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My P1 Drug Cards > Cardiology Drugs > Flashcards

Cardiology Drugs Flashcards

1
Q

Class I antidysrhythmic

A 
Na channel blocker
works in ventricles
slows conduction
decreases repolarization rate
widens QRT with prolonged QT interval
Ind: lower blood pressure / decrease SVR
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2
Q

Adenosine MOA / Description

A

decreases conduction of electrical impulses through the AV Node / interrupts AV reentry pathways in PSVT
rapid onset: 20-30sec
rapid half life: 10sec

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3
Q

Adenosine Indications

A

symptomatic PSVT / Atrial dysrhythmias with RVR / wide complex tachycardias / can be therapeutic or diagnostic

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4
Q

Adenosine class

A

Class V anti-arrhythmic (misc)

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5
Q

Adenosine contraindications

A

irregular AFib / polymorphic tach (torsade de pointes / 2nd/3rd degree block

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6
Q

Adenosine Precautions / Side effects

A

Pre: Typically causes arrhythmias / Transient Asystole /Asthma

SE: facial flushing, headache, SOB, dizziness, nausea

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7
Q

Adenosine Dose / Pharmocokinetics

A

6mg IV/IO rapid followed by flush
12mg follow up after 2 min
12mg follow up after 2 more minutes
30mg max

Onset: 20-30sec
Peak: 20-30sec
Duration: 30sec
Half-Life: 10sec

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8
Q

Class II antidysrhythmic

A 
Beta adrenergic antagonist
ends with OLOL
Ind: lower blood pressure / decrease SVR
also block Ca channels
should not be us with Ca blocker
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9
Q

Class III

A

K channel blocker
prolongs absolute refractory period, repolarization, and QT intervals
IND: atrial or vent tach

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10
Q

Class IV Antidysrhythmic

A

Ca channel blocker
decreases SA/AV automaticity and conduction
Blocks B1 receptors

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11
Q

Amiodarone Class

A

Class III Antiarrhythmic - K channel blocker (primarily)

also some Na channel blocker properties

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12
Q

Amiodarone MOA / Description

A

improves the rate of ROSC in adults with refractory V-Fib and PV-Tac
can also be used in supraventricular tachycardias
prolongs the action potential duration in ALL cardiac tissues

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13
Q

Amiodarone Indications

A

V-Tac / V-Fib
Can also be used for: A-FIb / stable regular narrow tach
to control rapid ventricular rate due to accessory pathways

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14
Q

Amiodarone Contraindications

A

Brest feeding Pts in cardiogenic shock

2nd/3rd blocks, symptomatic bradycardia

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15
Q

Amiodarone Precautions / Side Effects

A

Prec: Pts with latent/manifest heart failure
SE: hypotension, bradycardia, increased PVCs, prlonged PRs, QRSs, and QTs / monitor for pulmonary toxicity (dyspnea/cough)

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16
Q

Amiodarone Dose / Pharmocokinetics

A

V-Fib / PV-Tac = 300mg IV/IO/1min / repeat 150mg up to 450mg total
Narrow-tach = 150mg IV/IO/10min, repeat as necessary /
followed by 1mg/min infusion over 6hrs, then 0.5mg/min as needed

Onset: 2-3days oral
Peak: 3-7hrs oral
Duration: varies
1/2 life: 40-55days

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17
Q

Atropine Sulfate Class

A

Anticholinergic: blocks acetylcholine / inhibits sympathetic nervous system

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18
Q

Atropine Sulfate MOA / Description

A

parasympatholytic used to increase heart rate in hemodynamically significant (unstable) bradycardias

+ chronotropic properties / no inotropic effect

Antidote in organophosphate poisonings

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19
Q

Atropine Sulfate Indications

A

Heomodynamically significant bradycardia with a pulse

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20
Q

Atropine Sulfate Contraindications

A

none in emergency situations

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21
Q

Atropine Sulfate Precautions / Side Effects

A

Prec: coronary artery disease b/c the increased HR may worsen ischemia / can worsen bradycardia associated w/ 2:2 & 3rd degree blocks

SE: blurred vision, dilated pupils, dry mouth, tachycardia, drowsiness, confusion

