Medica/tion Chart
Medications in the Anesthesia Cart
Drug:
Mech of action &
Receptor:
Onset:
Duration of
action:
Normal Dose:
Uses:
Risks:
Other:
Alupent
Stimulates ß2
receptors, resulting in
relaxation of bronchial
smooth muscle.
Inhalation:
1 min.
Inhalation:
3-6 hrs.
MDI:
Bronchodilator to Tx:
- bronchospasm r/t
asthma, chronic
bronchitis, emphysema
HTN, hypoTN
Tachy, palpitations
Hypo-K
↑ BP followed by a
substantial ↓ in BP.
Severe paradoxical
bronchoconstriction.
Drowsiness, cough
N/V, tremor, HA
nervousness, vertigo
Insomnia
Caution: isch. Heart,
Facilitate tracheal
intubation, Improve
surgical working
conditions during
general anesthesia
(produces skeletal
muscle relaxation),
used to facilitate
mechanical ventilation
in critically ill.
HypoTN, vasodilation
ST, SB
Hypovent./apnea
Broncho/larynospasm
Dyspnea, urticaria
Histamine SE rare at
recommended doses.
Prolonged infus. ↑
seizure risk.
Caution: hx of asthma
& anaphylax.
Interactions: NM block
↑ w/: animogl. abx, LA,
Mg, lithium, ganglionic
blockers, hypothermia,
hypo-K, resp acidosis,
Succs, Volatile, loops,
MG, adrenocort. dysf.
Req ↓ & w/: Volatiles
Recurrent paralysis w/
quinidine.
Reversal effects ↓ w/:
theophylline, paresis,
anticonvul. Rx, burn pt.
Category C
Contra: obstruct.
Uropathy/GI, NA
glaucoma.
Caution: additive
effects w/ other Rx, Pts
w/ tachy arrhyth, CHF,
AMI, fever, GERD, GI
infect.
Antagonizes: Reglan &
Antichol-ase Rxs.
(metaproterenol
sulfate)
* Sympathomimetic
Selective ß2adrenergic receptor
agonist
Atracurium
Besylate
Competes for
cholinergic receptors
at the motor end plate.
Nicotinic receptors
(Tracrium)
* Non-depolarizing
NMBA
Atropine
Sulfate
Nebulizer:
Inhal x 5-15 of 5% soln.
(0.3ml/dose)
Kids: Rx not recommended
IV: <3 min.
hydrolysis &
Hoffman elim.
- Temp & pH
dep.
IV: 45-60
sec
ETT:10-20
sec
IM: 5-40
min.
Inhal: 3-5
min
Calcium
Chloride
3x ↑ Ca vs Ca gluc.
*electrolyte &
+ inotrope
Nerve and muscle
fxn/contraction, cell
memb. & cap. perm.,
renal fxn, resp.,
coagulation.
Ca channel receptors.
Intubation:
Elim: Ester
Anticholinesterase Rx
w/ Atropine or
Glycopyr.
*Anticholinergic
IV: 20-35 min.
IV: 0.3-0.5mg/kg (add’l doses at
10-50% of intub. dose).monitor:
w/ nerve stimulator to min. OD.
Reversal:
Competitively
antagonizes Ach at
Muscarinic receptor.
Inhal. x 2-3 q 3-4 hrs. PRN
(0.65mg/spray)
**MAX:12 inhalations/24 hrs
IV: <30 sec.
Active Metabolite:
Laudanosine can cause
CNS stim. (give 10X
the normal dose)
IV/IM:
antichol 1-2 hr
antisialog 4hr.
ACLS & Brady:
Inhalation:
antichol 3-6
hrs.
IV/IM 0.4-1 mg
IV/IM/SC 0.5-1mg, q 3-5 min x 3
Kids: 10-20 mcg/kg
Pre-Op:
Bronchodilation:
Brady, ACLS, pre-med
to ↓ secretion, NMBA
reversal /emergence,
bronchospasm.
Cholinergic crisis.
OP poisoning.
Inhal 0.025 mg/kg q 4-6 hrs.
(2.5 mg max)
Emergence:
Elim: Hepatic
IV 0.015 mg/kg with…
Edroph: 10mcg/kg
Neo: 0.05-1 mg/kg
& Renal
IV: 10-20 min.
Adult:
IV 500-1000 mg
Kids:
Elim: GI &
Renal
IV 10-25 mg/kg
Goal serum Ca:
**8.5-10mg/dL
Resp. dep., CNS
effects, dry mouth.
↓ GI motility & LES
tone,GERD(↑ asp risk)
UO retention.
High doses: tachy,
anhydrosis
Low doses: Brady
Toxicity: tx w/ Benzo &
physostigmine.
HTN, arrhyth.,
↑ thyroid, DM,
Seizures, RF, liver dx
Contra:pt w dysrhyth
hypersensitivity, tachy
r/t dig tox.
Interactions: other
Sympaths., MAOI’s,
BB.
Category C
Crosses BBB
Category C
ACLS, hyper-K (w/
EKG changes), hyperMg, Lg. vol. Transf.
(citrate),
Ca antagonist OD.
HTN, hypoTN, brady,
Arrest, N/V, lethargy,
hyper-Ca (weak, HA,
fatigue, confusion,
irregular HR).
Arrhyth. w/ rapid IVP
Antagonizes: CCB,
Verapamil, Mg.
↑ Arrhyth: dig tox.
Category C
Dexamethasone
(Decadron)
* Synthetic
Glucocorticoid
↓ inflammation by
inhibiting the
migration of
leukocytes and
reversal of increased
capillary permeability.
Suppresses normal
immune response.
IV/IM:
Antiinflam. 2-5
min.
IV/IM:
Anti-inflam.
36-54 hours
Anti-inflammatory:
IV/IM 0.5-25mg/day
↑ ICP/Cerebral edema:
IV 10-50mg initially → IV/IM 420mg q 6 hrs x 5-7 days.
Airway Edema:
Elim:
IV 10-25mg q 6 hrs x 5 PRN
(at least 24hrs prior to intub.)
Inflamm. diseases
↑ ICP/cerebral edema,
Aspir. pneumo.
Bronchial asthma
Prevent transplant rej.
Replace. therapy w/
adrenalcortical insuff.
Bronchospasm:
Inhal 300mcg (3) 3-4 x day
Glucocorticoid
receptors
0.75mg Dex. = 20mg Cortisol
Digoxin
(Digitalis)
(Lanoxin)
*Cardiac Glycoside
Diphenhydramine
(Benadryl)
Directly inotropic
effect d/t inhibitor of
the Na-K ATPase
pump. Indirect
vagomimetic effect ↓
conduction through
the SA node &
prolongs conduction at
AV node.
