Cardiology Meds Flashcards
___ decreases HR by suppressing SA node & AV node activity
Adenosine
Indications for adenosine
Narrow complex, unifocal tachycardias (SVT/PSVT/PAT)
Adenosine dosage
6 mg, if no change after 1-2 minutes follow with 12 mg
___ slows HR by altering impulses through conduction pathways; indicated in VT/VF/A fib/A flutter
Amiodarone
Pulseless VT/VF dose for Amiodarone
300 mg IV push, if no change after 3-5 minutes repeat at 150 mg IV
Amiodarone dose for VT w/ pulse
150 mg infused over 10 minutes, may repeat once
Indicated in symptomatic bradycardias
Atropine sulfate
Atropine dosage for symptomatic bradycardia
1 mg IV, repeat after 3-5 minutes if no response; max dose 3 mg
Atropine works by ___
inhibiting vagus nerve stimulation to Increase SA node automaticity
Atropine is contraindicated in ___
Pregnancy, 2nd & 3rd degree AV blocks
___ is indicated in PTs with narrow complex tachycardias with rapid ventricular response
Calcium channel blockers (diltiazem, verapimil)
Mechanism of action for diltiazem (calcium channel blockers)
Decreasing HR by slowing conduction through the AV node & lengthening refractory periods
Dosage for diltiazem
Initial dose: 0.25 mg/kg IV over 2 minutes;
repeat after 15 minutes at 0.35 mg/kg IV over 2 minutes
Adenosine is contraindicated in PTs with:
Unpaced 2nd & 3rd degree blocks, Afib, a flutter, WPW syndrome
___ increases rate and force of cardiac contractions to increase coronary & cerebral blood flow
Epinephrine
___ works by DECREASING automaticity to help decrease ventricular dysrhythmias
Lidocaine
If Amiodarone is unavailable, Lidocaine is an alternative treatment for ___
PVCs, VT, pulseless VT, or VF
Lidocaine dose for cardiac arrest
1-1.5 mg/kg IV/IO
Repeat at 5-10 minute intervals @ 0.5-0.75 mg/kg
Max total dose for lidocaine in cardiac arrest
3.0 mg/kg
Lidocaine infusion rate for ROSC
1-4 mg/min
Cardiac Indication for magnesium sulfate
Cardiac arrest attributed to torsades de pointes or hypomagnesemia; torsades de pointes with a pulse
Cardiac arrest dose for magnesium sulfate
1-2 grams diluted in 10cc saline, given over 5-20 minutes IV/IO
___ is used to suppress ventricular or atrial ectopy in order to control a variety or dysrhythmias (SVT or wide complex tachycardia)
Procainamide
Procainamide is a ___ channel blocker
Sodium
Dosage for Procainamide
20 mg/min IV
Situations that would necessitate ceasing Procainamide therapy
Dysrhythmia is suppressed
PT becomes hypotensive
QRS widens by 50% or more
Max dose of 17 mg/kg is reached
Procainamide may cause ___ if administered too quickly
Hypotension
Brand name for clopidogrel
Plavix
___ reduces the need for oxygen in the myocardium
Morphine sulfate
Narcotic analgesic that provides relief for severe chest pain
Morphine
Morphine dose for MI chest pain/STEMI
2-4 mg slow IV
Repeat every 5-15 minute @ 2-8 mg slow IV as needed
Morphine dose for non ST elevation ACS chest pain
1-5 mg slow IV, ONLY IF NITRATES DO NOT RELIEVE SYMPTOMS, OR IF SYMPTOMS RETURN
Narcotic analgesic used to reduce the need for oxygen in the myocardium
Morphine
STEMI dose for morphine sulfate
2-4 mg slow IV
May be repeated every 5-15 minutes as needed @ 2-8 mg
Morphine dose for non-ST elevation ACS
1-5 mg slow IV only if nitrates do not relieve ACS symptoms, or if symptoms return
___ increases myocardial contractility (cardiac med)
Calcium chloride & dopamine
Calcium chloride should not be given through the same line as ___
Sodium bicarbonate
Drug of choice for hypotension w/ S&S of shock and symptomatic bradycardia
Dopamine
Dopamine works to increase CO by:
improving myocardial contractility
Dopamine works to increase BP by:
Constricting peripheral arteries & veins
___ relaxes smooth muscle and raises glucose levels
Glucagon
Indications for glucagon
beta blocker or Calcium channel blocker overdose; hypoglycemia
Drug of choice for acute & severe non-hypovolemic hypotension
Norepinephrine (Levophed)
Norepinephrine dosage
0.1-0.5 mcg/kg/min IV infusion
Norepinephrine mechanism of action
Constricts blood vessels to raise BP, HR, and rate/force of cardiac contractions
Reduces acidosis
Sodium bicarbonate
Used to counteract hyperkalemia & acidosis in cardiac arrest
Sodium bicarbonate
Dosage for sodium bicarbonate
1 mE/kg, preceded and followed by 20cc NS flush
Class 1 antiarrhythmics work in the ___
Ventricles
Class 1 antiarrhythmics work by blocking ___ channels
Sodium
Clas 2 antiarrhythmics act on ___ to slow HR and decrease contractility
Beta-1 receptors
Class 3 antiarrhythmics work mainly by blocking ___ responsible for phase 3 repolarization
Potassium
Procainamide, quinidine, and lidocaine are all examples of class __ antiarrhythmics
1
Metoprolol, atenolol, propranolol, are all examples of class ____ antiarrhythmics
2
Closing calcium channels during depolarization is how class 4 antiarrhythmics cause ___ and ___
Slowed conduction & decreased automaticity
___ is indicated in acute SVT
Adenosine
___ plays an important role in transport of sodium, potassium, and calcium across cell membranes
Magnesium
Magnesium is the antiarrhythmic of choice for ___
Torsades de pointes
Unstable SVT/VT with Narrow complexes would indicate administration of ___
Adenosine
Treatments indicated in stable, WIDE complex, monomorphic SVT/VT
IV access, EKG, adenosine 6 mg; consider antiarrhythmics (lidocaine, Amiodarone, Sotalol
Stable, NARROW complex SVT/VT would indicate what treatment(s)?
IV, EKG, vagal maneuvers
Inferior infarctions (ST changes in leads II, III, & aVF) are caused by occlusion of the ___
RCA
Lateral infarctions (ST changes in lead I, aVL, v5 &v6) indicates infarction caused by occlusion of the ___
Circumflex artery
Septal or anterior infarction (ST changes in lead I and v1-v4) is caused by occlusion of the ___
LAD
If Amiodarone is unavailable, administer:
Lidocaine
Lidocaine dose for cardiac arrest:
Initial dose: 1-1.5 mg/kg
Repeat doses: 0.5-0.75 mg/kg
