MindMap Gallery 【Doctor's Order】04 Cardiovascular System
This is a mind map about [Doctor's Order] 04 cardiovascular system, covering the selection and application of a variety of drugs. Provides clear guidance for clinicians on prescribing.
Edited at 2024-11-18 08:50:04魯米:靈性覺醒的10個維度。當你停止尋找自己,便會找到整個宇宙,因為你正在尋找的東西,也在尋找你。任何你每天持之以恆在做的事情,都可以為你打開一扇通向精神深處的門。靜默中,我滑入祕境,萬般皆妙樂觀察身邊的神奇,不要聲張。你生而有翼,為何喜歡爬行?靈魂擁有了它自己的耳朵,能夠聽到頭腦無法理解的事情。向內尋求一切的答案吧,宇宙中的一切都在你體內。情人們並不最終相遇某處,這個世界沒有離別。傷口是光進入你內心的地方。
慢性心力衰竭,不僅僅是心率的快慢問題!它源於心肌收縮與舒張功能的下降,導致心輸出量不足,進而引發肺循環充血和體循環淤血。從病因、誘因到代償機制,心衰的病理生理過程複雜多樣。通過控制水腫、減輕心臟前後負荷、改善心臟舒縮功能,以及防治基本病因,我們可以有效應對這一挑戰。了解心衰的機制與臨床表現,掌握防治策略,才能更好地守護心臟健康。
缺血再灌注損傷是器官或組織恢復血液供應後,細胞功能代謝障礙和結構破壞反而加重的現象。其主要機制包括自由基生成增多、鈣超載以及微血管和白細胞的作用。心臟和腦是常見的受損器官,表現為心肌代謝和超微結構變化、心功能下降等。防治措施包括清除自由基、減輕鈣超載、改善代謝和控制再灌注條件,如低鈉、低溫、低壓等。理解這些機制有助於製定有效治療方案,減輕缺血性損傷。
魯米:靈性覺醒的10個維度。當你停止尋找自己,便會找到整個宇宙,因為你正在尋找的東西,也在尋找你。任何你每天持之以恆在做的事情,都可以為你打開一扇通向精神深處的門。靜默中,我滑入祕境,萬般皆妙樂觀察身邊的神奇,不要聲張。你生而有翼,為何喜歡爬行?靈魂擁有了它自己的耳朵,能夠聽到頭腦無法理解的事情。向內尋求一切的答案吧,宇宙中的一切都在你體內。情人們並不最終相遇某處,這個世界沒有離別。傷口是光進入你內心的地方。
慢性心力衰竭,不僅僅是心率的快慢問題!它源於心肌收縮與舒張功能的下降,導致心輸出量不足,進而引發肺循環充血和體循環淤血。從病因、誘因到代償機制,心衰的病理生理過程複雜多樣。通過控制水腫、減輕心臟前後負荷、改善心臟舒縮功能,以及防治基本病因,我們可以有效應對這一挑戰。了解心衰的機制與臨床表現,掌握防治策略,才能更好地守護心臟健康。
缺血再灌注損傷是器官或組織恢復血液供應後,細胞功能代謝障礙和結構破壞反而加重的現象。其主要機制包括自由基生成增多、鈣超載以及微血管和白細胞的作用。心臟和腦是常見的受損器官,表現為心肌代謝和超微結構變化、心功能下降等。防治措施包括清除自由基、減輕鈣超載、改善代謝和控制再灌注條件,如低鈉、低溫、低壓等。理解這些機制有助於製定有效治療方案,減輕缺血性損傷。
cardiovascular system
rescue medicine
Heart Triplet Call Erlian
rescue
Confusion, dilated pupils
Dopamine 160mg pump Nikosamid 1.125g intravenous drip
Decreased heart rate, hypotensive shock
Nikosamid 0.375g intravenous injection
cardiac arrest, respiratory arrest
Epinephrine 1mg Atropine 0.5mg Dopamine 20mg
Epinephrine hydrochloride 1mg iv
Atropine sulfate 1mg iv
Dopamine 5mg iv
Nikeshmi
NS 35mL 2~3mL/h pump Nikosamid 3g
Nikosamid 0.375g iv Repeated use in 1~2 hours
Lobeline hydrochloride
NS 250mLivgtt Nikshami (5 pieces) 1.875g Lobelin (5 sticks) 15mg
Lobeline hydrochloride 3mg iv Repeat injection every 30 minutes if necessary
Anti-platelet aggregation
Prevent thrombosis
antiplatelet
Aspirin enteric-coated tablets 100mg qd
Clopidogrel sulfate tablets 75mg qd
Prevention of thrombosis in acute myocardial infarction
Ticagrelor 90mg bid
Indobufen 100mg bid
Tirofiban
Tirofiban sodium chloride 50mg [iv pump] 4ml/h
Anticoagulation
Heparin sodium
Heparin sodium 12,500 u [for pharmaceutical use] qd
Prevention and treatment of thrombosis, hemodialysis/anticoagulation treatment of surgical instruments
Low molecular weight heparin sodium 3200U [for pharmaceutical use] qd
Prevention and treatment of deep vein thrombosis, hemodialysis prevention
Heparin calcium
Low molecular weight heparin calcium 4100U [for pharmaceutical use] qd
Prevention and treatment of deep vein thrombosis, hemodialysis prevention
Thrombolysis
Urokinase
Urokinase 100,000u [Ivgtt] qd
Thrombolytic therapy for thromboembolic disease
plasmin
NS 500ml [IVgtt] qd Plasmin 200u
Peripheral vascular diseases such as cerebral infarction, hypercoagulable state, and thromboangitis
Anti-platelet aggregation
Enzyme inhibitors
①Cepoxygenase inhibitor
Aspirin, indobufen
Aspirin (loading dose 300mg) 100mg qd Indobufen 100mg bid
② Thromboxane synthase inhibitor
Ozagrel sodium
⑥Phosphodiesterase inhibitors
Cilostazol
receptor antagonist
③Platelet membrane glycoprotein (GP) IIb/IIIa receptor inhibitor
Tirofiban
Tirofiban sodium chloride 50mg [iv pump] 4ml/h
