobutamine, dopamine, magnesium, and procainamide. It lists the indications, dosages, and nursing considerations for each drug. Torsades de pointes is defined as a specific type of ventricular tachycardia characterized by rotation of the heart's electrical axis by at least 180 degrees on ECG and preceded by irregular heartbeats.

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    This document provides information on emergency drugs used to treat cardiac conditions including epinephrine, lidocaine, atropine, adenosine, bretylium, dobutamine, dopamine, magnesium, and procainamide. It lists the indications, dosages, and nursing considerations for each drug. Torsades de pointes is defined as a specific type of ventricular tachycardia characterized by rotation of the heart's electrical axis by at least 180 degrees on ECG and preceded by irregular heartbeats.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    191 views19 pages

    Emergency Drugs

    Uploaded by

    Audi Kyle Saydoven
    This document provides information on emergency drugs used to treat cardiac conditions including epinephrine, lidocaine, atropine, adenosine, bretylium, dobutamine, dopamine, magnesium, and procainamide. It lists the indications, dosages, and nursing considerations for each drug. Torsades de pointes is defined as a specific type of ventricular tachycardia characterized by rotation of the heart's electrical axis by at least 180 degrees on ECG and preceded by irregular heartbeats.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    of 19

    Emergency

    DRUGS
    Epinephrine
    Indication
     VF, pulseless VT, or asystole
    1 mg I.V push every 3-5 min
    Intermediate dosing: 2-5 mg IV push over 3-5 min
    Escalating dosing: 1mg, 3mg, 5 mg IV push 3 min apart
    High dosing: ,1 mg/kg IV push every 3 – 5 min
    Symptomatic Bradycardia: continous infusion at 2-10 mcg/min;
    titrate to hemodynamic response
    Nsg. consideration
    Each dose is followed by 20 mL iv fluid flush.
    Can be given via ET tube 2-2.5 x the IV dose, followed
    with 10 mL Flush PNSS
    IC when no other route is available
    It increases systemic vascular resistance, BP, Cardiac
    elec. Activity, strenth of contraction, automaticity, and
    myocardial O2 requirement
    Lidocaine
    Indication
     VF or Pulseless VT: Initially 1-1.5 mg/kg IV push:
    every 3-5 mins, max of 3mg/kg
     Stable VT or Stable wide-complex tachycardia:
    repeat doses half the original dose.
    If lidocaine succesfully converts the VF/VT: begin
    continous infusion at 2-4 mg/min
    Nsg consideration
    Toxicity( Slurred speech, altertered LOC, Muscle
    twitching, and seizures), stop the drug/reduce dose
    Via ET: 2-2.5 times the iv dose, flush with 10 ml PNSS
    Don’t give if PVC occurs with bradycardia or escape
    rhythm.
    No longer recommended for VT/VF prophylaxis in
    acute MI
    Atropine
    Symptomatic Bradycardia
     .5-1 mg iv push q 3-5 min, not to exceed .04 mg/kg
    Asystole
     1 mg iv push q 3-5 min, not to exceed a total dose of .
    04mg/kg
    Nsg consideration
    Don’t give less than .5 mg dose – may further slow
    heart rate
    Via ET: dilute 1-2 mg in 10 mL sterile water of PNSS,
    flush with 10 mL PNSS
    Adenosine
    wide-complex tachycardia:
     Initially 6 mg rapid iv push; if no response in 1-2 min,
    give 12 mg iv push; may be followed by a third 12 mg
    dose given in 1-2 min.
    Nsg consideration
    Given rapidly over 1-3 sec
    Follow dose with a 20 ml PNSS flush
    If methylxanthines, dipyridamole and carbamazepine
    are present higher dose may be needed
    A brief period of Asystole is common after
    administration
    Bretylium
    VF/ pulseless VT unresponsive to defibrilation, epi and
    lido
     5mg/kg iv push; if arhythmia persists, increase to 10
    mg/kg q 5-10 min, to a max dose of 35 mg/kg
    Stable VT or Stable wide-complex tachycardia:
     5-10 mg/kg over 8-10 min, to max 35 mg/kg over 24 hrs,
    if loading dose converts arhythmia start infusion of 2
    mg/min.
    Dobutamine
    Heart Failure
     2-20 mcg/kg/min
    Nsg considerations
    May cause tachycardia and other arhythmias, BP
    fluctuations, nausea and hypokalemia
    Monitor heart closely; increases in heart heart rate
    more than 10% may induce or exacerbate Myocardial
    Ischemia
    Dopamine
    Hypotension with symptomatic bradycardia, heart
    failure or after spontaneous return of circulation
     Initially, 1-5 mcg/kg/min; max is 20 mcg/kg/min
    Enhances renal blood flow – 1-2 mcg/kg/min
    Nsg consideration
    May induce tachycardia, - dose reduction/withdrawal
    Extravasation may cause severe tissue necrosis
    Norepinephrine should be added is more than max
    dose is needed to maintain BP
    Use slowest infusion first
    Can exacerbate pulmonary congestion and
    compromise cardiac output
    Eliminate hypovolemia as a cause of hypotension
    before treating
    Magnesium
    VF/VT with hypomagnesemia
     1-2 grams diluted in 10 mL D5W given IV push over 1-2
    min
    Torsades de pointes: 5-10 grams iv
    Acute MI with hypomagnesemia
     Intermitent of continous infusions
    Nsg consideration
    Flushing, sweating, mild bradycardia, and
    hypotension may develop from rapid administration in
    non arrest situations
    Procainamide
    PVCs or recurrent VT with pulse
     Initially, 20 mg/min until
    Hypotension occurs
    QRS complex
    PR interval
    QT interval is widened by 50 %
    Total of 17mg/kg of the drug was administered
     Maintenance infusion 1-4 mg/min
    Nsg consideration
    Monitor BP closely during administration; may cause
    precipitous hypotension, infuse cautiously in patients
    with acute MI
    Contraindicated in patients with preexisting long QT
    intervals and torsades de pointes
    Torsades de pointes, or simply torsades is a French
    term that literally means "twisting of the points". It was
    first described by Dessertenne in 1966 and refers to a
    specific, rare variety of ventricular tachycardia that
    exhibits distinct characteristics on the electrocardiogram
    (ECG).
    Characteristics
    Rotation of the heart's electrical axis by at least 180º
    Prolonged QT interval (LQTS)
    Preceded by long and short RR-intervals
    Triggered by an early premature ventricular contraction

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