Antidysrhythmis Flashcards
Adenosine (Adenocard)
Class
Antidysrhythmic
Adenosine (Adenocard)
Description
Naturally occuring agent that can “chemically cardiovert” PSVT to a normal sinus rhythm. Half life of 10 secs. Does not cause hypotension.
Adenosine (Adenocard)
Indications
Narrow, complex paroxysmal supraventricular tachycardia refractory to vagal maneuvers.
- Tachycardia
Adenosine (Adenocard)
Contraindications
A-fib, 2nd and 3rd degree heart block
Adenosine (Adenocard)
Adult Dose
Adult: 12 mg rapidly IV, then rapid IV flush with 10c saline. If ineffective, 12mg in 1-2mins may be repeated.
Procainamide (Pronestyl)
Class
Anti-arrhythmic (Na+ blocker)
Procainamide (Pronestyl)
Description
Prolongs ventricular repolarization, slows conduction, and decreases myocardial excitability
Procainamide (Pronestyl)
Indications
Ventricular fibrillation and pulseless ventricular tachycardia refractory to lidocaine
Procainamide (Pronestyl)
Contraindications
Hypersensitivity, myasthenia gravis, and 2nd or 3rd degree heart block
Procainamide (Pronestyl)
Precautions
Hypotension, cardiac enlargement, CHF, AMI, ventricular dysrhythmias from digitalis, hepatic/renal impairment, bronchial asthma
Procainamide (Pronestyl)
Dosage
Adult: 20-30 mg/min IV drip @6-8mg/kg
Stop Points (1) up to 17 mg/kg to effect, then 1-4 mg/min (2) ectopy resolves (3) QRS complex widens more than 50% from original (4) hypotension ensues
Pedi: 15 mg/kg IV/IO over 30-60 mins
Lidocaine (Xylocaine)
Class
Antidysrhythmic (Na+ Blocker)
Lidocaine (Xylocaine)
Description
an antidysrhythmis that suppresses automaticity and raises stimulation threshold of the ventricles. Also causes sediation, anticonvulsant, and analgesic effects.
Lidocaine (Xylocaine)
Indications
Pulseless ventricular tachycardia, vfib, ventricular tachycardia with pulses
Lidocaine (Xylocaine)
Contraindications
Hypersensitivity to amide-type local anesthetics, supraventricular dysrhythmias, bradycardia, fasicular blocks
Lidocaine (Xylocaine)
Precautions
Hepatic/renal impairment, CHF, hypoxia, respiratory depression, hypovolemia, myasthenia gravis, schock, elderly
Lidocaine (Xylocaine)
Dosage Cardiac Arrest
Adult: 1-1.5 mg/kg IV every 3-5 mins up to 3mg/kg. Consider 1/2 dose for elderly follow conversion with a drip of 2-4 mg/min. 1Gram/250cc
Pedi: 1 mg/kg IV every 3-5 min up to 3 mg/kg, following conversion with a drip of 20-50 mcg/kg/min
Amiodarone (Cordarone, Pacerone)
Class
Antidysrhythmic (KCl Blocker)
Amiodarone (Cordarone, Pacerone)
Description
Antidysrhythmic that prolongs the duration of the action potential and refractory period and relaxes smooth muscles, reducing peripheral vascular resistance, and increasing coronary blood flow
Amiodarone (Cordarone, Pacerone)
Indications
V-fib/v-tach and wide complex tachycardia
Amiodarone (Cordarone, Pacerone)
Contraindications
Heart block and profound bradycardia
Amiodarone (Cordarone, Pacerone)
Adult dose
Pulses - 150mg over 10 mins.
Pulseless - 300 mg IVP, then 150mg IVP for recurrent episodes
Adenosine
Pedi dose
0.1 mg/kg (max 6mg)
If ineffective, 0.2 mg/kg (max 12mg)
Flush with 5cc saline
Amiodarone
Pedi dose
Pulses - 5 mg/kg over 5 mins.
Pulseless - 5 mg/kg IVP over 5 mins
Avoid in length color PINK