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22
Q

Atropine Sulfate Dosage / Pharmocokinetics

A

0.5mg IV / repeat every 3-5min until max dose of 3mg is reached

Onset: immediate
Peak: 2-4min
Duration: 4hrs
1/2 life: 2-3hrs

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23
Q

Calcium Chloride Class

A

Calcium supplement

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24
Q

Calcium Chloride MOA / Description

A

MOA: replaces Ca in cases of hypocalcemia / increased inotropic effect

Desc: provides elemental calcium

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25
Q

Calcium Chloride Indications

A

acute hyperkalemia
acute hypocalcemia
calcium channel blocker toxicity/OD (nifedipine, verapamil, diltiazem

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26
Q

Calcium Chloride Contraindications

A

Pt on Digitalis because it may precipitate digitalis toxicity

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27
Q

Calcium Chloride Precautions / Side Effects

A

Prec: must flush line between Ca chloride and Na bicarb to avoid precipitation / tissue necrosis

SE: bradycardia, arrhythmias, syncope, nausea, vomiting, cardiac arrest

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28
Q

Calcium Chloride Dose / Pharmocokinetics

A

2-4mg/kg IV/IO repeat every 10min as needed
should only be given in emergency setting

Onset: Immediate
Peak: unknown
Duration: varies
1/2 life: NA

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29
Q

Diltiazem (Cardizem) Class

A

Class III antiarrhythmic (Ca channel blocker)

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30
Q

Diltiazem (Cardizem) MOA / Description

A

MOA: causes vascular dilation or coronary arteries / relaxation of vascular smooth muscle / slows conduction through the AV node / slows rapid ventricular rate associated with A-Fib and A-flut

Desc: calcium channel blocker

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31
Q

Diltiazem (Cardizem) Indications

A

Narrow complex tachycardias (A-Fib / A-Flut)

recurrent SVT refractory to vagal maneuvers and adenosine

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32
Q

Diltiazem (Cardizem) Contraindications

A

severe hypotension, CHF, cardiogenic shock
V -Tac
WPW syndrome

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33
Q

Diltiazem (Cardizem) Precautions / Side Effects

A

Prec: systemic hypotension / keep refrigerated (can be kept at room temp for 1month)

SE: nausea, vomiting, dizziness, headache, bradycardia, heart block, hypotension, asystole

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34
Q

Diltiazem (Cardizem) Dose /Pharmocokinetics

A

initial: 0.25mg/kg IV/IO over 2min
Additional bolus 0.35mg/kg over 2min
maintenance infusion 5-15mg/hr titrate for effect

Onset: 3min
Peak: 7min
Duration: 1-3hrs
1/2 life: 2hrs

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35
Q

Furosemide (Lasix) Class

A

Diuretic

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36
Q

Furosemide (Lasix) MOA / Description

A

MOA: inhibits the reabsorption of Na and chloride in kidneys / cause venous dilation within 5min / diuretic effect in 5-15min

Desc: Same as above

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37
Q

Furosemide (Lasix) Indications

A

adjunct to Nitro and ACE inhibitors
CHF
Pulmonary edema

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38
Q

Furosemide (Lasix) Contraindications

A

Pregnancy unless life threatened

Sulfa allergy

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39
Q

Furosemide (Lasix) Precautions / Side Effects

A

Precautions: dehydration, electrolyte depletion, hypotension / protect from light

SE: headache,dizziness, hypotension, volume depletion, potassium depletion, arrhythmias, diarrhea, nausea, vomiting

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40
Q

Furosemide (Lasix) Dose / Pharmocokinetics

A

40mg IV/IO slow push for Pt ALREADY on oral furosemide
20mg IV/IO slow push for Pt NOT on oral furosemide
Up to 80-120mg in severe cases

Onset: 5-10min
Peak: 30min
Duration: 2hrs (vasodilation) / 6hrs (diuresis)
1/2 life: 30min

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41
Q

Labetalol Class

A

Class II antiarrhythmic / Non-selective beta-blocker

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42
Q

Labetalol MOA / Description

A

non selective Beta1/2 and Alpha1 blocker / inhibits peripheral vasoconstriction, thus causing peripheral vasodilation / lowers blood pressure by decreasing cardiac output through Beta1 blocking properties

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43
Q

Labetalol Indications

A

Hypertensive emergency (elevated BP w/ AMS, CP, renal failure)

NOT HTN w/ headache or HTN associated anxiety

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44
Q

Labetalol Contraindications

A

Bronchial asthma, CHF, Heart block, bradycardia, cardiogenic shock

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45
Q

Labetalol Precautions / Side Effects

A

Precautions: continuously monitor BP, pulse rate, ECG, respiratory status / anticipate postural hypotension / Pt should be supine at all times during med administration

