Drug Cards- Cardiology Flashcards
(20 cards)
Adenosine/adenocard Class: action: indications: contraindications: precautions: dosage: route: how often:
Peds: dosage, route, how often
Adenosine/adenocard
Class: antidysrhythmic
action: it terminate SVTs by binding to the AV node’s A1 receptors. This inhibits adenylyl cyclase, ultimately increasing potassium efflux from the cell, causing hyperpolarization, and thereby “blocking” the AV node
indications: narrow complex paroxysmal SVT refractory to vagal maneuvers; chemical cardiovertor
contraindications: 2ⁿᵈ and 3ʳᵈ degree heart block, sinus node disease, asthma
precautions: It may cause transient dysrhythmias, COPD.
dosage: 6 mg rapid IV push then saline flush
route: IV
how often: 12 mg in 1-2 min can be repeated
Peds: 0.1mg/kg rapid IV push then saline flush
0.2 mg/kg in 1-2 min, max = 12 mg
Amiodarone (Cordarone, Pacerone) Class: action: indications: contraindications: precautions: dosage: route: how often:
Peds: dosage, route, how often
Amiodarone (Cordarone, Pacerone)
Class: Class III antiarrhythmic (antidysrhythmic)
action: It prolongs the duration of the action potential and refractory period and relaxes smooth muscles, reducing peripheral vascular resistance and ↑ coronary blood flow
indications: Life-threatening ventricular and supraventricular dysrhythmias, frequently atrial fibrillation
contraindications: Cardiogenic shock, severe sinus bradycardia, advanced heart block
precautions: Hepatic impairment, pregnancy, nursing mothers, children.
dosage/route/how often:
(1) 150-300mg IV over 10 min
(2) 1 mg/min over 6 hrs
Peds: dosage, route, how often :
(1) 5 mg/kg IV/IO
(2) 15 mg/kg/day
Atenolol (Tenormin) Class: action: indications: contraindications: precautions: dosage: route: how often:
Peds: dosage, route, how often
Atenolol (Tenormin)
Class: β-adrenergic blocker
Antidysrhythmic, antihypertensive
action: Selective β-blocker that reduces the rate and force of cardiac contraction and lowers CO and BP
indications: Non- Q wave MI and unstable angina
contraindications: Sinus bradycardia, 2ⁿᵈ or 3ʳᵈ degree heart block, CHF, cardiogenic failure or shock
precautions: Asthma, COPD, CHF controlled by digitalis and diuretics
dosage/route/how often: 5 mg slow IV over 5 min; if tolerated, s/p 10 mins, repeat
Peds: 0.8-1.5 mg/kg/day PO (max 2mg/kg/day)
Atropine Class: action: indications: contraindications: precautions: dosage: route: how often:
Peds: dosage, route, how often
Atropine
Class: Parasympatholytic
action: Atropine blocks the parasympathetic NS, specifically the vagal effects on heart rate; doesn’t ↑ contractility but may ↑ myocardial O₂ demand; ↓ airway secretions
indications: Hemodynamically significant bradycardia, bradyasystolic arrest, organophosphate poisoning
contraindications: None in the emergency setting.
precautions: AMI, glaucoma
dosage/route/how often:
Symptomatic bradycardia:
0.5-1mg IV / 2mg ET, repeat 3-5 min to 0.4 mg/kg
Asystole:
1 mg IV or 2mg ET, may repeat 3-5 min up to 0.04 mg/kg
Organophosphate poisoning;
2-5 mg IV/IM/IO, 10-15 min
Peds: dosage, route, how often
Symptomatic bradycardia:
0.02 mg/kg IV, 0.04 mg/kg ET, may repeat in 5 min up to 1 mg
Organophosphate poisoning:
0.05 mg/kg IV/IM/IO 10-15 min
esmolol Class: action: indications: contraindications: precautions: dosage: route: how often:
esmolol
Class: β-blocker
action: an ultra-short-acting cardioselective beta-blocker that inhibits the actions of the catecholamines.
indications: Supraventricular tachycardias with rapid ventricular responses.
contraindications: Cardiac failure, 2nd- and 3rd-degree block, sinus bradycardia, and cardiogenic shock.
precautions: bronchial asthma, emphysema, CHF, diabetes, and renal impairment.
dosage/route/how often:
500 mcg/kg/min IV for 1 min, loading dose, then 50 mcg/kg/min for 4 min.
