CHF

Question 0

Digoxin/Lanoxin

P-Dyn

Answer 0

Increased inotropy with increased cellular Calcium
Decreased chronotropy (increased AV node sensitivity to vagal stimulation
Decreases dromotropy

Question 1

Digoxin/Lanoxin

Class

Answer 1

Cardiac glycoside

Question 2

Digoxin/Lanoxin

Indications

Answer 2

Control ventricular rates in A-Fib/A-Flutter
Alt. for reentry SVTs
Heart failure due to poor LV contractility

Question 3

Digitalis Toxicity

Answer 3

Arrythmias
Anorexia, nausea, diarrhea
Drowsiness, fatigue
Visual disturbances

Digibind is antidote

Question 4

Digoxin/Lanoxin

Contraindications

Answer 4

Allergy
Brady
Blocks
VT/VF

Question 5

Digoxin/Lanoxin

Dose

Answer 5

Loading 4-6 mcg/kg over 5 min
2&3 2-3 mcg/kg 4-8 hr intervals

No peds

Question 6

Dobutamine/Dobutrex

Class

Answer 6

Sympathomimetic

Synthetic catecholamine

Question 7

Dobutamine/Dobutrex

P-Dyn

Answer 7

Synthetic catecholamine
Primary beta 1 
-inotropic
-slight chronotropic
Minimal alpha

Question 8

Dobutamine/Dobutrex

Indications

Answer 8

Inotropic support in LV dysfunction

• pulmonary edema
• SBP 70-100
• no signs of shock

Question 9

Dobutamine/Dobutrex

Contraindications

Answer 9

Allergy, hypovolemia, hypotension with signs of shock
Drug/toxin induced shock
Hypertrophic aortic stenosis tachydysrhythmias

Question 10

Dobutamine/Dobutrex

Dose

Answer 10

2-20 mcg/kg/min

Question 11

Dobutamine/Dobutrex

Peds Indications

Answer 11

Treatment of shock with high vascular systemic resistance

• heart failure
• cardiogenic shock
• MUST have adequate volume

Question 12

Dobutamine/Dobutrex

Peds dose

Answer 12

2-20 mcg/kg/min

Question 13

Furosemide/Lasix

Class

Answer 13

Loop diuretic

Question 14

Furosemide/Lasix

P-Dyn

Answer 14

Inhibits reabsorption of sodium/chloride ions
Prompt diuresis
Increased venodilation (reduces preload)

Question 15

Furosemide/Lasix

Indications

Answer 15

Acute pulmonary edema associated with heart failure (adjunctive therapy)
HTN emergency
Increased ICP
Hyperkalemia

Question 16

Furosemide/Lasix

Contraindications

Answer 16

Allergy (lasix or sulfanomides)
Hypovolemia
Hypotension
Severe electrolyte depletion
Anuria

Question 17

Furosemide/Lasix

Dose

Answer 17

0.5-1 mg/kg over 1-2 min

Double initial dose

Question 18

Furosemide/Lasix

Peds Dose

Answer 18

1 mg/kg

Max 6 mg/kg

Question 19

Bumetanide/Bumex

Class

Answer 19

Loop diuretic

Question 20

Bumetanide/Bumex

P-Dyn

Answer 20

Inhibits reabsorption of sodium/chloride ions

Promotes prompt diuresis

Question 21

Bumex vs. Lasix

Answer 21

Faster onset
Shorter duration
Increased potency 1 mg to 40 mg

Question 22

Bumetanide/Bumex

Indications

Answer 22

Acute pulmonary edema/heart failure

Management of HTN

Question 23

Bumetanide/Bumex

Contraindications

Answer 23

Allergy (bumex, sulfonamides)
Hypovolemia
Hypotension
Electrolyte depletion
Anuria

Question 24

Bumetanide/Bumex

Dose

Answer 24

0.5-1 mg
Repeat prn q 2-3 hrs

No peds

Question 25

Norepinephrine/Levophed

Class

Answer 25

Sympathomimetic

Catecholamine

Question 26

Norepinephrine/Levophed

P-Dyn

Answer 26

Potent vasoconstrictor (primarily alpha, some beta 1, + inotropy)
Increased BP in cardiogenic shock/hypotensive emergencies
Constricts renal/mesenteric vessels

Question 27

Norepinephrine/Levophed

Indications

Answer 27

Cardiogenic shock
SBP <70
Severe hypotension without hypovolemia

Question 28

Norepinephrine/Levophed

Dose

Answer 28

0.1-0.5 mcg/min up to 35 mcg/min

Titrate to effect

Question 29

Norepinephrine/Levophed

Peds Dose

Answer 29

0.1-2 mcg/kg/min