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Paramedic Class 47 Drug List > Cardiac Drugs > Flashcards

Cardiac Drugs Flashcards

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1
Q

Adenosine trade name?

A

Adenocard

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2
Q

Adenosine classification?

A

Antiarrhythmic

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3
Q

Adenosine actions?

A

Decrease electrical conduction through the AV node

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4
Q

Adenosine onset/duration?

A

Immediate / 10 seconds (half-life)

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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)

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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

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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.

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8
Q

Adenosine route of admin?

A

Rapid IV push- followed by a 10-20mL saline flush

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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

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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)

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11
Q

Adenosine supply?

A

3mg/mL in 2mL vials

prefilled syringes

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12
Q

Adenosine special considerations?

A

Pts taking theophylline or caffeine may require larger doses

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13
Q

Amiodarone trade name?

A

Cordarone

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14
Q

Amiodarone classification?

A

Class 3 Antidysrhythmic

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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

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16
Q

Amiodarone onset/duration?

A

within minutes / variable

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17
Q

Amiodarone indications?

A

Vfib and pulseless VTach, VTach with a pulse, and some atrial dysrhythmias

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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

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19
Q

Amiodarone side effects?

A

Hypotension, prolonged QT interval, Dizziness, Bradycardia, AV conduction abnormalities, Cardiac arrest, Torsades, and Heart failure

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20
Q

Amiodarone route of admin?

A

IVP, IV infusion, IO

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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

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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

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23
Q

Amiodarone supply?

A

150mg/3mL ampules (50mg/mL)

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24
Q

Amiodarone special considerations?

A

Do not use with other drugs that cause prolonged QT interval (Procainamide)

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25
Q

Atropine trade name?

A

None

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26
Q

Atropine classification?

A

Parasympatholytic, Anticholinergic

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27
Q

Atropine actions?

A

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.

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28
Q

Atropine onset?

A

Rapid / 2-6 hours

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29
Q

Atropine indications?

A

Symptomatic bradycardia induced by increased vagal tone including sinus bradycardia, 1st, 2nd and 3rd degree AV heart blocks, prolonged sinus block, and organophosphate poisoning

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30
Q

Atropine contraindications?

A

Hypertension, tachycardia. Not likely to be effective in 2nd degree type 2 heart blocks or 3rd degree heart blocks.

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31
Q

Atropine side effects?

A

Paradoxical bradycardias may occur if less than 0.5mg is given or if given too slowly. Pupil dilation, dry mouth, blurred vision, tachycardia arrhythmias

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32
Q

Atropine route of admin?

A

Rapid IV, endotracheal, Rapid IO

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33
Q

Atropine adult dose?

A

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

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34
Q

Atropine peds dose?

A

Bradycardia (no response after 2-3 rounds of epi):
0.02 mg/kg IV,IO

Max single dose: 0.5mg
Max total dose: 1mg

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35
Q

Atropine supply?

A

Prefilled syringes containing 1mg/10mL, 0.5mg/5mL, ampules of 1mg/mL

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36
Q

Atropine special considerations?

A

Atropine does not work on heart transplant patients

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37
Q

Calcium Chloride trade name?

A

None

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38
Q

Calcium Chloride classification?

A

Electrolyte

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39
Q

Calcium Chloride actions?

A

Essential component for the functional integrity of the nervous and muscular systems, for normal cardiac contractility, and for the coagulation of blood

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40
Q

Calcium Chloride onset/duration?

A

5-15 min / dose-dependent (effects my persist for 4 hours after IV administration)

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41
Q

Calcium Chloride indications?

A

Hyperkalemia, hypocalcemia, calcium channel blocker toxicity (overdose), hypermagnesemia

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42
Q

Calcium Chloride contraindications?

A

Vfib during cardiac resuscitation, digitalis toxicity, hypercalcemia

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43
Q

Calcium Chloride side effects?

A

Bradycardia, hypotension, metallic taste, severe local necrosis and sloughing following IM use or IV infiltration

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44
Q

Calcium Chloride route of admin?

A

IV/IO

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45
Q

Calcium Chloride adult dose?

A

500-1000mg (5-10mL of a 10% solution)

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46
Q

Calcium Chloride peds dose?

A

20mg/kg (0.2mL/kg of a 10% solution)

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47
Q

Calcium Chloride special considerations?

A

May produce vasospasm in coronary and cerebral arteries

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48
Q

Cardizem generic name?

A

Diltiazem

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49
Q

Cardizem classification?

