A++ 응급약물 14가지 및 간호중재

문서 내 토픽

1. epinephrine

epinephrine은 말초혈관을 수축시켜 관상동맥 및 뇌혈류량을 증가시키고, 기관지 평활근에 직접 작용하여 강력한 기관지 확장 효과를 나타냅니다. 심정지 환자에게 투여되며, 기관지 경련 및 녹내장 치료에도 사용됩니다. 정맥 외로 주사할 경우 조직 괴사를 초래할 수 있으므로 주의가 필요합니다.
2. vasopressin

vasopressin은 뇌하수체 후엽 호르몬으로, 콩팥에서 수분 재흡수를 촉진하고 모세혈관을 수축시켜 혈압을 높이는 작용을 합니다. 심정지 환자의 치료에 사용되며, 뇌하수체성 요붕증 및 식도정맥류 출혈 치료에도 사용됩니다. 관상동맥경화증 환자나 고혈압 환자에게는 주의가 필요합니다.
3. amiodarone

amiodarone은 Class III 항부정맥 약물로, 교감신경 흥분 작용을 억제하고 심근의 활동전위와 불응기를 연장시킵니다. 다루기 힘든 심실세동 및 무맥성 심실빈맥 치료에 사용되며, 심방성 및 심실성 부정맥 치료에도 사용됩니다. 서맥, 간장애, 간질성 폐렴 등의 부작용이 나타날 수 있습니다.
4. lidocaine

lidocaine은 Na 이온의 통로를 막아 심실의 흥분을 억제하는 역할을 합니다. 심실성 부정맥 치료에 널리 사용되며, 과량 투여 시 방실차단, 자율성 억제, 심근수축력 감소 등의 부작용이 나타날 수 있습니다. 심인성 쇼크 환자에게는 용량을 반으로 줄이는 것이 좋습니다.
5. sodium bicarbonate

sodium bicarbonate는 혈장의 수소이온을 중화시켜 혈장과 소변의 pH를 증가시키는 알칼리화 제제입니다. 고칼륨혈증, 중증 대사성 산증 치료에 사용되며, 심정지 환자에게 혈액 산성화를 막기 위해 사용할 수 있습니다. 그러나 심폐소생술 중에는 폐관류량이 적어 CO2 배출이 충분하지 않으므로 사용이 권장되지 않습니다.
6. calcium gluconate

calcium gluconate는 심근의 수축력을 향상시키고 전신혈관 저항을 변화시킵니다. 저칼슘혈증, 고칼륨혈증 치료에 사용되며, 관상동맥 및 뇌동맥의 경련을 유발할 수 있습니다. digoxin 복용 환자에서는 부정맥을 유발할 가능성이 높습니다.
7. atropine

atropine은 부교감신경 차단제로, 동방결절의 흥분성을 증가시키고 방실결절에서의 전도를 촉진합니다. 서맥, 말초혈관 저항 감소, 저혈압 치료에 사용되며, 과량 투여 시 빈맥, 고열, 의식장애 등이 발생할 수 있습니다. 녹내장 환자에게는 사용이 금기됩니다.
8. dopamine

dopamine은 심장의 베타 수용체에 작용하여 심실 수축력과 박동수를 증가시키며, 다량 투여 시 혈관 수축을 일으킵니다. 저혈압 환자 치료에 사용되며, 고용량 투여 시 심근허혈과 심박출량 감소를 초래할 수 있습니다. 폐혈관 저항 증가와 폐부종 악화를 예방하기 위해 혈관확장제와 병용 투여가 고려됩니다.
9. dobutamine

dobutamine은 심장의 베타 수용체에 선택적으로 작용하여 심근 수축력을 증가시키지만, 빈맥이나 부정맥, 말초혈관 효과는 적습니다. 심근 수축력 저하로 인한 심장 기능 저하 환자 치료에 사용되며, 고용량 투여 시 두통, 오심, 빈맥, 고혈압, 심실부정맥 등의 부작용이 나타날 수 있습니다.
10. adenosine

adenosine은 교감신경 과다 흥분 시 ATP로부터 생성되어 심장 운동을 억제하고 관상혈관을 확장시켜 심근 혈액 공급을 증가시킵니다. 발작성 심실상성 빈맥 치료에 사용되며, 서맥, 동정지, 방실차단 등의 부작용이 나타날 수 있습니다. 전도 장애가 있거나 심방세동 환자에게는 주의가 필요합니다.

