Top 10 CT-ICU drugs

[CABGx4, ASN, BSN, MSN, CRNA]

Hey all,

I am leaving my position in the MICU/CCU after 2 years for a spot in the CT-ICU. During the interview, the clinician said they primarily use 10 (cardiac) drugs for the OH patients. Can someone list them all here for me so I can be as prepared as possible when I start in a couple weeks?

During the shadow, the pt I saw arrived on dobutamin, nitroprusside, precedex, and 4gm MagSulfate was standard.

Thanks for any suggestions!!

Jimmy

[clementinern]

Well, I can't say specifically what drugs your unit will use- but I can take an educated guess based on what we use in our CVICU.

Propofol

Dopamine

Lasix

Neosynephrine

Precedex

Angiomax

Calcium Gluconate

Calcium Chloride

Nitroglycerin

Milrinone

Dobutamine

Levophed

rarely, Vasopressin

Sodium Bicarb

Hope that helps. Good luck!

[WalkieTalkie, RN]

amiodarone

epinephrine

dobutamine

dopamine

phenylepherine

norepinephrine

vasopressin

diltiazem

nitroprusside

nitroglycerin

esmolol

[TakeBack]

shame on you guys for not mentioning this first one, more than 10 but all essential:

protamine

epinephrine

phenylephrine

vasopressin

norepinephrine for those about to die

dobutamine

amiodarone

nitrogylcerin

milrinone

dopamine

propofol

any narcotic

haloperidol

IV beta blocker of choice

diltiazem

hydralazine

[aCRNAhopeful]

I'll add fenaldopam and insulin

[WalkieTalkie, RN]

I'll add fenaldopam and insulin

Yeah, every post op heart comes back on insulin... OP, you'll soon learn that inotropes elevate your patient's glucose (in addition to the stress response). The pathophysiology behind this mechanism is actually very interesting, so look it up if you don't know.

We don't use fenaldopam enough. I still hear "renal dose" dopamine and cringe.

[WalkieTalkie, RN]

shame on you guys for not mentioning this first one, more than 10 but all essential:

protamine

epinephrine

phenylephrine

vasopressin

norepinephrine for those about to die

dobutamine

amiodarone

nitrogylcerin

milrinone

dopamine

propofol

any narcotic

haloperidol

IV beta blocker of choice

diltiazem

hydralazine

We actually very rarely use protamine... I've seen some very nasty anaphylactic reactions to it.

We do use a lot of milrinone, as we are a transplant center with a lot of heart failure patients. I personally rather like that drug :)

[CABGx4, ASN, BSN, MSN, CRNA]

thank you for all of the replies!! I am familiar with most but was looking for CT-ICU specific drugs. You have all listed drugs that I need to learn so again, thank you!!

[TakeBack]

We actually very rarely use protamine... I've seen some very nasty anaphylactic reactions to it.

All pts receive it in the OR so they should be exposed.

We use it routinely and with slow administration the reactions are rare,

[fiveofpeep]

Im orienting and I just went over the open heart meds with my preceptor yesterday...here is what we use:

nitroglycerin

nitroprusside

insulin gtt

dobutamine

dopamine

milrinone

albumin

potassium

magnesium

amiodarone

keep in mind, that at least on our unit, they still orient you to taking open hearts after you have already gotten some experience on the unit. you shouldnt be taking these patients right away (hopefully)

[aCRNAhopeful]

All pts receive it in the OR so they should be exposed.

We use it routinely and with slow administration the reactions are rare,

I'm not positive, but our patients don't receive protamine in OR, but they always come back on Amicar which reverses some of the anticoagulation. Is that something that is used instead of protamine, or in addition to it?

[clarkheart]

milrinone

ntg

nipride

levophed

dopamine

dobutamine

insulin

albumin

amiodarone

lasix

hard to keep it at just 10--off the top of my head these are the meds I use the most