Cardiac Drug Card Notes Flashcards

1
Q

inotropes

A

dobutamine
milrinone
epinephrine

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2
Q

vasopressors

A
dopamine
levophed
vasopressin
calcium
potassium chloride
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3
Q

vasodilators

A

Nitroglycerin
Nipride
Cardene

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4
Q

Glucose control

A

insulin

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5
Q

antiarrhythmics

A

magnesium

amiodarone

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6
Q

coagulation drugs

A

amicar

desmopressin (DDAVP)

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7
Q

dobutamine effects

A

beta 1 agonist
increase contractility
increase HR

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8
Q

administration of dobutamine

A

may be given peripheral line if no central line

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9
Q

milrinone effects

A
phosphodiesterase inhibitor
increases cAMP
increase contractility
decreased PVR
decreased SVR and BP
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10
Q

what is milrinone usually given with?

A

infusion of vasopressor

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11
Q

indications for milrinone

A

low EF/CO
pulm HTN

pulmonary HTN

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12
Q

can milrinone be administered via peripheral line?

A

NO only central line

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13
Q

epinephrine effects

A

alpha and beta agonist
increases contractility
increases HR and BP

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14
Q

where should epi be administered?

A

centrally

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15
Q

dopamine effects

A

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

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16
Q

dopamine renal vasodilation dose

A

2-5mcg/kg/min

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17
Q

dopamine increases HR dose

A

5-10 mcg/kg/min

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18
Q

dopamine increases BP dose

A

> 10mcg/kg/min

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19
Q

where should dopamine be administered?

A

ONLY central line

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20
Q

levophed preparation

A

4mg in 250mL bag for 16mcg/mL

or 10mL syringe with 16mcg/mL for bolus

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21
Q

what is the usual bolus for levophed

A

4-16mcg (0.25-1cc)

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22
Q

levophed effects

A

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

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23
Q

where should levophed be administered?

A

central vein

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24
Q

vasopressin preparation

A

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

25
Q

when is vasopressin popular?

A

shock states when in refractory to NE

26
Q

where should vasopressin be administered?

A

central line

27
Q

what are the two types of calcium

A

calcium chloride
calcium gluconate

calcium gluconate

28
Q

when is calcium considered

A

treat hypocalcemia due to massive transfusion
incr cardiac contractility

increase cardiac contractility (after cardioplegia)

29
Q

which calcium can be given peripherally?

A

calcium gluconate

30
Q

which calcium must be given through a central line

A

calcium chloride

31
Q

calcium gluconate is ___ as potenet as calcium chloride

A

1/3

32
Q

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

A

10minutes

33
Q

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

A

10mEq/hr

34
Q

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

A

20mEq/hr

35
Q

Nitroglycerin (NTG) effects

A
decreases BP (vasodilator)
short onset, short duration
36
Q

when is NTG given

A

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

37
Q

nipride

A

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

38
Q

what is special about nipride

A

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

39
Q

cardene

A

calcium channel blocker that is an alternative to nitroglycerin

40
Q

cardene preparation

A

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

0.5mg/mL

41
Q

cardene lower BP bolus

A

0.25-0.5mg

42
Q

cardene infusion preparation

A

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

43
Q

cardene infusion rate

A

5-15mg/hr

44
Q

insulin danger

A

bc its high concentration of 100units/mL

45
Q

when bolusing insulin what syringe do you use

A

TB syringe

46
Q

insulin infusion preparation

A

1mL (100units) in 100mL bag

47
Q

when do you give antiarrhythmics

A

off pump CABG when lifting heart
CAPB prior to cardioplegia washout

CPB prior to cardioplegia washout

48
Q

how fast can you give magnesium?

A

slowly over 10min

49
Q

how fast can you give amiodarone?

A

slowly over 10min

50
Q

amicar

A

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

51
Q

amicar bolus doses

A

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

52
Q

amicar infusion prep and rate

A

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

50mL per hr (1g)

53
Q

desmopressin (DDAVP)

A

synthetic antidiuretic hormone (ADH)

54
Q

when is DDAVP indicated?

A

diabetes insipidus
coagulopathies during surgery

coagulopathies during surgery

55
Q

what does DDAVP stimulate the release of?

A

vWF and increases factor VIII

56
Q

when is DDAVP usually used for cardiac?

A

end of operation if oozing after protamine administration

57
Q

how fast can DDAVP be adminitered?

A

slowly bc it can cause hypotension

58
Q

what does DDAVP stand for?

A

Deep
Down
Arterial
Venous
Pressure