A

Calcium channel blocker

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50
Q

Cardizem actions?

A

Slows conduction and increase the refractory period of the AV node. Controls ventricular response rate in A-fib and A-flutter

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51
Q

Cardizem onset / duration?

A

2-5 min/ 1-3 hours

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52
Q

Cardizem indications?

A

Control ventricular rate in A-fib and A-flutter. Paroxysmal SVT

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53
Q

Cardizem contraindications?

A

Wide complex tachycardia of uncertain origin, Sick Sinus Syndrome, AV block, WPW, hypotension (SBP <90), and cardiogenic shock

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54
Q

Cardizem side effects?

A

Decreased myocardial contractility, hypotension, bradycardia, heart failure, chest pain, syncope, nausea/vomiting, dyspnea, headache

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55
Q

Cardizem route of admin?

A

IVP

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56
Q

Cardizem adult dose?

A

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
Q

Cardizem supply?

A

25mg (5mL vial) or 50mg (10mL vial)

58
Q

Cardizem special considerations?

A

Use caution in patients taking oral beta blockers

59
Q

Epi 1:10 trade name?

A

Adrenaline

60
Q

Epi 1:10 classification?

A

Endogenous catecholamine, sympathomimetic

61
Q

Epi 1:10 actions

A

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
Q

Epi 1:10 onset/duration?

A

IV/ET: 1-2 minutes

63
Q

Epi 1:10 indications?

A

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
Q

Epi 1:10 contraindications?

A

Hypersensitivity, hypovolemic shock (correct hypovolemia first), and dilated cardiomyopathy

65
Q

Epi 1:10 side effects?

A

Tachycardia, headache, nausea/vomiting, restlessness, weakness, dysthymias, hypertension, precipitation of angina pectoris

66
Q

Epi 1:10 route of admin?

A

IV, IO

67
Q

Epi 1:10 adult dose?

A

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
Q

Epi 1:10 peds dose?

A

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
Q

Epi 1:10 supply?

A

1mg/10mL, prefilled syringes

70
Q

Epi 1:10 special considerations?

A

Epi should not be given with to mixed with sodium bicarbonate because it will be deactivated

71
Q

Furosemide trade name?

A

Lasix

72
Q

Lasix classification?

A

Loop diuretic

73
Q

Lasix actions?

A

Potent diuretic that inhibits the reabsorption of sodium and chloride in the proximal tubule and loop of Henle

74
Q

Lasix onset/duration?

A

15-20 minutes / 2 hours

75
Q

Lasix indications?

A

Acute pulmonary edema, hypertensive emergencies, hyperkalemia

76
Q

Lasix contraindications?

A

Anuria, hypersensitivity, hypovolemia/dehydration, hypokalemia

77
Q

Lasix side effects?

A

Hypotension, dry mouth, hypokalemia, hypoatremia, hypocalcemia, hyperglycemia

78
Q

Lasix route of admin?

A

IV

79
Q

Lasix adult dose?

A

0.5-1mg/kg over 1-2 minutes or (20-40mg)

80
Q

Lasix supply?

A

10mg/mL in 2,4, or 8mL ampules

10mg/mL in 10mL vials

81
Q

Heparin generic name?

A

None

82
Q

Heparin classification?

A

Anticoagulant

83
Q

Heparin actions?

A

Inhibits the clotting cascade by activating thrombin and activated X factor. Prevents clot extension and reformation

84
Q

Heparin onset/duration?

A

Immediate / approximately 12 hours

85
Q

Heparin indications?

A

Acute MI, STEMI

86
Q

Heparin contraindications?

A

Active bleeding; recent intracranial, intraspinal, or eye surgery; severe hypertension, bleeding tendencies, severe thrombocytopenia

87
Q

Heparin side effects?

A

Allergic reaction (chills, fever, back pain); Thrombocytopenia; hemorrhage, bruising, rash

88
Q

Heparin route of admin?

A

IV/IO

89
Q

Heparin adult dose?

A

STEMI:

4,000-5,000 units

90
Q

Heparin peds dose?

A

N/A

91
Q

Heparin supply?

A

Dilute 1mg of powered medication on 1mL of NS or sterile water for injection

92
Q

Heparin special considerations?

A

Use with caution in patients with liver disease

93
Q

Labetalol generic name?

A

None

94
Q

Labetalol classification?

A

Vasodilator, alpha and beta adrenergic blocker

95
Q

Labetalol actions?