IV: 5-30
min.
Antagonizes histamine
H1 receptors.
IV: 3-5 min.
H1 receptors
PO: 0.5-2
hrs.
(Inapsine)
* Neuroleptic
- Butrophenone
Edrophonium
Chloride
(Enlon)
(Tensilon)
(Reversol)
Adults:
CHF, SVT
+ inotrope
- chronotrope
Creat Cl. 10-79 & >65 y/o:
↑ contractility
↓ myocardial O2
consumption
IV/PO 0.5-1mg divided: 50% →
remaining in 25% x 4, then→
IV/PO 0.125-0.5mg/daily
↓ daily dose: IV/PO <0.25mg
Monitoring: K & Dig levels
Elim: Renal
(must be 4-6 hr post dose;
therep. takes up to 7 days)
IV/PO: 4-6 hrs
IV/IM 10-50mg
**MAX: 400mg/day
PO: <15
min.
PO 25-50mg q 6-8 hrs
Elim: Hepatic
* Antihistamine
Droperidol
IV/PO: 3-4
days
Antagonizes
dopamine, NE, &
serotonin at the NT
synapses, incl. the
CTZ. Producing
tranquilization,
antiemetic effects.
IV/IM:
3-10 min.
IV/IM: 2-4
hours
IV/IM 2.5-10mg
Antiemetic:
IV 0.625-2.5 mg
Neuroleptanesthesia:
Elim: Hepatic
& Renal
Dopamine, NE, &
Serotonin receptors
Inhibits hydrolysis
Ach by competitively
binding to
acetylcholinesterase.
improves intestinal/
skeletal muscle tone,
increases secretions,
Pre-Op:
Antiemetic, antivertigo,
allergic rxn., EPS rxn
(symptomatic), antichol
Partially inhib. vasodil
effects of histamine.
Anaphylaxis after Epi.
Anesth. pre-med - N/V
Neuroleptic
↓ potentiation and SE of
Opioid epidural.
IV 0.2mg/kg with…
Fentanyl 4mcg/kg
Epidural:
1.25-2.5mg
IV: 30-60
sec
IV: 5-20 min.
Emergence:
Slow IVP 0.5-1mg/kg
**MAX: 40mg with….
Atropine 0.015mg/kg
Glycopyrrolate 0.01mg/kg
PSVT:
Slow IVP 2mg q 1-2 min.
Reverse ND NMBA
Dx of MG (↑ strength)
DX & Tx PSVT
- including WPW
Short acting
Arrhyth, HTN
CHF (susceptible pts)
Seizure, ↑ICP, psychosis
↑ Insulin req.
↓ wound healing
Petechiae, erythema.
↑ IOP
H2O/Na retention
K depletion
Myopathy, weakness
Thromboembolism
↑ risk of infection (↑
masking of S&S)
Avoid NSAIS’s
Enhance ß-agonists
Alters Counadin resp
Caution: pt w/ HTN,
CHF, emboli hx, MG, ↓
thyroid, cirrhosis,
peptic ulcer, UC,
diverticulitis, new GI
anastomosis, psychosis,
seizures, syst.
fungal/viral inf.
Contra: admin of live
viral vaccines.
Long-term: muscle
wasting, spont. fx.
Narrow therp. range
CHB, arrhyth. (VT,
VF, ect.)
HA, psychosis, confs.
N/V/D, gynecomastia
Toxicity S&S: N/V,
arrhyth., HA, ↑or↓ K
(or normal), drowsy,
Yellow-green haols.
Category C
HypoTN, palp., PVC.
Wheezing, tightness.
Paradox. CNS stimul.
(more in kids)
Sedation, conf., blur.
vision, tinnitus,
tremors, seizures.
Urine frequency or
retention.
HypoTN, ↓SVR,
Tachy (↓ upstroke),
prolonged QT.
Prolonged CNS dep. w/
neuroleptanesth.
EPS, drowsiness,
hyperactivity.
“Fear of death” w/ preop admin.
Caution: Sedative
Brady, tachy, AV
block, hypoTN
↑ secretions, resp
ditress, bronchosp.
Anaphyl, allergic rxn
Seizures, dysarthria
HA, miosis
NO effect on depol
NMBA (Succs)
Interactions: effects ↓
with amino abx,
steroids, Mg, hypo-K,
hypothermia, resp &
metabolic acidosis.
Interactions:
Toxicity ↑ w/ ↓ K,
↓ Mg, ↑ Ca, ↑ serum
CCB levels, enzyme
inhibitors.
↑ thyroid ↑ resistance
↑ arrhyth w/ Succs
Contra: VF,
cardioversion w/ dig
toxicity.
effects are additive,
MAOI’s potentiate
antichol. effects, NA
glaucoma, ↑ IOP,
seizures, GI or bladder
neck obst. lower resp dx
(incl. asthma).
R/o hypoTN enduced
N/V before admin.
Contra: Parkinson’s
Caution: potentiates
other CNS dep. Rx,
↓ effects of Epi,
↑ threshold for Haloth.
& Epi-induced arrhyth.
Category C
* Anticholinesterase
salivation.
Binds to
acetylcholinesterase.
Elim: Hepatic
& Renal
Tx Chol. Crisis:
Ephedrine
*Non-Catecholamine
Sympathomimetic
Epinephrine
(Adrenaline)
*Sympathommetic
(Catecholamine)
Atropine: IV 10mcg/kg
q 3-10 min PRN
Mixed direct &
indirect stimul. of the
ɑ- & ß-adrenergic
receptors by ↑ the
activity of NE at
post-synaptic α- and βreceptors.
Alpha and Beta
adrenergic receptors
A1 ↑ vasoconstriction
A2 relax smooth muscle
B1 ↑ bronchodilation
B2 ↑ myocardial
contract. And HR
Agonist: alpha 1,
alpha 2, beta 1, beta 2.
(response dose dep.)
IV: immed.
IM: 2-5
min.
IV: 30-60
sec
SC: 6-15
min
ETT: 5-15
sec
Inhal: 3-5
min
Esmolol
(Brevibloc)
* Beta Blocker
Cardioselective
Selectively
antagonizes Beta1
receptors prod.
negative inotropic &
chronotropic effects:
↓ sinus HR, ↓ CO, ↓
BP.
IV: 1-2 min.
IV/IM: 10-60
min.
Elim:
Hepatic &
Renal
Resistant to:
MAO & COMT
IV: 5-10 min
ETT: 15-25
min.
Inhal/SC: 1-3
hrs.
MAX: 10mg w/ Atropine avail
(1mg/kg if > 90% twitch
depression when reversal is
intiated).
