Cardiac Drugs Flashcards
1
Q
Adenosine trade name?
A
Adenocard
2
Q
Adenosine classification?
A
Antiarrhythmic
3
Q
Adenosine actions?
A
Decrease electrical conduction through the AV node
4
Q
Adenosine onset/duration?
A
Immediate / 10 seconds (half-life)
5
Q
Adenosine indications?
A
SVT, WPW. May administer to VTach with a pulse if it does not convert with Amiodarone administration (SVT with aberrancy)
6
Q
Adenosine contraindications?
A
Drug-induced tachycardia, second or third-degree AV block, hypersensitivity, A-Flutter, A-fib, VTach (unless SVT with aberrancy), WPW with A-fib or A-flutter
7
Q
Adenosine side effects?
A
Facial flushing, light headedness, paresthesia, headache, diaphoresis, palpitations, chest pain, flushing, feeling of impending death or passing out, hypotension, SOB; transient periods of bradycardia, sinus pause, asystole; ventricular ectopy, nausea, metallic taste.
These side effects are usually limited due to short half-life of this drug.
8
Q
Adenosine route of admin?
A
Rapid IV push- followed by a 10-20mL saline flush
9
Q
Adenosine adult dose?
A
6mg rapid IV push given over 1-3 seconds. May repeat within 1-2 minutes at 12mg if needed
10
Q
Adenosine peds dose?
A
0.1 mg/kg (max 6mg) rapid IV and IO followed by a 5-10mL saline flush. May repeat within 2 minutes at 0.2 mg/kg (max 12mg)
11
Q
Adenosine supply?
A
3mg/mL in 2mL vials
prefilled syringes
12
Q
Adenosine special considerations?
A
Pts taking theophylline or caffeine may require larger doses
13
Q
Amiodarone trade name?
A
Cordarone
14
Q
Amiodarone classification?
A
Class 3 Antidysrhythmic
15
Q
Amiodarone actions?
A
Blocks sodium, potassium, and calcium channels of the cardiac conduction cycle that slows conduction and prolongs the refractoriness of the heart
16
Q
Amiodarone onset/duration?
A
within minutes / variable
17
Q
Amiodarone indications?
A
Vfib and pulseless VTach, VTach with a pulse, and some atrial dysrhythmias
18
Q
Amiodarone contraindications?
A
None in pulseless cardiac events.
Pts with predisposing history of bradycardia or AV node block, hypotension, hyperkalemia, and cardiogenic shock
19
Q
Amiodarone side effects?
A
Hypotension, prolonged QT interval, Dizziness, Bradycardia, AV conduction abnormalities, Cardiac arrest, Torsades, and Heart failure
20
Q
Amiodarone route of admin?
A
IVP, IV infusion, IO
21
Q
Amiodarone adult dose?
A
Vfib/pulseless Vtach:
300mg IV, IO; repeat 150mg IV,IO undiluted
Stable Vtach with a pulse:
150mg over 10 minutes (15mg/min)
Max cumulative dose of 2.2g in 24 hours
22
Q
Amiodarone peds dose?
A
Refractory Vfib/pulseless Vtach:
5mg/kg IV, IO bolus; can be repeated to a total of 15mg/kg. Max single dose of 300mg
Perfusing SVT and ventricular dysrhythmias:
5mg/kg IV, IO over 20-60 minutes
Max cumulative dose of 2.2g in 24 hours
23
Q
Amiodarone supply?
A
150mg/3mL ampules (50mg/mL)
24
Q
Amiodarone special considerations?
A
Do not use with other drugs that cause prolonged QT interval (Procainamide)
25
Atropine trade name?
None
26
Atropine classification?
Parasympatholytic, Anticholinergic
27
Atropine actions?
Blocks the action of acetylcholine at the neuromuscular junction of the parasympathetic nervous system that increases the conduction through the SA and AV nodes of the heart. With organophosphate poisoning, atropine competes for postsynaptic receptors at neuromuscular and neuro-glandular junctions that block he action of he poison.
28
Atropine onset?
Rapid / 2-6 hours
29
Atropine indications?
Symptomatic bradycardia induced by increased vagal tone including sinus bradycardia, 1st, 2nd and 3rd degree AV heart blocks, prolonged sinus block, and organophosphate poisoning
30
Atropine contraindications?
