Cardiovascular Drugs

Drug Indication(s) Common Doses Comments
Adenosine
(Adenocard)
SVT 6, 12, 12 mg IVP Caution with asthma/COPD
Avoid in heart xplant, and pts on tegretol or dypyridamole (Aggrenox)
Amiodarone
(Pacerone)
VT (no pulse)
VT (pulse)
SVT
300 mg IVP then 150 mg IVP in 3-5 min x1
150 mg IV over 10 min, rpt q 15 min PRN
150 mg IV over 10 min, rpt q 15 min PRN
Amio gtt: 1 mg/min IV over 6 hours then 0.5 mg/min for 18 hours
Atropine PEA/Asystole
Bradycardia
1 mg IV q3-5 min
0.5 mg - 1 mg IV q3-5 min
Only indicated for HR < 60 bpm (in PEA)
Can try dopamine gtt if needed
Use with caution in Mobitz type II or 3rd degree AV Block
Not effective in heart xplant patients
Captopril HTN, CHF 12.5 - 50 mg PO q8 hrs Afterload reducer, short acting
Diltiazem
(Cardizem)
SVT
AFib with RVR
0.25 mg/kg IV (~ 10-20 mg IV), repeat in 15 minutes at 0.35 mg/kg (25 mg IV)
then start gtt at 5-10 mg/hr up to 15 mg/hr
Do NOT use in WPW with a-fib (or antidromic WPW)
BB's are also contraindicated with these conditions.
Dopamine Hypotension
Renal Dose
Beta I
Alpha I

1 - 3 mcg/kg/min
3 - 10 mcg/kg/min
10 - 25 mcg/kg/min
Can result in tachycardia.
Consider switching to Norepi if over 20 mcg/kg/min or if SBP < 70 mm Hg
Dobutamine Hypotension 2 - 20 mcg/kg/min May be good agent in CHF and hypotension.
Beta-1 and Beta-2 activity cause increased HR and decreased SVR
Enalapril HTN, CHF 2.5 - 20 mg PO q 24 hrs Afterload reducer
Esmolol HTN
rate control
Load 500 mcg/kg IVP, then 50 mcg/kg/min gtt
increase by 50 mcg/kg/min q 4 min to max 200 mcg/kg/min
Excellent choice for rate control or for reflex tachycardia
when used concurrently with nitroprusside (i.e., aortic dissection)
Epinephrine Anaphylaxis
PEA/Asystole
Bradycardia/Hypotension
0.3 - 0.5 mg SQ/IM q10-15 min (of 1:1000)
1 mg IV q3-5 min (of 1:10,000)
2 - 10 mcg/min IV
Generally, use the 1:1000 for SQ/IM and 1:10,000 for IV
Add 1 amp (1 mg) of epi to 1 L of 0.9 NS and start at 1 mL/min and titrate up for bradycardia
Hydralazine HTN, pregnancy 10 - 20 mg IM/IV Very Potent
Isoproterenol Heart xplant bradycardia 1 - 10 mcg/min Titrate to effect
Labetalol
(Normodyne)
HTN 20 mg IV or 2 mg/min IV Max 200 mg
Metoprolol ACS 5 mg IVP q5 min x 3 Consider with patients in hyperadrenergic states
Careful with wheezers!
Magnesium Torsades de Pointes 1 - 2 grams IV over 2-5 mins Dilute in 100 ml D5W
Nitroprusside
(Nipride)
HTN Emergency 0.3 - 10 mcg/kg/min IV Long term use can lead to thiocyanate toxicity.
If treating aortic dissection, use BB first to avoid reflex tachycardia.
Norepinephrine
(Levophed)
Hypotension 1 - 30 mcg/min Correct volume first for hypotension
Consider Norepi for pts with SBP < 70
Phenylephrine
(Neosynephrine)
Hypotension 2 - 20 mcg/min Pure alpha agonist
Little effect on HR (may cause reflex bradycardia)
Procainamide WPW 100 mg IV q 5 min
Do not exceed 500 mg or 50 mg/min
Can cause hypotension.
Total dose = 17 mg/kg.
Maintenance @ 1 - 4 mg/min. Max 1 gram IV
Vasopressin Asystole/PEA 40 units IV Given only one time
Verapamil SVT 20 mg/min - 50 mg/min Can cause hypotension