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Cardiac Rotation > Drugs > Flashcards

Drugs Flashcards

1
Q

MOA of norepi

A

Potent alpha 1 and alpha 2 agonist, has some beta 1 agonism

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2
Q

Effects of norepi

A
  • Increase SVR via alpha 1
  • Decreases blood flow to all organs except heart and kidney
  • Can worse metabolic acidosis due to ischemia
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3
Q

Infusion range for norepi

A

0.01-0.1mcg/kg/min

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4
Q

Infusion range for phenylephrine

A

10-50mcg/min OR 0.05-1mcg/kg/min

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5
Q

MOA of insulin

A

Causes uptake of glucose by the cells and decreases blood glucose levels

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6
Q

Dose of insulin to treat lower K+ levels by 1mEq

A

10units (plus 25g dextrose)

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7
Q

By how much does 1 unit of insulin lower blood glucose levels

A

25-30mg/dL

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8
Q

How do you calculate insulin infusion rate in the OR

A

Glucose/150 to get the rate in units/hour

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9
Q

Initial symptoms of hypoglycemia

A
  • Diaphoresis
  • Tachycardia
  • Hypertension
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10
Q

What is “insulin sensitivity factor”

A

Amount of glucose that is lowered by 1 unit of insulin

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11
Q

Bolus dose of insulin for BG of 181-200

A

2

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12
Q

Bolus dose of insulin for BG of 201-250

A

3

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13
Q

Bolus dose of insulin for BG of 251-300

A

4

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14
Q

Bolus dose of insulin for BG of 301-350

A

6

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15
Q

Bolus dose of insulin for BG over 350

A

7

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16
Q

Maintenance dose of insulin drip

A

0.1units/kg/hour

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17
Q

MOA of Nicardipine

A

Calcium channel blocker that decreases BP by vasodilation

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18
Q

Dosing range for infusion of Nicardipine

A

2.5-10mg/hour (standard is 5mg/hr)

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19
Q

MOA of Milrinone

A

Phosphodiesterase 3 inhibitor that increases intracellular Ca2+ and increases force of heart contraction and decreases SVR

20
Q

Loading dose of Milrinone

A

50mcg/kg over 10 minutes

21
Q

Infusion dosing range of Milrinone

A

0.375-0.75mcg/kg/min

22
Q

When is Milrinone great to use in cardiac cases?

A

When coming off the bypass pump, but it decreases SVR so run a pressor with it

23
Q

MOA of Epinephrine

A

Direct alpha and beta agonist that increases contractility, SVR, and heart rate

24
Q

Bolus dose of epi

A

2-10mcg

25
Q

Dosing range for epi infusion

A

0.01-0.03mcg/kg/min

26
Q

MOA of Dobutamine

A

Beta 1 agonist that increases contractility (positive inotrope) and can cause tachycardia

27
Q

Dosing range for Dobutamine infusion

A

2-20mcg/kg/min

28
Q

MOA of Vasopressin

A

Intense arterial vasoconstriction short term, long term causes H2O reabsorption in renal tubules

29
Q

Bolus dose of Vasopressin

A

1-2 units

30
Q

Dosing range for vasopressin infusion

A

2-8units/hour

31
Q

MOA of nitroglycerin

A

Causes release of nitric oxide and vasodilates venous system

32
Q

Dosing range for nitroglycerin infusion

A

0.5-10mcg/kg/min

33
Q

Standard concentration for calcium

A

100mg/cc

34
Q

MOA of calcium

A

Increases cardiac contraction and blood pressure

35
Q

Standard concentration for heparin

A

1000units/cc

36
Q

MOA of heparin

A

Potentiates the activity of antithrombin III

37
Q

Dosing of heparin for CABG

A

300-400units/kg

38
Q

Dosing of heparin for vascular cases

A

3-10,000 units

39
Q

Dosing of heparin for DIC

A

50-100units/kg

40
Q

Loading dose for heparin drip

A

50-150units/kg

41
Q

Infusion dose for heparin drip

A

15-35units/kg/hr

42
Q

Cases requiring a right arm A line

A
  • CABG w/ radial harvest
  • Descending aorta
  • VA ECMO
43
Q

Cases requiring left arm A line

A
  • Ascending aorta
  • Aortic arch surgery
  • Re-do case w/ axillary cannulation
  • Minimally invasive valves
44
Q

Heparin dosing for off pump CABG

A

200units/kg

45
Q

Extra set-up considerations for re-do sternotomy

A
  • R2 pads
  • 4 units of blood checked and in room
  • Large bore access for potential blood loss

Cardiac Rotation (1 decks)

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