Hypertension, tachycardia. Not likely to be effective in 2nd degree type 2 heart blocks or 3rd degree heart blocks.
31
Atropine side effects?
Paradoxical bradycardias may occur if less than 0.5mg is given or if given too slowly. Pupil dilation, dry mouth, blurred vision, tachycardia arrhythmias
32
Atropine route of admin?
Rapid IV, endotracheal, Rapid IO
33
Atropine adult dose?
Bradycardia/heart blocks:
IV/IO- 1mg initial dose, may repeat at 1mg every 3-5 minutes up to a total of 3mg
Organophosphate poisoning:
IV- 1-2mg every 5-15 minutes until Atropine effects are observed; then every 1-4 hours for 24 hours
34
Atropine peds dose?
Bradycardia (no response after 2-3 rounds of epi):
0.02 mg/kg IV,IO
Max single dose: 0.5mg
Max total dose: 1mg
35
Atropine supply?
Prefilled syringes containing 1mg/10mL, 0.5mg/5mL, ampules of 1mg/mL
36
Atropine special considerations?
Atropine does not work on heart transplant patients
37
Calcium Chloride trade name?
None
38
Calcium Chloride classification?
Electrolyte
39
Calcium Chloride actions?
Essential component for the functional integrity of the nervous and muscular systems, for normal cardiac contractility, and for the coagulation of blood
40
Calcium Chloride onset/duration?
5-15 min / dose-dependent (effects my persist for 4 hours after IV administration)
41
Calcium Chloride indications?
Hyperkalemia, hypocalcemia, calcium channel blocker toxicity (overdose), hypermagnesemia
42
Calcium Chloride contraindications?
Vfib during cardiac resuscitation, digitalis toxicity, hypercalcemia
43
Calcium Chloride side effects?
Bradycardia, hypotension, metallic taste, severe local necrosis and sloughing following IM use or IV infiltration
44
Calcium Chloride route of admin?
IV/IO
45
Calcium Chloride adult dose?
500-1000mg (5-10mL of a 10% solution)
46
Calcium Chloride peds dose?
20mg/kg (0.2mL/kg of a 10% solution)
47
Calcium Chloride special considerations?
May produce vasospasm in coronary and cerebral arteries
48
Cardizem generic name?
Diltiazem
49
Cardizem classification?
Calcium channel blocker
50
Cardizem actions?
Slows conduction and increase the refractory period of the AV node. Controls ventricular response rate in A-fib and A-flutter
51
Cardizem onset / duration?
2-5 min/ 1-3 hours
52
Cardizem indications?
Control ventricular rate in A-fib and A-flutter. Paroxysmal SVT
53
Cardizem contraindications?
Wide complex tachycardia of uncertain origin, Sick Sinus Syndrome, AV block, WPW, hypotension (SBP <90), and cardiogenic shock
54
Cardizem side effects?
Decreased myocardial contractility, hypotension, bradycardia, heart failure, chest pain, syncope, nausea/vomiting, dyspnea, headache
55
Cardizem route of admin?
IVP
56
Cardizem adult dose?
0.25mg/kg (15-20mg for average patient) IV over 2 minutes. May repeat in 15 minutes at 0.35mg/kg (20-25mg for average patient) IV over 2 minutes
57
Cardizem supply?
25mg (5mL vial) or 50mg (10mL vial)
58
Cardizem special considerations?
Use caution in patients taking oral beta blockers
59
Epi 1:10 trade name?
Adrenaline
60
Epi 1:10 classification?
Endogenous catecholamine, sympathomimetic
61
Epi 1:10 actions
Epi contains both alpha and beta properties. Because of these properties, Epi will increase the following:
Heart rate, PVR, myocardial oxygen consumption, blood pressure, and automaticity of the heart
62
Epi 1:10 onset/duration?
IV/ET: 1-2 minutes
63
Epi 1:10 indications?
Cardiac arrest, PEA, Vfib, and pulseless Vtach unresponsive to initial defibrillation, symptomatic bradycardia, severe hypotension accompanied by bradycardia when atropine and pacing fail, bronchial asthma
64
Epi 1:10 contraindications?
