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ATROPINE


 PARASYMPATHETIC BLOCKING ( VAGOLYTIC ) AGENT .
 INCREASE HEART RATE , AV CONDUCTION
 MAY RESTORE CARDIAC RHYTHM IN ASYSTOLE IF DUE
TO INCREASE PARESYMPATHETIC TONE


AMIODARONE
 MULTIPLE EFFECT OF SODIUM , POTASSIUM & CALCIUM
CHANNELS
 LENGTHENS DURATION OF ACTION POTENTIAL
 PROLONGS Q –T INTERVAL
 ALPHA & BETA ADRENERGIC BLOCKING PROPERTIES
 MILD NEGATIVE INOTROPE – MAY CAUSE HYPOTENSION


INDICATIONS :
 SYMPTOMATIC BRADYCARDIA
 ASYSTOLE
 PEA ( RATE < 60 BEATS MIN )
 MAY BE BENIFICIAL IN PRESENCE OF AV BLOCK OF THE
NODAL LEVEL


MAXIMUM DOSE :
 UPTO TOTAL DOSE OF 0.04MG /KG ( ASYSTOLE CARDIAC
ARREST )
 UPTO A TOTAL DOSE OF 0.03 MG/KG ( BRADYCARDIA )


VASOPRESSIN
 VASOCONSTRICTOR THAT MAY BE USEFUL IN SEPTIC
SHOCK -0.4UNITS /MIN
 USED AS AN ALTERNATIVE PRECUSSOR TO EPINEPHRINE
IN REFRACTORY VF

, PAIN IN ICU
 PAIN LEADS TO A STRESS RESPONSE WHICH CAUSES:
 CATABOLISM
 ILEUS
 ADH RELEASE
 IMMUNE DYSREGULATION
 HYPERCOAGULATION STATE
 INCREASED MYOCARDIAL WORKLOAD


DOPAMINE
 RENAL DOSE DOPAMINE ONLY TRANSIENTLY INCREASES
URINE OUTPUT
 ADVERSE EFFECT –TAVHYARRHYTHMIAS


PAIN IN ICU :
 LINES
 TUBES
 UNDERLYING ILLNESS
 INTERVENTION
 EVERYTHING ELSE
RECOMMANDED DOSE :
 1.0MG (10ML OF 10,000 SOLUTION ) ADMINISTERED IV
EVERY 3-5 MINUTES
 3-5 ML 1,10,000 IV IN ANAPHYLATIC , DEPENDING ON
SEVERITY
ANALGESICS
 RELIEVE PAIN\
 OPOIDS
 NON –OPOIDES
 CAN BE GIVEN PRN OR CONTINIOUS INFUSION
 PRN AVOIDS OVER SEDATION , BUT ALSO HAS PEAKS &
VALLEYS & IS MORE LABOUR INTENSIVE