SE: bradycardia, hypotension, lethargy, CHF, dyspnea, wheezing, weakness

Incompatiblity: Pt who received class IV antiarrhythmics (Ca channel blocker)

Caution: Pt taking antihypertensive agents

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46
Q

Labetalol Dose / Pharmocokinetics

A

2 methods:
1. 20mg IV/IO/2min

Additional 40mg IV/IO/2min every 10min until desired supine BP is achieved max 300mg

  1. 500mg in 250mL D5W = 1mg/mL / give 2mg/min until desired supine BP is achieved max 300mg

Onset: 2-5min
Peak: 5-15min
Duration: 2-4hrs
1/2 Life: 3-8hrs

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47
Q

Metoprolol (Lopressor) Class

A

Class II antiarrhythmic (selective Beta blocker)

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48
Q

Metoprolol (Lopressor) MOA / Description

A

Desc: Beta antagonist that blocks both Beta1 and Beta2 receptors / selective for Beta1 with minimal effect on Beta2 at doses <100mg

MOA: reduction in HR, systolic BP, and CO / inhibits tachycardia / reduces incidences of V-Fib and CP

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49
Q

Metoprolol (Lopressor) Indications

A

Suspected or definite Acute MI w/ HTN
Stable, narrow tach if uncontrolled/unconverted by adenosine and vagal maneuvers / or if SVT is recurrent
Controls vent rate in Pts w/ AFib or AFlut

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50
Q

Metoprolol (Lopressor) Contraindications

A

HR <45 / Systolic BP <100 / CHF / Heart block Pts / shock / asthma / bronchospastic disease

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51
Q

Metoprolol (Lopressor) Precautions / Side Effects

A

Prec: be alert for S&S of CHF, bradycardia, shock, heart block, and bronchospasm

SE: bradycardia, hypotension, lethargy, CHF, dyspnea, wheezing, weakness

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52
Q

Metoprolol (Lopressor) Dose / Pharmacokinetics

A

Initial 5mg IV/IO slow push
2nd dose 5mg IV/IO slow 2min later if well tolerated / stable vitals
3rd dose5 mg IV/IO slow 2min later if well tolerated / stable vitals

MAX DOSE 15mg

Onset: immediate
Peak: 20min
Duration: 5-8hrs
Half-Life: 3-4hrs

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53
Q

Norepinephrine (Levophed) Class

A

Sympathetic agonist

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54
Q

Norepinephrine (Levophed) Description / MOA

A

Desc: nonselective catecholamine (sympathetic agonist) heavier towards Alpha

MOA: Alpha receptors = potent peripheral vasoconstriction therefore increased BP in cardiogenic shock or other hypotensive emergencies

55
Q

Norepinephrine (Levophed) Indications

A

Hypotension (systolic < 70) not related to hypovolemia or septic shock

56
Q

Norepinephrine (Levophed) Contraindications

A

Hypotension due to hypovolemia / sepsis

57
Q

Norepinephrine (Levophed) Precautions / Side Effects

A

Prec: monitor BP for HTN / fluids initiated prior to admin of norepi / may cause local tissue necrosis / increases myocardial O2 demand

SE: anxiety, tremors, headache, dizziness, nausea, vomiting

58
Q

Norepinephrine (Levophed) Dose / Pharmacokinetics

A

0.1-0.5mcg/minute max of 30mcg/min IV/IO

Onset: immediate
Peak: < 1min
Duration: 1-2min
1/2 Life: 3min

59
Q

Aspirin (ASA) Class

A

Platelet aggregation inhibitor / Anti-inflammatory

60
Q

Aspirin (ASA) MOA / Description

A

MOA: blocks the formation of thromboxane A2 which causes platelets to aggregate and arteries to constrict

Desc: anti-inflammatory and inhibitor of platelet function

61
Q

Aspirin (ASA) Indications

A

New CP suggestive of ACS and S&S of recent stroke

62
Q

Aspirin (ASA) Contraindications

A

Relatively contraindicated in Pts with active ulcer disease and asthma

63
Q

Aspirin (ASA) Precautions / Side Effects

A

Prec: may cause GI upset/bleeding / Pts with allergies to NSAIDs

SE: heartburn, GI bleeds, nausea, vomiting, wheezing, prolonged bleeding

64
Q

Aspirin (ASA) Dose / Pharmacokinetics

A

Dose: 160-325mg immediately after onset of CP

Onset: 5-30min
Peak: 15-120min
Duration: 1-4hrs
1/2 life: 15-20min

65
Q

Nitroglycerin Class

A

Nitrate

66
Q

Nitroglycerin MOA / Description

A

MOA: rapid smooth muscle relaxant that reduces cardiac work and dilates coronary arteries, results in increased coronary blood flow and improved perfusion of ischemic myocardium / causes vasodilation which decreased preload leading to decreased ventricular filling therefore reduced O2 demand

