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Paramedic > Cardiac Drugs 2 > Flashcards

Cardiac Drugs 2 Flashcards

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1
Q

Sodium Bicarbonate Class

A

Systemic hydrogen ion buffer, alkalizing agent

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2
Q

Sodium Bicarbonate Mechanism of Action

A

Buffers metabolic acidosis and lactic acid buildup in the body caused by anaerobic metabolism secondary to severe hypoxia by reacting with hydrogen ions to form water and carbon dioxide.

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3
Q

Sodium Bicarbonate Indications

A

Metabolic acidosis during cardiac arrest, trycyclic antidepressant, aspirin, and PHENobarbital overdose, hyperkalemia, crush injuries.

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4
Q

Sodium Bicarbonate Contraindications

A

Metabolic and respiratory alkalosis, hypokalemia, electrolyte imbalance due to severe vomiting or diarrhea.

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5
Q

Sodium Bicarbonate Adverse reactions/side effects

A

Hypernatremia, metabolic alkalosis, tissue sloughing, cellulitis, mecrosis at injection site, seizures, fluid retention, hypokalemia, electrolyte imbalance, tetany, sodium retention, peripheral edema.

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6
Q

Sodium Bicarbonate Drug interactions

A

increases the effects of amphetamines. Decreases the effects of benzodiazapines, tricyclic antidepressants. May deactivate sympathomimetics(DOPamine, EPINEPHrine, norepinephrine)

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7
Q

Sodium Bicarbonate Adult Dosage and administration

A

1 mEq/kg slow IV, IO push, may repeat at 0.5 mEQ/kg every 10 minutes.

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8
Q

Sodium Bicarbonate Pediatric Dosage and administration

A

1 mEq/kg slow IV, IO push(dilute in small children to 4.2%)

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9
Q

Sodium Bicarbonate Duration of Action

A

onset: seconds
peak effect: 1 to 2 minutes
duration: 10 minutes

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10
Q

Sodium Bicarbonate Pregnancy safety category

A

C

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11
Q

Sodium Bicarbonate Special Considerations

A

Repeat as needed in tricyclic antidepressant overdose until QRS narrows. Must be used in conjuction with effective ventilation and chest compressions in cardiac arrest. Avoid contact with other medications; may precipitate or inactivate them. Always flush IV line well before and after injecting. Use with caution in patients with heart failure and renal disease due to high sodium concentration. Monitor patient closely for signs and symptoms of fluid overload.

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12
Q

Furosemide (Lasix) class

A

loob diuretic

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13
Q

Furosemide (Lasix) Mechanism of Action

A

Blocks the absorption of sodium and chloride at the distal and proximal tubules and the loop of Henle, causing increased urine output

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14
Q

Furosemide (Lasix) Indications.

A

Heart failure, pulmonary edema, hypertensive crisis.

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15
Q

Furosemide (Lasix) Contraindications

A

hypovolemia, anuria, hypotension(relative contraindication), hypersensitivity, hepatic coma, suspected electrolyte imbalances.

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16
Q

Furosemide (Lasix) Adverse reactions/ side effects

A

Dizziness, headache, ECG changes, weakness, orthostatic hypotension, dysrhythmias, nausea, vomiting, diarrhea, dry mouth, may exacerbate hypovolemia and hypokalemia, hyperglycemia(due to hemoconcentration)

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17
Q

Furosemide (Lasix) Drug interactions

A

Lithium toxicity may be potentiated because of sodium depletion. Digitalis toxicity may be potentiated by potassium depletion.

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18
Q

Furosemide (Lasix) Adult Dosage and administration

A

0.5 to 1mg/kg IV over 1 to 2 minutes. If no response, double the dose to 2 mg/kg slowly over 1 to 2 minutes.

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19
Q

Furosemide (Lasix) Pediatric Dosage and Administration

A

1 mg/kg IV/IO

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20
Q

Furosemide (Lasix) Duration of action

A

onset: 5 minutes.
peak: 20-60 mins.
duration 4 to 6 hours.

