18类常用抢救药品精品PPT课件
18类常用急救药品
18种急救药品八种高危药品:1、重酒石酸去甲肾上腺素注射液(正肾)【药理作用】为肾上腺素受体激动药,是强烈的α受体激动药,同时也激动b受体。
通过α受体激动,也可引起血管极度收缩,时血压升高,冠状动脉血流增加;通过b受体的激动,时心肌收缩加强,心排出量增加。
【适应症】用于治疗急性心肌梗死,体外循环引起的低血压,对血容量不足所致的休克、低血压或嗜铬细胞瘤切除后的低血压,本品作为急救时补充血容量的辅助治疗,使血压回升,暂时维持脑与冠状动脉灌注,直到补充血容量发生作用;也可用于椎管内阻滞时的低血压及心跳骤停复苏后血压维持。
【规格】1ml:2mg【用法用量】用5%葡萄糖注射液或葡萄糖氯化钠注射液稀释后静滴。
【不良反应】1药液外漏可引起局部组织坏死。
2本品强烈的血管收缩可以使重要脏器器官血流减少,肾血流锐减后尿量减少,组织供血不足导致缺氧和酸中毒,之久或大量使用时,可使回心血量减少,外周血管阻力升高,心排血量减少,后果严重。
3应重视的反应包括静脉输注时沿静脉径路皮肤发白,注射局部皮肤破溃,皮肤紫癜,发红,严重眩晕,上述反应虽属少见,但后果严重。
4个别病人因过敏而有皮疹,面部水肿。
5在缺氧,电解质平衡失调、器质性心脏病病人中或逾量时,可出现心律失常,血压升高后可出现反射性心率减慢。
6以下反应如持续出现应注意:焦虑不安、眩晕、头疼、皮肤苍白、心悸、失眠等。
7逾量时可出现严重头痛及高血压、心率减慢、呕吐、抽搐。
2、盐酸肾上腺素注射液(副肾)【药理作用】可兴奋α、β二种受体。
兴奋心脏β1-受体,使心肌收缩力增强,心率加快,心肌耗氧量增加;兴奋α-受体,可收缩皮肤、粘膜血管及内脏小血管,使血压升高;兴奋β2-受体可松驰支气管平滑肌,解除支气管痉挛。
用于过敏性休克、心脏骤停、支气管哮喘、粘膜或齿龈的局部止血等。
【用法】1.抢救过敏性休克:肌注0.5~1mg/次,或以0.9%盐水稀释到10ml缓慢静注。
如疗效不好,可改用2~4mg溶于5%葡萄糖液250~500ml中静滴。
18种抢救药品 PPT课件
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四、抗心律失常药
心律平(普罗帕酮) 50mg/支
[药理及应用]延长动作电位的时间及有效不应期,减 少心肌的自发兴奋性,降低自律性,减慢传导速度。用 于室上性及室性心动过速和早搏,预激综合症伴发心动 过速或房颤患者。 [用法]首次70mg稀释后3~5分钟内静注,无效20分 钟后重复1次;或1次静注后继以(20~40mg/小时)维 持静滴。24小时总量<350mg。 [注意]1.不良反应有恶心、呕吐、便秘、味觉改变、 头痛、眩晕等,严重时可致心律失常,如传导阻滞、窦 房结功能障碍;2.注意观察心率、心律的变化;3.病窦 综合症、低血压、心衰、严重慢阻肺患者慎用。
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二、抗休克血管活性药
重酒石酸间羟胺(阿拉明) 10mg/支
[药理及应用]主要作用于α 受体,收缩血管、升高 血压 。 [用法]静滴 以10mg~40mg加入5%葡萄糖注射 液或生理盐水500ml中,以每分钟20~30滴的速度滴 注或根据病情调整滴速与用量,最大量可用至每次 100mg(每分钟0.2mg~0.4mg),小儿每次0.3mg~ 2mg。 [注意]1.不与碱性药物配伍;2.防止外渗;3.监 测血压变化,调整用量。
18种抢救药品
况调整用量,用量过大或皮下注射误入血管后,可引起 血压突然上升、心律失常,严重可致室颤而死亡。 ? 备选药:间羟胺(阿拉明)
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二、抗休克血管活性药
? 重酒石酸间羟胺(阿拉明) 10mg/ 支
[药理及应用]主要作用于α 受体,收缩血管、升高
血压 。
[ 用法]常用量:肌注或静注,3mg/次,必要时半
小时重复。极量20mg/日。
[ 注意] 1.大剂量可引起心动过速、呼吸抑制、血
压下降、甚至惊厥;2.不可与碱性药物配伍。
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二、抗休克血管活性药
? 多巴胺 20mg/ 支
[ 药理及应用]1.直接激动α 和β 受体,也激动多巴胺 受体,兴奋心脏,加强心肌收缩力; 2.扩张肾脏、肠系 膜、冠状动脉和脑血管,增加血流量和尿量。用于各种 类型休克,特别对伴有肾功能不全、心排出量降低、周 围血管阻力增高而已补足血容量的患者更有意义。
二、抗休克血管活性药
? 去甲肾上腺素(正肾素) 2mg/ 支
8%正肾冰盐水治疗上消化道出血:去甲肾上腺素 40mg+500ml 生理盐水中,置于冰箱中(8%正肾冰盐 水)。每次40ml 口服,每2h一次,配制的冰盐水应标
明口服专用,并加强标记,避免与静脉输液混淆 。
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三、强心药
? 西地兰(去乙酰毛花甙) 0.4mg/ 支
[药理及应用]增强心肌收缩力,并反射性兴奋迷走神
经,降低窦房结及心房的自律性,减慢心率与传导,使 心搏量增加(正性肌力、负性频率、减慢传导)。用于 充血性心力衰竭、房颤和阵发性室上性心动过速。
[ 用法]常用量:初次用量0.2 ~ 0.4mg,必要时
2~4小时再注半量。饱和量1~1.2mg。
常用抢救药品PPT课件
• 用于防治各种手术前后的出血,也可用于血小板功能不良、血 管脆性增加而引起的出血。
【用法用量】
• 静脉滴注:一次0.25~0.75g,一日2~3次,稀释后滴注 肌肉或静脉注射,一次0.25~0.5g,一日0.5~1.5g。
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重酒石酸去甲肾上腺素
(2mg/1ml)
【药理作用】:兴奋α受体,β1受体
【适应症】
• 缓慢型心率失常,也可用于继发于窦房结功能低下而出现的室性异位节 律
• 解救有机磷酸酯类中毒。
• 全身麻醉前给药、严重盗汗和流涎症。
【用法用量】
抗缓慢型心律失常时 成人静脉注射0.5~1mg,最大量<2.5mg
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解痉药--盐酸消旋山莨菪碱注射液(654-2) 1mL:10mg
• 【药理作用】
• 阻断M受体的抗胆碱药,改善微循环。松弛胃肠道平滑肌,并 抑制其蠕动。
• 【适应症】
• 解痉作用较强,抑制腺体分泌较弱。用于解除平滑肌痉挛,胃 肠绞痛、胆道痉挛以及急性微循环障碍及有机磷中毒等。
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多巴胺 (20mg/2ml)
• 【药理作用】:直接激动α和β受体,也激动多巴胺受体,效应呈剂量依
• 通过α受体激动,可引起血管极度收缩,使血压升 高,冠状动脉血流增加;
• 通过β受体的激动,使心肌收缩加强,心排出量增 加。
【适应症】:
• 1、低血压。
• 2. 消化道出血时局部止血用
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盐酸肾上腺素(1mg/1ml)
[药理作用]:可兴奋α 、β 二种受体。 • 兴奋心脏β1-受体,使心肌收缩力增强,心率加快,心肌耗氧
18种急救药品
18种常用的抢救药物急诊科长用药物有;肾上腺素、阿托品、利多卡因、胺碘酮、多巴胺、甘露醇、速尿、硝酸甘油、消心痛、西地兰、尼可刹米、纳洛酮、地塞米松、氨茶碱、吗啡、立止血、垂体后叶素、安定、碳酸氢钠、亚硝酸异戊脂、亚甲兰、氯磷定、二巯基丁二酸钠。
回一、中枢神经兴奋药:尼可刹米(可拉明)、山梗菜碱(洛贝林)二、抗休克血管活性药:多巴胺、肾上腺素(副肾素)间羟胺(阿拉明)三、强心药:西地兰(去乙酰毛花甙)四、抗心律失常药:利多卡因、心律平(普罗帕酮)乙胺碘呋酮五、降血压药:硝普钠、硫酸镁六、血管扩张药:硝酸甘油七、利尿剂:速尿(呋喃苯胺酸)八、脱水药:甘露醇九、镇静药:安定(地西泮)苯巴比妥(鲁米那)咪唑安定十、解热药:安痛定(含安基比林、安替比林、巴比妥)来比林十一、镇痛药:杜冷丁(哌替啶)吗啡十二、平喘药:氨茶碱喘啶甲强龙十三、止吐药:胃复安(甲氧氯普胺)异丙嗪十四、促凝血药:6-氨基己酸(氨甲环酸)止血芳酸(氨甲苯酸)止血敏(酚磺乙胺)立止血十五、解毒药:解磷定、阿托品备选药:山莨菪碱(654-2)十六、激素药:地塞米松(氟美松) 备选药:氢化可的松(皮质醇)十七、水电酸碱平衡药:碳酸氢钠氯化钾十八、抗过敏药:苯海拉明(可他敏)葡萄糖酸钙尼可刹米(可拉明)[药理及应用]直接兴奋延髓呼吸中枢,使呼吸加深加快,也可刺激颈动脉体和主动脉体化学感受器,提高呼吸中枢对CO2的敏感性。
对血管运动中枢也有微弱兴奋作用。
临床常用于中枢性呼吸抑制,对各种中枢抑制药如吗啡等过量引起的呼吸抑制疗效较好,对巴比妥类中毒者效果较差。
[用法]常用量:肌注或静注,0.375/次,必要时1~2小时重复。
剂量:1.25g/次。
[注意]大剂量可引起血压升高、心悸、出汗、呕吐、心律失常、震颤及惊厥。
山梗菜碱(洛贝林)[药理及应用]兴奋颈动脉体化学感受器而反射性兴奋呼吸中枢。
临床常用于用于新生儿窒息、小儿感染性疾病引起的呼吸衰竭以及一氧化碳中毒。
常用急救药品用法PPT
17. 艾司洛尔注射液
适应证:用于心房颤动、心房扑动时控制心室率。围手术期高血压。窦性心动过速。 用法用量及注意事项:
18. 硝酸甘油注射液
适应证: 1. 手术:在心脏手术中,可用来迅速控制高血压。在外科手术过程中,可用来降低血压,保持一种可控性的 低血压状态。在心脏血管手术过程中和术后,可用来控制心肌缺血。 2. 不稳定型心绞痛:对于不稳定型心绞痛,用 β 受体阻滞剂和舌下含硝酸盐制剂无效时,可以用本品治疗。 3. 隐匿性充血性心力衰竭:用于急性心肌梗塞后继发的隐匿性充血性心力衰竭的治疗。 用法用量及注意事项:
常用急救药品用法PPT
1. 肾上腺素注射液
适应证:主要适用于因支气管痉挛所致严重呼吸困难,可迅速缓解药物等引起的过敏性休克,亦 可用于延长浸润麻醉用药的作用时间。各种原因引起的心脏骤停进行心肺复苏的主要抢救用药。
用法用量及注意事项:
2. 去甲肾上腺素注射液
