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ICU E-cart 비치 응급약품 조사

"ICU E-cart 비치 응급약품 조사"에 대한 내용입니다.
6 페이지
한컴오피스
최초등록일 2023.03.02 최종저작일 2022.10
icu E-cart 응급간호 약품
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ICU E-cart 비치 응급약품 조사
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    소개

    "ICU E-cart 비치 응급약품 조사"에 대한 내용입니다.

    목차

    1. ICU E-cart 비치 응급약품
    2. 주사시 꼭 Double checking 해야 하는 고위험 약물

    본문내용

    Atropine sulfate (0.5mg/1ml)
    <부교감신경 차단제>
    - Bradycardia 서맥 1차 선택 약제
    - 심정지, 서맥성 PEA(무수축)환자 2번째 선택 약제
    ☞ 미주신경작용 항진에 의한 무수축 치료에 효과적
    <IV bolus>
    - 심정지환자 : 1mg IV push, q3~5min 반복투여, 최대 3mg
    (3mg 초과시 미주신경작용이 완전히 차단)
    - 서맥환자 : 0.5mg, q3~5min 반복투여, 최대 3mg
    <ET tube>
    - 1mg/10cc 증류수에 mix 후 투여
    -> ambu bagging -> 10분 후 흡수
    - Tachycardia
    - MI 등 심근허혈이 있는 환자에게는 심근의 허혈을 악화 -> 반복투여X
    - 0.5mg이하 투여시 오히려 부교감신경 흥분작용 발생, 서맥유발
    - 입마름, 광과민성, 안내압증가(녹내장 환자 금기)
    - 동공확대, 오심, 구토, 배뇨장애, 두통, 호흡곤란, 심계항진

    Epinephrine(1mg/ml)
    - 혈압과 맥박 증가
    ☞ 무맥성 VT(심실빈맥), Vfib(심실세동), 무맥성 전기활동 등
    - 모든 심정지 환자
    1mg/ml : CPR동안 3-5분마다 1.0mg IV
    ☞ 중간 3-way가 아닌 환자에게 가까운 쪽에서 투여, IV확보 전이라면 기관내 투여(intratracheal)
    ☞ asthma attack 시 0.3cc SC
    ☞ 지속투여 시 1mg/100cc 혼합투여
    - 정맥이 아닌 경우 조직의 괴사초래
    - 지속적 IV시 중심정맥관 이용
    - 심근수축력과 심박동수를 증가시키므로 심근의 허혈, 심실부정맥 유발
    - 뇌에 산소공급 -> 조직은 저산소혈증
    - Hypertnesion, nervousness(tremer, palpitation)
    - Bivon과 동시투여시 침전
    - 주의 : 말초혈관 수축으로 인한 부작용이 많음, 가능한 한 빨리 Dopamine과 교체하여 투여용량을 감소.

    참고자료

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  • 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.

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