If unsuccessful, repeat loading dose every 4 min and increase maintenance dose by 50 mcg/kg to 200 mcg/kg/min.
lebetalol Class: action: indications: contraindications: precautions: dosage: route: how often:
lebetalol (Trandate, Normodyne)
Class: β-blocker
action: a beta-blocker with some alpha -blocker characteristics . It induces vasodilation, reduces peripheral vascular resistance , and lowers blood pressure.
indications: Acute hypertensive crisis.
contraindications: Asthma, CHF, 2nd - and 3rd -degree heart block, severe bradycardia, or cardiogenic shock.
precautions: COPD, heart failure, hepatic impairment, diabetes, peripheral vascular disease.
dosage/route/how often: 20 mg slow IV 40-80 mg/10 min, as needed, max = 300 mg OR A continuous drip 2 mg/min, max < 300 mg
metroprolol Class: action: indications: contraindications: precautions: dosage: route: how often:
Peds: dosage, route, how often
metroprolol (Lopressor)
Class: β-adrenergic blocker
action: It’s a beta-adrenergic blocking agent that reduces heart rate, cardiac output, and blood pressure.
indications: AMI
contraindications: Cardiogenic shock, sinus bradycardia < 45, 2nd- or 3rd-degree heart block, PR interval > 0.24, cor pulmonale, asthma, or COPD .
precautions: hepatic or renal impairment, cardiomegaly, CHF controlled by digitalis and diuretics, AV conduction defects, thyrotoxicosis, diabetes, or peripheral vascular disease.
dosage:
route:
how often:
5 mg slow IV/5 min, max 3 times
propanolol Class: action: indications: contraindications: precautions: dosage: route: how often:
Peds: dosage, route, how often
propanolol
Class: Beta-blocker
action: It’s a nonselective beta-blocker affecting both bronchial and cardiac sites. It reduces heart rate, myocardial irritability, contraction force, cardiac output,’and blood pressure.
indications: Ventricular fibrillation and pulseless ventricular tachycardia refractory to lidocaine and bretyliurn and selected SVTs.
contraindications: 2nd- and 3rd -degree heart blocks, CHF, cor pulmonale, sinus bradycardia, cardiac impairment, cardiogenic shock, bronchospasm, or bronchial asthma, COPD, adrenergic -augmenting psychotropic or MAO inhibitors .
precautions: Peripheral vascular disease, bee sting allergy, mild COPD, renal or hepatic impairment, diabetes, hypoglycemia, myasthenia gravis, WPW syndrome , or major surgery.
dosage/route/how often:
1-3 mg slow IV (over 2-5 min), not to exceed 1 mg/min, may repeat 2 min- 0.1 mg/kg
Peds: dosage, route, how often: 0.1 mg/kg slow IV
sotalol Class: action: indications: contraindications: precautions: dosage: route: how often:
Peds: dosage, route, how often
Sotalol (Betaspace)
Class: β-blocker, antidysrhythmic
action: It’s a nonselective beta-blocker that slows heart rate and decreases AV conduction and irritability.
indications: Ventricular and supraventricular dysrhythmias.
contraindications: “Hypersensitivity, bronchial asthma, sinus bradycardia, 2nd- and 3rd-degree heart block,
long QT syndromes, cardiogenic shock, uncontrolled CHF, or COPD.”
precautions: CHF, electrolyte disturbances, recent MI, diabetes, sick sinus rhythms , or renal impairment.
dosage/route/how often:
1-1.5 mg/kg IV @ 10 mg/min
80 mg PO BID
160 mg PO QD
Diltizem Class: action: indications: contraindications: precautions: dosage: route: how often:
Diltizem (cardizem)
Class: Ca²⁺ channel blocker
Class IV antiarrhythmic
action: Lowers BP by relaxing vascular smooth muscle; slows AV conduction; it dilates coronary and peripheral arteries and arterioles, thus increasing circulation to the heart and reducing peripheral vascular resistance.
indications: Rapid ventricular rate w/ A-fib
Stable narrow complex tachyarrhythmias;
Supraventricular tachydysrhythmias (atrial fibrillation, atrial flutter, and PSVT refractory to adenosine) and to increase coronary artery perfusion in angina.
contraindications: Hypotension CHF Cardiogenic shock Wide-complex ventricular tachycardia sick sinus syndrome, 2nd- or 3rd-degree heart block, systolic BP < 90, diastolic BP < 60, wide-complex tachycardia and WPW.
precautions: CHF (especially with beta blockers), conduction abnormalities, renal or hepatic impairment, the elderly, and nursing mothers.
dosage/route/how often:
0.25 mg/kg IV over 2 min, may repeat as needed w/ 0.35 mg/kg followed by a drip of 5-10 mg/hr, max 15 mg/hr over 24 hrs
Nifedipine Class: action: indications: contraindications: precautions: dosage: route: how often:
Nifedipine (Procardia, Adalat)
Class: Calcium Channel Blocker
action: It’s a calcium channel blocker that reduces coronary artery spasm in angina . It also decreases peripheral vascular resistance, blood pressure, and cardiac workload.
indications: Severe hypertension and angina.
contraindications: Hypotension
precautions: Monitor blood pressure carefully, since it can drop significantly with nifedipine use.
