Cardiac Drug Card Notes

Question 1

inotropes

Answer 1

dobutamine
milrinone
epinephrine

Question 2

vasopressors

Answer 2

dopamine
levophed
vasopressin
calcium
potassium chloride

Question 3

vasodilators

Answer 3

Nitroglycerin
Nipride
Cardene

Question 4

Glucose control

Answer 4

insulin

Question 5

antiarrhythmics

Answer 5

magnesium

amiodarone

Question 6

coagulation drugs

Answer 6

amicar

desmopressin (DDAVP)

Question 7

dobutamine effects

Answer 7

beta 1 agonist
increase contractility
increase HR

Question 8

administration of dobutamine

Answer 8

may be given peripheral line if no central line

Question 9

milrinone effects

Answer 9

phosphodiesterase inhibitor
increases cAMP
increase contractility
decreased PVR
decreased SVR and BP

Question 10

what is milrinone usually given with?

Answer 10

infusion of vasopressor

Question 11

indications for milrinone

Answer 11

low EF/CO
pulm HTN

pulmonary HTN

Question 12

can milrinone be administered via peripheral line?

Answer 12

NO only central line

Question 13

epinephrine effects

Answer 13

alpha and beta agonist
increases contractility
increases HR and BP

Question 14

where should epi be administered?

Answer 14

centrally

Question 15

dopamine effects

Answer 15

dopaminergic, alpha, and beta agonist
renal vasodilation
increases HR
increases BP

Question 16

dopamine renal vasodilation dose

Answer 16

2-5mcg/kg/min

Question 17

dopamine increases HR dose

Answer 17

5-10 mcg/kg/min

Question 18

dopamine increases BP dose

Answer 18

> 10mcg/kg/min

Question 19

where should dopamine be administered?

Answer 19

ONLY central line

Question 20

levophed preparation

Answer 20

4mg in 250mL bag for 16mcg/mL

or 10mL syringe with 16mcg/mL for bolus

Question 21

what is the usual bolus for levophed

Answer 21

4-16mcg (0.25-1cc)

Question 22

levophed effects

Answer 22

ALPHA&raquo_space; beta agonist
powerful vasoconstrictor
increase contractility
increase HR

Question 23

where should levophed be administered?

Answer 23

central vein

Question 24

vasopressin preparation

Answer 24

5 vials (100units) in 100mL bag to make 1unit/mL

Question 25

when is vasopressin popular?

Answer 25

shock states when in refractory to NE

Question 26

where should vasopressin be administered?

Answer 26

central line

Question 27

what are the two types of calcium

Answer 27

calcium chloride calcium gluconate | calcium gluconate

Question 28

when is calcium considered

Answer 28

treat hypocalcemia due to massive transfusion incr cardiac contractility | increase cardiac contractility (after cardioplegia)

Question 29

which calcium can be given peripherally?

Answer 29

calcium gluconate

Question 30

which calcium must be given through a central line

Answer 30

calcium chloride

Question 31

calcium gluconate is ___ as potenet as calcium chloride

Answer 31

1/3

Question 32

what is the time frame that calcium should be given over?

Answer 32

10minutes

Question 33

if running potassium through a peripheral line is can be run up to

Answer 33

10mEq/hr

Question 34

if running potassium through a central line it can be run up to

Answer 34

20mEq/hr

Question 35

Nitroglycerin (NTG) effects

Answer 35

``` decreases BP (vasodilator) short onset, short duration ```

Question 36

when is NTG given

Answer 36

coronary ischemia decreases myocardial oxugen demand (decrease preload and afterload) increases myocardial oxygen supply (coronary vasodilation) increases pulmonary shunting

Question 37

nipride

Answer 37

a more potent version of NTG, used when NTG is ineffective.

Question 38

what is special about nipride

Answer 38

it is sensitive to light and it should be in a UV protective bag, provided in box

Question 39

cardene

Answer 39

calcium channel blocker that is an alternative to nitroglycerin

Question 40

cardene preparation

Answer 40

5mg (2mL) in 8mL N/S - 0.5 mg/mL (10 mL) | 0.5mg/mL

Question 41

cardene lower BP bolus

Answer 41

0.25-0.5mg

Question 42

cardene infusion preparation

Answer 42

25mg in 250mL bag to make 100mcg/mL

Question 43

cardene infusion rate

Answer 43

5-15mg/hr

Question 44

insulin danger

Answer 44

bc its high concentration of 100units/mL

Question 45

when bolusing insulin what syringe do you use

Answer 45

TB syringe

Question 46

insulin infusion preparation

Answer 46

1mL (100units) in 100mL bag

Question 47

when do you give antiarrhythmics

Answer 47

off pump CABG when lifting heart CAPB prior to cardioplegia washout | CPB prior to cardioplegia washout

Question 48

how fast can you give magnesium?

Answer 48

slowly over 10min

Question 49

how fast can you give amiodarone?

Answer 49

slowly over 10min

Question 50

amicar

Answer 50

antifibrinolytic that helps preserve clotting factors as blood goes through CPB machine and reduces bleeding post bypass

Question 51

amicar bolus doses

Answer 51

1vial is 5g (20mL) liberty- 5g bolus prior to incision MAHI- 10g bolus prior to incision

Question 52

amicar infusion prep and rate

Answer 52

2 vials in 500mL LR 50 mL (1g) per hour | 50mL per hr (1g)

Question 53

desmopressin (DDAVP)

Answer 53

synthetic antidiuretic hormone (ADH)

Question 54

when is DDAVP indicated?

Answer 54

diabetes insipidus coagulopathies during surgery | coagulopathies during surgery

Question 55

what does DDAVP stimulate the release of?

Answer 55

vWF and increases factor VIII

Question 56

when is DDAVP usually used for cardiac?

Answer 56

end of operation if oozing after protamine administration

Question 57

how fast can DDAVP be adminitered?

Answer 57

slowly bc it can cause hypotension

Question 58

what does DDAVP stand for?

Answer 58

Deep Down Arterial Venous Pressure