Cardiac Emergency Pharm Flashcards
The preferred route of administration for nitro in the prehospital setting is?
Sublingual
When administering Epi in CA with a 1:10000 IV or IO the standard initial dose is?
1 MG
What pharmacological drug would you use to treat a polymorphic ventricular tachycardia (Torsades)
Magnesium Sulfate
If avaliable what is the preferred method for clearing an arterial occlusion?
If this is not avaliable, what pharmacological route would you go?
Percutaneous Coronary Intervention. Fibrolytics
Excessive stimulation of the Vagus nerve may result in?
Bradycardia
Which of the following statements is TRUE regarding Digoxin?
Digoxin has a negitive chronotropic (slows AV condution) and increased inotropic (force of cardiac contraction) effects.
The beneficial effects of Epi in CA are thought to be beacause of
Alpha- adrenergic effects
Lidocaine is contraindicated in which of the following?
High grade heart blocks
Vassopressin may be used in CA when?
As a replacement for the first or second epi dose
in Hemodynamically significant bradycardic pts, when you can not pace or it is not available the recommended dose of atropine sulfate is?
0.5 mg
Indications for Dopamine include?
Cardiogenic Shock
Because of it’s selective alpha 1 antagonistic properties, labetalol is indicated in?
Tachycardia
Amiodarone is indicated in which of the following life-threatening arrythmias?
Stable V Tach
What is the initial dosage if dopamine?
2-10 mcg/kg/min
Following the administration of adenosine, the pmed should be aware that?
Pt may experience arrythmias including transient asystole.
What metabolism occurs without the presence of oxygen is inefficeint nad is termed? or ___ metabolism
Anaerobic, glucose
Oxygen should be administered?
to any patient that needs it, pt’s with signs of hypoxia
When utilizing Sodium Bicard, it is important to understand that:
Sodium Bicard will inactivate catecholamines administered through the same IV line unless the line is flushed thoroughly
When preparing sodium nitro prusside for use in hypertensive emergencies, it is important to remember that?
Once mixed, keep wrapped in an opaque wrapper to not deactivate.
Furosemide works by?
Inhibiting the reuptake of sodium and chloride resulting in diuresis
Dobutamine is useful in CHF because:
It causes less increase in HR than other sympathomimetics
In acute coronary syndrome, asprin is given because:
Asprin inhibits the aggregation of platelets preventing occlusion of Coronary arteries
According to Vaughn-Williamson classification diltiazem(cardizem) is a class ____ antiarrythmic?
IV
Contraindications that apply to both aspirin and clopidogrel include?
Bleeding disorders
The system that plays an important role in maintenance of BP through endocrine regulation is?
Renin- angiotensin-aldosterone (RAAS)
A contraindication for the use of morphine sulfate is?
Hypovolemia
It is important to understatd that the concomitant of a non selective B antagonist along with a slow Calcium Channel blocker may result in?
Asystole
You are treating a pt who has bee id’d as having stable V-tach. Med control ordered Amiodarone. What is the correct dosage?
150 mg IV bolus infusion over 10 minutes
Inital dose of Adenosine?
6 mg
Chemically similar drugs such as dopamine, epi, neoepi, isuprel, and dobutamine are referred to as?
Catecholamines
The primary use of a sympathomemetic in Emergency medicine is?
Increase BP in cardiogenic and septic shock.
What would the infusion rate for an Epi drip be when treating Bradycardia?
1mg epi in 500 NS D5W titrated at 2-10 micrograms/min
What would the infusion rate be for epi when treating post CA hypotension?
.1-.5 mcg/kg/minute.
What is the dosage for Norepinephrine?
.1-.5 mcg/kg/min. 8 mg in 500 mL d5w 4mg in 250 bag. should use a pump due to potency.
What is the correct doasge for Dopamine?
800 mg in 500 ml d5w initial infusion of 2 to 10 mcg/kg/min max of 20 mcg/kg/mkinute
What is an intropic agent?
agent that changes the force of your heart’s contractions. + inotrope increases strength of Heartbeat, (-) inotrope weakens the force of the Heart beat.
What is a chronotropic agent?
Changes the HR via rate or rythym. positive chronotro[pic increases HR i.e., Atropine, Negative chronotropic decreases HR i. digoxin/ cardizem (ditalizam)
What does MONA stand for in treating AMI?
(M)orphine or analgesia, (O)xygen, (N)itro, (A)sprin
B UH G C A F (Swearigen mnemonic)
(B)eta-blocker, (H)eparin, (G)lycoprotein, (C)lopidagril (bridge to Cabg) (A)ngioplasty, (F)ibrolytics
Main objective for treating AMI
Get the mypocardium O2. via slow HR, slippery platelets, B Blockers, Clot busting, angioplasty.
How would you treat a Narrow complex tachycardia that was regular?
SVT. Vagal Manuvers, Adenocard, BBlock, CaCH block, digoxin
How would you treat a narrow complex irregular tachyacardia?
Afib or flutter, Ditalizam, Heparin, BBlock, CaCh block, digoxin
How would you treat a Wide complex tachycardia that is regular?
Procamide, Amiodarone Softulol
How would you treat a Wide complex tachycardia that was irregular?
Torsades, mag sulfate.
How to treat bradycardia?
All Tall Dogs Eat. Atropine, Transcantaneous Pacing, Dopamine infusion, Epi Infusion.
How to manage Cardiac Arrest?
CPR/monitor/shock/plan / epi 3-5/Hand Ts
Manage AMI?
MONABUHGCAF
How to treat CHF?
O2 w peep/Cpap/Nitro/Lasix/
How to treat cardiogenic shock?
Cardiogenic shock is chf plus hypotension/ Dobutamine// Norepi, Neo
How to treat hypertensive emergencies?
Nitrprusside/ BBblocker (Labutolol)/ CCH blocker( cardine)
Numonic for Blocking classes
NBKC
