icu meds - j

Carvedilol (Coreg) - Class

Non-selective beta blocker with alpha-1 blockade 🫀

Carvedilol - MOA

Blocks β1, β2, α1 → ↓ HR, ↓ BP, vasodilation

Carvedilol - Why we use

Heart failure, HTN, post-MI

Carvedilol - ICU Dose

3.125 mg BID → titrate (max 25-50 mg BID)

Carvedilol - Major Adverse Effects

Bradycardia, hypotension, dizziness, bronchospasm

Carvedilol - Nursing Actions

• Check HR/BP • Hold HR

Metoprolol - Class

Beta-1 selective blocker 💓

Metoprolol - MOA

Blocks β1 receptors → ↓ HR, ↓ contractility

Metoprolol - Why we use

MI, HF, arrhythmias, HTN

Metoprolol - ICU Dose

5 mg IV bolus q5min ×3 (common ICU)

Metoprolol - Major Adverse Effects

Bradycardia, hypotension, HF worsening

Metoprolol - Nursing Actions

• Monitor HR/BP • ECG monitoring • Do not stop abruptly

Atenolol - Class

Beta-1 selective blocker

Atenolol - MOA

↓ sympathetic stimulation of heart

Atenolol - Why we use

MI, tachyarrhythmias, HTN

Atenolol - ICU Dose

25-50 mg PO

Atenolol - Major Adverse Effects

Bradycardia, fatigue, hypotension

Atenolol - Nursing Actions

• Check HR/BP • Monitor glucose (diabetics) • Fall risk

Enalapril - Class

ACE inhibitor 🌬️

Enalapril - MOA

Blocks angiotensin II formation → vasodilation, ↓ aldosterone

Enalapril - Why we use

HF, HTN, post-MI

Enalapril - ICU Dose

1.25-5 mg IV q6h

Enalapril - Major Adverse Effects

Cough, hyperkalemia, angioedema, hypotension

Enalapril - Nursing Actions

• Monitor K⁺/Cr • Watch facial swelling • Check BP

Lisinopril - Class

ACE inhibitor

Lisinopril - MOA

Same ACE inhibition

Lisinopril - Why we use

HTN, HF

Lisinopril - ICU Dose

10-40 mg PO

Lisinopril - Major Adverse Effects

Cough, hyperkalemia, angioedema

Lisinopril - Nursing Actions

• Monitor renal labs • Check BP • Assess K⁺

Valsartan - Class

ARB

Valsartan - MOA

Blocks angiotensin II receptors

Valsartan - Why we use

HF, HTN, post-MI

Valsartan - ICU Dose

40-160 mg BID

Valsartan - Major Adverse Effects

Hypotension, hyperkalemia, angioedema

Valsartan - Nursing Actions

• Monitor BP • Check K⁺ • Assess renal function

Amlodipine - Class

Dihydropyridine CCB

Amlodipine - MOA

Vasodilation via Ca²⁺ channel block

Amlodipine - Why we use

HTN, angina

Amlodipine - ICU Dose

2.5-10 mg PO

Amlodipine - Major Adverse Effects

Edema, flushing, dizziness

Amlodipine - Nursing Actions

• Monitor BP • Check edema • Assess HR

Diltiazem - Class

Non-dihydropyridine CCB

Diltiazem - MOA

Slows AV conduction, vasodilation

Diltiazem - Why we use

Afib, SVT, HTN

Diltiazem - ICU Dose

Bolus 0.25 mg/kg → drip 5-15 mg/hr

Diltiazem - Major Adverse Effects

Bradycardia, hypotension

Diltiazem - Nursing Actions

• Continuous ECG • Monitor BP • Hold for low HR

Vasopressin - Class

Antidiuretic hormone vasopressor

Vasopressin - MOA

V1 vasoconstriction, V2 water retention

Vasopressin - Why we use

Septic shock adjunct

Vasopressin - ICU Dose

0.01-0.04 units/min (fixed)

Vasopressin - Major Adverse Effects

Ischemia, hyponatremia

Vasopressin - Nursing Actions

• Do not titrate • Monitor perfusion • Check Na⁺

Phenylephrine - Class

Pure alpha-1 agonist vasopressor

Phenylephrine - MOA

Vasoconstriction → ↑ SVR

Phenylephrine - Why we use

Hypotension with tachycardia

Phenylephrine - ICU Dose

0.5-2 mcg/kg/min

Phenylephrine - Major Adverse Effects

Reflex bradycardia, HTN

Phenylephrine - Nursing Actions

• Monitor BP/HR • Assess perfusion

Nitroprusside - Class

Potent vasodilator

Nitroprusside - MOA

Dilates arteries & veins → ↓ preload/afterload

Nitroprusside - Why we use

Hypertensive crisis

Nitroprusside - ICU Dose

0.3-10 mcg/kg/min

Nitroprusside - Major Adverse Effects

Hypotension, cyanide toxicity

Nitroprusside - Nursing Actions

• Continuous BP monitoring • Watch thiocyanate levels • Protect from light

Lidocaine - Class

Class Ib antiarrhythmic

Lidocaine - MOA

Blocks sodium channels in ventricles

Lidocaine - Why we use

Ventricular arrhythmias

Lidocaine - ICU Dose

1-1.5 mg/kg IV bolus

Lidocaine - Major Adverse Effects

Seizures, confusion, cardiac depression

Lidocaine - Nursing Actions

• ECG monitoring • Watch neuro status

Dexmedetomidine (Precedex) - Class

Alpha-2 agonist sedative 🌙

Dexmedetomidine - MOA

↓ norepinephrine release → sedation

Dexmedetomidine - Why we use

ICU sedation (vented or not)

Dexmedetomidine - ICU Dose

0.2-0.7 mcg/kg/hr

Dexmedetomidine - Major Adverse Effects

Bradycardia, hypotension

Dexmedetomidine - Nursing Actions

• Monitor HR/BP • Titrate slowly • Assess sedation

Phenytoin - Class

Anticonvulsant

Phenytoin - MOA

Stabilizes neuronal sodium channels

Phenytoin - Why we use

Seizures, status epilepticus

Phenytoin - ICU Dose

15-20 mg/kg IV load

Phenytoin - Major Adverse Effects

Dysrhythmias, gingival hyperplasia, rash

Phenytoin - Nursing Actions

• Monitor levels (10-20) • Use NS only • Cardiac monitoring

Levetiracetam (Keppra) - Class

Anticonvulsant

Levetiracetam - MOA

Modulates neurotransmitter release

Levetiracetam - Why we use

Seizure prevention

Levetiracetam - ICU Dose

500-1500 mg IV BID

Levetiracetam - Major Adverse Effects

Mood changes, fatigue

Levetiracetam - Nursing Actions

• Monitor behavior • Renal dosing

Heparin - already provided above

Warfarin - Class

Oral anticoagulant

Warfarin - MOA

Blocks vitamin K clotting factors

Warfarin - Why we use

AFib, DVT, PE

Warfarin - ICU Dose

2-5 mg PO, titrate INR

Warfarin - Major Adverse Effects

Bleeding, skin necrosis

Warfarin - Nursing Actions

• Monitor INR • Bleeding precautions

Alteplase (tPA) - Class

Thrombolytic 🧬

Alteplase - MOA

Converts plasminogen → plasmin → clot breakdown

Alteplase - Why we use

Stroke, STEMI, PE