ICU E-cart 비치 응급약품 조사

본 내용은 " ICU E-cart 비치 응급약품 조사 " 의 원문 자료에서 일부 인용된 것입니다. 2023.03.05

문서 내 토픽

• 1. Atropine sulfate

  Atropine sulfate는 부교감신경 차단제로, 심정지 및 서맥성 PEA(무수축) 환자의 치료에 효과적입니다. 정맥 내 bolus로 1mg을 3-5분마다 최대 3mg까지 투여할 수 있으며, 기관내 투여 시에는 1mg/10cc 증류수에 혼합하여 투여합니다. 그러나 심근허혈이 있는 환자에게는 심근의 허혈을 악화시킬 수 있어 반복 투여를 피해야 합니다. 부작용으로는 입마름, 광과민성, 안내압 증가, 동공확대, 오심, 구토, 배뇨장애 등이 있습니다.

• 2. Epinephrine

  Epinephrine은 혈압과 맥박을 증가시키는 약물로, 무맥성 VT(심실빈맥), Vfib(심실세동), 무맥성 전기활동 등 모든 심정지 환자에게 사용됩니다. CPR 중 3-5분마다 1mg을 정맥 내 투여하며, 정맥 확보가 어려운 경우 기관내 투여도 가능합니다. 지속적인 투여 시 중심정맥관을 이용해야 하며, 심근의 허혈과 심실부정맥을 유발할 수 있습니다. 부작용으로는 고혈압, 신경과민, 떨림, 심계항진 등이 있습니다.

• 3. Norepinephrine

  Norepinephrine은 혈압상승제로, 저혈압, 패혈성 쇼크, 심인성 쇼크 등에 사용됩니다. 8mg을 5% 포도당 주사액에 희석하여 2-3ml/min으로 정맥 내 점적 투여하며, 유지량은 0.5-1ml/min입니다. 부작용으로는 심계항진, 서맥, 호흡곤란, 두통, 어지러움, 진전, 불안, 오심 등이 있으며, 정맥 외로 유출되면 조직 괴사를 일으킬 수 있습니다.

• 4. Sodium bicarbonate

  Sodium bicarbonate(Bivon)는 심정지 시 발생하는 산성화를 교정하기 위해 사용됩니다. 처음 1mEq/kg을 투여하고, 이후 10분마다 최초량의 절반을 투여합니다. 그러나 과나트륨혈증과 호흡성 산증을 악화시킬 수 있어 주의가 필요합니다. Calcium 제제와 함께 투여하면 침전물이 생길 수 있으므로 별도의 경로로 투여해야 합니다.

• 5. Magnesium sulfate

  Magnesium sulfate는 항부정맥제로, post infarction ventricular arrhythmia, digitalis 독성에 의한 심실성 빈맥, 임신성 고혈압(자간증) 등에 사용됩니다. 급성 정맥 투여 시 1-2g을 5% 포도당 용액에 혼합하여 1-2분 내 주사합니다. 부작용으로는 서맥, 말초혈관 확장, 마그네슘 중독 등이 있습니다.

• 6. Vecuronium bromide

  Vecuronium bromide는 근이완제로, 마취 시 근이완, 기관내 삽관, 수술 시 근이완 유지에 사용됩니다. 부작용으로는 쇽, 발적, 발진, 서맥, 저혈압, 딸꾹질, 기관지 경련, 근육통, 무력감 등이 있으며, 호흡곤란 및 기도폐색 환자, 기관지 천식 환자, 전해질 이상 환자, 고혈압 환자에게는 주의가 필요합니다.

• 7. Calcium chloride

  Calcium chloride는 저칼슘혈증성 tetany, Mg 중독의 해독에 사용됩니다. 3% 용액 600mg/20ml를 N/S 100ml에 혼합하여 4-5시간에 걸쳐 정맥 내 점적 투여합니다. 부작용으로는 말초혈관 이완 및 혈압강하, 산증, 골격근 이완, 식욕부진, 변비, 결석, 근육통, 관절통 등이 있으며, 심부전증 및 강심배당체 투여 중인 환자에게는 금기입니다.

• 8. Naloxone

  Naloxone은 아편 길항제로, 아편류에 의한 마약 억제의 역전에 사용됩니다. 초회 용량은 0.4-4mg을 정맥 내 투여하며, 이후 1일 4-8mg을 생리식염수 1000ml에 혼합하여 점적 투여합니다. 부작용으로는 구토, 빈맥, 발한, 혈압상승, 전율, 심실성 빈맥, 세동 및 폐부종, 경련 등이 있습니다.

• 9. Calcium gluconate

  Calcium gluconate는 저칼슘혈증에 의한 tetany 또는 경련, 고칼륨혈증, 중금속 중독 등에 사용됩니다. N/S 100ml에 10% Calcium gluconate 1앰플을 혼합하여 30분에 걸쳐 천천히 정맥 내 점적 투여합니다. 부작용으로는 식욕부진, 구역, 구토, 변비, 위통, 권태, 고칼슘혈증, 신결석 등이 있으며, 강심배당체 투여 중인 환자, 고칼슘혈증, 신결석, 중증 신부전 환자에게는 금기입니다.