适应证:用于治疗急性心肌梗死、体外循环等引起的低血压;对血容量不足所致的休克、低血压或 嗜铬细胞瘤切除术后的低血压。本品作为急救时补充血容量的辅助治疗,以使血压回升,暂时维持 脑与冠状动脉灌注,直到补充血容量治疗发生作用;也可用于椎管内阻滞时的低血压及心跳骤停复 苏后血压维持。
用法用量及注意事项:
11. 呋塞米注射液
适应证:水肿性疾病包括充血性心力衰竭、肝硬化、肾脏疾病,尤其是应用其他利尿药效果不佳时,应用 本类药物仍可能有效。与其他药物合用治疗急性肺水肿和急性脑水肿等。
在高血压的阶梯疗法中,当噻嗪类药物疗效不佳时,尤其当伴有肾功能不全或出现高血压危象时,尤为适 用。预防急性肾功能衰竭,用于各种原因导致肾脏血流灌注不足,在纠正血容量不足的同时及时应用,可 减少急性肾小管坏死的机会。高钾血症及高钙血症。稀释性低钠血症尤其是当血钠浓度低于 120 mmol/L 时。 抗利尿激素分泌过多症(SIADH)。急性药物毒物中毒如巴比妥类药物中毒等。
18种急救药品
18类常用抢救药品1、中枢神经兴奋药尼可刹米(可拉明)[用法]常用量:肌注或静注,0.25~0.5g/次,必要时1~2小时重复。
极量:1.25g/次。
[注意]大剂量可引起血压升高、心悸、出汗、呕吐、心律失常、震颤及惊厥。
山梗菜碱(洛贝林)[用法]常用量:肌注或静注,3mg/次,必要时半小时重复。
极量20mg/日。
[注意]不良反应有恶心、呕吐、腹泻、头痛、眩晕;大剂量可引起心动过速、呼吸抑制、血压下降、甚至惊厥。
2、抗休克血管活性药多巴胺[注意]1.不良反应有恶心、呕吐、头痛、中枢神经系统兴奋等;大剂量或过量时可使呼吸加速、快速型心律失常。
2.高血压、心梗、甲亢、糖尿病患者禁用。
3.使用以前应补充血容量及纠正酸中毒。
4.输注时不能外溢。
肾上腺素(副肾素[用法]1.抢救过敏性休克:肌注0.5~1mg/次,或以0.9%盐水稀释到10ml 缓慢静注。
如疗效不好,可改用2~4mg溶于5%葡萄糖液250~500ml中静滴。
2.抢救心脏骤停:1mg静注,每3~5分钟可加大剂量递增(1~5mg)重复。
3.与局麻药合用:加少量(约1:200000—500000)于局麻药内(<300μg)。
[注意]1.不良反应有心悸、头痛、血压升高,用量过大或皮下注射时误入血管后,可引起血压突然上升、心律失常,严重可致室颤而致死。
2.高血压、器质性心脏病、糖尿病、甲亢、洋地黄中毒、低血容量性休克、心源性哮喘等慎用。
备选药:间羟胺(阿拉明)3、强心药西地兰(去乙酰毛花甙)[用法]常用量:初次量0.4mg,必要时2~4小时再注半量。
饱和量1~1.2mg。
[注意]1.不良反应有恶心、呕吐、食欲不振、腹泻,头痛、幻觉、绿黄视,心律失常及房室传导阻滞。
2.急性心肌炎,心梗患者禁用;并禁与钙剂同用。
四、抗心律失常药4.利多卡因[用法]静注:1~1.5mg/kg/次(一般用50~100mg/次)必要时每5分钟后重复1~2次。
静滴:取100mg加入5%葡萄糖100~200ml中静滴,静速1~2ml/分。
18类常用抢救药品简介
18 types of commonly used rescue drugs(For emergencydepartment only)1. Central nervous system stimulantsNicosame (Colamin)[Pharmacology andapplication] Directly excite the medulla oblongata respiratory center to deepen and speed up breathing. It also has a weak excitatory effect on the vascular movement center. Used for central respiratory depression and circulatory failure, poisoning of anesthetics and other central depressants.[Usage] Common dosage: intramuscularly or intravenously, 0.25-0.5g/time, repeat 1 to 2 hours if necessary. Maximum amount:1.25g/time.[Note] Large doses can cause elevated bloodpressure, palpitations, sweating, vomiting, arrhythmia, tremor and convulsions.Lobeline (Lobeline)[Pharmacology and application] Exciting carotid body chemoreceptors and reflex excitement of respiratory center. It is used for neonatal asphyxia, inhalation anesthetics and other central depressant poisoning, carbon monoxide poisoning and respiratory failure caused by pneumonia.[Usage] Common dosage: intramuscularly or intravenously, 3 mg/time,repeat in half an hour if necessary. The maximum amount is 20mg/day.[Note] Adverse reactions include nausea, vomiting, diarrhea, headache, dizziness; large doses can cause tachycardia, respiratory depression, blood pressure drop, and even convulsions.2. Anti-shock vasoactive drugsDopamine[Pharmacology and application] Directactivation of α and β receptors, as well as dopamine receptors. The effect on different receptors is related to the dose: low-dose (2~5μg/kg•min) l ow-speed instillation, excites dopamine receptors, Dilate the kidneys, mesenteric, coronary arteries and cerebral vessels, increase blood flow and urine output. At the same time, it stimulates the β1 receptors of the heart, and also produces a moderately programmed positive inotropic effect by releasing norepinephrine; at a medium dose (5~10μg/kg•min), it can obviously activate β1 receptors to excite the heart and strengthen the myocardium. Contraction force. At thesame time, it also stimulates alpha receptors, causingperipheral blood vessels such as skin and mucous membranes to contract. At high doses (>10μg/kg•min), the positive muscle strength and vasoconstriction effect are more obvious, and the renal vasodilation effect disappears.Positive muscle strength and renal vasodilatation are dominant in medium and low-dose anti-shock therapy. It is used for various types of shock, especially for patients with renal insufficiency, decreased cardiac output, and increased peripheral vascular resistance that have already supplemented blood volume.[Usage] Common dosage: intravenous drip, add 20mg/time to 250ml of 5% glucose, start with 20 drops/min, adjust the drip rate as needed, and the maximum shall not exceed 0.5mg/min.[Note] 1. Adverse reactions include nausea, vomiting, headache, central nervous system excitement, etc.; large doses or overdose can accelerate breathing and rapid arrhythmia. 2.Disabled for patients with hypertension, myocardial infarction, hyperthyroidism, and diabetes. 3. Before use, blood volume should be supplemented and acidosis should be corrected. 