Cardiogenic Shock Meds

Question 1

TXA

Answer 1

Adult: 1,000mg IV over 10:00, followed by 1,000 mg IV over 8 hours.

Question 2

Dobutamine

Answer 2

Adult and Pediatric: 0.5 to 1 mcg/kg per minute IV, IO.
Maintenance infusions are 2 to 20 mcg/kg per minute.
At doses > 20 mcg/kg per minute, increases of heart rate > 10% may induce or exacerbate myocardial ischemia.

AKA: Dobutrex

Question 3

Dopamin5

Answer 3

Adult and Pediatric: 2 to 20 mcg / kg IV, IO infusion. Starting dose 5 mcg/kg per minute; may gradually increase the infusion by 5 to 10 mcg/kg per minute to desired effect.

Cardiac dose is usually 5 to 10 mcg/kg per minute; vasopressor dose is usually 10 to 20 mcg / kg per minute.

AKA: Intropin

Question 4

No4epinephrine

Answer 4

Adult: add 4 mg to 250ml of D5W or D5NS, but not normal saline alone.

0.1 to 0.5 mcg/kg per minute as IV, IO, titrated to maintain blood pressure > 80 mm Hg. Many settings still use non-weight-based dosing of 2 to 4 mcg/min titrated upward for the desired clinical effect.

Refractory shock may require doses as high as 30 mcg/min.

Pediatric: 0.05 to 2 mcg/kg per minute IV, IO infusion, to maximum dose of 2 mcg/kg per minute.

AKA: Levophed

Question 5

Milrinone

Answer 5

Adult and Pediatric: 50 mcg/kg IV, IO over a period of 10 minutes, followed by an infusion of 0.375 to 0.5 mcg/kg per minute (max dose: 0.75 mcg/kg per minute)

AKA: Primacor