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Arizona Drug Profiles > ACLS Drugs > Flashcards

ACLS Drugs Flashcards

1
Q

what are indications for ASA

A

Chest pain and other S/S of acute MI
unstable angina
pain discomfort fever in adult pt only

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2
Q

what are contraindications for ASA

A

bleedin ulcer, hemorrhagic state, hemophilia
hypersensitivity to salicylates or other non steroidal anti inflammatories that has led to hypotension and or bronchospasm
peds pts

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3
Q

what are adverse reactions associated with ASA

A

anaphylactic reactions in sensitive pts, skin eruptions

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4
Q

what is the normal onset of action for ASA

when are peak effects of ASA expected

A

20-30 mins

2 hours

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5
Q

what is the MOA of adenosine

A

slows conduction time through AV node, can interrupt re entrant pathways through the AV node
slows sinus rate
larger doses decrease bp by decreasing pvr

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6
Q

what are contraindications for adenosine

A

2nd 3rd degree block (except pts w/ functioning ventricular pacemaker
caution in pts with asthma
pts on theophylline and related methylxanthines
pts on dipyriamole or carbamazepine
known a fib or flutter
pregnancy

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7
Q

why are dipyridamole and carbamazepine contraindications for adenosine

A

block uptake and potentiate effects

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8
Q

what does theophylline and methyxanthines do to adenosine

A

decrease effectiveness

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9
Q

what is the peds dose of adenosine

A
  1. 1mg/kg

0. 2mg/kg

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10
Q

what is the duration of action of adenosine

A

10-12 seconds

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11
Q

what are CV adverse reactions associated with adenosine

A 
transient dysrhythmias (occur in 55% of pts)
palpitations
chest pressure/pain
hypotension
transient hypertension
facial flushing
sweating
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12
Q

what are respiratory adverse reactions associated with adenosine

A

dyspnea

hyperventilation, bronchospasm

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13
Q

CNS adverse reactions associated with adenosine

A

lighheadedness, headache, dizziness, paresthesias, apprehension, blurred vision, neck-back pain

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14
Q

what are the indications of use for amiodarone

A

treatment of defib refractory vf/pvt, torsades,
control stable vtach when cardioversion unsuccessful
rate control in afib/flutter

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15
Q

what conditions contraindicate amiodarone

A 
bradycardia
2nd 3rd degree block unless pacemaker is present
cardiogenic shock
hpotension
pulmonary congestion
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16
Q

what potential adverse reactions are associated with amiodarone

A

bradycardia, hypotension, asystole, av block, torsades, CHF
nausea, vomiting, abnormal liver function tests
blue skin pigmentation
fever, headache, dizziness, flushing, abnormal salivation, photophobia

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17
Q

what drugs is amiodarone incompatible with

A

beta blockers, ca channel blockers, other anti arrhythmics can be pro arrhythmic
sodium bicarb, heparin, lasix

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18
Q

when amiodarone is given for VF/pVT how is it administered

A

IV push over 30-60 seconds

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19
Q

how is amiodarone given when used to treat wide complex tachycardias, afib/flutter, SVT w/cardioversion

A

mixed in 50ml bag D5W given over 10 mins, can repeat every 10 mins

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20
Q

what is the max dose of amiodarone for peds in a day

A

15mg/kg/day

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21
Q

what is the peds dose of amiodarone for VF/pVT and for VT w/ pulse

A

5mg/kg IV push can repeat every 5 mins twice

5mg/kg over 20 mins

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22
Q

what is the half life for amiodarone

A

may exceed 40 days

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23
Q

what temp must amiodarone be stored below

A

77F

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24
Q

amiodarone MOA

A

prolongs action potential, refractory period
ventricular automaticity K
slows membrane depolarization and impulse conduction NA
negative chrono activity in nodal tissue, antisympathetic activity, dilate coronary arteries CA, Beta

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25
Q

contraindications for atropine

A 
2nd 3rd degree block
renal and hepatic disease
glaucoma (relative)
obstructive GI disease
asthma
thyrotoxicosis
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26
Q

atropine is pregnancy risk category

A

C

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27
Q

what are the major adverse reactions associated with atropine

A

tachydysrythmias, flushing, ventricular irritability, exacerbation/initiation of angina, acute narrow angle glaucoma, blurred vision, mydriasis, agitation to delirium, bloating, constipation

28
Q

what is the pediatric dose of atropine for bradycardia

A

0.02 mg/kg (minimum 0.1 mg)

29
Q

what is the expected time until onset of action for atropine

A

1 min

30
Q

what is the half life of atropine

what is the terminal half life of atropine

A

2-3 hours

12.5 hours

31
Q

what are the indications of use for diltiazem

A

rapid ventricular rates associated with afib/flutter

psvt refractory to adenosine

32
Q

what are the pharmacological efects of diltiazem

A

inhibits calcium influx during cardiac depolarization

decreases SA and AV conduction and dilates coronary and peripheral arteries and arterioles