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1. epinephrine

Epinephrine is a critical medication in emergency medicine, particularly for the treatment of anaphylaxis, cardiac arrest, and other life-threatening conditions. It acts as a potent alpha- and beta-adrenergic agonist, leading to increased heart rate, blood pressure, and bronchodilation. Epinephrine is the first-line treatment for anaphylaxis, as it rapidly reverses the symptoms of severe allergic reactions. In cardiac arrest, epinephrine helps restore spontaneous circulation by increasing myocardial contractility and peripheral vascular resistance. While epinephrine can have side effects such as tachycardia and hypertension, its benefits often outweigh the risks in emergency situations. Proper dosing and administration are crucial to ensure the safe and effective use of this medication.
2. vasopressin

Vasopressin, also known as antidiuretic hormone (ADH), is an important medication in the management of various medical conditions. It plays a crucial role in the regulation of fluid balance and blood pressure. In the context of emergency medicine, vasopressin has been used as an alternative to epinephrine in the treatment of cardiac arrest, as it can help maintain blood pressure and improve the chances of return of spontaneous circulation. Vasopressin may also be used to treat conditions such as diabetes insipidus, where it helps to regulate water balance in the body. However, the use of vasopressin in emergency situations is still being studied, and its efficacy compared to other vasopressors like epinephrine is an area of ongoing research. Careful consideration of the patient's clinical status and the potential risks and benefits of vasopressin administration is necessary for its appropriate use.
3. amiodarone

Amiodarone is a complex and versatile antiarrhythmic medication used in the management of various cardiac arrhythmias. It is particularly effective in the treatment of life-threatening ventricular arrhythmias, such as ventricular tachycardia and ventricular fibrillation. Amiodarone works by modulating the electrical activity of the heart, prolonging the refractory period, and slowing conduction. Its broad spectrum of action makes it useful in the treatment of both supraventricular and ventricular arrhythmias. However, amiodarone is also known for its potential for significant side effects, including thyroid dysfunction, pulmonary toxicity, and liver toxicity. Careful monitoring and dose adjustment are essential when using amiodarone, especially in the long-term management of chronic arrhythmias. The decision to use amiodarone should be based on a thorough evaluation of the patient's clinical condition, the potential benefits, and the risks associated with its use.
4. lidocaine

Lidocaine is a widely used local anesthetic and antiarrhythmic agent in emergency medicine and other clinical settings. As a local anesthetic, lidocaine is effective in providing pain relief and numbing the affected area, making it a valuable tool for various procedures, such as suturing wounds, performing regional nerve blocks, and administering other treatments. In the context of cardiac emergencies, lidocaine is used as an antiarrhythmic agent, particularly for the management of ventricular arrhythmias. It works by stabilizing the cell membrane, reducing the excitability of cardiac tissue, and suppressing the formation and propagation of abnormal electrical impulses. Lidocaine is generally well-tolerated, but it can have side effects, such as central nervous system toxicity and cardiovascular effects, especially with higher doses or rapid administration. Careful dosing and monitoring are essential to ensure the safe and effective use of lidocaine in both local anesthetic and antiarrhythmic applications.
5. sodium bicarbonate

Sodium bicarbonate is a versatile medication used in various medical situations, particularly in emergency and critical care settings. Its primary function is to help correct metabolic acidosis, a condition characterized by an imbalance in the body's pH levels. In the context of cardiac arrest, sodium bicarbonate is used to help restore the body's pH balance and improve the effectiveness of other resuscitative measures, such as chest compressions and defibrillation. Sodium bicarbonate can also be used to treat certain types of poisoning, such as those involving acids or certain drugs. However, the use of sodium bicarbonate in cardiac arrest is controversial, as its benefits have been debated, and it may have potential adverse effects, such as electrolyte imbalances and impaired cardiac function. Careful consideration of the patient's clinical status and the potential risks and benefits of sodium bicarbonate administration is necessary for its appropriate use.
6. calcium gluconate