Hypotension/ Bronchospasm:
IV 5-25 mg
IM/SC 25-50mg q 5-10 min
PO 25-50mg q 3-4 hr PRN
(PO for bronchospasm only)
Vasopressor
Bronchodilator
↑ CO, BP, HR, coronary
BF, skeletal BF
**MAX: 150mg/24 hrs
ACLS:
IVP 1mg q 3-5 min x2 (1:10,000
soln)
Intra-Op:
Infusion 2-20mcg/min.
Anaphylaxis:
ACLS, anaphylaxis,
prolong LA
Post-intubation &
infectious Croup.
IM/SC 0.1-0.5mg (1:1,000 soln.)
Bronchodilation:
Elim: MAO &
Neb w/ O2: Dilute 1ml 2.25%
racemic Epi OR 1% (1:100) Epi
w/ 3ml NS, give 1-3 inhal q 5
min.
COMT
IV: 10-20 min.
Induction:
IV 500mcg/kg/1 min. → infus.
50-200mcg/kg/min (titrate)
Elim:
HTN, tachy, arrhyth.
Pulm. edema
Anxiety, tremors
Insomnia (CNS stim.)
Trans. hyper-K then
results in hypo-K.
Unpredictable effects:
pt w/ depl. endrog NE
Volatiles: co-admin ↑
arrhyth, ↑ MAC
Potentiated: w/ TCA
Caution: pt w/ HTN,
ischemic heart dx.
HTN, tachy, angina,
arrhyth., pulm edema.
hypo-K, & transient
hyper-K.
Anxiety, HA
Cerebral hemorrhage.
↓ renal BF, ↓ UO.
Caution: ↑ effects of
SVT, peri/intra-op HTN
Attenuate pressor
response d/t intubation.
IVP 25-100mg q 5 min. PRN
Infus. 50-300mcg/kg/min.
HypoTN, brady
Confusion, N/V
Urinary retention
↑ Dig. levels
Mask ↓ BG
IV site rxn.
High-dose: Antag. B2
- Bronchospasm
- ↓ BG
Esterases
Reversal: Pacemaker
Etomidate
(Amidate)
Atropine IV 1-2mg
Isoproterenol IV
0.02-0.15mcg/kg/min
Glucagon IV 1-5mg
Enhances the effects of
GABA similar to
barbs, propofol, and
benzo’s.
GABA receptor
agonist
Category C
- Min alt. uterine BF
TCA’s, ↑ arrhyth w/
volatiles & dig tox.
Pt’s w/ HTN, CVD, DM,
hyperthyroid.
Contra: LA or reg. in
Category C
HTN:
Beta1-adrenergic
receptors
Caution: brady,
asthma, arrhyth.,
peptic ulcers.
Contra: peritonitis, GI
or urinary obst.
Category C
digits, nose, ect..
IV 25-100mg 2 min prior
SVT:
N/V/G, ↑ peristalsis
Urticaria, rash
OD: cholinergic crisis
↑ levels w/ co-admin:
morphine, warfarin.
Potentiates: myocar.
dep. w/ inhal. or IV
anesth.; NMB of Succs
& Panc.
Caution: AV-HB, nontachy HF, COPD
Incompatable: Bicarb
Category C
IV: 30-60
sec
IV: 3-10 min.
Elim: Hepatic
Induction:
IV 0.1-0.4 mg/kg
Infus 0.25-1mg/min.
Induction
Anesth. supplement
- alt. to propofol/ Barbs
esp. w/ CV instability.
HypoTN, HTN
Arrhyth., N/V
Hypovent., hypervent
Laryngospasm
hiccup, eye/muscle
movements.
Adrenocortical supp.
Thrombophlebitis
Rapid IVP: ven.pain &
myoclonus.↓w/
benzo/opioid pre-med
Interactions: CV & CNS
dep. ↑ w/ Narcs,
sedatives, & volatiles
Caution: pt w/ focal
epilepsy
Category C
(Sublimaze)
Activates Mu1 & Mu2
opioid receptors.
*Opioid
Reversal: Naloxone
Fentanyl
Flumazenil
(Romazicon)
*Benzo antagonist
IV: 30 sec
IM: <8 min.
IV/IM/SC: 0.2-0.4 mg
Antagonizes the effect
of benzos at the GABA
receptor.
IV: 30-60 min.
Pre-Op & Analgesia:
IM: 1-2 hrs.
IM/IV 25-100 mcg
Induction:
IVP 5-40 mcg/kg
Elim: Hepatic
& Pulm.
IV/ETT:
1-2 min.
GABA receptor
antagonist.
IV/ETT:
45-90 min.
Elim: Hepatic
**Reversal Rx**
Inhibits reabsorp. of
Na, Cl & K at the
ascending medullary.
* Loop Diuretic
Na-K-2Cl
cotransporter
Ascending loop of
Henle
Glycopyrrolate
(Robinul)
* Anticholinergic
Intra-Op:
Inhibits action of ACh
at post-ganglionic PNS
receptors in smooth
muscle, secretory
glands, CNS.
IV: 5-15
min.
IV: 2 hrs
PO: 6-8 hrs
Reversal/OD:
IV 0.2-1 mg at a rate of 0.2
mg/min. q 20 min PRN
**MAX: 3mg/hr
Kids: 0.01mg/kg, PRN 45 sec →
6sec.x 4.
**MAX: 1mg
Reversal of sedative
effects of Benzo’s.
- reverse NMBA first.
IM/PO:
15-30 min.
Muscarinic receptors
IV:
Vagal block 23hr
↓ secretions 7
hrs
PO: Vagal
block
8-12hrs.
**Reversal Rx**
Caution: MAOI’s
N/V, confusion, HA,
agitation, seizures.
Arrhyth., tachy, brady,
angina, HTN, flushing.
Caution: Resedation
Benzo OD: other Rx
SE may emerge. Esp
TCA’s
Other:
Diuresis:
Slow IV/IM 5-40 mg
PO 20-160mg/day
Infusion 4mg/min or ↓
Kids: slow IV/IM 0.1-1mg/kg
PO 1-2mg/kg daily
Elim: Renal
IV: <1 min.
Resp. dep.(dose dep),
Rigidity(high dose),
Brady, HypoTN
Urinary retention
N/V
Category C
- Crosses placenta
IV 2-20 mcg/kg
ETT 1 mg/10ml NS (adult)
(Lasix)
Furosemide
Analgesia,
pre-med., anesthesia.
Pre-med:
IV/IM 0.1-0.2mg
PO 1-2mg (dilute in 3-5ml of
apple juice or soda).