④5-hydroxytryptamine receptor antagonist
Sargrelate
⑤Adenosine diphosphate receptor Antagonist (ADPR-A)
Clopidogrel, Ticagrelor
Clopidogrel (loading dose 300mg) 75mg qd Ticagrelor 90mg bid
other
⑦Biphasic inhibition of ADP and inhibition of TXA2 formation Enhance the effects of endogenous PGI2
Dipyridamole et al.
anticoagulants
direct thrombin inhibitor /Factor IIa inhibitor
Dabigatran etexilate, bivalirudin, Argatroban, recombinant hirudin (lepirudin)
Dabigatran etexilate capsules 110mg
thrombin indirect inhibitor
Heparin (heparin sodium, heparin calcium), Low molecular weight heparin (dalteparin sodium, enoxaparin sodium, nadroparin calcium)
Heparin sodium
Heparin sodium 12,500 u [for pharmaceutical use] qd
Low molecular weight heparin sodium 3200U [for pharmaceutical use] qd
Heparin calcium
Low molecular weight heparin calcium 4100U [for pharmaceutical use] qd
Vitamin K antagonist (VKA)
warfarin
selective factor Xa inhibitor /FⅩa inhibitor
selective factor Xa direct inhibitor
Rivaroxaban apixaban edusaban
Rivaroxaban 25mg qd
Deep vein thrombosis (DVT) and pulmonary embolism (PE) Non-valvular atrial fibrillation with one/multiple risk factors
selective factor Xa indirect inhibitor
Fondaparinux
Regulate lipids and stabilize plaque
Starting dose/maximum daily dose/usage method
L-carnitine
NS 100ml [Ivgtt] L-carnitine 3g [Ivgtt]
Chronic renal failure: long-term hemodialysis
L-carnitine 1g [Ivgtt]
Complications of long-term hemodialysis: cardiomyopathy, bone disease, hypotension
L-carnitine 1.0ml [iv] tid
Promote fat metabolism and protect cardiovascular and cerebrovascular diseases
Statins
Atorvastatin (Lipitor) 10mg qd/80mg/oral
Rosuvastatin 5mg qd/20mg/oral
Lovastatin 20mg qd/80mg with dinner
Simvastatin 10mg qd/40mg in the evening
Pravastatin 10mg qd/40mg/oral
fibrates
Bezafibrate 2# po tid
Bezafibrate 200mg tid/1200mg/oral
Fenofibrate 200mg qd/oral
Niacin
Acipimox 250mg bid/1200mg/oral
Antihypertensive, antiventricular remodeling (ACEI/ARB)
ACEI
Benazepril Hydrochloride Tablets
Benazepril 10mg qd
Heart failure: 2.5/5mg qd/bid Antihypertensive: 10mg qd
Enalapril maleate tablets
Heart failure: 25mg qd/bid Antihypertensive: 5~10mg qd
captopril tablets
Heart failure: 12.5mg bid Antihypertensive: 25mg bid
Perindopril tert-butyl film
Heart failure: 2/4mg qd Antihypertensive: 4mg qd
Perindopril Indapamide Tablets 5.25mg qd
Fosinopril sodium tablets 10mg qd
ARB
Losartan Potassium Tablets 50/100mg qd
Valsartan capsules 80mg qd
Valsartan Hydrochlorothiazide Tablets 92.5mg qd
Irbesartan Capsules 0.15g qd
Irbesartan tablets 0.15g qd
Irbesartan Hydrochlorothiazide Tablets 150mg qd
Telmisartan tablets 80mg qd
Valsartan and Amlodipine Tablets 80mg qd
Losartan Potassium Hydrochlorothiazide Tablets 50mg qd
step down
Hypertensive emergency medication
Nitroglycerin
Hypertensive emergency combined with ACS or acute heart failure
sodium nitroprusside
Various hypertensive emergencies
Nicardipine hydrochloride
Hypertensive emergency combined with acute cerebrovascular disease
Urapidil hydrochloride
hypertensive emergency
labetalol hydrochloride
Hypertensive emergency complicated by pregnancy or renal insufficiency
β resistance
Metoprolol succinate extended-release tablets (Betaloc) 47.5mg qd
Metoprolol tartrate tablets 12.5mg bid
Bisoprolol Fumarate Tablets 2.5mg qd
Carvedilol 12.5~25mg qd/bid
Atenolol(25mg) 12.5mg bid
