Class of Drug
Antiarrhythmic
CRITICAL CARE IV MEDICATIONS USED FOR SHOCK
Specific Drug
Mechanism of Action
Amiodarone
-Class III
(Cordarone)
antiarrhythmic agent
that slows intracardiac conduction.
Lidocaine
(Xylocaine)
-Class IB
antiarrhythmic agent
block inactivated
sodium channels and
shorten
repolarization and
duration of the action
potential.
-Short acting β1selective betablocker.
Beta Blocker
Esmolol
(Brevibloc)
Calcium Channel Blocker
Diltiazem
(Cardizem)
Non-dihydropyridine
calcium channel
blocker.
Nicardipine
(Cardene)
-Dihydropyridine
calcium channel
blocker.
Milrinone
(Primacor)
-Inotrope
(phosphodiesterase-3
inhibitor).
- Dose-dependent
ventricular
dysfunction can ↑ CO
through SVR
reduction.
-Lowering of PAP may
be beneficial in
patients with
pulmonary
congestion due to LV
dysfunction
(pulmonary
hypertension).
Inotrope
Contraindication
Contraindicated
in complete or
2nd degree AV
Block
Sinus
bradycardia,
AVB>1°,
cardiogenic shock
AVB > 1°, WPW
syndrome, Vtach, SSS, short
PR syndrome
CRITICAL CARE IV MEDICATIONS USED FOR SHOCK
Class of Drug
Specific Drug
Mechanism of Action
Dobutamine
-Potent beta-1
(Dobutrex)
agonist: strong
positive ionotropic
activity
-Some beta-2 and
alpha agonist activity.
Because of beta-2
activity, does not
cause vasoconstriction may ↓ BP.
Sympathomimetics
Dopamine
-Dopamine receptor
(Intropin)
agonist, at higher
doses activates alphaand beta-adrenergic
receptors.
Sympathomimetics/Vasopressors Norepinephrine -Potent alpha-1
(Levophed)
agonist activity, weak
beta-1 activity (may
see ↑ HR).
Phenylephrine
-Acts as a pure alpha(Neo1 agonist ONLY.
Synephrine)
Vasopressin
-Stimulates
(Pitressin)
vasopressin receptor
resulting in
vasoconstriction
and free water
retention (no
inotropic or
chronotropic
effects).
Vasodilators
Sodium
-Direct vasodilator
nitroprusside
potent arterial
(Nipride)
vasodilator.
Nitroglycerine
(Tridil)
-Coronary vasodilator
and peripheral
vasodilator (reduces
preload).
Contraindication
Uncorrected
tachyarrhythmias,
ventricular
fibrillation, septic
shock