Emergence:
IV 0.01mg/kg with…
Neo IV 0.05mg/kg
Pyridostigmine IV 0.25mg/kg
(0.2 mg Glyco. per 1mg Neo, or
5mg of Pyridostigmine)
Diuretic, HTN, ↑ ICP
CHF edema,
Hepatic cirrhosis
Nephrotic syndrome
CRF pts.
Diuretic resistant pts
↓ prod. of CSF
Dx acute oliguria
Ortho-hypoTN
Hypo-K, ↑ BG, ↑ uric
Hypo-Cl alkalosis
Ototox. (rapid IVP)
Tinnitus, vertigo
N/V/D
↓ clearance of:
salicylates & lithium.
Phototox. (1-2 weeks
post exposure)
Bladder spasm
Pancreatitis
TCP, neutropenia,
aplastic anemia.
Pre-med (vagolysis)
- ↓ secretions, relax
bronch., ↓ GI
tone/motility, ↓ LES
tone, ↑ IOP.
Reversal of NMBA
Adjunct w/ peptic ulcer,
& bronchospasm.
Tachy, brady, palp.
Confusion esp elderly
Dizzy, HA, dry mouth
Urinary hesit/retent.
N/V, urticaria, ↑ IOP
Poor PO absorption
vs. Atropine: ↓ tachy & ↓
secretions.
may occur (up to 2 hrs.
after reversal).
More potent Benzo’s req
↑ dose
Category C
Diuretic of choice w/
acute CHF
Periph vasodil occurs
before diuresis
Safe w/o BBB
Contra: co-admin w/
aminoglycoside abx &
ethacrynic acid, oliguria
d/t hypovol.
Potentiates:antiHTN
Hypo-K ↑ dig tox. &
potentiates NMBA.
Caution: ↓ effects if coadmin w/ NSAID’s &
indomethacin, Liver dx.
Category C
DOESN’T cross BBB
Devoid of sed. effects
Small doses may prod.
paradox brady.
Caution: glaucoma,
asthma, CAD, GI or
urinary obst.
Category B
Elim: Renal &
Heparin
Sodium
* Anticoagulant
Inhibits thrombosis by
inactivating. factors:
IX, X, XI, XII.
Inhibites conversion of
prothrombin to
thrombin, forms
complexes with
thrombin to inactive.
and prevent stable
fibrin formation.
IV: immed.
SC:
20-30 min.
Hepatic
IV/SC:
1-3 hrs (1/2
life)
Elim: Hepatic
IV Flush: 10-100 units
Prophylaxis:
Low-dose: SC 5000U 2hrs preop → q 12 hrs
Full-dose SC: IV 5000U & SC
10-20K U → SC 8-10K U q 8 hrs
or 15-20K U q 12 hrs.
Full-dose IV: IV 5000U →
infusion 20-40K U/24 hrs.
Bypass Surgery:
Prophylaxis/Tx of
thrombus/emboli
Anti-coag for Bypass
Dx and Tx DIC
↑ bleeding/ hemorrh.
(monitor: plt, HCT,
occult stool & urine).
TCP, ↑ AST/ALT
Injection site rxn.
Hypersensitivity
Priapism
Erratic SC absorption
NO IM admin.
↑ risk of bleed w/ coadmin of plt. aggreg.
inhibitors.
Caution: effects ↓ w/
Dig, Propran.,
Tetracyc., Nicotine,
Antihistamine.
Contra: TCP, non-DIC
uncontrolled active
IV 350-450U/kg
Goal ACT : 400-480 sec
Goal aPTT: 1.5-2 x control
(control normal: 25-35 sec)
Reversal: Protamine
slow IV 1mg per 100U
Hydralazine
(Apresoline)
* Antihypertensive
Vasodilator
Keterolac
(Toradol)
* NSAID
IV: 2-4 hours
Dilation:
IM/PO: 2-8 hrs.
IV/IM 2.5-40 mg
PO: 10-100mg 4 x daily
(↑ dose w/ rapid acetylators)
Direct relaxant effect
on arteriolar smooth
muscle. Interferes
with Ca transport in
vascular smooth
muscle.
↓ BP & SVR
↑ CO & SV
IV: 5-20
min.
PO: 0.5-2
hrs
Elim: Hepatic
Inhibits prostaglandin
synthesis.
Casues analgesia,
↓ inflamm., ↓ plt
aggregation & ↑
bleeding time, &
antipyretic.
IV: <1 min.
IV/IM: 3-7 hrs
IM: 10-30
min.
bleed.
HTN
↓ afterload w/ CHF
HTN secondary to
preeclampsia,
eclampsia, primary
pulmonary HTN.
(acetylation)
Analgesic:
IV/IM 30mg q 6 hrs. PRN
**MAX: 120mg daily
IM: <10
min.
Analgesia
- mild to moderate pain
>65 y/o, RF, Kids, <50kg:
Elim: Renal &
Hepatic
IV 15mg q 6 hrs. PRN
IM 30mgq 6 hrs PRN
**MAX: 40mg daily
NOT recomm. as pre-med
Tachy, hypoTN,
angina, palpitations
Dyspnea, congestion
HA, dizzy, anxiety
Periph neuritis
N/V/D, urticaria
SLE-like syndrome
Splenomegaly
Leukopenia, esinoph.
Agranulocytosis
GI bleed, peptic ulcer
↑ risk RF w/ ↓ renal
fxn, HF, LF, elderly,
on diuretics.
Vasodil, pallor, angina,
N/V/D
Dyspnea, asthma
Drowzy, dizzy, HA,
sweating, euphoria
Puritis, urticarial.
30mg = 9mg Morphine
- w/ ↓ SE
Labetolol
( Normodyne )
(Trandate)
*Antihypertensive
Blocks adrenergic
receptors at ɑ1, ß1, &
ß2.
IV: ɑ-ß blockade ratio of
1:7
PO:ɑ-ß blockade ratio of
1:3
IV: 2-5 min.
PO:
20 min.2hrs.
Lidocaine
* Class Ib
Antiarrhythmic
PO: 8-24 hrs.
Elim: Hepatic,
HTN:
Slow IVP 2.5-20mg/2 min.
(titrate to desired response)
Infus 0.5-2mg/min.
** MAX: 1-4mg/kg
PO 100-400mg 2 x daily
HTN (dose dep. ↓)
- w/o profound ↓ HR
Bronchoconstriction
- prior hyper airway.
Dyspnea
Maskes ↓ BG
HypoTN, brady, CHF
VT/VF, angina, HA
Drowsiness, vertigo
Paresthesia, tremor
Cognitive dep., rash
Numbness, fatigue
Dizziness, diarrhea
Cholestasis, ↑ LFT’s.
Ventricular arrhyth.
LA, epidural/spinal.
Attenuate pressor resp.
or Succs induced
fasciculation.