Desc: smooth muscle relaxant used for angina

67
Q

Nitroglycerin Indications

A

CP associated with ACS and acute pulmonary edema (unless accompanied by hypotension) / first line therapy for acute CHF

68
Q

Nitroglycerin Contraindications

A

Hypotension / possible increased ICP / Pt in shock

69
Q

Nitroglycerin Precautions / Side Effects

A

Prec: Pts develop tolerance / deteriorates quickly especially if exposed to light

SE: headache, dizziness, weakness, tachycardia, hypotension, orthostasis, skin rash, dry mouth, nausea, vomiting

70
Q

Nitroglycerin Dose / Pharmacokinetics

A

Dose: 0.4mg SL repeated every 3-5min up to 3 tablets

Onset: 1-3min
Peak: 5-10min
Duration: 20-30min
1/2 life: 1-4min

71
Q

Nitroglycerin Paste Class

A

Nitrate

72
Q

Nitroglycerin Paste Description / MOA

A

Desc: 2% solution of nitro and special absorbent pasted / absorbed into systemic circulation through skin / longer duration of action

MOA: smooth muscle relaxant

73
Q

Nitroglycerin Paste Indications

A

CP associated with angina pectoris or AMI

74
Q

Nitroglycerin Paste Contraindications

A

Increased ICP / Hypotension / Shock

75
Q

Nitroglycerin Paste Precautions / Side Effects

A

Prec: increased tolerance / postural syncope may occur

SE: headache, dizziness, weakness, tachycardia, hypotension, orthostasis, skin rash, dry mouth, nausea, vomiting

76
Q

Nitroglycerin Paste Dose / Pharmacokinetics

A

Dose: 1/2-1” of Niro-Bid Ointment is applied

Onset: 30min
Peak: varies
Duration: 3-6hrs
1/2 Life: 1-4min

77
Q

Epinephrine 1:10000 (Adrenalin) Class

A

Sympathetic Agonist

78
Q

Epinephrine 1:10000 (Adrenalin) MOA / Description

A

Desc: catecholamine with both Alpha and Beta adrenergic stimulant effect

MOA: acts directly on Alpha and Beta receptors / causes increased HR, cardiac contractile force, electrical activity in myocardium, systemic vascular resistance, BP, automaticity

79
Q

Epinephrine 1:10000 (Adrenalin) Indications

A

Cardiac arrest, severe anaphylaxis, severe reactive airway disease, symptomatic bradycardia refractory to to atropine

80
Q

Epinephrine 1:10000 (Adrenalin) Contraindications

A

Pts who do not require extensive cardiopulmonary resuscitative efforts / with simple allergic reactions and asthma 1:10 should be used IM

81
Q

Epinephrine 1:10000 (Adrenalin) Precautions / Side Effects

A

Prec: protect from light / can be deactivated by alkaline solutions like Sodium Bicarb

SE: palpitations, anxiety, tremors, headache, dizziness, nausea, vomiting, strong inotropic and chronotropic properties cause increased myocardial O2 demand

82
Q

Epinephrine 1:10000 (Adrenalin) Dose / Pharmacokinetics

A

Cardiac arrest (adult): 1mg of 1:10 IV/IO every 3-5min / ETT dose is increased 2-2.5times
Cardiac Arrest (child): 0.01mg/kg IV/IO (0.1mL/kg) every 3-5min
Severe anaphylaxis/asthma (adult): 0.05-0.1mg IV/IO of 1:10 every 5-15min / 1:1 IM / epi drip may be required
Severe anaphylaxis/asthma (child): 1:1 IM / 0.01mg/kg IV/IO every 5-15min

Onset: < 2min
Peak: < 5min
Duration: 5-10min
1/2 Life 5min

83
Q

Magnesium Sulfate Class

A

Antiarrhythmic

84
Q

Magnesium Sulfate MOA / Description

A

MOA: physiological Calcium channel blocker and blocks neuromuscular transmission / hypomagnesemia is associated with arrhythmia, cardiac insufficiency and sudden death