Esmolol hydrochloride
NS 50mlL micropump infusion Esmolol hydrochloride 0.4g
15mL/h maintenance after 2.5mL loading volume
CCB
Amlodipine besylate tablets 5mg qd
Levamlodipine besylate tablets 2.5mg qd
Amlodipine Atorvastatin Calcium Tablets 1 tablet qd
Nifedipine controlled release tablets 30mg qd
Felodipine extended-release tablets 5mg qd
Lacidipine tablets 4mg qd
Anti-heart failure
empagliflozin
Dapagliflozin 10mg qd
Sacubitril/Valsartan (Nosinto)
Anti-heart failure: 50mg bid Antihypertensive: 200mg qd
diuretic
Furosemide
Furosemide 20/40mg [iv]
Torasemi
NS 100ml/6ml intravenous injection Torsemide 20mg
Diuresis after prescribing albumin
NS/GS 10mL [iv] or micropump infusion 80ml/h Torsemide 20mg
NS 20mL micropump infusion qd Torsemide 20mg
po
Furosemide tablets (furosemide) 20mg qd
Spironolactone tablets 20mg bid
combined use
Furosemide 20mg bid Spironolactone 40mg bid
Cirrhosis, ascites; edema of both lower limbs Furosemide:spironolactone=1:2, qd Eat for 3 days, stop for 2 days
Indapamide tablets 2.5mg qd (note low potassium)
Indapamide extended-release tablets 1.5mg qd
essential hypertension
vasodilators
Isosorbide mononitrate
5%GS 40mL intravenous pump 6mL/h Isosorbide mononitrate 40mg
Isosorbide dinitrate
Isosorbide dinitrate 50mg intravenous pump 3~5mL/h
Nitroglycerin
NS 50ml micropump input Nitroglycerin 10ml
After thrombectomy, blood pressure is high, lower blood pressure
NS 49mL intravenous pump 6mL/h Nitroglycerin 5mg
po
Isosorbide mononitrate 40mg qd
Isosorbide mononitrate tablets (20mg/tablet) 20mg bid
Isosorbide mononitrate sustained-release tablets (40mg/tablet) 40mg qd
Isosorbide mononitrate extended-release tablets 30mg qd
coronary heart disease, angina pectoris
Isosorbide dinitrate tablets (5mg/tablet) 10mg tid
Breast widening aerosol
Improve circulation
pancreatic kallikreinogenase
NS (water injection) 2ml intramuscular injection qd Pancreatic kallikreinogenase 40u intramuscular injection qd
Vasodilators to improve microcirculation
papaverine
NS 250ml [Ivgtt] qd Papaverine 150mg
NS 100ml [Ivgtt] qd Papaverine 90mg
Cerebrocardiac and peripheral vasospasm ischemia, visceral spasm
Cardiotonic boost
Recombinant human brain natriuretic peptide (Xinhuosin)
NS 50ml [micropump input] ×3 Recombinant human brain natriuretic peptide 0.5mg
Intravenous therapy for acute decompensated heart failure at rest NYHA>Grade II 3ml/h
Desacetyllanosin (Cedilan)
5%GS 20ml [IV] Deacetyllanosin 0.2mg
Mainly used for heart failure: acute heart failure/acute exacerbation of chronic heart failure Control the ventricular rate of atrial fibrillation and atrial flutter with rapid ventricular rate
Milrinone
5%GS 50ml [micropump input] Milrinone 15mg
NS 35mL micropump infusion 5mL/h qd Milrinone 15mg
Short-term treatment of acute decompensated heart failure
Zuo Ximendan
5%GS 50ml [micropump infusion] Levosimendan 12.50mg
5%GS 45mL intravenous micropump 2mL/h Levosimendan 12.5mg
dopamine
NS 50ml [for dispensing] ×3 Dopamine hydrochloride 160mg Furosemide 40mg
NS 50ml [micropump input] Dobutamine hydrochloride 60mg Furosemide 60mg
NS 250mLivgtt Dopamine 100mg
Dobutamine hydrochloride
NS 40mL micropump infusion 3mL/h Dobutamine hydrochloride 100mg
Norepinephrine tartrate
NS 20mL slowly injected intravenously Norepinephrine tartrate 1mg
po
Digoxin tablets 0.1250mg qd
antiarrhythmic drugs
Amiodarone
5%GS 20ml [IV] Amiodarone hydrochloride 0.15g