4. No spillage during infusion.Adrenaline (Adrenaline)[Pharmacology and Application] It can excite the α and β receptors. Exciting the heart β1-receptors can increase myocardial contractility, increase heart rate, and increase myocardial oxygen consumption; excite α-receptors, which cancontract skin, mucosal blood vessels and small bloodvessels in internal organs, and increase blood pressure; excite β2-receptors Relax bronchial smooth muscles and relieve bronchospasm. Used for anaphylactic shock,cardiac arrest, bronchial asthma, local hemostasis of mucosa or gums, etc.[Usage] 1. Rescue anaphylactic shock: intramuscular injection of 0.5 to 1 mg/time, or slow intravenous injection with 0.9% saline diluted to 10 ml. If the curative effect is not good, use 2~4mg dissolved in 5% glucose solution 250~500ml intravenously instead. 2. Rescue cardiac arrest: 1 mg intravenously, the dose can be increased and repeated every 3 to 5 minutes (1 to 5 mg). 3. Combined with local anesthetics: add a small amount (about 1:200,000-500,000) in the local anesthetic (<300μg).[Note] 1. Adverse reactions include palpitations, headaches, and increased blood pressure. Excessive dosage or stray blood pressure during subcutaneous injection can cause a sudden increase in blood pressure, arrhythmia, and severe ventricular fibrillation and death. 2. Use with caution in hypertension, organic heart disease, diabetes, hyperthyroidism, digitalis poisoning, hypovolemic shock, cardiogenic asthma, etc.Alternative medicine: meta-hydroxylamine (alamin)Three, cardiotonicmedicineCedilan (desacetyl lanolin)[Pharmacology and application] Strengthen myocardial contractility, reflexly excite the vagus nerve, reduce the autonomy of the sinus node and atrium, slow down the heart rate and conduction, and increase the heart rate. Used for congestive heart failure, atrial fibrillation and paroxysmal supraventricular tachycardia.[Usage] Common dose: 0.4mg for the initial dose, if necessary, inject half the dose for 2 to 4 hours. Saturation amount is 1~1.2mg.[Note] 1. Adverse reactions include nausea, vomiting, loss of appetite, diarrhea,headache, hallucinations, green and yellow vision, arrhythmia and atrioventricular block. 2. Acute myocarditis, patients with myocardial infarction are forbidden; and it is forbidden to use it with calcium.Fourth, anti-arrhythmic drugsLidocaine[Pharmacology and application] At low doses, it promotes K+ outflow in myocardial cells, reduces the autonomy of myocardial conduction fibers, and has the effect of anti-ventricular arrhythmia. Used for ventricular tachycardia and premature ventricular.[Usage] Intravenous injection: 1~1.5mg/kg/time (usually 50~100mg/time) if necessary, repeat 1~2 times every 5 minutes. Intravenous infusion: Take 100mg and add 5% glucose 100~200ml forintravenous infusion, static speed is 1~2ml/min. The total amount is <300mg.[Note] 1. Adverse reactions are mainly central nervous system symptoms such as dizziness, drowsiness, paresthesia, muscle tremor, etc. Excessive amounts can cause convulsions, coma and respiratory depression. ccasionally, symptoms of cardiotoxicity such as hypotension, bradycardia, and conduction block are seen. 2. It is forbidden for patients with Alzheimer's syndrome, pre-excitation syndrome and conduction block.Use with caution in patients with liver insufficiency,congestive heart failure, glaucoma, epilepsy, and shock.Propafenone (Propafenone)[Pharmacology andapplication] Extend the time of action potential andeffective refractory period, reduce the spontaneous excitability of the myocardium, reduce the autonomy, and slow down the conduction velocity. In addition, it also blocks beta receptors and L-type calcium channels, and has a mildly negative inotropic effect. It is used for patients with supraventricular and ventricular tachycardia andpremature beats, and pre-excitation syndrome withtachycardia or atrial fibrillation.[Usage] Intravenous injection within 3 to 5 minutes after the first dilution of 70mg, and repeated once after 20 minutes of ineffective; or 1 intravenous injection followed by (20-40/hour) to maintain intravenous infusion. The total amount in 24 hours is less than 350mg.[Note] 1. Adverse reactions include nausea, vomiting, constipation, taste changes, headache, dizziness, etc. In severe cases, it can cause arrhythmia, such as conduction block, sinus node dysfunction. 