Desc: essential element in numerous biochemical reactions in the body

85
Q

Magnesium Sulfate Indications

A

Torsade de pointes (irregular, polymorphic VTac associated with prolonged QT)

86
Q

Magnesium Sulfate Contraindications

A

Pts in shock / persistent severe HTN / 3rd degree AV block / Pts who routinely undergo dialysis / known hypocalcemia

87
Q

Magnesium Sulfate Precautions / Side Effects

A

Prec: slow push to minimize side effects / use caution in Pts with known renal insufficiency / hypermanesemia can occur Calcium chloride/gluconate should be available as antidote

SE: flushing, sweating, bradycardia, decreased deep tendon relexes, drowsiness, respiratory depression, arrhythmia, hypotension, hypothermia, itching, rash

Incompatibility: can cause cardiac conduction abnormalities if administered with digitalis

88
Q

Magnesium Sulfate Dose / Pharmacokinetics

A

Dose: 1-2g diluted in 10mL of D5W for Torsade de Points
1-2g diluted in 100mL of D5W over 15min

Onset: Immediate
Peak: varies
Duration: 1hr
1/2 Life: NA

89
Q

Morphine Class

A

Narcotic analgesic

90
Q

Morphine MOA / Description

A

MOA: CNS depressant that acts on opiate receptors in brain , providing analgesia and sedation / decreases myocardial O2 demand

Desc: CNS depressant

91
Q

Morphine Indications

A

severe pain associated with MI, kidney stones, etc. use in PE and CHF has been limited in favor of more vasoactive agents (nitro, ACE inhibitors)

92
Q

Morphine Indications

A

severe pain associated with MI, kidney stones, etc. use in PE and CHF has been limited in favor of more vasoactive agents (nitro, ACE inhibitors)

93
Q

Morphine Indications

A

severe pain associated with MI, kidney stones, etc. use in PE and CHF has been limited in favor of more vasoactive agents (nitro, ACE inhibitors)

94
Q

Morphine Contraindications

A

Pts who are volume depleted / severe hypotension / undiagnosed head injury or abdominal pain

95
Q

Morphine Precautions / Side Effects

A

Prec: high tendency for addiction or abuse / Schedule II medication / respiratory depression / narcan should be available

SE: nausea, vomiting, abdominal cramps, blurred vision, constricted pupils, AMS, headache, respiratory depression

96
Q

Morphine Dose / Pharmacokinetics

A

Dose: 2-10mg IV with additional 2mg IV every few minutes until pain is relieved or respiratory depression occurs / 5-15mg IM / normally given with antiemetic to help prevent nausea/vomiting

Onset: IV = immediate / IM = 15-30min
Peak: IV = 20min / IM = 30-60min
Duration: 2-7hrs
1/2 Life: 1-7hrs

97
Q

Lidocaine Class

A

Antiarrhythmic

98
Q

Lidocaine Description / MOA

A

Desc: local anesthetic / used to treat life threatening ventricular arrhythmias

MOA: depresses depolarization and automaticity in ventricles with very little effect on atrial tissue

99
Q

Lidocaine Indications

A

VTach and VFib refractory to Amiodarone

100
Q

Lidocaine Contraindications

A

2nd degree type 2 block / 3rd degree block

101
Q

Lidocaine Precautions / Side Effects

A

Prec: CNS depression may occur when dose exceeds 300mg/hr / high doses can result in coma and death / routine prophylactic lidocaine therapy fo AMI in no longer recommended

SE: drowsiness, slurred speech, seizure, confusion, hypotension, bradycardia, heart blocks, nausea, vomiting, respiratory arrest, cardiac arrest

102
Q

Lidocaine Precautions / Side Effects

A

Prec: CNS depression may occur when dose exceeds 300mg/hr / high doses can result in coma and death / routine prophylactic lidocaine therapy fo AMI in no longer recommended

SE: drowsiness, slurred speech, seizure, confusion, hypotension, bradycardia, heart blocks, nausea, vomiting, respiratory arrest, cardiac arrest

103
Q

Lidocaine Precautions / Side Effects

A

Prec: CNS depression may occur when dose exceeds 300mg/hr / high doses can result in coma and death / routine prophylactic lidocaine therapy fo AMI in no longer recommended