A

Reduces blood pressure by decreasing PVR

96
Q

Labetalol onset/duration?

A

Within 5 minutes; peaks in 15 minutes / Duration up to 18 hours

97
Q

Labetalol indicatons?

A

Hypertensive emergencies

98
Q

Labetalol contradictions?

A

Hemodynamically unstable patients, bradycardia, hypotension, heart block greater than first degree, asthma, sick sinus syndrome, heart failure

99
Q

Labetalol side effects?

A

Hypotension, bradycardia, dizziness, fatigue, arrhythmias

100
Q

Labetalol route of admin?

A

IV, IO

101
Q

Labetalol adult dose?

A

10-20mg slow IV over 2 minutes, first bolus. May repeat or double dose every 10 minutes to max dose of 200mg

102
Q

Labetalol peds dose?

A

Safety has not been established

103
Q

Labetalol supply?

A

20mg/4mL vial

104
Q

Labetalol special considerations?

A

Administer only with patient in supine position

Reduce blood pressure to 185 systolic or 110 diastolic, but never greater than 20% from baseline

105
Q

Lidocaine trade name?

A

Xylocaine

106
Q

Lidocaine classification?

A

Antiarrhythmic, local anesthetic

107
Q

Lidocaine actions?

A

Decreases ventricular ectopy by suppressing spontaneous depolarization of ventricular pacemaker cells and raises fibrillation threshold level

108
Q

Lidocaine onset/duration?

A

45-90 seconds / 10-20 minutes

109
Q

Lidocaine indications?

A

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
Q

Lidocaine contraindications?

A

Third degree heart blocks, idioventricular rhythms, sinus bradycardia with escape PVC’s

111
Q

Lidocaine side effects?

A

Light-headedness, confusion, blurred vision, hypotension, bradycardia, seizures, altered LOC

112
Q

Lidocaine route of admin?

A

IV, IO, IV infusion, Endotracheal

113
Q

Lidocaine adult dose?

A

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
Q

Lidocaine peds dose?

A

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
Q

Lidocaine special considerations?

A

Treat Lidocaine toxic seizures with Valium

IF bradycardia occurs along with PVC’s, always treat the bradycardia first with atropine

116
Q

Magnesium Sulfate trade name?

A

None

117
Q

Magnesium Sulfate classification?

A

Anticonvulsant; Electrolyte

118
Q

Magnesium Sulfate actions?

A

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
Q

Magnesium Sulfate onset/duration?

A

IV: immediate IM: 3-4 hours / IV: 30 minutes IM: 3-4 hours

120
Q

Magnesium Sulfate indications?

A

Seizures of eclampsia, known hypomagnesemia, Torsades, asthma

121
Q

Magnesium Sulfate contraindications?

A

Heart blocks or recent MI, hypotension, patients on digitalis or other cardiac glycoside, respiratory depression, hypermagnesemia, or hypercalcemia

122
Q

Magnesium Sulfate side effects?

A

Hypotension, respiratory and neurological depression, hypermagnesemia, heart blocks, facial flushing, diaphoresis, bradycardia

123
Q

Magnesium Sulfate route of admin?

A

IM, IVP, IV infusion

124
Q

Magnesium Sulfate adult dose?

A

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
Q

Magnesium Sulfate peds dose?

A

N/A

126
Q

Magnesium Sulfate supply?

A

500mg/mL in 10mL vials

127
Q

Magnesium Sulfate special considerations?

A

Calcium chloride should be ready to use as an antidote for respiratory depression

Do not mix with sodium bicarbonate

128
Q

Ticagrelor trade name?

A

Brilinta

129
Q

Brilinta classification?

A

Antiplatelet

130
Q

Brilinta actions?

A

Platelet inhibitor the reduces the rate of thrombotic events in acute coronary syndrome and STEMI patients

131
Q

Brilinta onset/duration?

A

<30 minutes / 1-2 days

132
Q

Brilinta indications?

A

STEMI

133
Q

Brilinta contraindications?

A

Stroke, GI bleed, trauma, intracranial hemorrhage

134
Q

Brilinta side effects?

A

Bleeding, difficulty breathing

135
Q

Brilinta route of admin?

A

PO

136
Q

Brilinta adult dose?

A

180mg (two 90mg tablets)

137
Q

Brilinta supply?

A

90mg tablets

138
Q

Brilinta special considerations?

A

Use caution in patients that are also taking other antiplatelet medication such as Coumadin, aspirin, xerelto

Paramedic Class 47 Drug List (11 decks)

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