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ACLS Meds > ACLS Meds > Flashcards

ACLS Meds Flashcards

1
Q

MOA of adenosine

A

produces negative chronotropic effect on the SA and AV node

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2
Q

indication for adenosine

A
  • stable PSVT

- questioning wide complex tachycardia as reentry SVT

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3
Q

precautions with adenosine

A
  • poison/drug induced 2nd/3rd HB
  • less effective if the pt is on theophylline or caffeine
  • reduce if on dipyrdamole or carbamazepine
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4
Q

dose of adenosine

A
  • 6 mg, 12 mg, 12 mg

- rapid push 1-3 sec with immediate flush 20 mL NS then elevation of the extremity

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5
Q

MOA of amiodarone

A

-affects Na, K and Ca channels
prolongs phase III of action potential
-also has alpha/beta blocking properties

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6
Q

indication from amiodarone

A

ventricular arrhythmias

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7
Q

precautions with amiodarone

A
  • > 2.2g/24 associated with hypotension
  • watch other QT prolonging drugs
  • 1/2 life up to 40 days
  • resembles T4 hormone
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8
Q

dose of amiodarone

A
  • unstable: 1st dose 300 mg 2nd dose 150 mg in 3-5 min

- stable: 150 mg with maintenance 540 mg IV over 18 hrs at rate of 0.5 mg/min

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9
Q

MOA of aspirin

A
  • inhibits platelet cyclooxygenase

- blocks thromboxane A2

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10
Q

indication for aspirin

A

ACS

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11
Q

precautions with aspirin

A
  • relative contraindication: active ulcer/asthma

- absolute: hypersensitivity rxn

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12
Q

dose of aspirin

A
  • 160-325 mg PO non-enteric coated/chewed

- 300 mg PR with cannot tolerate PO

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13
Q

MOA of atropine sulfate

A
  • parasympatholytic: blocks parasympathetic tone (only sympathetic gets through)
  • anticholinergic
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14
Q

indication for atropine sulfate

A
  • bradycardia

- organophosphatae poisoning

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15
Q

precautions with atropine sulfate

A

worsen bradycardia Mobits II or 3rd degree

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16
Q

dose of atropine sulfate

A
  • 0.5 mg IV Q3-5 min

- NOT exceeding 3 mg or 0.03 mg/kg

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17
Q

MOA of beta blockers

A

beta-adrenergic blockers = blocks beta receptors of the sympathetic nervous system

18
Q

indication for beta blockers

A
  • rate control in a. fib/flutter/PSVT when cardioversion is NOT an option
  • antihypertensive therapy s/p stroke
19
Q

precatutions with beta blockers

A
  • used w/ CCBs may cause hypotension
  • careful with heart failue and bronchospastic disease
  • myocardial demand, cocaine induced ACS esp propanolol
20
Q

dose of metoprolol

A

5 mg IV Q5 min MAX 15 mg

21
Q

dose of labetalol

A

10 mg over 1-2 min Q10 OR double MAX 150 mg, infusion 2-8 mg/min

22
Q

dose of esmolol

A

0.5 mg/kg over 1 min Q4 min infusion at 0.05 mg/kg/min MAX 0.3 mg/kg/min TOTAL 200 ug/kg

23
Q

MOA of diltiazem

A

blocks voltage-gated Ca channels in cardiac an d blood vessels

24
Q

indications for diltiazem

A

controls ventricular rate in a. fib/flutter & refractory SVT (narrow)

25
Q

precautions for diltiazem

A
  • wide QRS
  • poisons/drug induced tachycardia, WPW, SSS or AV block w/o pacer
  • watch with BB
26
Q

dosing of diltiazem

A
  • 15-20 mg (0.25 mg/kg) over 2 min
  • rebolus in 15 min at 20-25 mg
  • maintenance infusion 5-15 mg/hr
27
Q

MOA of dopamine

A
  • dose dependent in IV form
  • acts on the sympathetic nervous system
  • effects alpha 1, beta 1-2 and dopamine receptors
28
Q

indications for dopamine

A
  • 2nd line bradycardia

- hypotensive BP

29
Q

precautions with dopamine

A
  • always correct volume first
  • caution with cardigrnic shock/CHF
  • may cause tachyarrhythmias and excessive vasoconstriction
  • don’t mix with bicarb
30
Q

dose of dopamine

A

2-20 mcg/kg/min titrate to response

31
Q

MOA of dobutamine

A

primarily effects beta 1, some beta 2 and some dopamine

32
Q

indication for dobutamine

A

pump problems (HF)

33
Q

precautions with dobutamine

A
  • pressures btn 70-100 mmHg w/o s/sx of shock, tachyarrhythmias
  • BP fluctuations
  • less effective in the elderly
  • don’t mix with sodium bicarb
34
Q

dose of dobutamine

A

2-20 mcg/kg/min titrate HR not >10% baseline

35
Q

MOA of epinephrine

A

primarily effects alpha 1, however also effects alpha 2 and beta 1

36
Q

indications for epinephrine

A
  • cardiac arrest: VF, pulseless VT, asystole, PEA
  • 2nd line for bradycardia and hypotension
  • anaphylaxis
37
Q

precautions with epinephrine

A
  • spike in BP
  • increase in myocardial O2 demand
  • high doses needed to treat poison/drug induced shock
38
Q

dose of epinephrine

A
  • IV/IO 1 mg (10 mL of 1:10,000) Q3-5 min
  • infusion rate 0.1-0.5 mcg/kg/min
  • profound bradycardia: 2-10 mcg/min
39
Q

MOA of fibrinolytics

A

acts on fibrin rich clots, converting plasminogen to plasmin (breaks down fibrin in clot)

40
Q

indications for fibrinolytics

A

-ST elevation >1mm in >2 contiguous leads/new LBBB

-

41
Q

precautions with fibrinolytics

A
  • Active internal bleeding w/in 21d(not menses)
  • Hx CVA or intra spinal event w/in 3mo (stroke, AV mal, neoplasm, aneurysm,)
  • trauma or surgery w/in 14d
  • Aortic dissection
  • uncontrolled HTN
  • bleeding disorders
  • prolonged CPR w/ evidence of thoracic trauma
  • LP w/in 7d
  • non compressible arterial puncture
  • during the 1st 24h of ischemic stroke
  • NO ASA NO Heprin if given

ACLS Meds (1 decks)

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