Hypersensitivity, hypovolemic shock (correct hypovolemia first), and dilated cardiomyopathy
65
Epi 1:10 side effects?
Tachycardia, headache, nausea/vomiting, restlessness, weakness, dysthymias, hypertension, precipitation of angina pectoris
66
Epi 1:10 route of admin?
IV, IO
67
Epi 1:10 adult dose?
Pulseless arrest:
1mg IVP repeated every 3-5 minutes, no maximum dose
ET: 2-2.5mg, every 3-5 minutes
Bradycardia:
2-10mcg/min infusion; titrate to patient response
68
Epi 1:10 peds dose?
Pulseless arrest:
0.01mg/kg (0.1mL/kg or 0.1mg/mL solution) every 3-5 minutes during arrest; Max dose of 1mg
ETT: 0.1mg/kg (1mg/mL solution); every 5 minutes
Bradycardia:
0.01mg/kg
Stridor:
0.5mg (0.5mL of 0.1mg/mL solution) nebulized
69
Epi 1:10 supply?
1mg/10mL, prefilled syringes
70
Epi 1:10 special considerations?
Epi should not be given with to mixed with sodium bicarbonate because it will be deactivated
71
Furosemide trade name?
Lasix
72
Lasix classification?
Loop diuretic
73
Lasix actions?
Potent diuretic that inhibits the reabsorption of sodium and chloride in the proximal tubule and loop of Henle
74
Lasix onset/duration?
15-20 minutes / 2 hours
75
Lasix indications?
Acute pulmonary edema, hypertensive emergencies, hyperkalemia
76
Lasix contraindications?
Anuria, hypersensitivity, hypovolemia/dehydration, hypokalemia
77
Lasix side effects?
Hypotension, dry mouth, hypokalemia, hypoatremia, hypocalcemia, hyperglycemia
78
Lasix route of admin?
IV
79
Lasix adult dose?
0.5-1mg/kg over 1-2 minutes or (20-40mg)
80
Lasix supply?
10mg/mL in 2,4, or 8mL ampules
| 10mg/mL in 10mL vials
81
Heparin generic name?
None
82
Heparin classification?
Anticoagulant
83
Heparin actions?
Inhibits the clotting cascade by activating thrombin and activated X factor. Prevents clot extension and reformation
84
Heparin onset/duration?
Immediate / approximately 12 hours
85
Heparin indications?
Acute MI, STEMI
86
Heparin contraindications?
Active bleeding; recent intracranial, intraspinal, or eye surgery; severe hypertension, bleeding tendencies, severe thrombocytopenia
87
Heparin side effects?
Allergic reaction (chills, fever, back pain); Thrombocytopenia; hemorrhage, bruising, rash
88
Heparin route of admin?
IV/IO
89
Heparin adult dose?
STEMI:
| 4,000-5,000 units
90
Heparin peds dose?
N/A
91
Heparin supply?
Dilute 1mg of powered medication on 1mL of NS or sterile water for injection
92
Heparin special considerations?
Use with caution in patients with liver disease
93
Labetalol generic name?
None
94
Labetalol classification?
Vasodilator, alpha and beta adrenergic blocker
95
Labetalol actions?
Reduces blood pressure by decreasing PVR
96
Labetalol onset/duration?
Within 5 minutes; peaks in 15 minutes / Duration up to 18 hours
97
Labetalol indicatons?
Hypertensive emergencies
98
Labetalol contradictions?
Hemodynamically unstable patients, bradycardia, hypotension, heart block greater than first degree, asthma, sick sinus syndrome, heart failure
99
Labetalol side effects?
Hypotension, bradycardia, dizziness, fatigue, arrhythmias
100
Labetalol route of admin?
IV, IO
101
Labetalol adult dose?
10-20mg slow IV over 2 minutes, first bolus. May repeat or double dose every 10 minutes to max dose of 200mg
102
Labetalol peds dose?
Safety has not been established
103
Labetalol supply?
20mg/4mL vial
104
Labetalol special considerations?
Administer only with patient in supine position
Reduce blood pressure to 185 systolic or 110 diastolic, but never greater than 20% from baseline
105
Lidocaine trade name?
Xylocaine
106
Lidocaine classification?
Antiarrhythmic, local anesthetic
107
Lidocaine actions?
