Electrolytes Flashcards
Calcium Chloride
Indications
Mag antidote CaChannel blocker OD Acute hyperK (no dig) Acute hypoCa 2nd choice--Beta blocker OD Pretreat for CCB therapy CA Renal failure
Calcium Chloride
P-Dyn
Stabilizes myocardial cell membrane
Essential for contractility/coag
Increased squish
!!Mag antidote!!
Calcium Chloride
A/S
Brady/blocks
Asystole
Hypotension
Calcium Chloride
Contraindications
VF-Relative (yes hyperK/renal)
Dig toxicity
HyperCa
Renal/cardiac disease
Calcium Chloride
Precautions
Extravasation=necrosis
Maybe vasospasm in coronary/cerebral arteries
SLOW IV push 100 mg/1 min
No scalp veins in peds
Calcium Chloride
Interactions
Dig-Increased arrhythmias
Precipitate with Bicarb
Blunts CC blockers
Calcium Chloride
Dose
500-1000 mg IV may repeat PRN q10
2-4 mg/kg may repeat PRN (pretreat for CCB therapy)
Calcium Chloride
Peds Dose
20 mg/kg repeat q10 if indications persist
Mag Sulfate
Class
Antiarrythmic
Anticonvulsant
Electrolyte
Mag Sulfate
P-Dyn
Essential in ion movement Decreased Acth release Depresses smooth/skeletal/cardiac Stabilizes excitable cell membranes CNS depressant Ca antidote
Mag Sulfate
Indications
Torsades
Dig caused V-arrhythmias
Eclampsia seizures
Unresponsive status asthmaticus/severe COPD
Mag Sulfate
A/S
CNS/resp depression Brady/blocks Decreased BP Hypothermia Flushing
Mag Sulfate
Contraindications
Resp depression Blocks Shock HypoCa HyperMag
Mag Sulfate
Precautions
Dilute, caustic to veins
Impaired renal function
Pt on dig
Mag Sulfate
Interactions
Increased effects of CNS depressants
Digitalis
Mag Sulfate
Dose
Arrest 1-2 g/10 mL Non-arrest 1-2 g/50-100 mL over 5-60 Eclampsia 2-4 g/50-100 mL over 2-5 Or 2-4 g IM divided doses DIB 1-2 g over 20 min
Mag Sulfate
Peds Dose
25-50 mg/kg (max 2g) IV/IO over 10-20
TdP
Hypomag
Asthma (rare)
Sodium Bicarbonate
Class
Alkalinizing agent
Buffer
Electrolyte
Sodium Bicarbonate
P-Dyn
Reacts with hydrogen to form water and CO2
Raises blood pH
Sodium Bicarbonate
Indications
2ndary in HyperK to/with CC
TCA/ASA/Procainamide OD
DKA
Late/never in CA
In conjunction with CC in Ca/renal
Sodium Bicarbonate
A/S
Alkalosis Paradoxical acidosis (cerebral/cardiac depression) Hypoxia Electrolyte imbalance Seizures
Sodium Bicarbonate
Contraindications
Rare in emergencies
Alkalosis
Sodium Bicarbonate
Interactions
Deactivates catecholamines/vasopressors
Precipitates with calcium
Sodium Bicarbonate
Dose
1 mEq/kg
Repeat 0.5 mEq/kg q 10
Sodium Bicarbonate
Peds Dose
1 mEq/kg
0.5 mEq/kg q 10
Hypercalcemia-ECG
Shortened QT interval
Inc PRI, QRS
T wave flattening
AV blocks/BBB
Hypercalcemia-ECG
Inc QT interval
Inc R on T probability
Hypermag-ECG
Inc PRI/QRS
Elevated T waves
3rd degree block
Asystole
Hypomag-ECG
Diminished amplitude of P and QRS Inc PRI/QRS/QT ST changes Flat/wide T waves U wave presence
HypoK-ECG
Decreased/flat T waves U waves ST depression Inc PRI/QRS/QT interval Bradydysrhythmias AV block/disassociation VT
HyperK-ECG
Changes correlate with degree Tall/peaked T waves Inc PRI/QT interval Flat P and ST Wide QRS VF, asystole