HypoTN, brady,
arrhyth. CHB.
Resp dep.
Seizures
Potentiates Succs
Urine & Feces
Slows HR, decreases
SVR, cardiac output,
B/P.
ɑ1, ß1, and ß2
receptors
Blocks Na Channel
receptors.
IV: 2-4 hrs.
IV: 45-90
sec
LT: 10-15
sec
IV: 10-20 min.
Induction (attenuate):
LT: 30-50 min.
IV 1.5-2 mg/kg 2-3 min prior to
intub/Sux
LT 2 mg/kg
Infiltration:
30-60 min.
Infiltration:
0.5-1 min.
Elim: Hepatic
& Pulm.
LA:
Topical 0.6-3 mg/kg
Infiltration/periph NB 0.5-5
mg/kg
Anti-Arrhythmic:
Slow IVP: 1-1.5 mg/kg → 0.5
mg/kg q 2-5 min
Category C
- NO cross placenta
NO ↓ in renal, uterine,
or cereb. BF.
Interactions: ↓ rxn to
Epi, ↑ hypotn w/
MAOI’s, diuretics,
dizoxide, anti-HTNs,
↑Desfl & Enflurane.
Category C
NO ↓ in MAC
Use limit: 5 days
No effect on plt. count,
PT, or PTT.
Interactions: ↑ tox. of
Lith. & methotrexate
Contra:ASA, NSAID,
anti-coags, (↑ bleed)
salicylates (↑ effects),
Hx PUD & GI bleed,
hypovol risk, any
bleeding Hx or acute.
Incomp: morphine,
meperd., hydrolazine
Promethazine.
Category C
- contra in L&D
NO change in CBF or
ICP.
Interactions: ↑ bioavail. w/ cimetidine, ↑
resist. to ß2 dilators
hypoTN ↑ w/ Volities.
Contra: asthma, HF,
>1sr deg. HB, cardioshock, severe brady.
Caution: abrupt d/c ↑
isch/MI risk w/ CAD.
Caution: hypovol., CHF,
Shock, all heart blocks.
Category B
Magnesium
Sulfate
*mineral
Presynaptic: regulates
release of Ach at nerve
endings, enzyme
active., req. for ox.
phos. (ATP).
NMJ: ↓ Ach release, ↓
motor end plate Ach
sensitivity, ↓
amplitude of MEP
potential.
IV: immed.
IV: 30 min.
IM: <1hr.
IM: 3-4 hrs.
Torsades:
IV 1-2g over 30-60 sec q 5-15
min. PRN
Metoclopramide
( Reglan)
* Antidopaminergic
Hypo-Mg, toxemia/
eclampsia/tocolytic,
epilepsy, nephritis.
Torsades, AMI, hypo-K
w/ arryth.
Resp. dep., CNS dep.,
brady, hypo, CHB,
wide QRS-I, vasodil.,
loss of deep tendon
reflexes, flaccid
paralysis. hypothermia
Hypo-Ca
High dose: ↓ ABP
Pregnancy: transient ↓
uterine vasc. resist., ↑
uteroplacental BF.
Potentiates: depol &
↑ gastric emptying
antiemetic
Tx DM gastroparesis,
Tx symptomatic GERD
HTN, hypoTN,
arrhyth.
↑ catechol. release
Drowsiness, anxiety
insomnia, akathisia
Minimal sedation
EPS rare
N/D, ↓ BG
Caution: pt w/ HTN,
Analgesia (potent)
Anesthesia
Reverse resp dep. of
Opioid agonists.
↑ withdrawl S&S (w/
Narc-dep. pts)
HTN, hypoTN
Tachy, brady.
Resp dep, dyspnea,
asthma.
Sedation, confusion
Euphoria, dysphoria.
Cramps, dyspepsia
Puritis, burning.
Urinary urgency
↑ gallbladder pain
↑ SNS activity (HTN,
tachy, arrhyth, pulm.
edema)
Goal plasma Mg:
**1.5-2.2mEq/L
Reversal:
Ca Gluc. 5-10 mEq
(10-20ml of 10%)
- fluid loading &
diuretic
Sensitizes GI smooth
muscle to Ach causing
↑ motility of upper GI
tract & ↑ LES tone.
Antagonism of
dopamine receptors &
inhib of CTZ result in
↓ N/V.
**MAX: 300mg/hr
Hypo-Mg: (10-20% soln.)
IV 10-15mg/kg/15 min→1g/hr.
IM 10-15mg/kg q6 x 4
PO 3g q 6 hrs. x 4
IV: 1-3 min.
Elim: Renal
Toxemia/Eclampsia/Tocolysis:
- maintain UO
at 100ml q
4hrs.
Slow IV 1-4g → Infus. 1-2g/hr
Therapeutic plasma Mg:
IV/IM/PO:
1-2 hrs.
Aspiration Risk:
IM: 10-15
min
PO:
30-60 min.
**4-6mEq/L
IV/IM 10mg/ 1-2 min.
PO: 10mg 30 min. before meals
& at bedtime.
Elim: Renal
Dopamine receptor
antagonist, selective
cholinergic agonists.
Nalbuphine
(Nubain)
* Synthetic Opioid
agonist-antagonist
Binds to opioid
receptors within the
CNS, narcotic agonistantagonist.
IV: 2-3 min.
IV/IM/SC:
3-6 hrs.
IM/SC:
<15 min.
Mu, Kappa & Delta
receptors
(Narcan)
**Reversal Rx**
Neostigmine
(Prostigmine)
Competitively inhibits
opiates at Mu, Delta,
& Kappa receptor
sites, & prevents or
reverses the effects of
opiate
Opioid Mu, Delta, &
Kappa receptors
Inhibits hydrolysis of
Ach by competing w/
Ach for attachment to
Ach-esterase at the
Induction:
↓ dose: w/ elderly, hypovol., coadmin of Narcs & sedatives.
Analgesic Potency:
= to Morphine
Antagonist Potency:
IV/IM/SC 0.2-0.4mg or
↑
Naloxone
IV/IM/SC 5-10mg
IV 0.3-3mg/kg
Elim: Hepatic
Reversal: Narcan
Analgesia/Sedation:
1/4th of Nalorphine
IV/ETT:
1-2 min.
IM/SC:
2-5 min.
IV/IM/SC/ETT:
1-4 hrs.
Elim: Hepatic
Reversal/OD:
IV/IM/SC 0.1-2mg q 2-3 min.
PRN
ETT dilute 1:1 in NS
**MAX: 10 mg
Kids: 10-100mcg/kg
Prophylaxis/SE Tx:
IV/IM/SC 0.1-0.8 mg
IV: <3 min.
IV: 40-60 min.