• 10. Amiodarone HCI

  Amiodarone HCI는 항부정맥제로, VT(심실빈맥), Vfib(심실세동) 등 심실성 부정맥 치료에 사용됩니다. 정맥 내 투여 시 150mg을 20-30ml 생리식염수에 혼합하여 빠르게 투여하며, 부작용으로는 저혈압, 서맥 등이 있습니다.

• 11. Lidocaine

  Lidocaine은 항부정맥제로, Vfib(심실세동), 무맥성 VT 환자에게 제세동 및 에피네프린 투여 후에도 회복되지 않을 때 사용됩니다. 정맥 내 bolus로 50-100mg을 1-2분에 걸쳐 천천히 투여하며, 부작용으로는 저혈압, 부종, 주사부위 홍조, 변비, 구토, 현기증, 두통, 무감각, 혼돈, 졸음, 떨림 등이 있습니다.

Easy AI와 토픽 톺아보기

• 1. Atropine sulfate

  Atropine sulfate is a widely used medication in emergency and critical care settings. It is a parasympatholytic drug that acts as an antagonist to acetylcholine, the primary neurotransmitter of the parasympathetic nervous system. Atropine sulfate is primarily used to treat bradycardia, or slow heart rate, as well as to counteract the effects of cholinergic agents such as organophosphate poisoning. It can also be used to reduce excessive secretions, such as those seen in certain respiratory conditions. The drug has a relatively rapid onset of action and is generally well-tolerated, although it can cause side effects such as dry mouth, blurred vision, and confusion, especially in elderly patients. Overall, atropine sulfate is an important and versatile medication in the management of various acute medical emergencies and conditions.

• 2. Epinephrine

  Epinephrine, also known as adrenaline, is a critical medication in emergency medicine and anaphylaxis management. It is a potent sympathomimetic drug that acts on both alpha and beta adrenergic receptors, leading to a wide range of physiological effects. Epinephrine is primarily used to treat anaphylactic reactions, as it can rapidly reverse the life-threatening symptoms of airway swelling, hypotension, and bronchospasm. It is also used in the management of cardiac arrest, as it can improve myocardial contractility and increase blood pressure. Additionally, epinephrine has a role in the treatment of certain respiratory conditions, such as asthma exacerbations. While epinephrine is generally safe and effective when used appropriately, it can cause side effects such as tachycardia, hypertension, and anxiety. Careful dosing and monitoring are essential when administering this powerful medication. Overall, epinephrine is a critical and indispensable tool in the management of acute, life-threatening medical emergencies.

• 3. Norepinephrine

  Norepinephrine, also known as noradrenaline, is a potent vasoconstrictor and an important medication in the management of shock and hypotension. It acts primarily on alpha-adrenergic receptors, leading to increased peripheral vascular resistance and improved blood pressure. Norepinephrine is particularly useful in the treatment of distributive shock, such as septic shock, where it can help restore organ perfusion and prevent tissue hypoxia. It is also used in the management of cardiogenic shock, where it can improve cardiac contractility and output. Norepinephrine is generally considered a first-line vasopressor in the treatment of shock, as it is more selective and less likely to cause adverse effects on the heart compared to other vasopressors. However, it must be used with caution, as it can lead to excessive vasoconstriction, tissue ischemia, and arrhythmias if not titrated properly. Careful monitoring and dose adjustment are essential when administering norepinephrine to ensure optimal patient outcomes.

• 4. Sodium bicarbonate

  Sodium bicarbonate, also known as baking soda, is a versatile medication used in various medical settings. It is primarily used to correct metabolic acidosis, a condition characterized by an abnormally low pH in the body. Sodium bicarbonate can be particularly useful in the management of certain acute conditions, such as diabetic ketoacidosis, where it can help restore the body's pH balance. It is also used in the treatment of hyperkalemia, or high potassium levels, as it can help drive potassium back into cells. Additionally, sodium bicarbonate has a role in the management of certain poisonings, such as tricyclic antidepressant overdose, where it can help alkalinize the blood and enhance the elimination of the toxin. While sodium bicarbonate is generally considered safe, it can cause side effects such as metabolic alkalosis, hyperosmolarity, and electrolyte imbalances if not used judiciously. Careful monitoring and dose adjustment are essential when administering this medication to ensure optimal patient outcomes.

• 5. Magnesium sulfate

  Magnesium sulfate is a versatile medication with a wide range of clinical applications. It is primarily used in the management of eclampsia and pre-eclampsia, where it can help prevent and control seizures in pregnant women. Magnesium sulfate works by blocking the entry of calcium into muscle cells, leading to a reduction in neuromuscular excitability and muscle contractions. In addition to its use in obstetrics, magnesium sulfate is also used in the treatment of certain cardiac arrhythmias, such as torsades de pointes, and in the management of acute asthma exacerbations. It can also be used as a muscle relaxant and in the treatment of certain neurological conditions, such as acute migraine. While generally well-tolerated, magnesium sulfate can cause side effects such as hypotension, respiratory depression, and neuromuscular blockade, particularly at high doses. Careful monitoring and dose adjustment are essential when administering this medication to ensure optimal patient outcomes.