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21
Q

Furosemide (Lasix) Pregnancy safety

A

C

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22
Q

Furosemide (Lasix) special considerations.

A

Should only be used during pregnancy if maternal benefit outweighs fetal risk. Ototoxicity, deafness and projectile vomiting can occur with rapid administration. Should be protected from light. Vasodilatory effects within 5 minutes; diuretic effects within 30 minutes. Expect 10 to 12 minutes. Expect to 10 12 mm Hg systolic and a 5 to 7 mm Hg diastolic drop in BP. Being phased out due to nephrotoxic side effects. Furosemide administration has decreased with the advent of CPAP.

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23
Q

Labetalol (Normodyne, Trandate) Class

A

Selective alpha and nonselective beta adrenergic blocker, antihypertensive

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24
Q

Labetalol (Normodyne, Trandate) Mechanism of action

A

BP reduction without reflex tachycardia; total peripheral resistance reduced without significant alteration in cardiac output

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25
Q

Labetalol (Normodyne, Trandate) Indications

A

Moderate to severe hypertension.

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26
Q

Labetalol (Normodyne, Trandate) Contraindications

A

Bronchial asthma, heart failure, cardiogenic shock, second and third degree heart block, bradycardia

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27
Q

Labetalol (Normodyne, Trandate) Adverse reactions/side effects

A

Fatigue, weakness, depression, headache, dizziness, bronchospasm, wheezing, dyspnea, bradycardia, heart failure, pulmonary edema, orthostatic hypotension, ventricular dysrhythmias, nausea, vomiting, diarrhea.

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28
Q

Labetalol (Normodyne, Trandate) Drug Interactions

A

Labetalol may block bronchodilator effects of beta adrenergic agonists. NTG may augment hypotensive effects.

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29
Q

Labetalol (Normodyne, Trandate) Adult Dosage and Administration

A

10 mg IV push over 1 to 2 minutes. May repeat or double every 10 minutes to a maximum dose of 150 mg.
or infusion of 2 to 8 mg/min, titrated to supine BP.

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30
Q

Labetalol (Normodyne, Trandate) Pediatric Dosage and administration

A

Not recommended.

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31
Q

Labetalol (Normodyne, Trandate) Duration of action

A

onset: Less than 5 minutes
peak: Variable
duration: 3 to 6 hours.

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32
Q

Labetalol (Normodyne, Trandate) pregnancy safety category

A

C

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33
Q

Labetalol (Normodyne, Trandate) Special considerations

A

BP, pulse rate, and ECG should be monitored continuously. Observe for signs of heart failure, bradycardia, and bronchospasm. Should only be administered with patient in the supine position.

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34
Q

Metroprolol Tartrate (Lopressor) Class

A

Beta blocker, beta 1 selective

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35
Q

Metroprolol Tartrate (Lopressor) Mechanism of action

A

decreases heart rate, conduction velocity, myocardial contractility, and cardiac output. Used to control ventricular response in SVT(PSVT, AF, atrial flutter) Considered second line agent after adenosine, diltiazem, or digitalis derivative.

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36
Q

Metroprolol Tartrate (Lopressor) Indications

A

PSVT, atrial flutter, AF, reduces myocardial ischemia and damage in patients with AMI.

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37
Q

Metroprolol Tartrate (Lopressor) Contraindications

A

heart failure, second or third degree AV block, first degree heart block (if PR interval is equal to or greater than 0.24), sick sinus syndrome, cardiogenic shock, bradycardia.

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38
Q

Metroprolol Tartrate (Lopressor) Adverse reactions/ side effects

A

weakness, dizziness, depression, bronchospasm, wheezing, dyspnea, bradycardia, pulmonary edema, heart failure, AV blocks, hypotension, nausea, indigestion

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39
Q

Metroprolol Tartrate (Lopressor) Drug Interactions

A

Metoprolol may potentiate antihypertensive effects when given to patients taking calcium channel blockers or MAOIs. Catecholamine depleting drugs may potentiate hypotension

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40
Q

Metroprolol Tartrate (Lopressor) Adult Dosage and Administration

A

5 mg IV over 1 to 2 minutes. May repeat as needed every 5 minutes for a total of three doses.