ST or SVT:
IV 0.25-0.5mg (tx cause)
Reversal of NMBA:
Slow IV 0.05mg/kg with…
Reversal of opioid
Narcotic dep/sedation.
Adjunt for other Rx
OD’s, Narcotic SE
prophylaxis/tx.
Help reverse hemodyn.
instability in septic &
cardiogenic shock pts.
Reversal of nondepolarizing NMBA.
Tx Myasthenia Gravis
Tx post-op urinary
N/V d/t rapid admin.
non-dep NMBA, CSN
dep w/ seds, narcs, &
volatiles.
Monitoring: assess
patellar reflex before
repeat dose.
Contra: CHB &
extensive heart
damage.
Life-threatening hyperMg can be Tx w/ Ca
Gluconate.
MAOI’s, ↑ GI motility
antagonized w/ Antichol
Rx & Narcs.
Potentiated: ↑ sedative
effects ETOH, sedationhypnotics, tranq, Narcs.
Prolongs Sucs
Contra: Parkinson’s,
Peds, HTN crisis w/
PheoCC pt., GI bleed,
epilepsy, GI obst/perf
Category B
Good CV stability
Potentiates: dep. effects
of Narc. Rx, volatiles,
sedative-hypnotics,
phenothiazides.
Category B
- crosses placenta
Caution: Resedation
may occur, pt w/ cardiac
disease, pt/newborns
physically dep on
opioids → Acute
Abstinence synd.
HypoTN, trembling,
seizures, sweating.
Brady, tachy, AV
block, hypoTN.
↑ secretions, rep dep.,
Bronchospasm
NMBA reversal ↓ w/:
animoglyc abx, hypo-K,
hypothermia, resp &
metabolic acidosis.
* Anticholinesterase
esteratic site.
Causes ↑ Ach
Atropine: IV 0.015mg/kg
Glycopyrrolate: IV 0.01mg/kg
Elim: Hepatic
Binds to Ach-esterase.
Tx Chol. Crisis:
Pentothal
(sodium
thiopental)
*Barbiturate
Phenylephrine
( Neosynepherine)
*Sympathomimetic
Atropine: IV 10mcg/kg
q 3-10 min PRN
Enhances action of
GABA receptors.
IV: 10-20
sec
IV: <1 min.
IM/SC:
10-15 min.
(Diprivan)
* Sedative Hypnotic
* LMW Protein
Puralube
(Lubricant tears)
Forms an occlusive
film on eye surface.
Lubricates/protects
eye from drying.
↓ SVR, CO, BP, CPP.
↓uterine BF
N/V
Resp dep.
May ↓ plasma Cortisol
Anaphylaxis
Intra-Op:
IV 0.5-1 mg/kg
Barb. Narcosis:
- slow
IVP 8mg/kg → drip @ 0.05-0.35
mg/kg/min.
IV: 15-20 min.
Hypotension during anesth.:
IM/SC: 0.5-2
hrs.
IV 50-100mcg
SC/IM 2-5mg
Infusion 10-200mcg/min.
Kids: IV 1-2mcg/kg
Periph vasoconstriction
HypoTN.
shock
PSVT
R-to-L shunt
Prolongs anesth. (LA’s)
Reflex brady, palp.,
arrhyth., hypoTN,
HTN, precordial pain
Acute pulm. edema,
resp distress
N/V, HA, anxiety
cerebral hemorrhage
Hepatic necrosis
Tissue necrosis
IV 0.5-1mg rapid, wait 1-1.5
min.→ if same, 2mg IV slow
Maint SBP <160mmHg
Elim: Hepatic
IV: <40 sec
IV: 5-10 min.
Shunt Reversal:
Induction:
Intra-Op:
IVP 25-50mg
Infusion 100-200mcg/kg/min.
Sedation:
Elim: Hepatic
IV: 0.5-1
min.
↓ BF to: renal, skin,
splanchnic & uterine.
↑ PAP
IV 50-100mcg
Slow IV 2-2.5mg/kg/ 30 sec
GABA receptor
agonist
Combinds with
Heparin to form a
stable complex devoid
of anti-coag activity.
Results in ↓ of
anticoagulant activity
of Heparin
Induction:
IV 3-5mg/kg
- high Vol.
distrib.
- rapid elim.
Protamine
sulfate
Induction,
to ↓ ICP,
anticonvulsant, cerebral
protection (Barb coma).
IM/SC 0.25-1mg q 4-6 hrs
PSVT:
Extravasation:
Propofol
IV: 5-15 min
Elim: Hepatic
No analgesia
Phentolamine
SC 5-10mg in 10ml NS
Produces sedative/
hypnotic effects via
interaction with
GABA.
Seizures, HA
N/V/F, ↑ peristalsis
↑ urinary frequency
Anaphylaxis
OD: cholinergic crisis
& plasma
esterases
Ultra short-acting
Activates alphaadrenergic receptors of
the vascular smooth
muscle.
Causing
vasoconstriction of the
arterioles.
Little ß effects.
Alpha-adrenergic
receptors
Post-Op Retention/Ileus:
retention & ileus.
Adjunct Tx: ST or SVT
IVP 25-50mg (titrate slowly desired effect slurred speech)
Maintenance of anesthesia: 100300 mcg/kg/min (typical ICU
max dose is 50 mcg/kg/min)
IV: 2 hrs.
IV: slow 1mg neutralizes 90-115
Elim: Hepatic
units of Heparin
> 30-60 min: give ½ dose
> 2 hrs: give ¼ dose
Induction/maintenance
of anesthesia.
- blunts resp. to intub.
Chemotherapy or postop N/V.
HypoTN, ↓ SVR, apnea.
↓: cerb. BF, MBR, ICP.
Tx severe Heparin OD
**MAX: 50mg/10 min.
Place small amount in the
conjunctival sac PRN
Protection/lubrication of
eye during and
following surgery
Post removal of a
HypoTN, HTN, fever
arrhyth. tachy, brady
Resp dep., apnea
Broncho/larynospasm
Hiccups, HA, dizzy.
confusion, euphoria.
Seizures, clonic/
myoclonic movement.
N/V, abd cramps.
Pain at IV site
Erythema, urticaria.
Histamine release
poss.: prod. anaphyl.
HypoTN, HTN, brady
Pulm. HTN, dyspnea
Bronchospasm
Anaphylaxis (or rxn)
N/V, flushing, TCP
Hyperheparinemia
Temp. blurring post
admin.
Caution: pt w/ brady,
asthma, epilepsy,
arrhyth., peptic ulcer.
Contra: pt w/
peritonitis, bowel or
urinary obstruction.
Category C
Incomp: Succs & Rx w/
acid pH.