33
Q

what are the clinical effects of diltizaem

A

slows RVR associated with afib/flutter

reduces coronary and peripheral vascular resistance

34
Q

what are contraindications for diltiazem

A 
hypotension
acute mi
cardiogenic shock
Vtach
2nd 3rd block
WPW
SSS
Beta blocker use
35
Q

what is the adult dose of diltiazem

A

initial 0.25 mg/kg IVP over 2 mins
may repeat w/ 0.35 mg/kg IVP over 2 mins
maintenance infusion: 5-15 mg/hr

36
Q

what is the pediatric dose for diltiazem

A

not used for kids

37
Q

what is the expected onset of action for diltiazem

A

immediate

38
Q

when are the peak effects of diltiazem

A

2 hours or less

39
Q

when is administration of dopamine indicated

A

symptomatic bradycardia

hemodynamically significant hypotension in absence of hypovolemia

40
Q

what are contraindications for dopamine

A

hypovolemia
phenochromocytoma
MAO inhibitors such as marplan nardil parnate

41
Q

what adverse reactions are associated with dopamine

A 
arrythmias (due to increased myocardial O2 demand)
hypertension
hypotension at low doses
nausea/vomiting
renal shutdown
tissue necrosis
42
Q

why is dopamine contraindicated in the presence of MAO inhibitors

A

will cause hypertensive crisis

43
Q

dopamine is incompatible with any __________ solution

A

alkaline

44
Q

dopamine: onset of action, peak effects, duration of action

A

almost immediate, upon intro to central circulation
5-10 mins
effects cease almost immediately when infusion is shut off

45
Q

what are the adverse reactions associated with epinephrine

A

hypertension, ventricular disrhythmias, tachycardia, angine
anxiety, agitation
nausea/vomiting

46
Q

what are the notes about incompatibilities/ drug interactions for epienephrine

A

potentiates other sympathomimetics

reacts with alkaline solutions, such as sodium bicarb, should not be mixed with alkaline agents

47
Q

what is the pediatric dose of epinephrine for cardiac arrest

A

0.01 mg/kg 1:10,000 repeat every 3-5 minutes, max single dose of 1mg

48
Q

in a cardiac arrest situation what is the dose of epinephrine that is administered via ET tube for peds and neonates

A

0.1 mg/kg 1:1,000

49
Q

what is the MOA of lidocaine

A

decreases automaticity by slowing rate of spontaneous phase 4 depolarization
terminates re-entry by decreasing conduction in re-entrant pathways
increases v-fib threshold

50
Q

what are the indication for use of lidocaine

A

suppression of ventricular arrhythmias
prevent recurrence of vtach/vfib
pain management after IO insertion

51
Q

what are the contraindications for the use of lidocaine

A

hypersensitivity
2nd 3rd blocks warrant extreme caution
ectopic beats when HR is less than 60

52
Q

what adverse reactions are associated with lidocaine

A

SA depression or conduction problems and hypotension in large doses or if given too rapidly
large doses can cause drowsiness, disorientation, paresthesias, decreased hearing acuity, muscle twitching, agitation, focal or generalized seizures

53
Q

what is the dose of lidocaine for cardiac arrest

A

1-1.5 mg/kg every 3-5 minutes

ROSC: drug 2-4 mg/min

54
Q

what is the dose of lidocaine for arrhythmias with a pulse

A
  1. 5-0.75 mg/kg initial

0. 5-0.75 additional every 5-10 minutes

55
Q

what is the pediatric dose of lidocaine

A

1 mg/kg may repeat 1 time in 3-5 mins of vf/pvt or in 15 mins for refractory dysrhythmias with a pulse

56
Q

what is the expected onset of action for lidocaine

A

5-10 minutes

57
Q

what is the duration of action for lidocaine

A

20 mins (bolus only)

58
Q

what is the MOA of verapamil

A

calcium blockade causes (-) inotropic effect
reduces coronary and peripheral vascular resistance
slows conduction and prolongs refractory period in the AV node
slows SA node discharge

59
Q

what are the indication of use for verapamil

A

SVT

RVR associated with afib/flutter

60
Q

what are contraindications for verapamil

A 
AV block
SSS
wide complex tachycardia
WPW
shock
severe CHF
IV beta blocker
hypotension
61
Q

what adverse reactions are associated with verapamil

A 
extreme bradycardia
asystole
AV block
hypotension
CHF
62
Q

what drugs is verapmil incompatible with

A

beta blockers

63
Q

what is the adult dose of verapamil

A

2.5-5 mg slow iv push over 2-3 mins may repeat in 15-30 mins with 5-10 mg max dose of 30mg

64
Q

what is the pediatric dose of verapamil

A

not used for kids

65
Q

what is the on set of action for verapamil

A

1-3 mins

66
Q

what is the duration of action for verapamil

A

2-5 hours

Arizona Drug Profiles (5 decks)

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