Decreases ventricular ectopy by suppressing spontaneous depolarization of ventricular pacemaker cells and raises fibrillation threshold level
108
Lidocaine onset/duration?
45-90 seconds / 10-20 minutes
109
Lidocaine indications?
Cardiac arrest from pulseless VTach or Vfib, more than 6 PVC's a minute, multifocal PVC's, coupled or paired PVC's, runs of two or more PVC's
110
Lidocaine contraindications?
Third degree heart blocks, idioventricular rhythms, sinus bradycardia with escape PVC's
111
Lidocaine side effects?
Light-headedness, confusion, blurred vision, hypotension, bradycardia, seizures, altered LOC
112
Lidocaine route of admin?
IV, IO, IV infusion, Endotracheal
113
Lidocaine adult dose?
Pulseless VT or VF: 1-1.5mg/kg IV
Refractory VT or VF: repeat 0.50-0.75mg/kg every 5-10 minutes. Max cumulative dose 3mg/kg
ETT: 2 times the IV dose
PVC's or VT with a pulse: 0.50-0.75mg/kg (up to 1-1.5mg/kg) IV repeated at 0.75mg/kg IV every 5 to 10 minutes up to a total of 3mg/kg
Maintenance infusion: 4mg/min (give half of this for patients with an acute MI, CHF, shock, age greater than 70, or those with hepatic dysfunction)
114
Lidocaine peds dose?
Pulseless VT or VF: 1mg/kg IV,IO loading dose
ETT: 2-3mg/kg
PVC's or VT with a pulse: 1mg/kg IV,IO
Maintenance infusion: 1mg/kg IV,IO loading dose, followed by infusion of 20-30 mcg/kg/min
115
Lidocaine special considerations?
Treat Lidocaine toxic seizures with Valium
IF bradycardia occurs along with PVC's, always treat the bradycardia first with atropine
116
Magnesium Sulfate trade name?
None
117
Magnesium Sulfate classification?
Anticonvulsant; Electrolyte
118
Magnesium Sulfate actions?
CNS depressant, anticonvulsant, and elevates magnesium levels. Reduces striated muscle contractions and blocks peripheral neuromuscular transmission by reducing acetylcholine release at the myoneural junction
119
Magnesium Sulfate onset/duration?
IV: immediate IM: 3-4 hours / IV: 30 minutes IM: 3-4 hours
120
Magnesium Sulfate indications?
Seizures of eclampsia, known hypomagnesemia, Torsades, asthma
121
Magnesium Sulfate contraindications?
Heart blocks or recent MI, hypotension, patients on digitalis or other cardiac glycoside, respiratory depression, hypermagnesemia, or hypercalcemia
122
Magnesium Sulfate side effects?
Hypotension, respiratory and neurological depression, hypermagnesemia, heart blocks, facial flushing, diaphoresis, bradycardia
123
Magnesium Sulfate route of admin?
IM, IVP, IV infusion
124
Magnesium Sulfate adult dose?
Eclampsia: 4 grams diluted in 100mL NS given slow IVP or infusion (15-20 minutes)
Torsades: 1-2 grams diluted in 10mL slow IVP
125
Magnesium Sulfate peds dose?
N/A
126
Magnesium Sulfate supply?
500mg/mL in 10mL vials
127
Magnesium Sulfate special considerations?
Calcium chloride should be ready to use as an antidote for respiratory depression
Do not mix with sodium bicarbonate
128
Ticagrelor trade name?
Brilinta
129
Brilinta classification?
Antiplatelet
130
Brilinta actions?
Platelet inhibitor the reduces the rate of thrombotic events in acute coronary syndrome and STEMI patients
131
Brilinta onset/duration?
<30 minutes / 1-2 days
132
Brilinta indications?
STEMI
133
Brilinta contraindications?
Stroke, GI bleed, trauma, intracranial hemorrhage
134
Brilinta side effects?
Bleeding, difficulty breathing
135
Brilinta route of admin?
PO
136
Brilinta adult dose?
180mg (two 90mg tablets)
137
Brilinta supply?
90mg tablets
138
Brilinta special considerations?
Use caution in patients that are also taking other antiplatelet medication such as Coumadin, aspirin, xerelto
