Before Flashcards
Adenosine
Any irregular tachycardia. Specifically never administer to an irregular wide-complex tachycardia, which may be lethal
Drug Intx
Methylxanthines (eg caffeine) antagonize adenosine, a higher dose may be required
Dipyridamole (persantine) potentiates the effect of adenosine; reduction of adenosine dose may be required
Carbamazepine may potentiate the AV-nodal blocking effect of adenosine
Albuterol
Severe tachycardia is a relative contraindication
Drug Intx
Sympathomimetics may exacerbate adverse cardiovascular effects
B-Blockers may antagonize albuterol
Amiodarone
Precautions
Wide complex irregular tachycardia
Sympathomimetic toxidromes, i.e. cocaine or amphetamine overdose
NOT to be used to treat ventricular escape beats or accelerated idioventricular rhythms
Contraindications
2nd or 3rd degree AV block
Cardiogenic shock
Aspirin
Active GI bleed
Allergy
Atropine
Precautions
Should not be used w/o medical control direction for stable bradycardias
Closed-angle glaucoma
Calcium Gluconate
Known hypercalcemia
Suspected digoxin toxicity
Dextrose 50%
None
Diazepam (Valium)
Precaution
CNS or cardiovascular side effects are compounded with patients under the influence of drugs or alcohol.
Diltiazem (Cardizem)
Precaution
Concurrent use with Midazolam may required decreased dose
Use with caution in patients on PO/IV beta-blockers
Diphenhydramine (Benadryl)
Precautions
Asthma or COPD, thickens bronchial secretions
Narrow-angle glaucoma
Drug Intx
CNS depressants and alcohol may have additive effects
MAO inhibitors may prolong and intensify anticholinergic affects of antihistamines
Dopamine
Hypovolemia
Hemorrhagic shock
Epinephrine
Drug intx
Should not be added to sodium bicarbonate or other alkaloids as epinephrine will be inactivated at higher pH
Fentanyl
Hypotension, hemodynamic instability or shock
Respiratory depression
Furosemide
Pregnancy
Dehydration or shock
Glucagon
None
Haloperidol (Haldol)
Contraindications Suspected myocardial infarction Hypotension Respiratory or CNS depression Pregnancy Children < 8 years old
Precautions
Haldol may cause hypotension, tachycardia, and prolongation of the QT interval. Use with caution in severe cardiovascular disease
Cardiac monitor and establish an IV as soon as possible with all administrations
Some patients may experience unpleasant sensations manifested as restlessness, hyperactivity, or anxiety following haloperidol administration
Rare instances of neuroleptic malignant syndrome (very high fever, muscular rigidity) have been known to occur after the use of haloperidol.
Ipratropium Bromide (Atrovent)
Do not administer to children < 2 years
Soy or peanut allergy is a contraindication to use of Atrovent metered dose inhaler, not the nebulized solution, which does not have the allergen contained in propellant.
Lidocaine 2% Solution
Precaution: Lidocaine is metabolized in the liver and therefore, elderly patients and those with liver disease or poor liver perfusion secondary to shock or congestive heart failure are more likely to experience side effects.
Lorazepam (Ativan)
Hypersensitivity to benzodiazepines
Acute narrow-angle glaucoma
Intraarterial administration
Pregnancy class D (benefit may outweigh risk for life threatening situation)
Magnesium Sulfate
Precautions
Bradycardia
Hypotension
Respiratory depression
Metoclopramide (Reglan)
Children < 8 years
Methylprednisolone (Solu-Medrol)
Evidence of active GI bleed
Midazolam (Versed)
Hypotension
Morphine Sulfate
Hypovolemia
Hypotension (relative)