• 6. Vecuronium bromide

  Vecuronium bromide is a non-depolarizing neuromuscular blocking agent used in anesthesia and critical care settings. It works by competitively binding to acetylcholine receptors at the neuromuscular junction, leading to a temporary paralysis of skeletal muscles. Vecuronium is primarily used to facilitate endotracheal intubation and mechanical ventilation, as well as to provide muscle relaxation during surgical procedures. It is considered a relatively short-acting neuromuscular blocker, with a duration of action that can be easily titrated and reversed with the administration of cholinesterase inhibitors. Vecuronium is generally well-tolerated, but it can cause side effects such as hypotension, bradycardia, and histamine release, particularly at higher doses. Careful monitoring and dose adjustment are essential when using this medication, as improper use can lead to prolonged paralysis and respiratory depression. Overall, vecuronium bromide is an important tool in the management of patients requiring airway control and muscle relaxation in various clinical settings.

• 7. Calcium chloride

  Calcium chloride is a medication used in emergency and critical care settings to treat various medical conditions. It is primarily used to correct hypocalcemia, or low levels of calcium in the blood, which can occur in conditions such as severe pancreatitis, renal failure, and certain medication overdoses. Calcium chloride can also be used to treat hyperkalemia, or high potassium levels, as it can help drive potassium back into cells. Additionally, it has a role in the management of cardiac arrest, where it can help improve myocardial contractility and restore normal heart rhythm. Calcium chloride is generally considered a safe and effective medication, but it can cause side effects such as hypercalcemia, tissue necrosis, and cardiac arrhythmias if not used judiciously. Careful monitoring and dose adjustment are essential when administering this medication to ensure optimal patient outcomes.

• 8. Naloxone

  Naloxone is a critical medication used in the management of opioid overdose. It is a potent opioid antagonist that works by competitively binding to and blocking the effects of opioid receptors in the body. This action can rapidly reverse the life-threatening respiratory depression and sedation associated with opioid overdose, potentially saving the life of the patient. Naloxone is widely used in emergency medical settings, as well as by first responders and community members, to provide immediate treatment for suspected opioid overdoses. It is generally considered a safe and effective medication, with a relatively short duration of action. However, it is important to note that naloxone can also precipitate opioid withdrawal symptoms in individuals who are physically dependent on opioids. Overall, naloxone is an essential tool in the fight against the opioid epidemic and a crucial component of comprehensive overdose prevention and response strategies.

• 9. Calcium gluconate

  Calcium gluconate is a medication used to treat various medical conditions related to calcium imbalances. It is primarily used to correct hypocalcemia, or low levels of calcium in the blood, which can occur in conditions such as hypoparathyroidism, acute pancreatitis, and certain medication overdoses. Calcium gluconate can also be used to treat hyperkalemia, or high potassium levels, as it can help drive potassium back into cells. Additionally, it has a role in the management of certain cardiac arrhythmias, where it can help stabilize the heart's electrical activity. Calcium gluconate is generally considered a safe and effective medication, but it can cause side effects such as hypercalcemia, tissue necrosis, and cardiac arrhythmias if not used judiciously. Careful monitoring and dose adjustment are essential when administering this medication to ensure optimal patient outcomes.

• 10. Amiodarone HCI

  Amiodarone hydrochloride (HCl) is a complex and versatile antiarrhythmic medication used in the management of various cardiac arrhythmias. It is primarily used to treat life-threatening ventricular arrhythmias, such as ventricular tachycardia and ventricular fibrillation, as well as to maintain normal sinus rhythm in patients with atrial fibrillation or flutter. Amiodarone works by blocking multiple ion channels in the heart, which can help restore normal heart rhythm and prevent the recurrence of arrhythmias. While amiodarone is generally effective, it can also cause a wide range of adverse effects, including thyroid dysfunction, pulmonary toxicity, and liver and neurological complications. Careful patient selection, monitoring, and dose adjustment are essential when using this medication, as the potential benefits must be weighed against the risks. Overall, amiodarone is a powerful antiarrhythmic drug that plays a critical role in the management of complex cardiac rhythm disorders, but its use requires close clinical supervision and a thorough understanding of its pharmacology and potential side effects.

• 11. Lidocaine

  Lidocaine is a local anesthetic and antiarrhythmic medication with a wide range of clinical applications. In the context of emergency and critical care medicine, lidocaine is primarily used to treat ventricular arrhythmias, such as ventricular tachycardia and ventricular fibrillation. It works by blocking sodium channels in the heart, which can help restore normal heart rhythm and prevent the recurrence of these life-threatening arrhythmias. Lidocaine is also used as a local anesthetic, particularly in the management of certain traumatic injuries and procedures, where it can help provide pain relief and facilitate necessary interventions. While generally well-tolerated, lidocaine can cause side effects such as central nervous system toxicity, cardiovascular depression, and allergic reactions, especially at higher doses. Careful monitoring and dose adjustment are essential when administering lidocaine to ensure optimal patient outcomes. Overall, lidocaine is a versatile and important medication in the management of various acute medical conditions, particularly in the context of emergency and critical care settings.