NUR 220 Quiz 2 Meds

Norepinephrine class and indications

Vasopressor, for shock and severe hypotension

Norepinephrine moa

stimulates alpha1sites for vasoconstriction and beta1 receptors to increase cardiac output

Norepinephrine side effects

HTN, arrhythmias, digital necrosis with high doses

Epinephrine class and indication

vasopressor/bronchodilator, indicated for anaphylaxis and advanced cardiac life support

Epinephrine moa

stimulates alpha1 sites for vasoconstriction, beta1 receptors to increase HR, and beta2 receptors for bronchodilation

Epinephrine side effects

HTN, arrhythmias, angina, nervousness, tremor

nitroglycerin class and indications

Nitrate, for angina and cardiogenic shock

Nitroglycerin moa

vasodilation, decreases preload and myocardial oxygen demand

Nitroglycerin side effects

Orthostatic hypotension, headache, reflex tachycardia, don’t take with ED meds (sildenafil)

Furosemide class and indications

Loop diuretic, indicated for pulmonary edema, edema, and HTN

Furosemide moa

blocks reabsorption of Na, Cl, and water in the ascending loop of Henle, causing rapid diuresis

Furosemide side effects

dehydration, hypokalemia, hyponatremia, hypotension, ototoxicity, hyperglycemia, rash

Dobutamine class and indications

inotropic, indicated for cardiogenic shock and HF

Dobutamine moa

stimulates beta1 receptors to increase cardiac output

Dobutamine side effects

HTN, arrhythmias, angina

Paralytics indications

Decreases O2 consumption, allows full support of ventilator, provides all muscle paralysis, including respiratory muscles, patient appears to be unconscious, loses motor function, loses all protective reflexes

Paralytics adverse effects

anaphylaxis, little cardiac effect, hyperkalemia, malignant hyperthermia, increased intraocular gastric and intracranial pressure, hypotension and bradycardia, hemodynamic instability, bronchospasm, rash, tachycardia, hypo/hypertension, bronchospasm, rash

Paralytics antidote

acetylcholinesterase inhibitor like neostigmine with antimuscarinic agents like atropine or glycopyrrolate

Blood transfusion protocol

rate not faster than 120 ml/hrfor first 15 minutes, VS 15x2, 30 minx2, then 60 min until done; needs to be completed within 4 hours of obtaining from blood bank

Blood transfusion reactions

Febrile nonhemolytic transfusion reaction, acute hemolytic (flank pain), delayed hemolytic, allergic, TRALI, TACO

.9% sodium chloride NS

widely available, inexpensive, requires large volume of infusion, can cause hyperchloremic metabolic acidosis, pulmonary edema

LR

lactate ion helps buffer metabolic acidosis, requires large volume of infusion, mildly hypotonic, can cause pulmonary edema, cerebral edema, shouldn’t be used in patients with severe hyperkalemia or patients with severe liver dysfunction or TBI; since it contains calcium, it’s contraindicated with blood due to risk of coagulation

Hypertonic saline

small volume needed to restore intravascular volume, danger of hypernatremia, osmotic demyelination syndrome, and increased serum osmolality