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FARMACOLOGIA FARMACOLOGIA ACLS ACLS Dr. Alejandro Villatoro-Martinez Urgencias Medico Quirúrgicas The American British Cowdray Medical Center Santa Fe Mexico D.F. www.reeme.arizona.edu www.reeme.arizona.edu Clasificación de Medicamentos 2000 para Reanimación Cardiopulmonar CCllaassee II:: EExxcceelleennttee ddeeffiinniittiivvaammeennttee rreeccoommeennddaaddoo.. CCllaassee IIIIaa:: BBuueennoo aa mmuuyy BBuueennoo,, aacceeppttaabbllee yy úúttiill ((ddee eelleecccciióónn)).. CCllaassee IIIIbb:: RReegguullaarr aa BBuueennoo,, aacceeppttaabbllee yy úúttiill ((ooppcciioonnaall oo aalltteerrnnaattiivvoo)).. CCllaassee IInnddeetteerrmmiinnaaddaa:: EEvviiddeenncciiaa iinnssuuffiicciieennttee.. UUssoo rreeccoommeennddaaddoo ppeerroo nnoo hhaayy iinnffoorrmmaacciióónn ssuuffiicciieennttee ppaarraa uunnaa ddeecciissiióónn ddee ccllaassiiffiiccaacciióónn ffiinnaall.. CCllaassee IIIIII:: IInnaacceeppttaabbllee,, nnoo hhaayy bbeenneeffiicciioo ddooccuummeennttaaddoo,, ppuueeddee sseerr ppeelliiggrroossoo.. www.reeme.arizona.edu MMEEDDIICCAAMMEENNTTOOSS La aplicación de los medicamentos, durante ► AVCA será casi siempre Push, Flush and Up (bolo, infusión 20 ml sol. Salina y levantar el brazo del paciente). Se ministran en infusión: Aminas, ► Amiodarona, adrenalina, Procainamida, Sulfato magnesio. www.reeme.arizona.edu www.reeme.arizona.edu AADDEENNOOSSIINNAA NNuucclleeóóssiiddoo ddee ppuurriinnaa eennddóóggeennoo.. ►► Disminuye conducción a través del nodo AV. ► Interrumpe las vías de reentrada AV-nodal.. ► PPrriimmeerraa ddrrooggaa eenn TTSSVVPP ppoorr rreeeennttrraaddaa ((II)).. ►► UUssoo ddiiaaggnnoossttiiccoo ((IIIIaa)).. ►► Efecto farmacológico rápido, vviiddaa mmeeddiiaa ► << 1100”” ((55””)).. www.reeme.arizona.edu AADDEENNOOSSIINNAA Dosis inicial de 6 mg bolo rápido (1-3 seg), Si no ► hay respuesta 1 a 2 minutos; Repetir 12 mg, bolo rápido, y hasta 3º bolo, si no hay respuesta. Menos efectiva en quienes toman xantinas. ► RRuubbiiccuunnddeezz,, ddoolloorr ttoorraacciiccoo,, aassiissttoolliiaa yy eeccttooppiiaa ►► vveennttrriiccuullaarr.. CCoonnttrraaiinnddiiccaacciioonneess:: TTaaqquuiiccaarrddiiaa iinndduucciiddaa ppoorr ►► ddrrooggaass.. www.reeme.arizona.edu AADDRREENNAALLIINNAA ((EEPPIINNEEFFRRIINNAA)) IInnccrreemmeennttaa:: TTAA,, RReessiisstteenncciiaass vvaassccuullaarreess ►► ssiissttéémmiiccaass,, AAcctt.. EEllééccttrriiccaa ccoorraazzóónn,, iinnoottrrooppiissmmoo yy aauuttoommaattiissmmoo,, aaddeemmááss ddee ccoonnssuummoo ddee OO .. 22 PPaarroo ccaarrddiiaaccoo ppoorr FFVV,, TTVV ssiinn ppuullssoo,, aassiissttoolliiaa yy ►► AAEEssPP ((IIIIaa)).. CCaammbbiiaa FFVV ffiinnaa aa ggrruueessaa ((IIIIaa)).. ►► www.reeme.arizona.edu MMEECCAANNIISSMMOO DDEE AACCCCIIÓÓNN CCaatteeccoollaammiinnaa eennddóóggeennaa αα yy ββ.. ►► PPrroodduuccee llaass ssiigguuiieenntteess rreeppuueessttaass:: ►► ►►RReessiisstteenncciiaa vvaassccuullaarr ppeerriifféérriiccaa ((αα)).. ►►PPrreessiioonneess ddiiaassttóólliiccaa yy ssiissttóólliiccaa ((αα)).. AAccttiivviiddaadd eellééccttrriiccaa,, ffzzaa ddee ccoonnttrraacccciióónn yy ►► rreeqquueerriimmiieennttooss ddee OO22 ddeell mmiiooccaarrddiioo ((ββ)).. ►►FFlluujjoo ssaanngguuíínneeoo ccoorroonnaarriioo yy cceerreebbrraall ((αα)).. ►►AAuuttoommaattiicciiddaadd((ββ)).. www.reeme.arizona.edu PPAARROO CCAARRDDIIAACCOO EEssttiimmuullaa rreecceeppttoorreess αα aaddrreennéérrggiiccooss VVaassooccoonnssttrriicccciióónn ppeerriifféérriiccaa AAuummeennttaa fflluujjoo ssaanngguuíínneeoo mmiiooccáárrddiiccoo yy cceerreebbrraall dduurraannttee RRCCPP www.reeme.arizona.edu

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www.reeme.arizona.edu. ADENOSINA. ▻Nucleósido de purina endógeno. ▻Disminuye conducción a través del nodo AV. ▻Interrumpe las vías de reentrada AV-nodal. ▻Primera droga en TSVP por reentrada (I). ▻Uso diagnostico (IIa). ▻Efecto farmacológico rápido, vida media. < 10” (5”).

Farmacología ACLS PDF

61 Pages·2005·0.72 MB·Spanish

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Publication Year:	2005
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Language:	Spanish
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