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41
Q

Metroprolol Tartrate (Lopressor) Pediatric Dosage and Administration

A

Safety not established.

42
Q

Metroprolol Tartrate (Lopressor) Duration of Action

A

onset 1 to 2 minutes

peak: 5 to 10 minutes
duration: 3 to 4 hours

43
Q

Metroprolol Tartrate (Lopressor) Pregnancy safety Category

A

C

44
Q

Metroprolol Tartrate (Lopressor) Special considerations

A

Contraindicated for use in breastfeeding women. Metoprolol must be given slow IV over 5 minutes. Concurrent IV administration with IV calcium channel blocker such as verapamil or diltiazem can cause severe hypotension. Metoprolol should be used with caution in patients with liver or renal dysfunction, hypotension, and COPD.

45
Q

Nitroglycerin(Nitrostat, Nitro-Bid, Tridil) Class

A

Vasodilator

46
Q

Nitroglycerin(Nitrostat, Nitro-Bid, Tridil) mechanism of action

A

Smooth muscle relaxant acting on vasculature, bronchial, uterine, intestinal smooth muscle. Dilation of arterioles and veins in the periphery. Reduces preload and afterload, decreasing workload of the heart, pulmonary edema.

47
Q

Nitroglycerin(Nitrostat, Nitro-Bid, Tridil) Indictions

A

Acute angina pectoris, ischemic chest pain, hypertension, heart failure, pulmonary edema.

48
Q

Nitroglycerin(Nitrostat, Nitro-Bid, Tridil)Contraindications

A

Hypotension, hypovolemia, intracranial bleeding or head injury, pericardial tamponade, severe bradycardia or tachycardia, RV infarction, previous administration in the last 24 hours: sildenafil (Viagra) or 48 hours: vardenafil (Levitra) or tadalafil (Cialis)

49
Q

Nitroglycerin(Nitrostat, Nitro-Bid, Tridil) Adverse reactions/side effects

A

Headache, dizziness, weakness, reflex tachycardia, syncope, hypotension, nausea, vomiting, dry mouth, muscle twitching, diaphoresis.

50
Q

Nitroglycerin(Nitrostat, Nitro-Bid, Tridil) Drug Interactions

A

Additive effects with other vasodilators. Incompatible with other drugs IV

51
Q

Nitroglycerin(Nitrostat, Nitro-Bid, Tridil) Adult Dosage and Administration

A

0.4 mg SL; may repeat in 3 to 5 minutes to maximum of 3 doses. NTG IV infusion: Begin at 10 mcg/min; increase by 10 mcg/min every 3 to 5 minutes until desired effect. Maximum dosage of 200 mcg/min

52
Q

Nitroglycerin(Nitrostat, Nitro-Bid, Tridil) Pediatric Dosage and Administration

A

Not recomended

53
Q

Nitroglycerin(Nitrostat, Nitro-Bid, Tridil) Duration of Action

A

onset: 1 to 3 minutes
peak: 5 to 10 minutes
duration: SL:20 to 30 mintues, IV 1 to 10 minutes after discontinuation of infusion

54
Q

Nitroglycerin(Nitrostat, Nitro-Bid, Tridil) Pregnancy safety Category

A

C

55
Q

Nitroglycerin(Nitrostat, Nitro-Bid, Tridil) Special considerations

A

Has been used safely during pregnancy. Use caution with breastfeeding women and monitor infants for adverse effects. hypotension more common in older patients. If 12 lead ECG shows inferior wall infarct, rule out RV infarction prior to administering NTG. NTG decomposes when exposed to light or heat, must be kept in airtight containers. Must be administered only with an infusion pump direct from bottle with a vented IV set and non - PVC tubing. Active ingredient may have stinging effect when administered.

56
Q

Nitropaste(Nitro-bid ointment) Adult Dosage and administration

A

Paste: apply a 1/2 to 3/4 inch (1 to 2 cm) line (15 to 30 mg), cover with wrap, and secure with tape. Maximum: 5 inch(12.5 cm) line(75 mg) per application. Transdermal: apply to intact skin (usually chest wall) in various doses.