dosage/route/how often: One 10-20 mg capsule SL/PO
verapamil Class: action: indications: contraindications: precautions: dosage: route: how often:
Peds: dosage, route, how often
verapamil
Class: Calcium channel blocker
action: It slows AV conduction, suppresses reentry dysrhythmias such as PSVT, and slows ventricular responses to atrial tachydysrhythmias. Verapamil also dilates coronary arteries and reduces myocardial oxygen demand.
indications: PSVT refractory to adenosine, atrial flutter, and atrial fibrillation with rapid ventricular response.
contraindications: Severe hypotension, cardiogenic sho.ck, 2nd - or 3rd-degree heart block, CHF, sinus node disease, and accessory AV pathways, WPW syndrome. It should not be administered to persons taking beta-blockers.
precautions: Hepatic and renal impairment, MI with coronary artery occlusion, or myocardial stenosis.
dosage/route/how often: 2,5-5 mg IV bolus over 2-3 min
5-10 mg s/p 15-30 min, max = 30 mg in 30 min
Peds: dosage, route, how often
Newborn: 0.1-0.2 mg/kg (max = 2 mg)
1-15: 0.01-0.3 mg/kg (max = 5 mg)
Calcium chloride Class: action: indications: contraindications: precautions: dosage: route: how often:
Peds: dosage, route, how often
Calcium chloride
Class: Electrolyte
action: It increases myocardial contractile force and increases ventricular automaticity
indications: Hyperkalemia, hypocalcemia, hypermagnesmia, calcium channel blocker toxicity
contraindications: V-fib, hypercalcemia, possible digitalis toxicity
precautions: It may precipitate toxicity in pts taking digoxin. Ensure the IV line is in a large vein and is flushed before using and after calcium
dosage/route:/how often: 2-4 mg/kg IV (10% solution)/10 min as needed
Peds: dosage, route, how often: 20 mg/kg IV (10% solution) repeat @ 10 min, as needed
epinephrine Class: action: indications: contraindications: precautions: dosage: route: how often:
Peds: dosage, route, how often
epinephrine (adrenaline)
Class: Sympathomimetic
action: Epinephrine is a naturally occurring catecholamine that ↑ HR, cardiac contractile force, myocardial electrical activity, systemic vascular resistance, and systolic BP, and ↓ overall airway resistance and automaticity. Through bronchial artery constriction, it may reduce pulmonary congestion and ↑ tidal volume and vital capacity
indications: To restore rhythm in cardiac arrest and severe allergic reactions
contraindications: Allergies to sympathomimetic amines, narrow angle glaucoma, hemorrhagic, traumatic, or cardiac shock, coronary insufficiency; dysrhythmias; organic brain or heart disease, or during labor
precautions: Elderly, debilitated pts, HTN, diabetes, hyperthyroidism, Parkinson’s disease, TB, asthma, emphysema, and peds < 6 yo
dosage:
route:
how often:
“Arrest:
1 mg of 1:10,000 IV, 3-5 min (ET: 2-2.5 mg of 1:1,000)
Allergies:
0.3-0.5 mg of 1:1,000 SQ, 5-15 mins as needed; or 0.5-1 mg of 1:10,000 IV if SQ dose ineffective or severe rxn.”
Peds: dosage, route, how often
“Arrest:
0.01 mg/kg of 1:10,000 IV/IO (ET: 0.1 mg/kg of 1:1,000) all subsequent doses 0.1 mg/kg IV/IO
Allergies:
0.01 mg/kg of 1:1,000 SQ, 10-15 min, or 0.01 mg/kg of 1:10,000 IV if SQQ dose ineffective or severe rxn.”
vasopressin Class: action: indications: contraindications: precautions: dosage: route: how often:
Peds: dosage, route, how often
vasopressin- Pitressin
Class: Hormone, vasopressor
action: it’s a hormone with strong vasopressive and antidiuretic properties but that may precipitate angina and/or AMI.
indications: To ↑ peripheral vascular resistance in arrest (CPR) or to control bleeding from esophageal varices.
contraindications: Chronic nephritis with nitrogen retention, ischemic heart disease, PVCs, advanced arteriosclerosis, or 1st stage of labor.
precautions: Epilepsy, migraine, heart failure, angina, vascular disease, hepatic impairment, elderly, and children.
dosage:
route:
how often: “Arrest:
40 units IV
Esophageal varices: 0.2-0.4 units/min IV drip”
Peds: dosage, route, how often
lidocaine Class: action: indications: contraindications: precautions: dosage: route: how often:
Peds: dosage, route, how often
lidocaine (Xylocaine)
Class: Class Ib antiarrhythmic/ antidysrhythmic local anesthetic
action: it’s an antidysrhythmic that suppresses automaticity and raises stimulation threshold of the ventricles . It also causes sedation, anticonvulsant, and analgesic effects.