2. Use with caution in patients with sick sinus syndrome, hypotension, heart failure, and severe CPD.Five, blood pressure lowering drugsReserpine[Pharmacology and application] It can empty the storage of norepinephrine, block the transmission of sympathetic nerve impulse, thus make blood vessels relax and blood pressure drop. It is characterized by slowness, gentleness and long-lasting; and has a calming and slowing heart rate effect. Suitable for patients with mild and moderate hypertension (especially effective for patients with mental stress).[Usage] Common dosage: intramuscularly or intravenously,1mg/time, repeat once after 6 hours of ineffective.[Note] 1.Common adverse reactions include nasal congestion, fatigue, lethargy, and diarrhea. Large doses can causeparalysis tremens. Long-term application can causedepression. 2. Avoid use for patients with gastric and duodenal ulcer.Magnesium Sulfate[Pharmacology and application] After injection, excessive magnesium ions relax the peripheral vascular smooth muscles, causing sympathetic nerve impulse transmission barriers, thereby dilating blood vessels and lowering blood pressure, characterized by rapid and strong antihypertensive effect. Used for convulsions, pregnancy-induced hypertension, eclampsia, tetanus, hypertension, acute renal hypertensive crisis, etc.[Usage] Common dosage: 25% magnesium sulfate 10ml/time, deep intramuscular injection (slow).[Note] 1. Too fast injection speed or excessive dosage can cause rapid hypotension, central nervous system depression, respiratory depression, etc. (calcium rescue); 2. Use digitalis with caution during menstruation.Six, vasodilatorsNitroglycerin[Pharmacology and application] It has the effect of relaxing smooth muscles, relaxing the veins and arteries of the whole body, and it is more obvious than the small arteries in thepost-capillary veins (volume vessels). It also has asignificant diastolic effect on coronary blood vessels, reduces peripheral resistance, and reduces heart load. It isused for the treatment and prevention of angina pectoris of coronary heart disease, and can also be used to lower blood pressure or treat congestive heart failure.[Usage] Dilute with 5% dextrose or sodium chloride solution and then intravenously, the starting dose is 5μg/min, it is best to use an infusion pump to input at a constant rate. There are great differences between patients and the drug. There is no fixed suitable dose for intravenous drip. The dose should be adjusted according to individual blood pressure, heart rate and other hemodynamic parameters.[Note] 1. Common adverse reactions include headache, dizziness, facial flushing, palpitations, orthostatic hypotension, and syncope. 2. It is contraindicated in patients with severe hypotension and tachycardia in the early stage ofmyocardial infarction, severe anemia, glaucoma, and increased intracranial pressure.Seven, diureticsFurosemide (furananiline)[Pharmacology and application] Inhibit the reabsorption of sodium and chlorine in the medulla of the ascending branch of the loop, promote the excretion of sodium, chloride, and potassium, and affect the formation of renal medulla hyperosmotic pressure, thereby interfering with the process of urineconcentration and diuresis Strong. It is used for theadjuvant treatment of various edema, reduction ofintracranial pressure, excretion of drug poisoning and hypertensive crisis.[Usage] Intramuscular or intravenous injection: 20mg~80mg/day, every other day or 1 to 2 timesa day, starting from a small dose.[Note] Long-termmedication has water and electrolyte disorders (hypokalemia, hyponatremia, hypochlorite), which can cause nausea, vomiting, diarrhea, thirst, dizziness, muscle cramps, etc.; occasionally skin rash, itching, blurred vision;sometimes Produce orthostatic hypotension, hearingimpairment, leukopenia and thrombocytopenia.Eight,dehydration medicineMannitol[Pharmacology and application] Causes high osmotic pressure in the renal tubules and diuresis, and at the same time increases blood osmotic pressure, which can dehydrate tissues and reduce intracranial pressure. It is used to treat cerebral edema and glaucoma. It is also used for early renal failure andprevention of acute oliguria.[Usage] Intravenous drip: 250~500ml/time of 20% solution, drip rate 10ml/min.[Note]1. Adverse reactions include water and electrolyteimbalance. ther headaches, blurred vision, dizziness,long-term use of large doses can cause renal tubulardamage. 