Diltiazem & Adenosine

Question 1

Diltiazem Trade Name:

Answer 1

Cardizem®

Question 2

Diltiazem Classes:

Answer 2

-Calcium channel blocker
-Antidysrhythmic

Question 3

Diltiazem Standard Supply:

Answer 3

Vial

Question 4

Diltiazem MOA:

Answer 4

-Slows extracellular calcium ion influx across myocardial cell membranes
-Slows conduction through the SA node and the AV nose
-Slows ventricular conduction rates in atrial fibrillation & atrial flutter

Question 5

Diltiazem Indications:

Answer 5

-Atrial fibrillation w/ rapid ventricular rate
-Atrial flutter w/ rapid ventricular rate
-Supraventricular tachycardia second-line to administration of Adenosine

Question 6

Diltiazem Contraindications:

Answer 6

-Hypersensitivity
-Hypotension
-Myocardial infarction
-Cardiogenic shock
-Ventricular tachycardia
-2nd degree & 3rd degree heart block
-Wolff Parkinson White (WPW) syndrome
-Not recommended w/ PEDS

Question 7

Diltiazem S/E:

Answer 7

-Hypotension
-Dysrhythmias
-Bradycardia
-Dizziness
-Weakness
-Headache
-Nausea, Vomiting

Question 8

Diltiazem Routes:

Answer 8

-IV
-IO
-Infusion

Question 9

Diltiazem Onset:

Answer 9

2-5 min

Question 10

Diltiazem Adult Dosages:

Answer 10

-0.25 mg/kg (usually 20 mg) over 2 min; MAY REPEAT the dosage 0.35 mg/kg (usually 25 mg) in 15 min
-Infusion: 5-15 mg/hr

Question 11

Adenosine Trade Name:

Answer 11

Adenocard®

Question 12

Adenosine Class:

Answer 12

Antidysrhythmic

Question 13

Adenosine Standard Supply:

Answer 13

-Prefilled syringe
-Vial

Question 14

Adenosine MOA:

Answer 14

Slows atrioventricular conduction

Question 15

Adenosine Indications:

Answer 15

-SVT
-WPW syndrome
-Monomorphic wide complex tachycardia

Question 16

Adenosine Contraindications:

Answer 16

-Atrial fibrillation
-Atrial flutter
-Polymorphic ventricular tachycardia (Torsades de pointes)
-2nd degree & 3rd degree heart block

Question 17

Adenosine S/E:

Answer 17

-Transient dysrhythmias
-Chest pain
-Palpitations
-Dyspnea
-Dizziness
-Hypotension
-Blurred vision
-Cardiac arrest
-Asystole

Question 18

Adenosine Routes:

Answer 18

-IV
-IO

Question 19

Adenosine Onset:

Answer 19

Immediate

Question 20

Adenosine Adult dosages:

Answer 20

-6.0 mg RAPID bolus over 1-3 seconds followed by 20 mL normal saline flush
-If no response to initial bolus after 1-2 min, admin 12 mg RAPID bolus over 1-3 seconds followed by 20 mL normal saline flush

Question 21

Adenosine PEDS dosages:

Answer 21

-0.1 mg/kg (up to 6.0 mg) RAPID bolus over 1-3 seconds followed by 5-10 mL normal saline flush
-If no response to initial bolus after 1-2 min, admin 0.2 mg/kg (up to 12 mg) RAPID bolus over 1-3 seconds followed by 5-10 mL normal saline flush