Contra: status
asthmaticus, & all
Porphyria’s.
Caution: MAOI’s, HTN,
Hypovol., cardiac
ischemia, Septic.
Category C
↑ pressor effects w/:
oxytocics, bretylium,
guanethidine, MAOI’s
& other
sympathomimetics.
Caution: elderly,
↑thyroid, brady, partial
HB, severe
arteriosclerosis.
↑ arrhyth w/ volatiles
Contra: IV regional, LA
of end organs.
Category C
Interactions: ↑ CNS &
CV effects w/ Narcs,
sed-hypnotics,
Volatiles. ↓ resp. cl. w/
Afent/fentanyl.
Caution: pt w/ ↑ ICP,
Hx seizure/epilepsy, Csection, generic has ↑
allergic rxn.
Contra: allergy to eggs
&/or soybean oil.
Category B
Rapid IV:↑ histamine
- anaphyl., hypoTN
Interaction: ↑ effects of
vasodilators.
Incomp: PCN, Cephlo
Caution: fish allergy,
Insulin w/ protamine.
Category C
* Eye Lubricant
Rocuronium
Bromide
(Zemuron)
foreign body.
Competes for
cholinergic receptors
at the motor end plate.
Nicotinic receptors
IV: 1-2 min.
IV: 15-120 min.
(dose
dependant)
Intubation:
IV 0.6-1.2mg/kg (add’l doses at
10-50% intub. dose).
**base on actual body weight
Facilitate tracheal
intubation.
- esp. if can’t use Succs
Rapid acting
* Non-depolarizing
NMBA
Sodium
Bicarbonate
*Buffer
Sodium
Nitroprusside
(Nipride)
(Nitropress)
*Antihypertensive
Vecuronium
(Norcuron)
Elim: Renal &
Reversal:
Monitor: w/ nerve stimulator to
Tachy, arrhyth.
Hypovent./apnea
Bronchospasm
Pulm. HTN
Pruritis, rash
Edema at IV site
Histamine SE rare
min. OD.
Hepatic
Anticholinesterase Rx
w/ Atropine or
Glycopyr.
Dissociates to form
HCO3- & Na.
Buffers excess H ions,
promotes cell uptake
of K.
IV: 2-8 min.
Potent peripheral
vasodilator at arterial
& venous smooth
muscle.
Generates NO, which
activates smooth
muscle guanylate
cyclase forming ↑ IC
cGMP.
To cause relaxation:
cGMP inhibits Ca
from moving into the
cell.
NO causes hyperpol.
at K channels leading.
cGMP also acts on
myosin at the
sarcomere.
↓PVR, preload,
afterload & ↑ CO.
Competes for
cholinergic receptors
at the motor end plate.
Nicotinic receptors
IV: 30-60
sec
IV: 30-60 min.
Elim: Renal
IV: 1-10 min.
Correct Metabolic
acidosis, urinary
alkalization, ACLS.
Alkalization of urine:
Peripheral vasodilation:
IV: 25-30 min.
↑ w/: animogl. abx, LA,
Mg, lithium, ganglionic
blockers, hypo
therrmia, hypo-K, resp
acidosis, Succs,
Volatile, loops,
MG, adrenocort. dysf.
Req ↓ & w/: Volatiles
Recurrent paralysis w/
quinidine.
Reversal effects ↓ w/ &
theophylline,
anticonvul. rx, burn pt,
& paresis.
Category C
Incomp: Ca
↑ EtCO2
Category C
HTN Crisis, HTN,
controlled hypoTN,
acute CHF, pre-heart
transplant.
HypoTN, tachy, circ.
collapse, palpitations.
↑ ICP, HA, ↓ thyroid.
N/V-retching
Methheme., Cyanide
tox., thocy. tox. antiplt effect.
May ↑ V/Q mismatch
↓ uterine BF
Cyanide Tox S&S:
Tachyphylaxis, ↑
MvPO2, metab acid
Thiocy. tox S&S:
Elim: Hepatic
IV: <3 min.
Metabolic alkalosis,
hypo-K
Carpopedal spasm
w/hypo-Ca pt.
IV 48mEq, →
12-24mEq q 4 hrs.
**1 AMP = 50mEq
**MAX:
10mcg/kg/min for 10 min.
**Protect from light
Caution: RF ↑ tox risk,
↑ fetal cyanide risk if
mother under gen.
anesth.
HypoTN poten. by:
Volatiles, antiHTN ,
ganglionic BA,
circulatory dep Rx.
Contra: pt w/
compensatory HTN,
inadequate cerebral BF.
(> 10mg/100ml)
Sk. muscle weakness
N/V, confusion.
- lab req if inf >48hrs
Intubation:
IV 0.08-0.1mg/kg
Intra-Op:
Hepatic
Reversal:
0.5mEq/kg q 10 min.
Acidosis: IV (kg x mEq/L deficit
x 0.3) /2
IV infusion: 10-300mcg/min.
Elim: Renal &
* Non-depolarizing
NMBA
ACLS: IV 1mEq/kg, →
Interactions: NM block
IV 0.01-0.0mg/kg initially
Infusion 1-2 mcg/kg/min
Monitor: w/ nerve stimulator to
min. OD.
Facilitate tracheal
intubation.
Hypovent./apnea
Prolonged paralysis w/
long-term infusion
- RF, ↓K, ↓Ca, ↑Mg,
amino abx, corticoster.
Brady w/ co-admin of
potent opioids.
Histamine SE rare
Interactions: NM block
↑ w/: animogl. abx, LA,
Mg, lithium, ganglionic
blockers, hypo
therrmia, hypo-K, resp
acidosis, Succs,
Volatile, loops,
MG, adrenocort. dysf.
Req ↓ & w/: Volatiles
Recurrent paralysis w/
Verapamil
(Calan)
(Isoptin)
* CCB
Anticholinesterase Rx
(Neostigmine) w/
Antichol. (Atropine or
Glycopyrrlate).
Selectively inhibits
influx of Ca ions into
cardiac & smooth
muscle
Antiarrhythmic effects
are d/t inhibition of Ca
influx through slow
channels in pacemaker
cells. AV conduction is
slowed & the effective
refractory period is
prolonged.
Calcium channel
receptors
IV: 2-5 min.
PO: 30 min.
IV: 30-60 min.
PO: 3-7 hrs.
(1/2 life)
PSVT, A-Fib or A-Flutter:
IV 5-10 mg/ 2 min q 30 min
PRN
HTN:
IV 2.5-10mg (titrate)
PO 40-80mg (RR) 3 x daily
Chronic A-Fib (on Digoxin):
Elim: Renal
PO 240-320mg/day (RR)
- taken in 3-4 divided doses
PSVT (NOT on Digoxin):
PO 240-480mg/day (RR)
- taken in 3-4 divided doses
Tx SVT (PSVT)
Temp. control of A-fib
or A-flutter w/RVR not
assoc. w/ accessory
pathway.