5%GS 50ml [micropump input] Amiodarone hydrochloride 0.3g
Ventricular premature/ventricular tachycardia/atrial fibrillation (use with caution for low potassium)
propafenone hydrochloride
Propafenone tablets 150mg tid/q8h
Atrial fibrillation, frequent ventricular premature beats
diltiazem
Angina pectoris/hypertensive emergency/supraventricular tachycardia
Diltiazem Hydrochloride Tablets 30mg tid
Diltiazem Hydrochloride Extended Release Tablets 90mg qd
Angina pectoris
verapamil hydrochloride
NS/5%GS 20mL iv Verapamil 5mg
paroxysmal supraventricular tachycardia cardioversion (>2min) Can be repeated after 15min
lidocaine
Ventricular premature and ventricular tachycardia after acute myocardial infarction
Deacetyllanosin
Atrial fibrillation with rapid ventricular rate and strong heart
isoproterenol
Complete AVB (heart rate less than 40 beats/min), Cardiac arrest, cardiogenic/septic shock?
Postoperative medical instructions
Operation
♦Planned to undergo coronary angiography and PCI today
♦Lidocaine 1 bottle ♦Nitroglycerin 1 bottle ♦Heparin sodium 1 tube ♦Iodixanol 1000ml
Intraoperative preparation
IABP flushing anticoagulation
Heparin sodium
NS 500ml [for dispensing] qd Heparin sodium 12,500 u
coronary angiography PCI
♦Bedside ECG ♦Loosen the right radial artery compressor half a turn q2h×6 times ♦Measure blood pressure q1h×6 times ♦Routine blood test, renal function, electrolytes, cardiac enzymes tomorrow morning
Coronary angiography after PCI: high sensitivity troponin critical value →Consider PCI-related myocardial injury
pacemaker implantation
♦Bedside ECG ♦Pacemaker incision sandbag compression for 24 hours ♦Measure blood pressure q1h×6 times ♦Routine blood test, renal function, electrolytes, cardiac enzymes tomorrow morning
femoral artery
♦Bedside ECG ♦Femoral artery sheath care ♦Measure blood pressure q1h×6 times ♦Routine blood test, renal function, electrolytes, cardiac enzymes tomorrow morning
5%GS 500ml [IVgtt] ×3 hydration
Cardiology
coronary heart disease
Potassium supplement
NS 250ml [IVgtt] Potassium chloride 0.75g Magnesium sulfate 1.25g
NS 500ml [IVgtt] Potassium chloride 1.5g Magnesium sulfate 2.5g
10%GS 500ml [IVgtt] qd potassium chloride Magnesium sulfate
Anti-platelet aggregation
Tirofiban
Tirofiban sodium chloride 50mg [iv pump] 4ml/h
Aspirin 100mg qd
Ticagrelor 90mg bid
Indobufen 100mg bid
Clopidogrel 75mg qd
Anticoagulation
Heparin sodium
NS 500ml [for dispensing] qd Heparin sodium 12,500 u
low molecular weight heparin
Rivaroxaban 25mg qd
Deep vein thrombosis (DVT) and pulmonary embolism (PE) Non-valvular atrial fibrillation with one/multiple risk factors
Lipid regulation and plaque stabilization
Atorvastatin Calcium 20mg qn
subtopic
step down
Lacidipine 4mg qd
Inhibit ventricular remodeling
Benazepril 10mg qd
Irbesartan 15mg qd
Losartan Potassium 50mg qd
Metoprolol succinate extended-release tablets (Betaloc) 23.75mg qd
diuretic
Torasemi
NS 2/5ml [IV] Torsemide 20mg
Furosemide
Furosemide 20mg intravenous injection
Furosemide 20mg qd Spironolactone 20mg qd
Anti-heart failure
empagliflozin
Dapagliflozin 10mg qd
Sacubitril/Valsartan (Nosinto)
Anti-heart failure: 50mg bid Antihypertensive: 200mg qd
dilated coronary arteries
Nitroglycerin
NS 50ml micropump input Nitroglycerin 10ml
After thrombectomy, blood pressure is high, lower blood pressure
Isosorbide mononitrate 40mg qd
Breast widening aerosol