Calcium gluconate is an important medication used in emergency and critical care settings for the treatment of various medical conditions. Its primary function is to provide a source of calcium, which is essential for the proper functioning of the cardiovascular, neuromuscular, and other physiological systems. In the context of emergency medicine, calcium gluconate is commonly used to treat hypocalcemia, which can occur in conditions such as severe burns, pancreatitis, and certain drug overdoses. Calcium gluconate can also be used to treat hyperkalemia, a potentially life-threatening condition characterized by high potassium levels in the blood. Additionally, calcium gluconate may be used in the management of certain cardiac arrhythmias and to counteract the effects of certain toxins or medications. While generally well-tolerated, calcium gluconate administration requires careful monitoring and dosing to avoid potential side effects, such as hypercalcemia or cardiac complications. The decision to use calcium gluconate should be based on a thorough evaluation of the patient's clinical condition and the potential benefits and risks of the treatment.
7. atropine

Atropine is a medication with a wide range of applications in emergency and critical care settings. Its primary mechanism of action is as an anticholinergic agent, which means it blocks the effects of the neurotransmitter acetylcholine. In the context of emergency medicine, atropine is commonly used to treat bradycardia, a condition characterized by a slow heart rate. By blocking the parasympathetic nervous system, atropine can help increase heart rate and improve cardiac output. Atropine may also be used to counteract the effects of certain types of poisoning, such as those involving cholinergic agents or organophosphate insecticides. Additionally, atropine can be used to facilitate certain medical procedures, such as intubation, by reducing secretions and minimizing the gag reflex. While generally well-tolerated, atropine can have side effects, such as dry mouth, blurred vision, and urinary retention. Careful consideration of the patient's clinical status and the potential risks and benefits of atropine administration is necessary for its appropriate use.
8. dopamine

Dopamine is a catecholamine medication with a wide range of applications in emergency and critical care settings. It is primarily used as a vasopressor, which means it helps to increase blood pressure and improve organ perfusion. In the context of shock states, such as septic shock or cardiogenic shock, dopamine can be used to support cardiovascular function and maintain adequate tissue perfusion. Dopamine also has effects on the renal system, and it may be used to help maintain or improve renal function in certain clinical situations. Additionally, dopamine can be used to treat bradycardia and to support cardiac output in patients with heart failure. However, the use of dopamine is not without risks, as it can have significant side effects, such as tachycardia, arrhythmias, and vasoconstriction. Careful titration and monitoring are essential when using dopamine to ensure the appropriate balance between its benefits and potential risks.
9. dobutamine

Dobutamine is a synthetic catecholamine medication used primarily in emergency and critical care settings to support cardiovascular function. Unlike dopamine, which has both alpha- and beta-adrenergic effects, dobutamine is a selective beta-1 agonist, meaning it primarily stimulates the beta-1 receptors in the heart. This results in increased myocardial contractility, heart rate, and cardiac output, without the significant vasoconstriction associated with dopamine. In the context of cardiogenic shock or heart failure, dobutamine can be used to improve cardiac performance and tissue perfusion. It may also be used to support cardiac function in the setting of septic shock or other conditions where the heart is unable to maintain adequate cardiac output. While generally well-tolerated, dobutamine can have side effects, such as tachycardia, arrhythmias, and hypotension, particularly with higher doses. Careful titration and monitoring are essential when using dobutamine to ensure the appropriate balance between its benefits and potential risks.
10. adenosine

Adenosine is a unique medication used in emergency and critical care settings for the treatment of certain types of supraventricular tachycardia (SVT). It works by temporarily slowing down the electrical conduction through the atrioventricular (AV) node, which can help terminate the abnormal heart rhythm. Adenosine is particularly effective in the treatment of paroxysmal SVT, a condition characterized by sudden-onset, rapid heart rates. By interrupting the reentrant circuit responsible for the tachycardia, adenosine can help restore normal sinus rhythm. Adenosine is typically administered as a rapid intravenous bolus, and its effects are very short-lived, lasting only a few seconds. This makes it a valuable tool in the acute management of SVT, as it can quickly and effectively terminate the arrhythmia without the need for more prolonged or invasive interventions. While generally well-tolerated, adenosine can have side effects, such as flushing, chest discomfort, and transient atrioventricular block. Careful patient selection and monitoring are essential when using adenosine to ensure its safe and effective use.

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