Cardiology - Drugs Flashcards
Adenosine (Adenocard)
Dose:
Onset and Duration:
Dose - Adult: 6, 12, 12. Follow each dose with a 10-20 mL rapid bonus and elevate the extremity. (2nd dose, if needed, 1-2 min later)
Dose - Pediatric: 0.1mg/kg, 0.2mg/kg. Follow each dose with a 5mL rapid bonus and elevate the extremity.
Onset: Immediate
Duration: 6-10 seconds
Adenosine (Adenocard)
Class:
MOA:
Class: Antidysrhythmic; Endogenous nucleoside
MOA: Slows conduction at the AV node by inducing hyper-polarization of the AV node, causing a temporary absolute refractory period where no further signal can travel through the AV node
Adenosine (Adenocard)
Indications:
Side Effects:
Indications: Narrow complex SVT
Side Effects: Patient may experience sense of impending doom, flushing, chest pressure, throat tightness or numbness (all generally mild and short-lived); may have brief episode of asystole
Adenosine (Adenocard)
Contraindications:
Considerations:
Contraindications: Second or third degree heart block, or sick sinus syndrome.
Considerations: Should be administered through a large-bore IV; closer to the heart the better; half dose on patient on carbamepazine or dipyridamole
Amiodarone (Cordarone)
Dose:
Onset and Duration:
Dose - Pulseless Adult: 300mg IV/IO, repeat dose 150mg IV/IO
Dose - Pulseless Pediatric: 5mg/kg IV/IO, repeat to MAX 15mg/kg
Dose - Stable Adult: 150mg in 100mL D5W over 10min; repeat every 10 min or 0.5-1mg/min infusion
Dose - Stable Pediatric: 5mg/kg IV/IO over 20-60min; repeat to MAX 15mg/kg
Onset: Minutes
Duration: Variable
Amiodarone (Cordarone)
Class:
MOA:
Class: Antidysrhythmic
MOA: Delays depolarization and prolongs duration of action potential and effective refractory period; which inhibits andrenergic stimulation (alpha and beta blocking properties), affects sodium, potassium, and calcium channels, prolongs the action potential and refractory period in myocardial tissue; decreases AV conduction and sinus node function
Amiodarone (Cordarone)
Indications:
Side Effects:
Indications: VF; VT; refractory PSVT
Side Effects: May cause hypotension, bradycardia, do not administer with other drugs that prolong QT interval (Procanimide); slow or stop infusion if bradycardia or AV block occurs
Amiodarone (Cordarone)
Contraindications:
Considerations:
Contraindications: Cardiogenic shock; hypotension; bradycardia; pulmonary congestion; sick sinus syndrome; 2nd or 3rd degree AVB; sensitivity to benzoyl alcohol and iodine
Considerations: None
Aspirin (Bayer; Ecotrin; St. Josephs)
Dose:
Side Effects:
Dose Adult MI: 162-324 mg PO
Dose Adult Pain Management: 325-650 mg PO
Onset: 15-30min
Duration: 4-6 hours
Aspirin (Bayer; Ecotrin; St. Josephs)
Class:
MOA:
Class: Antiplatelet agent; nonsteroidal anti-inflammatory; antipyretic
MOA: Prevents the formation of thromboxane A2, which causes platelets to aggregate and form plugs that obstruct or constrict small coronary arteries; inhibits cyclooxygenase 1 and 2 (COX 1 and 2) enzymes; decreases inflammation; blocks pain impulses in the CNS
Aspirin (Bayer; Ecotrin; St. Josephs)
Indications:
Side Effects:
Indications: Unstable angina; acute MI; Acute Coronary Syndrome
Side Effects: Anaphylaxis; angioedema; bronchospasm; increased bleeding; nausea/vomiting; heartburn; stomach irritation
Aspirin (Bayer; Ecotrin; St. Josephs)
Contraindications:
Considerations:
Contraindications: GI bleeding; active ulcer; hemorrhagic stroke; bleeding disorder; pediatric patients with chickenpox or flu-like symptoms
Considerations: Increased effects with anticoagulants, insulin, and oral hypoglycemics; use with caution in asthmatics; pregnancy class C in months 1-6, pregnancy class D in last trimester
Atropine
Class:
MOA:
Class: Anticholinergic agent (parasympatholytic)
MOA: Blocks vagal effects to increase heart rate and enhance AV conduction; inhibits acetylcholine at postganglion ic parasympathetic receptor sites
Atropine
Indications:
Side Effects:
Indications: Hemodynamically significant bradycardia; to dry secretions secondary to organophosphate or nerve gas poisoning
Side Effects: Tachycardia; paradoxical bradycardia at doses <0.5mg; palpitations; dysrhythmias; headache; dizziness; anticholinergic effects; nausea/vomiting; flushing; dilated pupils; decreased GI motility
Atropine
Contraindications:
Considerations:
Contraindications: Tachycardia; obstructive disease of GI tract; narrow-angle glaucoma; thyrotoxicosis
Considerations: Use caution in presence of MI and hypoxia (increases myocardial O2 demand); may be given via ETT at 2-2.5 x dose; effects pupils so not an accurate monitor of CNS status. Will not be effective in 2nd degree type II, or 3rd (complete) heart block
Atropine
Dose:
Onset and Duration:
Dose Bradydysrhythmias:
Clopidogrel (Plavix)
Class:
MOA:
Class: Antiplatelet
MOA: Antagonizes the glycoprotein llb/lla receptors to block platelet aggregation (prevents platelets from sticking)
Clopidogrel (Plavix)
Indications:
Side Effects:
Indications: Acute coronary syndrome (ACS); chronic coronary and vascular disease; ischemic stroke; allergy to ASA
Side Effects: Nausea; abdominal pain; hemorrhage
Clopidogrel (Plavix)
Contraindications:
Considerations:
Contraindications: History of intracranial hemorrhage; GI bleed; trauma
Considerations: Use caution in patients with hepatic impairment; withhold for 5-7 days if CABG is planned (unless need for revascularization is urgent)
Clopidogrel (Plavix)
Dose:
Onset and Duration:
Dose Adult: 300mg PO loading dose
Dose Pediatric: Not Indicated
Onset: Variable
Duration: 3-4 hours
Diltiazem (Cardizem)
Class:
MOA:
Class: Class IV anti-dysrhythmic (calcium-channel blocker)
MOA: Blocks the calcium channels to slow conduction and increase refractory period at the AV node, thus slowing the ventricular response in patients with tachycardia originating above the ventricles
Epinephrine (1:10,000)
Class:
MOA:
Class: Sympathomimetic
MOA: Endogenous catecholamine that directly stimulates alpha 1, beta 1, and beta 2 adrenergic receptors
Epinephrine (1:10,000)
Indications:
Side Effects:
Indications: Cardiac arrest
Side Effects: Headache; nausea; weakness; dysrhythmias; hypertension; angina; tachycardia; antagonizes effects of histamine; MAOIs may potentiate effects; Beta-blockers may blunt inotropic response
Epinephrine (1:10,000)
Contraindications:
Considerations:
Contraindications: None when used as indicated
Considerations: May increase oxygen demand