HTN, angina
Migraine prophylaxis
↓: Contractility, HR,
SVR, ABP, myocardial
demand.
HypoTN
Brady, tachy
Worsen HF w/ poor LV
fxn pts.
Bronchospasm
Laryngospasm
HA, dizzy, seizures
N/V, Abd pain
Urticaria, puritis
Tx RVR with WPW:
Procainamid,
Lidocaine,
cardioversion.
quinidine.
Reversal effects ↓ w/
theophylline.
Category C
Interactions: ↑ effects of
ALL NMBA, CV dep
effects are additive w/
Volatiles & Anti-HTN
Rx’s, ↑ cardiac risk w/
co-admin of BB, ↑
cardiac dep effects of
Bupiv. & LA’s, ↓
Lithium effects, ↓ cl. w/
cimetidine, levels ↑ w/
grapefruit.
Enzyme Inhibitor
Incompatible: Bicarb &
Nafcillin
Caution: pt on highly
protein-bound Rx’s.
Tx Brady or AV block:
Versed
(Midazolam)
*Benzo
Isopro., CaCl, NE,
Atropine, Pacing.
Enhances action of
GABA receptors.
GABA receptor
agonist.
IV: 0.5-1
min.
IM: 15 min.
PO: <10
min.
Reversal: Flumazenil
IV/IM:
15-80 min.
Pre-Op: IM 2.5-10 mg
PO 0.25-0.5mg/kg (kid)
Conscious Sedation:
PO: 2-6 hr.
IV 0.5-5 mg
Elim: Renal
Infusion 2-15 mg/hr
Induction:
0.25mg/kg
IVP 1-2.5 mg
PO 0.5 mg/kg
slow IV 0.2-1 mg
Deep sedation:
Pre-med, sedation,
induction, anxiolytic,
amnesia,
anticonvulsant.
↓ RR, Possible ↓ BP
Contra:
NA glaucoma
↓ dose >60y
Category D
↓ MAC req.
Other Meds not listed on the REQ sheet
Drug:
Mech of action &
Receptor:
Onset:
Duration of
action:
Normal Dose:
Uses:
Risks:
Other:
Succinylcholine
Combines w/ chol.
receptors at the motor
end plate to depol.observed as
fasciculations. Prod.
flaccid paralysis.
IV: 30-60
secs.
IV: 5 mins
Induction:
Sleletal muscle
relaxation
Induction
↓or↑ BP, ↓or↑ HR, arrhyth.
↑ LES press. (Aspir.)
Prolonged blockade w/:
↓K, ↓Ca, ↓ pseudochol-ase,
phenelzine, BB, lidocaine,
procainamide, reglan, ,
Mg, oxytosin, Volitiles,
trimethaphan, Anticholase,pre-tx w/ Panc,
MAOI’s, BCP.
Blockade ↓ w/: pre-tx ND
Will ↑ K (0.5mEq in
normal pt)
Unpred resp w/: MG
Contra: severe burns, ↑
K, -lyte imbal., trauma, ↑
IOP, paraplegia, sp.cord
injury.
Histamine r not signif.
Inconp. w/ Alkaline soln.
Repeat dose: ↑ brady
Preg: ↑ sensitivity, NO
(Anectine)
*DEPOL. NMB
Reversal:
Anticholinesterase Rx
(Neostigmine) w/
Antichol. (Atropine or
Glycopyrrlate).
Peak:
60 secs
0.7-1mg/kg
(1.5mg/kg w/ ND pre-tx)
Elim: plasma
pseudochol-ase
Neonates & Infants:
2-3mg/kg
Children:
1-2mg/kg
Ultra-short acting
Monitor w/ nerve
stimul
MH: Tx w/ Dantroline
2.5mg/kg
Methergine
(Methylergonovine
Maleate)
* Semisynthetis
Ergot Alkaloid
Metoprolol
(Lopressor)
Act directly on
uterine smooth
muscle: ↑ tone, rate,
& amplit. of
contractions.
↓ 3rd stage of labor & ↓
bleeding
IV: immed
IM: 2-5 mins
IV:.45 mins
IM: 4-6 hrs
Peak:
IV: <5 min
IM: <30 min
Elim: Hepatic
Cardio-selective BB
Can block ß2 in high
doses
IV: immed
IV/PO: 5-8 hrs
*Antihypertensive
IV/IM: 0.2mg over 60 secs
Repeat q 2-4 hrs
HTN & Angina:
PO: 50-400mg daily
PO:
<15 mins
Elim: Hepatic
AMI:
Tx postpartum
uterine atony &
bleeding
HTN, SVT, AMI, antianginal, ETOH
withdrawal
IV: 5mg q 2mins x 3
Peak:
IV 20 mins.
NMB.
MH: ridgidity (esp jaw),
tachy, tachypnea, unresp to
↑ Volatiles.
↑or↓ BP, chest pain,
dyspnea, ↑ CVP & PAP,
tinnitus, HA, SZ, N/V/D,
hematuria, extremity
necrosis
D/C w/ c/o: tingling in
extremities
↓ BP, arrhyth, rebound
angina, bronchospasm,
dyspnea, cough, N/V,
TCP purpura,
arthralgia.
Mask S&S of ↓ BG
effect on Uterus or other
smooth muscle.
Category C
Vasoconstr. potent. w/:
ephedrine, phynel.,
nicotine
Caution: preeclampsia,
HTN, heart disease.
Avoid in pt w/: PVD
Limits lactation, IS in
breast milk.
↓ BP worse w/: Volatiles,
↓ catechol.
Potentiates: ALL NMBA
↑ levels: Dig & morphine
Rebound HTN w/ abrupt
d/c
Contra: brady, HB >1°,
cardio shock
Propranolol
Indigo carmine
Methylene
Blue
Oxidation-reduction
rxn
IV: immed
Peak: <1 hr
Varies
Elim: Renal
IV: 1-2mg/kg over minutes
PO: 65-130mg q TID
(Urolene Blue)
Solu-cortef
ancef
Decadron
Oxytosin
Physostigmine
Promethazine
Zofran
Nitroglycerine
Pepsid
Nitrobid 2%
Tx Rx induced
methemoglobinemia
↑ HR, HTN, cyanosis,
confustion, HA, N/V/D,
abd pain
False ↓ in SaO2 <85% or
false ↑ SaO2 >85%
Hemolytic Anemia
Hyperbilirubinemia
BLUE skin color
Discolor. of UO & feces
Contra: RF pt