2. Use with caution in patients with cardiac insufficiency, cerebral hemorrhage, and oliguria due to dehydration.Nine, sedativesValium (Diazepam)[Pharmacology and Application] It has sedative, hypnotic, anti-anxiety, anti-convulsant and skeletal muscle relaxation effects. It is used for anxiety and various neuroses, insomnia and anti-epilepsy, and relieves reflex muscle spasm caused by inflammation.[Usage] Common dosage: 10mg/time, then add 5-10mg every 3 to 4 hours as needed. The total amount in 24 hours is limited to40-50mg.[Note] 1. Adverse reactions include drowsiness, dizziness, ataxia, etc., occasionally respiratory depression and hypotension. 2. Use with caution in patients with acute alcoholism, myasthenia gravis, glaucoma, hypoproteinemia, and chronic obstructive pulmonary disease.Alternative medicine: Phenobarbital (lumina)10. AntipyreticsAntongding (including antipyrine, antipyrine, barbital)[Pharmacology and Application] It has antipyretic, analgesic and anti-inflammatory effects. Mainly used for fever, headache, migraine, neuralgia, toothache and rheumatic pain.[Usage] Common dosage: intramuscularinjection, 2~4ml/time.[Note] ccasionally skin rash orexfoliative dermatitis, a very small number of allergic patients have agranulocytosis; weak physique to prevent collapse; anemia, hematopoietic dysfunction patients are not used.11. AnalgesicsDulantin (Meperidine)[Pharmacology and application] The opioid receptor acting on the central nervous system produces sedation and analgesia. Used for all kinds of severe pain, cardiogenic asthma, and pre-anaesthetic administration.[Usage] Common dosage: intramuscular injection 25~100mg/time, 100~400mg/day. Maximum amount: 150mg/time, 600mg/day. The interval between two medications should not be less than 4 hours.[Note] This product is dependent. Adverse reactions include nausea, vomiting, dizziness, headache, sweating, and dry mouth. verdose can cause dilated pupils, drop in blood pressure, tachycardia, respiratory depression, hallucinations, convulsions, coma, etc.Alternative medicine:Morphine12. Antiasthmatic drugsAminophylline[Pharmacology and Application] It has a relaxing effect on bronchial smooth muscle, intermittentlyinhibits the release of histamine and other allergicsubstances, and relieves congestion and edema of tracheal mucosa. It also relaxes the smooth muscle of the biliary tract, dilates the coronary arteries and has mild diuretic, cardiac and central excitatory effects. Used for bronchial asthma, also can be used for cardiogenic asthma, biliary colic, etc.[Usage] Common dosage: intravenous injection, intravenous drip. 0.25~0.5g/time, diluted with 5% glucose for use. The maximum amount is 0.5g/time, 1g/day.[Note] Too fast intravenous injection or too high concentration can cause nausea, vomiting, palpitations, drop in blood pressure and convulsions. Contraindicated in patients with acute myocardial infarction, hypotension, and severe coronary atherosclerosis.13.AntiemeticsMetoclopramide (Metoclopramide)[Pharmacology and Application] It can block the dopamine receptors, inhibit the emetic chemoreceptors of the brain to exert antiemetic effect, promote gastric peristalsis, and accelerate the emptying of gastric contents. It is used for uremia, vomiting caused by tumor chemotherapy and radiotherapy, and gastrointestinal dyskinesia caused by chronic functional dyspepsia.[Usage] Common dosage: intramuscularinjection, 10mg~20mg/time, no more than 0.5mg/kg per day.[Note] 1. Adverse reactions include orthostatic hypotension, constipation, etc. Large doses can causeextrapyramidal reactions and hyperlactemia. 2. It is contraindicated in pheochromocytoma, epilepsy, breast cancer patients undergoing radiotherapy or chemotherapy.14. Procoagulant drugs6-aminocaproic acid (tranexamic acid)[Pharmacology and application] Byinhibiting fibrinolysis, it can stop bleeding. Used for hemorrhage caused by elevated plasmin activity, such as postpartum hemorrhage, postoperative hemorrhage of prostate, liver, pancreas, lung and other internal organs.[Usage] Common dosage: intravenous infusion, the initial dosage is 4~6g, after dilution, the maintenance amount is 1g/h.[Note] 1. Adverse reactions include nausea, diarrhea, dizziness, skin rash, muscle pain, etc. Too fast intravenous injection can cause hypotension and bradycardia. verdose can cause thrombosis. 2. Those who have a tendency to thrombosis or have a history of thrombotic vascular disease are prohibited. Reduce or use with caution in patients with renal insufficiency.Alternative medicine: Hemostatic acid (aminomethyl methanoic acid),hemostatic allergic (sulphur ethyl amine), reptilase15. AntidotePralidoxime[Pharmacology and application] In the body, it can combine with the phosphoryl group inphosphorylated cholinesterase to form a non-toxicsubstance and be excreted in urine to restorecholinesterase activity. Used for the rescue of organophosphorus pesticides.