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Amiodarone - used in Ventricular Tachycardia & Fibrillation and for Conversion of Atrial Fibrillation
. Bolus -150 mg in 100m1 to run over 10 minutes (Give 300mg IYP for Y Fib or Pulseless V Tach)
. Initiate infusion at I mg/min over 6 hrs and then 0.5mg/min [V maintenance
. Use 0.2 micronrtber
. Plasma level in 3-7 hrs / therapeutic effect 2-3 days
. Yrlife 45 days

Cardene- (Irlicardipine) - used to decrease SBP

o Post- cardiac surgery; Initial dose 2.5mg/hr.
r Arterial dilation is achieved by afterload reduction only; no venous dilatation or preload reduction
o Initial dose 5mg/hr IV infusion. Titrate 2.5mglhr every 5-15 min to a max of l5mg/hr, After reaching the BP goal
the maintenance goal should be 3mg hr. ,t
o Contraindicated in advanced aortic stenosis.
o Watch for hypotension and tachyarrhyhmia's.
. It is a calcium channel blocker. If bradycardia develops give CaCl and glucagon (Atropine is usually not
effective).
1
Diltiazem - used to treat PSVT and RATE CONTROL in Atrial Fibrillation/Flutter
. Bolus - 0.25 mg/r,.g over 2 minutes, MR in 15 min. if inadequate response with 0.35 mdkg over 2 minutes.
. For Infusion, set pump at mg/hr
. lnitiate at 5mg/hr and titrate up in 5mg/hr increments to a Max dose of l5mg/hr
, Watch for hypotension

Dopamine - used to support hemodynamics, inerease SBP & renal perfusion

. Set pump to run in mcg/kg/ min
. Initiate between 1-5 mcg/kg/min and titrate up by 1-2 mcg&g/min at 10-30 min intervals
. Max dose 20 mcg&g/min as needed to reach optimal response
. Adverse side effect tachycardia

Dobutamine * used to support hemodynamics, esp. contractility, increase SBP & renal perfusion
,Set pump to run in mcg/kgimin
.Initiate it}mcgkglmin and titrate up by 1-2 mcg/ kg/min at 10-30min intervals
.Usual dose 5-10 mcg/kg/min, and rarely may go up to 20 mcg&g/min
.Tachycardia but usually less than dopamiae

Epinephrine - used to support SBP in shock statcs (cardiogenic or septic shock)

I Set pump at mcg/min
. Initiate at lmcg/min and titrate up until desired blood pressure effect
r Max doses of 10 -15 mcg/min have been used

Esmolol- to treat supraventricular arrhythmias

r Post cardiac surgery; no bolus, initial dose 2lmcglkglmin
o Loading dose 500mcg/kg over I minute, followed by a maintenance dose
o Maintenance sequential setup; Infusion rates 50,100,150,200 mcg/kg/min every 20-40 minutes
o Esmolol is a short acting cardio selective beta blocker with a duration of about l0 min.
o Contraindicated in cardiogenic shock, overt cardiac failure, second and third degree heart block, bradycardia.
e Watch for brad-varrythimia, chest pain, hypotension
3 -2O 13 dhawkins-wdugan