indications: “V-tach
V-fib unresponsive to CPR, defib, and vasopressor therapy
Local anesthetic
Pulseless VTach, V-fib, ventricular tachycardia (w/ pulse).”
contraindications: Allergies to amide-type local anesthetics, supraventricular dysrhythmias, Stokes-Adams syndrome, 2nd - and 3rd-degree heart blocks, and bradycardias.
precautions: Hepatic or renal impairment, CHF, hypovolemia, respiratory depression , hypovolemia, myasthenia gravis, shock, debilitated patients, elderly, family history of malignant hypothermia .
dosage:
route:
how often: “Cardiac arrest:
1.0-1.5 mg/kg IV, repeated q 3-5 min, max = 3mg/kg
Follow conversion w/ a drip of 2-4 mg/min
V-tach w/ a pulse:
1-1.5 mg/kg slow IV; may repeat @ 1/2 dose q 5-10 min until conversion, max 3 mg/kg
Follow conversion w/ an infusion of 2-4 mg/min”
Peds: dosage, route, how often:
“Cardiac arrest:
1 mg/kg IV, repeat 3-5 min, max 3 mg/kg
Follow conversion w/ a drip of 20-50 µcg/kg/min
V-tach w/ a pulse:
1 mg/kg
Followed by a drip @ 20-50 mg/kg/min”
procainamide Class: action: indications: contraindications: precautions: dosage: route: how often:
Peds: dosage, route, how often
Procainamide (Pronestyl)
Class: Class Ia antiarrhythmic; local anesthetic
action: It prolongs ventricular repolarization, slows conduction, and decreases myocardial excitability.
indications: V-fib and pulseless V-tach, refractory to lidocaine
contraindications: Hypersensitivity to procainamide or procaine, myasthenia gravis, and 2nd- or 3rd-degree heart block.
precautions: Hypotension, cardiac enlargement , CHF, AMI, ventricular dysrhythmias from digitalis, hepatic or renal impairment, electrolyte imbalance, or bronchial asthma.
dosage:
route:
how often: “20-30 mg/min IV drip, max 17 mg/kg to effect
1-4 mg/min”
Peds: dosage, route, how often: 15 mg/kg, IV/IO over 30-60 min
bicarb Class: action: indications: contraindications: precautions: dosage: route: how often:
Peds: dosage, route, how often
bicarb
Class: Alkalizing agent
action: It provides vascular bicarbonate to assist the buffer system in reducing the effects of metabolic acidosis and in the treatment of some overdoses.
indications: Tricyclic antidepressant and barbiturate overdose, refractory acidosis, or hyperkalernia.
contraindications: None when used in severe hypoxia or late cardiac arrest.
precautions: May cause alkalosis if given in too large a quantity. It may also deactivate vasopressors and may precipitate with calcium chloride.
dosage:
route:
how often: 1 mEq/kg IV
0.5 mEq/kg, 10 min
Peds: dosage, route, how often 1 mEq/kg IV
0.5 mEq/kg, 10 min
Aspirin Class: action: indications: contraindications: precautions: dosage: route: how often:
Peds: dosage, route, how often
Aspirin (acetylsalicylic aickd; alka-seltzer, Bayer, Empirin, St. Joseph Children’s)
Class: Analgesic, antipyretic, platelet inhibitor, anti-inflammatory
action: Aspirin inhibits agents that cause the production of inflammation, pain, and fever; relieves mild-moderate pain by acting on the Peripheral NS, lowers body temp in fever; inhibits platelet aggregation
indications: Chest pain suggestive of an MI
contraindications: Active ulcer disease, asthma
precautions: Bleeding disorders, children or teens w/ varicella or flu- like symptoms
dosage:
route:
how often: 160-325 mg PO
Peds: dosage, route, how often
Nitroglycerin Class: action: indications: contraindications: precautions: dosage: route: how often:
Peds: dosage, route, how often
Nitroglycerin/nitrostat
Class: nitrate
action: Relaxes vascular smooth muscle → vasodilation, ↓ cardiac work, improved coronary blood flow
indications: Chest pain associated with angina and acute myocardial infarction, and acute pulmonary edema.
contraindications: Hypersensitivity, tolerance to nitrates, severe anemia, head trauma, hypotension, increased ICP, patients taking sildenafil, glaucoma, and shock.
precautions: May induce headache that is sometimes severe. Nitroglycerin is light sensitive and will lose potency when exposed to the air.
dosage:
route:
how often: “1 tablet = 0.4 mg
SL tablet or spray; may be repeated q 3-5 min, max = 3 tablets, or 1/2 inch of topical ointment, or 0.4 mg (1 spray) SL, max 3 sprays/25 min”
Peds: dosage, route, how often