57
Q

Nitropaste Pediatric Dosage and administration

A

Not recommended

58
Q

Nitropaste Special considerations

A

Wear gloves during application. Store paste in a cool place with tube tightly capped. Erratic absorption rates quite common.

59
Q

Propranolol Hydrochloride(Inderal) class

A

Beta - adrenergic blocker

60
Q

Propranolol Hydrochloride(Inderal) Mechanism of action

A

Nonselective Beta- adrenergic blocker that reduces chronotropic, inotropic, and vasokilator response to beta adrenergic stimulation.

61
Q

Propranolol Hydrochloride(Inderal) Indications

A

Hypertension, angina pectoris, VT, VF refractory to lidocaine, selected SVT.

62
Q

Propranolol Hydrochloride(Inderal) Contraindications

A

Sinus bradycardia(if no pacemaker present), second or third degree AV block(if no pacemaker present), bronchial asthma, sick sinus syndrome(if no pacemaker present), cardiogenic shock, heart failure, acute pulmonary edema

63
Q

Propranolol Hydrochloride(Inderal) Adverse reactions/side effects

A

Weakness, depression, fatigue, anxiety, dizziness, bronchospasm, wheezing, hypotension, bradycardia, heart failure, AV blocks, nausea, vomiting, diarrhea, hypoglycemia, hyperglycemia

64
Q

Propranolol Hydrochloride(Inderal) Drug interactions

A

Verapamil may worsen AV conduction abnormalities. Succinylcholine effects may be enhanced. Effects may be reversed by isoproterenol, norepinephrine, dopamine.

65
Q

Propranolol Hydrochloride(Inderal) Adult Dosage and Administration

A

Dilute 1 to 3 mg in 10 to 30 mL of d5w. Administer slowly IV at rate of 1 mg/min. Maximum dose: 5mg

66
Q

Propranolol Hydrochloride(Inderal) Pediatric Dosage and Administration

A

0.01 to 0.05 mg/kg per dose slow IV over 10 minutes. Maximum dose 3 mg

67
Q

Propranolol Hydrochloride(Inderal) Duration of action

A

onset: 15 to 60 minutes
peak: variable
duration: 6 to 12 hours

68
Q

Propranolol Hydrochloride(Inderal) Pregancy safety category

A

C

69
Q

Propranolol Hydrochloride(Inderal) Special considerations

A

Use cautiosly in pregnant women due to potential and congenital anomalies. Closely monitor patient during administration. Use with caution in older patients. Atropine should be readily available.

70
Q

Ceftriaxone (Rocephin) Class

A

Antibiotic

71
Q

Ceftriaxone (Rocephin) Mechanism of Action

A

Inhibits bacterial cell wall synthesis

72
Q

Ceftriaxone (Rocephin) Indications

A

Respiratory tract infections, skin infections, urinary tract infections, pelvic inflammatory disease, bacterial septicemia, bone and joint infections, and meningitis.

73
Q

Ceftriaxone (Rocephin) Contraindications

A

Hypersensitivity

74
Q

Ceftriaxone (Rocephin) Precautions

A

Calcium containing meds including OTC meds.

75
Q

Ceftriaxone (Rocephin) Side Effects

A

Chest pain, chills, cough, fever, painful or difficult urination, shortness of breath, sore throat.

76
Q

Ceftriaxone (Rocephin) Dosage

A

1 to 2 g IM or IV

77
Q

Ceftriaxone (Rocephin) Route

A

IV, IM

78
Q

Ceftriaxone (Rocephin) How Supplied

A

1g powder for reconstitution

79
Q

Ceftriaxone (Rocephin) Pediatric Dosage

A

50 to 75mg/kg IM or IV

80
Q

Ceftriaxone (Rocephin) Onset/Duration

A

<30 mins, 12 - 24 hours.