SE: drowsiness, slurred speech, seizure, confusion, hypotension, bradycardia, heart blocks, nausea, vomiting, respiratory arrest, cardiac arrest

104
Q

Lidocaine Precautions / Side Effects

A

Prec: CNS depression may occur when dose exceeds 300mg/hr / high doses can result in coma and death / routine prophylactic lidocaine therapy fo AMI in no longer recommended

SE: drowsiness, slurred speech, seizure, confusion, hypotension, bradycardia, heart blocks, nausea, vomiting, respiratory arrest, cardiac arrest

105
Q

Lidocaine Dose / Pharmacokinetics

A

Dose: Hemodynamically stable monomorphic VTach
Initial: 1.0-1.5mg/kg / boluses of 0.5-0.75mg/kg repeated every 5-10min / max dose of 3.0mg/kg / once arrhythmia is suppressed a 2-4mg/min drip should be initiated
Reduce by 50% for >70YO / liver disease / heart failure / bradycardias / conduction disturbances

Onset: < 3min
Peak: 5-7min
Duration: 10-20min
1/2 Life: 1.5-2hrs

106
Q

Procainamide (Pronestyl) Class

A

Antiarrhythmic

107
Q

Procainamide (Pronestyl) Description / MOA

A

Desc: ester-type local anesthetic / used for life threatening ventricular arrhythmias refractory to other antiarrhythmics

MOA: suppresses ventricular ectopy / reduces automaticity of various pacemaker sites / slows intraventricular conduction to a much greater degree than Lidocaine

108
Q

Procainamide (Pronestyl) Indications

A

VTac w/ pulse / pre-excited AFib

109
Q

Procainamide (Pronestyl) Contraindications

A

severe conduction system disturbances, especially 2nd or 3rd degree blocks

110
Q

Procainamide (Pronestyl) Precautions / Side Effects

A

Prec: avoid in Pts with prolonged QT syndrome or CHF / hypotension is common

SE: drowsiness, seizures, confusion, hypotension, bradycardia, heart blocks, nausea, vomiting, respiratory arrest, cardiac arrest

111
Q

Procainamide (Pronestyl) Dose / Pharmacokinetics

A

Dose: 20-50mg/min until arrhythmia is suppressed / discontinue if: arrhythmia is suppressed, Hypotension occurs, QRS is widened by 50% of original width, a total of 17mg/kg has been administered
Maintenance infusion of 1-4mg/kg (generally 1g in 500mL of D5W or NS = 2mg/mL

Onset: 10-30min
Peak: 15-20min
Duration: 3-6hrs
1/2 Life: 3hrs

112
Q

Clopidogrel (Plavix) Class

A

Platelet aggregation inhibitor (ADP Inhibitor)

113
Q

Clopidogrel (Plavix) Description / MOA

A

Desc: adenosine diphosphate (ADP) platelet aggregation inhibitor

MOA: inhibits platelet aggregation by selectively binding to adenlyate cyclase-coupled ADP receptors on the surface of platelets

114
Q

Clopidogrel (Plavix) Indications

A

Treatment of ACS / recent MI, stroke, or established peripheral vascular disease

115
Q

Clopidogrel (Plavix) Contraindications

A

presence of a hemostatic disorder / active pathological bleeding (eg: bleeding peptic ulcer, intracranial bleeding, etc)

116
Q

Clopidogrel (Plavix) Precautions / Side Effects

A

Prec: Pts taking NSAIDS

SE: increased risk of bleeding, fever, allergic reactions, myalgias, arthralgia, bronchospasm, skin rash

117
Q

Clopidogrel (Plavix) Dose / Pharmacokinetics

A

Non STE ACS (UA/NSTEMI): 300mg loading dose PO, followed by 75mg PO once daily in combo w/ ASA 75-325mg PO once daily)
STEMI: 75mg PO once daily w/ ASA 75-325 PO
Recent MI, Stroke, or established peripheral arterial disease: 75mg once daily

Onset: 2hrs
Peak: 3-7days
Duration: 7-10days
1/2 Life: 7-8hrs

118
Q

Heparin Class

A

Anticoagulant (unfractionated)

119
Q

Heparin Description / MOA

A

Desc: rapid acting anticoagulant prepared from bovine lung tissue or porcine intestinal mucosa

MOA: indirect inhibitor of thrombin, blocks the conversion of prothrombin to thrombin / prevents the conversion of fibrinogen to fibrin

