* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
Download Atropine Dopamine Epinephrine
Survey
Document related concepts
Discovery and development of beta-blockers wikipedia , lookup
Drug discovery wikipedia , lookup
Cannabinoid receptor antagonist wikipedia , lookup
Pharmacognosy wikipedia , lookup
Prescription costs wikipedia , lookup
Pharmaceutical industry wikipedia , lookup
Pharmacogenomics wikipedia , lookup
Drug design wikipedia , lookup
Prescription drug prices in the United States wikipedia , lookup
Chlorpromazine wikipedia , lookup
Theralizumab wikipedia , lookup
Drug interaction wikipedia , lookup
Pharmacokinetics wikipedia , lookup
Plateau principle wikipedia , lookup
Neuropsychopharmacology wikipedia , lookup
Epinephrine autoinjector wikipedia , lookup
Transcript
Ch05-A04750.qxd 8/3/06 214 11:01 AM Page 214 Pediatric Advanced Life Support Study Guide Drug Pearl boxes feature relevant medication information in clearly marked boxes. Drug Pearl Drug Pearl Atropine Epinephrine • Atropine enhances AV conduction and oxygenation and ventilation do • Epinephrine is a direct-acting and increases heart rate (positive not correct the bradycardia. Give endogenous catecholamine chronotropic effect) by accelerating atropine before epinephrine if the with moderate β2-adrenergic the SA node discharge rate and bradycardia is due to increased (bronchodilation) and blocking the vagus nerve. Atropine vagal tone or if AV block is present. potent α-adrenergic has little or no effect on the force • Do not give atropine slowly or in of contraction (inotropic effect). (vasoconstriction) and smaller than recommended doses β1-adrenergic (↑ heart rate, (0.1 mg) because paradoxic slowing ↑ force of contraction) require large doses of atropine. of the heart rate can occur. properties. • Epinephrine is the drug of choice Paradoxic slowing may last • Anticholinesterase poisonings may if bradycardia is due to hypoxia 2 minutes. • Although epinephrine’s β1 effects increase myocardial oxygen consumption, it is Drug Pearl Dopamine generally well tolerated in the pediatric patient. • In cardiac arrest, epinephrine increasing myocardial contractility produces beneficial effects catecholamine with dose-related and stroke volume, thereby primarily because of its actions (there is some “overlap” of increasing cardiac output. At high α-adrenergic stimulating effects). At low doses (0.5 to doses (10 to 20 mcg/ effects: ↑ peripheral vascular 5 mcg/kg/min), dopamine acts on kg/min), dopamine acts on vascular resistance (vasoconstriction) dopaminergic receptors that are α-adrenergic receptors, producing → ↑ diastolic pressure → ↑ located mainly in mesenteric, renal, systemic vasoconstriction. Because myocardial and cerebral and coronary vessels, causing of the extreme variation in dosages blood flow during CPR. vasodilation. At moderate doses required to activate receptor sites (5 to 10 mcg/kg/min), dopamine in patients, it is impossible to stimulates the β1-adrenergic predict the infusion rate required receptors on the myocardium for an individual patient. • Dopamine is an endogenous • Use personal protective equipment. • Perform an initial assessment and obtain a focused history. • If the child is unstable (“sick”) (i.e., increased work of breathing with altered mental status, hypotension, or congestive heart failure with diminished peripheral perfusion) immediate intervention is necessary. • Administer high-concentration oxygen; ensure effective ventilation and oxygenation. Apply a pulse oximeter. Maintain oxygen saturation at above 95%. • Attach a cardiac monitor and identify the rhythm. • If the HR is slower than 60 beats per minute and accompanied by abnormal skin color, a decreased level of responsiveness, capillary refill below 2 seconds, or hypotension despite adequate oxygenation and ventilation, perform chest compressions.