[Usage] Common dosage: intravenous drip or slow intravenous injection. 1. Mildpoisoning: 0.4g/time, repeat once in 2 to 4 hours if necessary. 2. Moderate poisoning: 0.8~1.2g for the first time, then 0.4~0.8g every 2 hours, 2~3 times; 3. Severe poisoning: 1~1.2g for the first time, 0.4g per hourthereafter.[Note] Because of iodine, it can sometimes cause sore throat and parotid gland swelling. Excessive injection can cause dizziness, blurred vision, nausea, vomiting, and tachycardia. In severe cases, convulsions and even respiratory depression can occur. Avoid compatibility with alkaline drugs.atropine[Pharmacology and application] M cholinergic receptor blocker. In addition to the general anti-M choline effect, such as relief ofgastrointestinal smooth muscle spasm, inhibition of glandular secretion, pupil dilation, increase of intraocularpressure, paralysis of vision adjustment, heart rate increase, etc., large doses can act on vascular smooth muscle and make blood vessels dilate , Relieve vasospasm, improve microcirculation. Used to relieve various visceral colic. 2. Sinus block, atrioventricular block and other slow arrhythmias caused by excessive vagus nerve excitement. 3. Anti-infective toxic shock. 4. Rescue organophosphate poisoning. 5. Administer before general anesthesia.[Usage] Common dosage: intramuscular or intravenous injection, 0.5-1 mg/time, total amount<2mg/day. When used for organophosphorus poisoning, 1-2 mg (5-10 times in severe cases), repeat every 10-20 minutes, and sometimes need 2 to 3 days to maintain.[Note] 1. The adverse reactions caused by the dose from small to large are as follows: 0.5mg, slight heart rate slowdown, slightly dry mouth and less sweat; 1mg, dry mouth, accelerated heart rate, slightly dilated pupils; 2mg, palpitations, significant Dry mouth, dilated pupils, and sometimes blurred vision; 5 mg, the above symptoms are aggravated, and there are slurred speech, irritability, dry skin, fever, difficulty urinating, and decreased bowel movements; above 10 mg, the above symptoms are moresevere, and the pulse is weak. , The central excitement phenomenon is serious, breathing speeds up and deepens, delirium, hallucinations, convulsions, etc.; severepoisoning can be turned from central excitement to inhibition, resulting in coma and respiratory paralysis. The lowest lethal dose is about 80-130 mg for adults and 10 mg for children. 2. High fever, tachycardia, diarrhea and the elderly should be used with caution. Those with glaucoma, pyloric obstruction and prostatic hypertrophy are disabled.Alternative medicine: Anisodamine (654-2)16. HormonesDexamethasone (flumethasone)[Pharmacology and Application] Anti-inflammatory, anti-toxic, anti-allergic, anti-shock and immunosuppressive effects. Used for the treatment of various inflammations and allergies.[Usage] Intramuscular injection, intravenous drip. 2~20mg/time.[Note] Adverse reactions: Inducing or aggravating infection, osteoporosis, muscle atrophy, slow wound healing, etc.; when used in large quantities, it is easy to cause Cushings syndrome (full moon face, buffalo back, central obesity, skin thinning, low Potassium, high blood pressure, urine sugar, etc.); long-term use can easily cause mental symptoms (insomnia, agitation, euphoria)and mental illness. People with a history of hysteria and mental illness are not used. Use with caution in patients with ulcer disease, thrombophlebitis, active tuberculosis, and postoperative intestinal anastomosis.Alternativemedicine: Hydrocortisone (cortisol)17. Hydropoweracid-base balance medicineSodium bicarbonate[Pharmacology and Application] It can increase the body's alkali reserve. Used to prevent and correct metabolic acidosis, septic shock, etc.[Usage] Metabolic acidosis: 1.4% 20ml/kg/time, intravenously. Infectious shock acidosis: 5% 5ml/kg/time, intravenously. All of the above can increase the C2 binding capacity by 10% (V), and correct it in stages until the symptoms disappear.