120
Q

Heparin Indications

A

inhibit clot formation in ACS / adjunct in fibrinolysis / helps prevent PE and DVT

121
Q

Heparin Contraindications

A

Hypersensitivity to pork and beef products

122
Q

Heparin Precautions / Side Effects

A

Prec: do not use in Pts with active major bleeding or thrombocytopenia / caution in Pts with chronic alcoholism, Hx of atrophy or anaphylaxis, and pregnant (especially the last trimester)

SE: CNS confusion and dizziness / Cardiovascular: edema, CP, irregular heart beat / Injection site: irritation, pain, erythema, bruising / Other: bleeding complications, agioedema, rash, urticaria

Interactions: NSAIDS, warfarin, antiplatelet agents

123
Q

Heparin Dose / Pharmacokinetics

A

Adult STEMI / unstable angina: 60U/kg IV (max of 4000U) followed by 12U/kg/hr (max 1000U/hr) often given with alteplase (rtPA)
Adult NSTEMI / unstable angina: 60-70U/kg IV bolus (max 5000U) followed by 12-15U/kg/hr infusion
Pediatric: 50U/kg followed by IV infusion based on lab values and body mass

Onset: Immediate
Peak: 2-3min
Duration: 2-6hrs
1/2 Life: 90min

124
Q

Esmolol (Brevibloc) Class

A

Class II antiarrhythmic (selective Beta blocker)

125
Q

Esmolol (Brevibloc) Description / MOA

A

Desc: Beta1 selective blocker w/ very short half life

MOA: Beta1 blocker / rapid onset / shourt duration of action (9min) / used to slow rapid heart rates in Pts with SVT, AFlut, AFib /

126
Q

Esmolol (Brevibloc) Indications

A

Stable, narrow complex Tachs refractory to adenosine or vagal maneuvers or if SVT is recurrent

Control ventricular rate in Pts with AFib or AFlut

Certain forms of polymorphic VT (associated with acute ischemia, familial Long QT Syndrome, catecholaminergic

127
Q

Esmolol (Brevibloc) Contraindications

A

Pts with sinus bradycardia, heart block greater than first degree, cardiogenic shock, overt CHF

128
Q

Esmolol (Brevibloc) Precautions / Side Effects

A

Prec: hypotension which is primarily dose related (may need to reduce dose) / CHF may worsen / Pts with bronchospastic diseases (asthma/COPD) should not use unless medical control physician deems that the benefits outweigh the risks

SE: bradycardia, dizziness, hypotension, lethargy, CHF, dyspnea, wheezing, weakness

Incompatibilities: Pts who received IV Calcium channel blockers / Morphine can increase the blood levels of esmolol

129
Q

Esmolol (Brevibloc) Dose / Pharmacokinetics

A

Loading dose: 500mcg/kg over 1min
Maintenance dose: 50mcg/kg/min for 4min
If therapeutic effect is not seen then repeat loading dose of 500mcg/kg followed by 100mcg/kg/min for 4min
Can be tirated at 4min intervals by repeating the loading dose and increasing the maintenance dose by 5omcg/kg/min
Max maint dose is 300mcg/kg/min

Onset: < 5min
Peak: 10-20min
Duration: 10-30min
1/2 Life: 2-9min

130
Q

Sodium Nitroprusside (Nitropress, Nipride) Class

A

Antihypertensive and vasodilator

131
Q

Sodium Nitroprusside (Nitropress, Nipride) Description / MOA

A

Desc: potent vasodilator used in management of HTN emergencies

MOA: dilates both peripheral arteries and peripheral veins causing immediate reduction in BP / occasionally used for severe CHF (although not approved)
Use almost always requires ICU admission

132
Q

Sodium Nitroprusside (Nitropress, Nipride) Indications

A

HTN emergency

133
Q

Sodium Nitroprusside (Nitropress, Nipride) Contraindications

A

None when used in the management of life threatening HTN crisis

134
Q

Sodium Nitroprusside (Nitropress, Nipride) Precautions / Side Effects

A

Prec: once infusion is prepared it must be immediately wrapped to protect from light, quickly inactivated / shouldn’t be used in peds or pregnant women / dose should be reduced in elderly Pts / constant monitoring of BP and HR required

SE: dizziness, headache, hypotension, CP, dyspnea, palpitations, nausea, vomiting / can also cause cyanide toxicity in higher doses

My P1 Drug Cards (3 decks)

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