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CARDIAC DRUGS > Cardic 3 > Flashcards

Cardic 3 Flashcards

1
Q

Calcium chloride

Drug classification

A

Mineral

Electrolyte

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2
Q

Calcium chloride

Mechanism of action

A

Replacement of elemental calcium -> dissociates rapidly to Ca2+ and Cl- ions -> positive inotropy and chronotropy

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3
Q

Calcium chloride

Pharmacokinetics

A

Onset: immediate
Peak: unknown
Duration: varies
Half-life: N/a

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4
Q

Calcium chloride

Indications / field use

A

Acute hyperkalemia
Ca2+ channel blocker toxicity
Crush syndrome
Abdominal muscle spam from brown spider or man of war jellyfish
Cardiac arrest secondary to suspected hyperkalemia (known dialysis pt, etc)

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5
Q

Calcium chloride

Contraindications

A

Hypercalcemia

Pt taking digoxin

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6
Q

Calcium chloride

Side effects / adverse reactions

A

Bad dysrhythmias need some calcium

Bradycardia,Dysrhythmias, Nausea and vomiting, Syncope, Cardiac arrest

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7
Q

Calcium chloride

Dose (Adult)

A

1g slow IV/IO over 5 minutes

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8
Q

Calcium chloride

Dose (pedi)

A

20mg/kg slow IV/IO

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9
Q

Calcium chloride

Precautions

A

Can cause tissue necrosis at injection side; ensure patent IV line

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10
Q

Calcium chloride

Drug-Drug Interactions

A

Forms PPT w/ NaHCO3, flush tubing between administration
Digitalis toxicity when administered to pt currently taking digitalis / digoxin - inhibits Ca2+ channels causing “stone heart”

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11
Q

Calcium Gluconate

Drug classification

A

Mineral

Electrolyte

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12
Q

Calcium Gluconate

Mechanism of action

A

Replacement of elemental calcium -> dissociates rapidly to Ca2+ and gluconate ions -> positive inotropy and chronotropy

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13
Q

Calcium Gluconate

Pharmacokinetics

A

Onset : immediate
Peak : unknown
Duration : varies
Half-life : N/a

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14
Q

Calcium Gluconate

Indications / field use

A

Acute hyperkalemia
Ca2+ channel blocker toxicity
Cardiac arrest secondary to suspected hyperkalemia (known dialysis pt, etc)

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15
Q

Calcium Gluconate

Side effects / adverse reactions

A

Bad dysrhythmias need some calcium

Bradycardia, dysrhythmias, nausea and vomiting, syncope, cardiac arrest

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16
Q

Calcium Gluconate

Dose (adult)

A

2g slow IV/IO over 5 minutes

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17
Q

Calcium Gluconate

Dose (pedi)

A

60mg/kg slow IV/IO over 5 minutes

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18
Q

Calcium Gluconate

Precautions

A

Can cause tissue necrosis at injection site, ensure patent IV line

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19
Q

Calcium Gluconate

Drug-Drug interactions

A

Forms PPT w/ NaHCO3, flush tubing between administration
Digitalis toxicity when administered to pt currently taking digitalis/digoxin - inhibits Ca2+ channels causing “stone heart”

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20
Q 
Dopamine HCL (Intropin) 
Drug classification
A

Sympathomimetic
Sympathetic agonist
Catecholamine

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21
Q 
Dopamine HCL (Intropin) 
Mechanism of action
A

Alpha 1 agonist -> second messenger release of Ca2+ in VSMC -> peripheral vasoconstriction -> increased SVR -> increased BP
Beta 1 agonist -> increased intracellular Ca2+ in cardiac cells -> positive inotropy, chronotropy, dromotropy

the mechanism for this drug is dose dependent

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22
Q 
Dopamine HCL (Intropin) 
Pharmacokinetics
A

Onset : <5 minutes
Peak : 5-8 minutes
Duration : <10 minutes
Half-life : 2 minutes

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23
Q 
Dopamine HCL (Intropin) 
Indications / field use
A

Cardiogenic shock
Symptomatic bradycardia
Septic shock following fluid resuscitation

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24
Q 
Dopamine HCL (Intropin) 
Contraindications
A

Uncorrected hypovolemia (if profoundly hypotensive, may give IV fluids concurrently)

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25
Q 
Dopamine HCL (Intropin) 
Side effects / adverse reactions
A