[Note] A large amount of intravenous injection in a short time cancause metabolic alkalosis, hypokalemia, and hypocalcemia. It should be used with caution in patients with congestive heart failure and renal insufficiency.18.Anti-allergic drugsDiphenhydramine (Ketamine)[Pharmacology and application] H1 receptor antagonist. It can compete with the histamine released from the tissues for H1 receptors on effector cells, thereby eliminating allergic symptoms; and has central nervoussystem inhibitory effects such as sedation and hypnosis;also has antiemetic, local anesthesia and anti-M-choline-like effects. It is used to treat allergic diseases, motion sickness and vomiting.[Usage] Common dosage: intramuscular injection, 20 mg/time, 1 to 2times/day.[Note] 1. Adverse reactions include fatigue, dizziness, drowsiness, dry mouth, nausea, etc. ccasionally, it can cause skin rash and neutropenia. 2. Contraindicated in patients with glaucoma, enlarged prostate, pyloric obstruction and intestinal obstruction.Alternative medicine: calcium gluconate【翻译失败,可能限速延时太小!】。
18类常用抢救药品 (急诊科专用)
速尿(呋喃苯胺酸)
[药理及应用]抑制髓袢升支的髓质部对钠、氯的重吸收,促进钠、氯、钾的排泄和影响肾髓质高渗透压的形成,从而干扰尿的浓缩过程,利尿作用强。用于各种水肿,降低颅内压,药物中毒的排泄以及高血压危象的辅助2次,从小剂量开始。
[注意]长期用药有水电解质紊乱(低血钾、低血钠、低血氯)而引起恶心、呕吐、腹泻、口渴、头晕、肌痉挛等;偶有皮疹、瘙痒、视力模糊;有时可产生体位性低血压、听力障碍、白细胞减少及血小板减少等。
八、脱水药
甘露醇
[药理及应用]在肾小管造成高渗透压而利尿,同时增加血液渗透压,可使组织脱水,而降低颅内压。用于治疗脑水肿及青光眼,亦用于早期肾衰及防止急性少尿症。
[用法]常用量:肌注或静注,1mg/次,无效6小时后重复1次。
[注意]1.不良反应常见有鼻塞、乏力、嗜睡、腹泻等。大剂量可引起震颤性麻痹。长期应用,则能引起精神抑郁症。2.胃及十二指肠溃疡病人忌用。
硫酸镁
[药理及应用]注射后,过量镁离子舒张周围血管平滑肌,引起交感神经冲动传递障碍,从而使血管扩张,血压下降,特点为降压作用快而强。用于惊厥、妊高症、子痫、破伤风、高血压病、急性肾性高血压危象等。
[注意]1.不良反应有恶心、呕吐、便秘、味觉改变、头痛、眩晕等,严重时可致心律失常,如传导阻滞、窦房结功能障碍。2.病窦综合症、低血压、心衰、严重慢阻肺患者慎用。
五、降血压药
利血平
[药理及应用]能使去甲肾上腺素的贮存排空,阻滞交感神经冲动的传递,因而使血管舒张,血压下降。特点为缓慢、温和而持久;并有镇静和减慢心率作用。适用于轻度、中度高血压患者(精神紧张病人疗效尤好)。
肾上腺素(副肾素)
[药理及应用]可兴奋α、β二种受体。兴奋心脏β1-受体,使心肌收缩力增强,心率加快,心肌耗氧量增加;兴奋α-受体,可收缩皮肤、粘膜血管及内脏小血管,使血压升高;兴奋β2-受体可松驰支气管平滑肌,解除支气管痉挛。用于过敏性休克、心脏骤停、支气管哮喘、粘膜或齿龈的局部止血等。
常用的急救药品PPT课件
(五)抢救结束后,应及时清点,补齐药品,以备后用。
(六)特殊药品,按有关规定管理。并接受有关部门的指导, 监督检查。
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(一)三联针 (二)急救药品分类
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(一)三联针:
1.心三联(利多卡因、阿托品、肾上腺素) 2.呼三联(洛贝林、回苏灵、可拉明) 3.老三联针:肾上腺素、去甲肾上腺素、异
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(一)设急救药品处,根据病种保存一定基数的药品,便于 临床应急使用,工作人员不得擅自取用。
(二)根据药品种类与性质(如针剂,内服,外用,剧毒药等) 分别放置,编号定量,定位存放,逐班交接,每日清点,保 证备用状态,专人管理。
(三)定期检查药品质量,防止积压变质。如发生沉淀, 变色,过期,药瓶标签与盒内药品不符,标签模糊或经涂 改者不得使用。
●[注意]不良反应有恶心、呕吐、腹泻、头痛、 眩晕;大剂量可引起心动过速、呼吸抑制、 血压下降、甚至惊厥
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2、抗休克血管活性药
(1)多巴胺 (2)肾上腺素(副肾素) (3)阿拉明(间羟胺)
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(1)多巴胺
●[药理及应用]直接激动α和β受体,也激动多巴胺受体,对不同受体的作用与 剂量有关:小剂量(2~5μg/kg?min)低速滴注时,兴奋多巴胺受体,使 肾、 肠系膜、冠状动脉及脑血管扩张,增加血流量及尿量。同时激动心脏的β1 受体,也通过释放去甲肾上腺素产生中等程序的正性肌力作用;中等剂量 (5~10μg/kg?min)时,可明显激动β1受体而兴奋心脏,加强心肌收缩力。 同时也激动α受体,使皮肤、黏膜等外周血管收缩。大剂量(> 10μg /kg?min)时,正性肌力和血管收缩作用更明显,肾血管扩张作用消失。在中、 小剂量的抗休克治疗中正性肌力和肾血管扩张作用占优势。用于各种类型 休 克,特别对伴有肾功能不全、心排出量降低、周围血管阻力增高而已补 足血容量的患者更有意义。
18类常用抢救药品
18类常用抢救药品(急诊科专用)一、中枢神经兴奋药尼可刹米(可拉明)[药理及应用]直接兴奋延髓呼吸中枢,使呼吸加深加快。
对血管运动中枢也有微弱兴奋作用。
用于中枢性呼吸抑制及循环衰竭、麻醉药及其它中枢抑制药的中毒。
[用法]常用量:肌注或静注,0.25~0.5g/次,必要时1~2小时重复。
极量:1.25g/次。
[注意]大剂量可引起血压升高、心悸、出汗、呕吐、心律失常、震颤及惊厥。
山梗菜碱(洛贝林)[药理及应用]兴奋颈动脉体化学感受器而反射性兴奋呼吸中枢。
用于新生儿窒息、吸入麻醉药及其它中枢抑制药的中毒,一氧化碳中毒以及肺炎引起的呼吸衰竭。
[用法]常用量:肌注或静注,3mg/次,必要时半小时重复。
极量20mg/日。
[注意]不良反应有恶心、呕吐、腹泻、头痛、眩晕;大剂量可引起心动过速、呼吸抑制、血压下降、甚至惊厥。
二、抗休克血管活性药多巴胺[药理及应用]直接激动α和β受体,也激动多巴胺受体,对不同受体的作用与剂量有关:小剂量(2~5μg/kg•min)低速滴注时,兴奋多巴胺受体,使肾、肠系膜、冠状动脉及脑血管扩张,增加血流量及尿量。
同时激动心脏的β1受体,也通过释放去甲肾上腺素产生中等程序的正性肌力作用;中等剂量(5~10μg/kg•min)时,可明显激动β1受体而兴奋心脏,加强心肌收缩力。
同时也激动α受体,使皮肤、黏膜等外周血管收缩。
大剂量(>10μg /kg•min)时,正性肌力和血管收缩作用更明显,肾血管扩张作用消失。
在中、小剂量的抗休克治疗中正性肌力和肾血管扩张作用占优势。
用于各种类型休克,特别对伴有肾功能不全、心排出量降低、周围血管阻力增高而已补足血容量的患者更有意义。
[用法]常用量:静滴,20mg/次加入5%葡萄糖250ml中,开始以20滴/分,根据需要调整滴速,最大不超过0.5mg/分。
[注意]1.不良反应有恶心、呕吐、头痛、中枢神经系统兴奋等;大剂量或过量时可使呼吸加速、快速型心律失常。
2024版18种抢救药品
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氨茶碱
药品剂型
片剂、注射液
2024/1/24
适应症
注意事项
适用于支气管哮喘、喘息型支气管炎、 阻塞性肺气肿等缓解喘息症状;也可用 于心力衰竭的哮喘(心源性哮喘)
茶碱的毒性常出现在血清浓度为1520μg/ml,特别是在治疗开始,早期 多见的有恶心、呕吐、易激动、失眠等, 当血清浓度超过20μg/ml,可出现心 动过速、心律失常,血清中茶碱超过 40μg/ml,可发生发热、失水、惊厥 等症状,严重的甚至引起呼吸、心跳停 止致死
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利血平
功效:降血压,用于高血压危象的紧急治疗
注意事项:活动性溃疡、溃疡性结肠炎、抑郁症患者 禁用;孕妇及哺乳期妇女慎用
2024/1/24
主要成分:利血平
用法用量:口服,初始剂量0.1-0.25mg/次,每 日1次,经过7-14天的剂量调整期,以最小有效 剂量确定维持量;极量一次0.5mg/次
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药品剂型:注射液 2024/1/24
适应症:治疗支气管哮喘,心 源性或感染性休克,完全性房
室传导阻滞,心搏骤停
使用方法:救治过敏性休克用 量0.25mg~0.5mg,立即静
注
注意事项:冠心病,心肌炎及甲 状腺机能亢进患者禁用
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多巴胺
• 药品剂型:注射液 • 适应症:心肌梗死、创伤、内毒素败血症、心脏手术、肾功能衰竭、充血性心
注意事项
皮下或肌内注射时可引起出汗;极量时可引起惊厥;少数患者用药后可 出现皮疹、咽喉水肿等过敏反应。
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抗过敏及抗休克抢救药品
2024/1/24
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盐酸异丙嗪
