Cardiac Misc Flashcards
Name/class Heparin
Heparin
Anticoagulant
Indications
Heparin
To prevent thrombus formation in acute MI
Name/class Levophed
Norepinephrine
Sympathomimetic agent
Name/class Norepinephrine
Levophed
Sympathomimetic agent
Description
Norepinephrine
Levophed
Norepinephrine is a naturally occurring catecholamine and causes vasoconstriction, cardiac stimulation, and increased blood pressure, myocardial oxygen demand, and coronary blood flow
Indications
Norepinephrine
Levophed
Refractory hypotension and neurogenic shock
Contraindications
Norepinephrine
Levophed
Hypotension due to uncorrected hypovolemia
Precautions
Norepinephrine
Levophed
Hypertension, severe heart disease, elderly, MAO inhibitor therapy, monitor blood pressure frequently and infuse the drug through the largest vein available as it may cause tissue necrosis
Dosage/route
Norepinephrine
Levophed
0.5 to 30 mcg/min IV, titrated to BP
Pedi dose/route
Norepinephrine
Levophed
0.01 mcg/kg/min rarely used
Description
Heparin
Heparin is a rapid onset anticoagulant enhancing the effects of antithrombin III and blocking the conversion of prothrombin to thrombin and fibrinogen to fibrin
name/class activase
alteplase recombinant, TPA
thrombolytic
name/class TPA
alteplase recombinant, activase
thrombolytic
name/class alteplase recombinant
TPA, Activase
Thromboltic
indications
alteplase recombinant
TPA
Activase
to thrombolyse in acute myocardial infarction, acute ischemic stroke and pulmonary embolism
contraindications
alteplase recombinant
TPA
Activase
active internal bleedin, suspected aortic dissection, traumatic CPR, recent hemorrhagic stroke(6 months), intracranial or intraspinial surgery or trauma(2 months), pregnancy, uncontrolled hypertension, or hypersensitivity to thrombolytics
precautions
alteplase recombinant
TPA
Activase
recent major surgery, cerebral vascular disease, recent GI or GU bleeding, recent trauma, hypertension, patient>75 years, current oral anticoagulants or hemorrhagic ophthalmic conditions
description
alteplase recombinant
TPA
Activase
recombinant DNA derived form of human TPA promotes thrombolysis by forming plasmin. plasmin in turn, degrades fibrin and fibrinogen and ultimately the clot
name/class tridail
nitroglycerin injection
vasodilator/nitrate
name/class nitroglycerin injection
tridil
vasodilator/nitrate
description
tridil
nitroglycerin injection
relaxes blood vessels increasing the blood and oxygen supply to the heart
indications
tridil
nitroglycerin injection
nitroglycerin infusions are sed to help relieve the pain associated with anginia that does not respond to oral treatment; to control BP; and to help treat congestive heart failure
contraindications
tridil
nitroglycerin injection
hypotension, uncorrected hypovolemia, increased intracranial pressure, constrictive pericarditis and pericardial tamponade
precautions/side effects
tridil
nitroglycerin injection
headache, severe hypotension, reflex tachycardia
dose/route
tridil
nitroglycerin injection
0.2-1.5 mcg/kg/min
name/class verapamil
isoptin,calan
calcium channel blocker
name/class isoptin
verapamil, calan
calcium channel blocker
name/class calan
verapamil, isoptin
calcium channel blocker
description
verapamil
isoptin
calan
verapamil is a calcium channel blocker that slows AV conduction, suppresses reentry dysrhythmias such as PSVT, and slows ventricular responses to atrial tachydysrhythmias verapamil also dilates coronary arteries and reduces myocardial oxygen demand
indications
verapamil
isoptin
calan
PVST refactory to adenosine, atrial flutter, and atrial fibrillation with rapid ventricullar response
contraindications
verapamil
isoptin
calan
severe hypotension, cardiogenic shock, 2nd pr 3rd degree heart block, CHF, Sinus node disease, and accessory AV pathways, WPW syndrome. It should not be administered to persons taking beta blockers
precautions
verapamil
isoptin
calan
MI with coronary artery occlusion or myocardial stenosis
dose/route
verapamil
isoptin
calan
2.5-5mg IV bolus over 2-3 min, then 5-10mg after 15-30 min to a max of 30mg in 30 min
name/class vasopressin
pitressin
hormone,vasopressor
name/class pitressin
vasopressin
hormone, vasopressor
description
vasopressin
pitressin
vasopressin is a hormone with strong vasopressive and anti-diuretic properties but they may precipitate anginia and or AMI
indications
vasopressin
pitressin
to increase peripheral vascular resistance in arrest (CPR) or to control bleeding from esophageal varices
contraindications
vasopressin
pitressin
PVC’s
1st stage of labor
precautions
vasopressin
pitressin
Epilepsy, Migrane, Heart failure, Anginia, vascular disease, hepatic impairment, elderly and children
cardiac arrest dose/route
vasopressin
pitressin
40 units IV
esophageal varices dose/route
vasopressin
pitressin
0.2 to 0.4 units/min IV drip
name/class eptifibatide
integrilin
glycoprotein IIb/IIIa inhibitor, platelet aggregation inhibitor
name/class integrilin
eptifibatide
glycoprotein IIb/IIIa inhibitor, platelet aggregation inhibitor
description
eptifibatide
integrilin
prevents the aggregation of platelets by binding to the glycoprotein IIb/IIIa receptor preventing the binding of fibrinogen and Von Willebrand factors
indications
eptifibatide
integrilin
unstable anginia and NSTEMI(ACS) being managed medically
contraindications
eptifibatide
integrilin
any prior intracranial hemorrhage, known malignant intracranial neoplasm, suspected, aortic dissection, significant closed head trauma or facial trauma within 3 hours
precautions/side effects
eptifibatide
integrilin
cerebral hemorrhage, pulmonary hemorrhage, hypotension, GI bleeding, internal bleeding, anaphylactic shock
dose/route
eptifibatide
integrilin
medical management 180 ug/kg IV bolus over 1-2 min, followed by a 2ug/kg infusion for 72-96 hours
name/class bumetanide
bumex
loop diuretic
name/class bumex
bumetanide
loop diuretic
description
bumetanide
bumex
a patent loop diuretic with a rapid onset and short duration of action. inhibits the re-absorption of sodium and chloride in the ascending limb of the loop of henle
indications
bumetanide
bumex
pulmonary
CHF
contraindications
bumetanide
bumex
hypersensitivity to bumetainide or sulfonamides, hypotension, anuria, electrolyte deficiencies, hepatic coma.
USE CAUTION: hepatic cirrhosis, ascites, diabetes, hypersensitivity to furosemide
dose/route
bumetanide
bumex
0.5-1.0 mg IV slowly over 1-2 min or IM
pedi dose/route
bumetanide
bumex
safety and effectiveness in pediatrics is not established
