Drug Cards- Cardiology COPY

Question 1

Amiodarone (Cordarone, Pacerone)
Class:
action:
indications:
contraindications:
precautions:
dosage:
route:
how often:

Peds: dosage, route, how often

Answer 1

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

Question 2

epinephrine
Class:
action:
indications:
contraindications:
precautions:
dosage:
route:
how often:

Peds: dosage, route, how often

Answer 2

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.

Question 3

vasopressin
Class:
action:
indications:
contraindications:
precautions:
dosage:
route:
how often:

Answer 3

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

Question 4

lidocaine
Class:
action:
indications:
contraindications:
precautions:
dosage:
route:
how often:

Peds: dosage, route, how often

Answer 4

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

Question 5

procainamide
Class:
action:
indications:
contraindications:
precautions:
dosage:
route:
how often:

Peds: dosage, route, how often

Answer 5

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