Chapter 4 - Cardiac

Question 1

Adenosine

Adenocard

Answer 1

Indications:
Conversion of SVT
Conversion of re-entry SVT due to Wolff-Parkinson-White.

Contraindications:
     2nd / 3rd Deg Heart Block
     Sick Sinus Syndrome
     A-Flutter / A-Fib
     Ventricular Tachycardia
     Poision Induced Tachycardia

Dose:
Adult:
6mg / 12mg / 12mg with 1 - 2 min between
Max dose 30mg

 Peds:
 0.1 - 0.2mg / kg Rapid IV
 Max single dose:  12mg

Question 2

Amiodarone

Cardarone, Pacerone

Answer 2

Indications:
V-Fib / Pulseless V-Tach & Unstable V-Tach
Persistent SVTs Unresponsive to other Treatments

Contraindications:
     Cardiogenic Shock
     Sinus Bradycardia
     2nd / 3rd Deg AV Blocks
     (Unless functional pacemaker is available)

Dosage:
Adult V-Fib / Pulseless V-Tach unresponsive to:
CPR, Defib, & Vasopressors
300mg IVP in 20-30 ml D5W
In 3 - 5 min, follow with 150mg Bolus over 10 min

 Adult Ventricular Dysrhythmias:
 150mg Rapid Infusion over 10 min
 May repeat every 10 min as needed
 Max dose 2.2g / 24 hrs

Question 3

Atropine Sulfate

Answer 3

Indications:
Bradycardia (<60 beats / min)
Organophosphate Poisoning
Bronchospastic Pulmonary Disorders

Contraindications:
     Tachycardia
     Hemorrhage
     Myocardial Ischemia
     Narrow-Angle Glaucoma

Dosage:
     Adult Bradycardia:
     0.5mg every 3 - 5 min
     Max dose:  0.04mg / kg
     Shorter dosing intervals & higher doses in severe clinical conditions

     Adult Organophosphate Poisoning:
     Large doses (2 - 4mg) may be needed

 Peds:
 0.02mg / kg IVP
 May double for second dose
 Min single dose:  0.1mg

     Max doses:
     Child Single Dose:  0.5mg
     Child Total Dose:  1mg
     Adolescent Single Dose:  1mg
     Adolescent Total Dose:  2mg