Diuretics:

 First-line therapy generally includes a loop diuretic such as furosemide, which inhibits
sodium chloride reabsorption in the ascending loop of Henle.

 Furosemide (Lasix)
 intravenously (IV)
 To allow both superior potency and a higher peak concentration despite an increased
incidence of adverse effects, particularly ototoxicity.

 Metolazone (Zaroxolyn)
 a potent thiazide-related diuretic that sometimes is used in combination with furosemide
for more aggressive diuresis. It is also used for initiating diuresis in patients with a degree of
renal dysfunction.

Nitrates
 reduces myocardial oxygen demand by lowering preload and afterload.

 Nitroglycerin sublingual (Nitro-Bid, NitroMist, Nitrostat, Nitrolingual)

 For acute pulmonary edema with a systolic blood pressure of at least 100 mm Hg.

 Nitroprusside sodium (Nitropress)

 produces vasodilation of venous and arterial circulation.

Opioid Analgesics

 Morphine sulfate (Duramorph, Astramorph)

 has reliable and predictable effects, safety profile, and ease of reversibility with naloxone.

Inotropic Agents
 to increase cardiac contractility and reduce vascular tone by vasodilatation.

 Dopamine
 stimulates both adrenergic and dopaminergic receptors.
 Lower doses stimulate mainly dopaminergic receptors that produce renal and mesenteric
vasodilation
 higher doses produce cardiac stimulation and renal vasodilation.

 Norepinephrine (Levophed)
 used in protracted hypotension after adequate fluid replacement.
 norepinephrine increases systemic blood pressure and cardiac output

 Dobutamine

 produces vasodilation and increases the inotropic state.

Beta2 Agonists
 act to decrease muscle tone in both small and large airways in the lungs.

 Terbutaline (Brethaire, Bricanyl)

 acts directly on beta2 receptors to relax bronchial smooth muscle, relieving bronchospasm
and reducing airway resistance.

 Albuterol (Proventil)
 useful in the treatment of bronchospasm. It selectively stimulates beta2-adrenergic
receptors of the lungs

Xanthine Derivatives
 relaxes smooth muscle of the bronchi.

 Theophylline (Elixophyllin Elixir, Theo-24)

 increases in collateral ventilation, respiratory muscle function, mucociliary clearance, and
central respiratory drive.

Anticholinergics, Respiratory

 Ipratropium bromide (Atrovent HFA)

 inhibit vagally mediated reflexes by antagonizing the action of acetylcholine, specifically
with the muscarinic receptor on bronchial smooth muscle.

Corticosteroids

 Methylprednisolone (Solu-Medrol, Depo-Medrol, Medrol)

 Methylprednisolone is usually given IV.