Pharmacology

Vasopressor basics

  1. Levo

  2. Vaso

  3. Neo

  4. Epi

  5. Dop

Levophed

Analgesics


Sedation basics

  • Propofol

  • Fentanyl

  • Versed

  • Precedex

Propofol

Fentanyl

Versed

Paralytics


Anti-arrhythmics

Adenosine cardioversion of SVT

Cardizem- slows down electrical activity



Anti-Hypertensives

Nicardipine (Cardene)- anti htn


Anti-biotics


Other

Phentolamine (Regitine) in 5-10mg in 10ml saline. Antidote for extravasation. Administer subcutaneously via multiple sticks at the site of extravasation. 1 ml may be pushed through the guilty IV.


*RSI Kit- order of intubation etomodate then atropine

Atropine- give when pulse is 30
Etomodate- wears out the quickest of the RSI sedation meds

Intubation indicated at 20/10 vent settings.

Vasopressin Rates

Vasopressin is a non-adrenergic vasopressor. Many recommend a set rate over titration.

Septic shock protocol - Shock of unknown origin protocol - Refractory cardiogenic shock physician order
SET RATE TITRATE TITRATE
0.03 units/min 0.04 units/min 0.1 units/min

Why is a set rate for vasopressin beneficial? At a set rate, less catecholamines can by used.
Titratable rates- adverse effects occur more often at higher rates. These include myocardial infarction and gut ischemia.