Page 132 - Critical Care Nursing Demystified

Chapter 3 CARE OF THE PATIENT WITH CRITICAL CARDIAC AND VASCULAR NEEDS 117

TABLE 3–7 Drugs That Affect Contractility (Continued)
Action Use Precautions
Epinephrine Synthetic form of First-line drug Continuous cardiac
adrenaline that stim- in most monitoring is
ulates the action of advanced car- needed to see HR
the sympathetic ner- diac life support increases
vous system algorithms for Given IV push in an
Causes vasocon- cardiac arrest arrest. Infusion
striction leading to bradycardia and may be prepared
increased HR <BP via pump
Also given when Assess VS fre-
patient is in quently during ini-
symptomatic tiation and infusion
bradycardias
and heart Destroyed in alka-
blocks line solutions like
bicarbonate; so
use separate line
for infusion
Check label as
comes in varying
solutions
Dobutrex (Dob- Works on B1 and B2 In acute heart Always use infu- Downloaded by [ Faculty of Nursing, Chiangmai University 5.62.158.117] at [07/18/16]. Copyright © McGraw-Hill Global Education Holdings, LLC. Not to be redistributed or modified in any way without permission.
utamine) receptors of adren- failure sion pump for
ergic system to administration
increase contractility Assess VS fre-
and reduce afterload quently during ini-
Improves CO tiation and during
infusion
Monitor SaO
2
Observe especially
for hypotension
and tachycardia
Milrinone Phosphodiesterase For acute heart Always use an
(Primacor) inhibitor failure infusion pump
Increases contractil- Assess VS fre-
ity by blocking the quently during ini-
breakdown of cyclic tiation and during
AMP infusion
Also vasodilates and Monitor SaO
2
reduces afterload Observe especially
for hypotension,
ventricular dys-
rhythmias, and
tachycardia