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Propofol (Diprivan®) continued… Cardiac/Circulatory Medications • Administration – Use an infusion pump – 5 – 50 µg/kg/min. • Make any changes in rate very slowly. • Watch Out’s – Avoid rapid IV bolus – May cause hypotension – Monitor ABC’s Beta Blocking Agents • Class: – Β adrenergic blocker • Indications: – Used to manage hypertension, angina, prevent MI. • Contraindications: – Uncompensated CHF – Pulmonary edema, – Cardiogenic shock – Bradycardia or heart blocks β Blocking Agents continued… • Interactions: – May decrease β effects of dopamine or dobutamine. – Additive hypotension with other anti-HTN, alcohol, nitrates. – May alter effectiveness of insulin or other oral hypoglycemics. Dobutamine • Class: – Sympathomimetic, dopaminergic • Indications: – Cardiogenic shock with pulmonary edema • Contraindications: – Use cautiously with AMI and A-fib. Dobutamine continued… • Interactions: – Synergistic effect with sodium nitroprusside. – Reduces effects of β-adrenergic blockers – HTN crisis with TCA’s – HTN crisis with TCA s • Administration: – 2 – 20 µg/kg/min – Titrate to effect – Use an infusion pump 4
Procainamide • Class: – Antidysrhythmic • Indications: – Ventricular dysrhythmias • Contraindications – QT prolongation – High AV blocks Procainamide continued… • Interactions: – Additive effects – Hypotension with anti-HTN – Additive anticholinergic effects with other anticholinergics – Neuro-toxicity with lidocaine Procainamide continued… • Administration: – Infusion of 1 – 4 mg/min • Mixed as 1 gm in 250 ml D 5 W • Watch Out’s – Nausea and vomiting common Glycoprotein Inhibitors • Class: – GP IIb/IIIa Inhibitor • Indications: – Treatment of ACS, in combination with heparin. • Contraindications – Similar to your fibrinolytics Glycoprotein Inhibitors continued… • Interactions: – Increase in bleeding when used with heparin and aspirin. • Administration: – Use an infusion pump – Initial rate 0.4 mg/kg/min for 1 st 30 minutes – Reduce to 0.1 mg/kg/min • Watch Out’s – Avoid vascular and other trauma Heparin • Class: – Anticoagulant • Indications – ACS, pulmonary emboli, DIC • Contraindications – Uncontrolled bleeding – Sensitivity to pork and/or beef – Severe hepatic disease 5
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Page 7 and 8: Nipride® continued… Head/Spinal
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Transport Drugs

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