81
Q

Tranexamic Acid (Cyklokapron, Lysteda) Class

A

Hemostatic agent, antifibrinolytic

82
Q

Tranexamic Acid (Cyklokapron, Lysteda) Mechanism of action

A

Readuces plasminogen activation, mitigating conversion to plasmin

83
Q

Tranexamic Acid (Cyklokapron, Lysteda) Indications

A

Blunt or penetrating trauma less than 3 hours from onset with hemodynamic compromise, bleeding

84
Q

Tranexamic Acid (Cyklokapron, Lysteda) Contraindications

A

Hypersensitivity; MOI greater than 3 hours; subarachnoid hemorrhage; history of PE, DVT, or other thromboembolic disorder.

85
Q

Tranexamic Acid (Cyklokapron, Lysteda) Adverse reactioin/side effects

A

Fatigue, headache, abdominal pain, anemia, DVT, PE, other thromboembolic disorder. Rapid infusion may cause hypotension.

86
Q

Tranexamic Acid (Cyklokapron, Lysteda) Drug interations

A

Hormonal contraceptives, clotting factor complexes

87
Q

Tranexamic Acid (Cyklokapron, Lysteda) Adult Dosage and administration

A

1 g IV infusion over 10 minutes.

88
Q

Tranexamic Acid (Cyklokapron, Lysteda) Pediatric Dosage and administration

A

Not recommended

89
Q

Tranexamic Acid (Cyklokapron, Lysteda) Duration of action.

A

onset: unknown
peak: unknown
duration: 7 to 8 hours

90
Q

Tranexamic Acid (Cyklokapron, Lysteda) Pregnancy safety category

A

C

91
Q

Tranexamic Acid (Cyklokapron, Lysteda) Special Considerations

A

Use in pregnant and breastfeeding women should be clearly indicated. Must be mixed into an infusion bag, typically 100 mL of NaCL

92
Q

Vancomycin (Vancocin) Class

A

Antibiotic

93
Q

Vancomycin (Vancocin) Mechanism of Action

A

Inhibits cell wall synthesis, cell membrane permeability, and RNA synthesis of gram positive bacteria

94
Q

Vancomycin (Vancocin) Indications

A

Staphylococcal infections, clostridium difficile, endocarditis, meningitis, osteomyelitis, pneumonia, soft tissue infections.

95
Q

Vancomycin (Vancocin) Contraindications

A

Hypersensitivity, allergy to corn or corn products, heart failure, renal disease or failure, ulcerative colitis.

96
Q

Vancomycin (Vancocin) Adverse Reactions/side effects

A

Chills, dizziness, abdominal pain, nausea, vomiting, diarrhea, hypokalemia, hypotension, tinnitus, ototoxicity, nephrotoxicity/renal failure, urticaria, wheezing.

97
Q

Vancomycin (Vancocin) Drug interactions

A

May enhance neuromuscular blockade with nondepolarizing muscle relaxants(eg pancuronium); Combined use with aminoglycosides may increase the risk of ototoxicity and nephrotoxicity.

98
Q

Vancomycin (Vancocin) Adult Dosage and administration

A

7.5 mg/kg or 500 mg every 6 hours or 15 mg/kg or 1 g every 12 hours for 7 to 10 days IV infusion.

99
Q

Vancomycin (Vancocin) Pediatric Dosage and Administration

A

40 mg/kg of body weight/24 hours equally divided and given every 6,8,12 hrs. for 7 to 10 days IV infusion

100
Q

Vancomycin (Vancocin) Duration of Action

A

onset: Rapid
peak effect: End of the infusion
duration:12 to 24 hours.

101
Q

Vancomycin (Vancocin) Pregnancy safety category

A

C

102
Q

Vancomycin (Vancocin) Special considerations

A

Often administered to patients with penicillin allergies. Dose reduction required for patients with impaired renal function. Rapid infusion can cause histamine release resulting in “red man syndrome” that is characterized by flushing of the face, nech, upper body, arms, and or back. Symptoms usually resolve within 20 minutes but sometimes last for several hours. Stopping or slowing the infusion rate may reduce the severity of the reaction.

Paramedic (9 decks)

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