This Drug Does Not Help Neither Chest pain or Extravasated necrosis

Tachycardia, Dyspnea, Dysrhythmias (a-fib, PVC’s), HA, Nausea and vomiting, Chest pain, Extravasated necrosis

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26
Q 
Dopamine HCL (Intropin) 
Dose (adult)
A

2-5mcg/kg/min IV/IO infusion (low dose) causes increased blood flow to mesentery renal (GUT)
5-10mcg/kg/min IV/IO infusion (medium dose) stimulates beta effects
10-20mcg/kg/min IV/IO infusion (high dose) stimulates alpha effects

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27
Q 
Dopamine HCL (Intropin) 
Dose (pedi)
A

2-20mcg/kg/min IV/IO infusion

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28
Q 
Dopamine HCL (Intropin) 
Precautions
A

Must be kept out of direct sunlight

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29
Q 
Dopamine HCL (Intropin) 
Drug-Drug interactions
30
Q

Norepinephrine (levophed)

Drug classification

A

Sympathomimetic
Sympathetic agonist
Catecholamine

31
Q

Norepinephrine (levophed)

Mechanism of action

A
  • primary* alpha 1 agonist -> second messenger release of Ca2+ in VSMC -> peripheral vasoconstriction -> increased SVR -> increased BP
  • secondary* beta 1 agonist -> increased intracellular Ca2+ in cardiac cells -> positive inotropy, chronotropy, dromotropy
32
Q

Norepinephrine (levophed)

Pharmacokinetics

A

Onset : <1 minute
Peak : <2 minutes
Duration : 1-2 minutes
Half-life : 3 minutes

33
Q

Norepinephrine (levophed)

Indications / field use

A

Cardiogenic shock
Septic shock following fluid resuscitation
Neurogenic shock

34
Q

Norepinephrine (levophed)

Contraindications

A

Hypovolemia

35
Q

Norepinephrine (levophed)

Side effects / adverse reactions

A

Norepi Tries to Help Really Dangerous Agonists not Dysrhythmias

Nausea and vomiting, tremulousness, HA, Reflex bradycardia, Dizziness, Anxiety, Dysrhythmias

36
Q

Norepinephrine (levophed)

Dose (adult)

A

1-30mcg/min IV/IO infusion - titration to systolic BP 90mmHg

37
Q

Norepinephrine (levophed)

Dose (pedi)

A

0.1-2mcg/kg/min IV/IO infusion - titration to normotensive systolic BP

38
Q

Norepinephrine (levophed)

Precautions

A

Can cause tissue necrosis with extraversion
Caution with CAD

lead to increased myocardial oxygen demand

39
Q

Norepinephrine (levophed)

Drug-Drug interactions

A

MAOI and TCA may potentiate cardiovascular effects

40
Q

Phenylephrine (Neo-Synephrine)

Drug classification

A

Sympathomimetic

Sympathetic agonist

41
Q

Phenylephrine (Neo-Synephrine)

Mechanism of action

A

Alpha 1 agonist -> second messenger release of calcium in VSMC -> peripheral vasoconstriction -> increased SVR -> increased BP

42
Q

Phenylephrine (Neo-Synephrine)

Pharmacokinetics

A

Onset : immediate
Peak : <1 minute
Duration : 15-20 minutes
Half-life : 2 minutes

43
Q

Phenylephrine (Neo-Synephrine)

Indications / field use

A

Septic shock following fluid resuscitation

Neurogenic shock

44
Q

Phenylephrine (Neo-Synephrine)

Contraindications

A

Cardiogenic shock

45
Q

Phenylephrine (Neo-Synephrine)

Side effects / adverse reactions

A

Hypertension Decreases Need to Titrate

Dysrhythmias, hypertension, nausea and vomiting, tremulousness

46
Q

Phenylephrine (Neo-Synephrine)

Dose (adult)

A

100-180mcg/min IV/IO infusion until BP > 90 systolic

47
Q

Phenylephrine (Neo-Synephrine)

Dose (pedi)

A

0.1-0.5mcg/kg/min

48
Q

Phenylephrine (Neo-Synephrine)

Precautions

A

Can cause tissue necrosis with extravasation

49
Q

Phenylephrine (Neo-Synephrine)

Drug-Drug Interactions

A

Deactivated by alkaline solutions

Caution in pts with digitalis toxicity, may aggravate tachydysrhythmias

50
Q

Procainamide (Pronestyl)