常用的急救药品ppt课件
阿司匹林
药物类别
非处方药
主要作用
减少血小板聚集,预防血栓 形成
常见副作用
胃肠道不适、出血等
常用的急救药品ppt课件
本课件介绍了常用的急救药品,包括胰岛素、紧急避孕药、氧气、心肌梗死 急救药物等。旨在帮助大家了解这些药品的用途和作用。
胰岛素
药物类别
内分泌药物
主要用途
治疗糖尿病
注意事项
需按医生指导使用
紧急避孕药
适用人群
女性在发生未保护性行为后72小时内
服用方式
口服
常见副作用
恶心、呕吐、乳房胀痛等
口干、视力模糊等
3 适用人群
患有消化系统疾病的人群
利多卡因
药物类型
局麻药
常见应用
手术麻醉、牙科治疗等
作用原理
阻断神经传导信号
注意事项
需遵循临床医生的建议和安全用药原则
抗生素
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常见品种
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青霉素、头孢菌素、红霉素等
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注意事项
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使用抗生素时应注意遵从医生嘱咐, 规定时长和剂量
作用
杀灭细菌或抑制细菌生长
氧气
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用途
呼吸急救
供应Байду номын сангаас式
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气瓶或氧气机
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注意事项
使用时需遵守安全规定,防止火灾
常见应急场景
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高海拔地区、溺水等紧急情况
心肌梗死急救药物
阿司匹林
减少血小板聚集,迅速抑制 血栓形成
速效救心丸
舌下含服,扩张冠状动脉, 缓解心肌缺血
肾上腺素
用于心脏骤停时进行心肺复苏
阿托品
1 用途
缓解胃肠痉挛
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心律平(普罗帕酮)
[注意] 1.不良反应有恶心、呕吐、便秘、味觉改变、
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心律平(普罗帕酮)
[药理及应用]延长动作电位的时间及有效不应 期,减少心肌的自发兴奋性,降低自律性,减 慢传导速度。此外亦阻断β受体及L-型钙通道, 具有轻度负性肌力作用。用于室上性及室性心 动过速和早搏,及预激综合症伴发心动过速或 房颤患者。
[用法]首次70mg稀释后3~5分钟内静注,无效 20分钟后重复1次;24小时总量<350mg。
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肾上腺素(副肾素)
[药理及应用]可兴奋α、β二种受体。 兴奋心脏β1-受体,使心肌收缩力增强,心率
加快,心肌耗氧量增加; 兴奋α-受体,可收缩皮肤、粘膜血管及内脏小
血管,使血压升高; 兴奋β2-受体可松驰支气管平滑肌,解除支气
管痉挛。用于过敏性休克、心脏骤停、支气管 哮喘、粘膜或齿龈的局部止血等。
静滴:一般以5%葡萄糖注射液配成1-4mg/ml 药液滴注或用输液泵给药. 。
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利多卡因
[注意] 1.不良反应主要为头晕、嗜睡、感觉异常、肌
颤等中枢神经系统症状,超量可引起惊厥、昏 迷及呼吸抑制等。偶见低血压下降、心动过缓、 传导阻滞等心脏毒性症状。 2.阿-斯氏综合征、预激综合征、传导阻滞患者 禁用。肝功能不全、充血性心力衰竭、青光眼、 癫痫病、休克等患者慎用。
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肾上腺素(副肾素)
[用法] 1.抢救过敏性休克:肌注0.5~1mg/次,或以
0.9%盐水稀释到10ml缓慢静注。如疗效不好, 可改用2~4mg溶于5%葡萄糖液 250~500ml 中静滴。 2.抢救心脏骤停:1mg静注,每3~5分钟可 加大剂量递增(1~5mg)重复。 3.与局麻药合用:加少量(约1: 200000— 500000)于局麻药内(<300μg)。
[用法]常用量:肌注或静注,3mg/次,必要时 半小时重复。极量:6mg /次,极量20mg/日。
[注意]不良反应有恶心、呕吐、腹泻、头痛、 眩晕;大剂量可引起心动过速、呼吸抑制、血 压下降、甚至惊厥。
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二、抗休克血管活性药
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多巴胺
[药理及应用]直接激动α和β受体,也激动多巴胺受体, 对不同受体的作用与剂量有关:
用药期间应注意随访检查: 血压、心率及心律
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西地兰(去乙酰毛花甙)
禁用: 1. 预激综合征伴心房颤动或扑动; 2. 任何强心甙制剂中毒; 3. 室性心动过速、心室颤动; 4. 梗阻性肥厚型心肌病(若伴收缩功能不 全或心房颤动仍可考虑)。
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西地兰(去乙酰毛花甙)
慎用: 1. 低钾血症; 2. 不完全性房室传导阻滞; 3. 高钙血症; 4. 甲状腺功能低下; 5. 缺血性心脏病; 6. 急性心肌梗死早期(AMI); 7. 心肌炎活动期; 8. 肾功能损害。
作用时间短暂,应视病情间隔给药
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尼可刹米(可拉明)
[注意] 大剂量可引起血压升高、心悸、出汗、
呕吐、心律失常、震颤及惊厥。 抽搐及惊厥患者禁用。
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山梗菜碱(洛贝林)
[药理及应用]兴奋颈动脉体化学感受器而反射 性兴奋呼吸中枢。用于新生儿窒息、吸入麻醉 药及其它中枢抑制药的中毒,一氧化碳中毒以 及肺炎引起的呼吸衰竭。
由于本品可增加心排血量,也用于洋地 黄和利尿剂无效的心功能不全。
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多巴胺
[用法]常用量:静滴,20mg/次加入5% 葡萄糖250ml中,开始以20滴/分,根据需 要调整滴速,最大不超过0.5mg/分。
[注意]1.不良反应有恶心、呕吐、头痛、 中枢神经系统兴奋等;大剂量或过量时 可使呼吸加速、快速型心律失常。2. 使 用以前应补充血容量及纠正酸中毒。3. 输注时不能外溢。
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肾上腺素(副肾素)
[注意] 1.不良反应有心悸、头痛、血压升高,用量过
大或皮下注射时误入血管后,可引起血压突然 上升、心律失常,严重可致室颤而致死。 2.高血压、器质性心脏病、糖尿病、甲亢、 洋地黄中毒、低血容量性休克、心源性哮喘等 慎用。 备选药:间羟胺(阿拉明)
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三、强心药
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流及耗氧改善
大剂量(> 10μg /kg/min)时,激动 α受体,导致周围血
管阻力增加,肾血管收缩,肾血流量及尿量反而减少。
由于心排血量及周围血管阻力增加,致使收缩压及舒
张压均增高。
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多巴胺
适用于心肌梗死、创伤、内毒素败血症、 心脏手术、肾功能衰竭、充血性心力衰 竭等引起的休克综合征;补充血容量后 休克仍不能纠正者,尤其有少尿及周围 血管阻力正常或较低的休克。
18类常用抢救药品
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一、中枢神经兴奋药
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尼可刹米(可拉明)
[药理及应用]直接兴奋延髓呼吸中枢,使呼吸 加深加快。对血管运动中枢也有微弱兴奋作用。 用于中枢性呼吸抑制及循环衰竭、麻醉药及其 它中枢抑制药的中毒。
[用法]常用量:皮下注射、肌肉注射、静脉注 射 ,0.25~0.5g/次,必要时1~2小时重复。 极量:1.25g/次。
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四、低剂量时,促进心肌细胞内K+ 外流,降低心肌传导纤维的自律性,而具有抗 室性心律失常作用。用于室性心动过速和室早。
[用法] 静注:1~1.5mg/kg/次(一般用50~100mg/
次)必要时每5分钟后重复1~2次,但1小时 之内的总量不得超过 300mg 。
西地兰(去乙酰毛花甙)
[药理及应用]增强心肌收缩力,并反射性兴奋 迷走神经,降低窦房结及心房的自律性,减慢 心率与传导,使心博量增加。用于充血性心衰、 房颤和阵发性室上性心动过速。
[用法]常用量:初次量0.4mg,必要时2~4小 时再注半量。
[注意]不良反应有恶心、呕吐、食欲不振、腹 泻,头痛、幻觉、绿黄视,心律失常及房室传 导阻滞。
小剂量(0.5~2μg/kg/min) 主要作用于多巴胺受体,使 肾及肠系膜血管扩张,肾血流量及肾小球滤过率增加, 尿量及钠排泄量增加
中等剂量 (2~10μg/kg/min)时,能直接激动β1受体及 间接促使去甲肾上腺素自储藏部位释放,对心肌产生 正性应力作用,使心肌收缩力及心搏量增加,最终使 心排血量增加、收缩压升高、脉压可能增大,舒张压 无变化或有轻度升高,外周总阻力常无改变,冠脉血