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## Mometrix other artery. The MAP is most commonly used to evaluate perfusion as it shows pressure throughout the cardiac cycle. Systole is one-third and diastole two-thirds of the normal cardiac cycle. The MAP for a blood pressure of 100/60 (Normal range 70-100 mm Hg with 60 the critical level):...

## Mometrix other artery. The MAP is most commonly used to evaluate perfusion as it shows pressure throughout the cardiac cycle. Systole is one-third and diastole two-thirds of the normal cardiac cycle. The MAP for a blood pressure of 100/60 (Normal range 70-100 mm Hg with 60 the critical level): [(Diastole x 2) + (Systole × 1)] / 3 = MAP For example: (60 x 2 = 120) + (100) = 220/3 = MAP of 73.3 ### INOTROPIC AGENTS Inotropic agents are used to increase cardiac output and improve contractibility of the myocardium. Dosage and administration of pediatric medications are weight and age related. Inotropic agents include: * Dobutamine is given intravenously before and after surgery to improve cardiac output and treat cardiac decompensation * Dopamine is given intravenously before and after surgery to increase cardiac output, blood pressure, and the excretion of urine * Digoxin is given intravenously or by mouth and is used to increase the strength of myocardial contractions, resulting in better cardiac output * Epinephrine is given intravenously before and after surgery to increase blood pressure and cardiac output, but it must be used judiciously because it also increases consumption of oxygen * Milrinone/Amrinone is given after surgery to increase cardiac output and stroke volume, decrease systemic vascular resistance (SVR) as well as control congestive heart failure ### DIURETICS Diuretics are used in the cardiac patient to increase renal perfusion and filtration, thereby reducing preload. Dosages are weight and age related. Diuretics commonly used include: * Bumetanide (Bumex®) is a loop diuretic (acting on the renal ascending loop of Henle) given intravenously after surgery to reduce preload * Ethacrynic acid (Edecrin®) is a loop diuretic given intravenously after surgery to reduce preload * Furosemide (Lasix®) is a loop diuretic and is used for the control of congestive heart failure as well as renal insufficiency. It is used after surgery to decrease preload and to reduce the inflammatory response caused by cardiopulmonary bypass (post-perfusion syndrome) * Spironolactone (Aldactone®) is a potassium-sparing synthetic steroid diuretic that increases the secretion of both water and sodium and is used to treat congestive heart failure. It may be given orally or intravenously ### ANTIHYPERTENSIVES AND MISCELLANEOUS CARDIAC DRUGS Antihypertensives are used to control congestive heart failure and reduce the cardiac workload: * Captopril is an ace inhibitor is used to control hypertension * Propranolol is a beta-blocker used to control hypertension * Labetalol (Normodyne®, Trandate®) is an alpha-1 and beta-adrenergic blocker that slows the heart rate and decreases peripheral vascular resistance and cardiac output