Drug classification

A

Antidysrhythmic

51
Q

Procainamide (Pronestyl)

Mechanism of action

A

Class 1A antiarrhythmic / moderate Na+ channel blocker -> decreases slope and amplitude of phase 0 depolarization for non-pacemaker action potential

52
Q

Procainamide (Pronestyl)

Pharmacokinetics

A

Onset : 10-30 minutes
Peak : 15-20 minutes
Duration : 3-6 hours
Half-life : 3 hours

53
Q

Procainamide (Pronestyl)

Indications / field use

A

Recurrent cardiac arrest secondary to VT/VF refractory to amiodarone

54
Q

Procainamide (Pronestyl)

Contraindications

A

Severe conduction disturbances, especially 2nd degree and 3rd degree heart blocks
PVC’s with bradycardia

55
Q

Procainamide (Pronestyl)

Side effects / adverse reactions

A

Drowsiness, seizures, confusion, hypotension, bradycardia, heart blocks, nausea & vomiting, respiratory and cardiac arrest

56
Q

Procainamide (Pronestyl)

Dose (adult)

A

20mg/min infusion until one of D/C precautions observed

1-4mg/min maintenance

57
Q

Procainamide (Pronestyl)

Dose (pedi)

A

15mg/kg IV/IO over 30-60 minutes

58
Q

Procainamide (Pronestyl)

Precautions

A 
D/C if: 
Dysrhythmia is suppressed
Hypotension occurs
QRS complex widens by 50%
17mg/kg of procainamide has been administered
59
Q

Procainamide (Pronestyl)

Drug-Drug Interactions

A

Chance of neurotoxicity increases if given with lidocaine

60
Q

Magnesium Sulfate

Drug classification

A

Electrolyte

Antidysrhythmic

61
Q

Magnesium Sulfate

Mechanism of action

A
  • SMC* Ca2+ channel blocker -> inhibits Ca2+ entry and subsequent interaction between actin and myosin in SMC -> smooth muscle relaxation and dilation of blood vessels and bronchial tree
  • Cardiac* Ca2+ channel blocker -> negative inotropy, chronotropy, dromotropy
62
Q

Magnesium Sulfate

Pharmacokinetics

A

Onset : immediate IV, 1 hour IM
Peak : varies
Duration : 1 hour
Half-life : N/a

63
Q

Magnesium Sulfate

Indications / field use

A

Severe asthma / bronchospasm
Severe refractory VF or pulseless VT with hypoMg2+
Torsades de pointes
Eclampsia

64
Q

Magnesium Sulfate

Contraindications

A

Third degree heart block, hypotension

65
Q

Magnesium Sulfate

Indications / Field Use

A

Severe asthma / Bronchospasm
Severe refractory VF or pulseless VT w hypoMg2+
Torsades de Pointes
Eclampsia

66
Q

Magnesium Sulfate

Contraindications

A

There degree heart block, hypotension

67
Q

Magnesium Sulfate

Side Effects / Adverse Reactions

A

Dude, First Itching Becomes Rashes Due to Severe Respiratory Hypotension

Drowsiness, Flushing, Itch, Bradycardia, Rash, Dysrhythmias, Sweating, Respiratory depression, Hypotension

68
Q

Magnesium Sulfate

Dose (Adult)

A

Asthma: 2g in 10cc NS IV/IO infusion over 10 minutes
VT, VF, Torsades-no pulse: 2g IV/IO over 1-2 minutes
VT/Torsades: 1-2g in 50-100cc NS IV/IO over 5-60 minutes
Eclampsia: 4mg in 20mL IV/IO over 5 minutes

69
Q

Magnesium Sulfate

Dose (Pedi)

A

Asthma: 25-50mg/kg IV/IO infusion over 15-30 minutes, max dose 2g
VT/Torsades - no pulse: 25-50mg/kg IV/IO, max dose 2g
VT/Torsades + pulse: 25-50mg/kg IV/IO over 10-20 minutes, max dose 2g

70
Q

Magnesium Sulfate

Precautions

A

No benefit with COPD
Caution with impaired renal function
Watch for respiratory depression

71
Q

Magnesium Sulfate

Drug-Drug Interactions

A

Cardiac conduction abnormalities if give with digitalis

CARDIAC DRUGS (1 decks)

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