Drugs Flashcards
Oxygen indications
- Chest pain or SOB for any reason
- 10-15 L/min by non-rebreather mask
- Don’t mess with NC, not enough at 6 L/min max
- Positive pressure in cardiopulmonary arrest
Oxygen indication for positive pressure in cardiopulmonary arrest
- Bag-valve-mask with an oropharyngeal airway (BVM with an OPA)
- Laryngeal mask airway (LMA)
- Endotrachial tube
Epinephrine indications
- V-fib
- pulseless V-tach
- PEA
- asystole
Epinephrine MOA
Increases:
- systemic vascular resistance
- arterial pressure
- heart rate
- contractility
- myocardial oxygen demand
- automaticity
Epinephrine dose
1 mg Q 3-5 mins (IV or IO)
- No max dose
- 10 ml of 1:10,000 soln = 1 mg
- 2.5 X IV dose down ET tube
Amiodarone indications
- V-fib, pulseless v-tach
- wide complex v-tach
- SVT due to WPW
Amiodarone MOA
- suppresses ectopy
- increases atrial, AV and ventricular refractory periods
- antianginal effect
- slows sinus rate
- prolongs QRS and QT intervals
Amiodarone dose
- 300 mg, may rebolus 150 mg in v-fib/pulseless v-tach, PSVT
- 150 mg over 10 min, may bolus once in wide complex v-tach
- drip rate 0.2-2 mg/min
Atropine indications
bradycardia
Atropine MOA
- parasympatholytic
- accelerates rate of SA discharge
- improves AV conduction
Atropine dose
- 0.5 mg IV q 3-5 min prn
- MAX dose 3 mg
Adenosine indications
- SVT
- diagnostic tool in stable VT
Adenosine MOA
- slows AV conduction
- interrupts AV nodal re-entry pathway
- may worsen SVT due to WPW
- half-life is less than 10 seconds
Adenosine dose
- 6 mg IV push followed by 20 cc saline flush
- may repeat at 12 mg IV in 1-2 minutes
- may repeat 12 mg dose once more
- sinus pause if effective
Diltiazem (Cardizem) indications
- SVT
* *DO NOT use in WPW, AV block, with IV beta-blockers
Diltiazem (Cardizem) MOA
- calcium channel blocker
- prolongs AV nodal conduction
- decreases systemic vascular resistance
Magnesium sulfate indications
- Torsades de pointes
- post-MI
Magnesium sulfate MOA
- NA and K channel blocker
- blocks neuromuscular transmission
- magic
Magnesium sulfate dose
- 1-2 gm IV over 5-50 min in torsades
- 0.5-1.0 gm/hr infusion in post-MI
Nitroglycerin indications
- angina
- MI
*if BP and HR allow
Nitroglycerin MOA
- dilates coronary arteries – and others
- decreases ventricular work/volume/venous return
Nitroglycerin dose
- 0.4 mg SL q 5 mins X 3, tabs or spray
- may apply 1 inch nitropaste
- IV rate 10-20 mcg/min, may increase by 5
**watch for hypotension with all
Dilaudid indications
- morphine is NO MORE!
- acute MI
- acute pulmonary edema
Dilaudid MOA
- vasodilator
- opioid analgesic
Dilaudid dose
- monitor hemodynamic effect
- dilaudid (hydromorphone) 1-4 mg IV titrated to desired analgesic
Dopamine/Dobutamine indications
- bradycardia
- hypotension/cardiogenic shock
- CHF – with other drugs
Dopamine/Dobutamine MOA
- precursor of epi
- alpha- and beta-adrenergic agonist
- arterial and venous constriction
- dopamine increases myocardial oxygen demand, dobutamine does not
Dopamine/Dobutamine Dose
- 5-10 mcg/kg/min
- adjust to desired BP, urine output and clinical response
