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Module 7 (Critical Care) > Exam 1 Pharmacology > Flashcards

Exam 1 Pharmacology Flashcards

Adenosine, Amiodarone, Epinephrine, Atropine, Lidocaine, Magnesium, Levetiracetam, Simvastation

1
Q

Adenosine MOA

A

GIves the heart a break for the SA node to take back control in a normal sinus rhythm

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2
Q

Adenosine med type

A

Antidysrhythmic
- Bring heart back to normal sinus rhythm

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3
Q

Adenosine can treat

A

PSVT (IV adenosine 1st)
Myocardial perfusion stress imaging study (vasodilator)
**chemical cardioversion

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4
Q

Adenosine injection half-life

A

short 10 seconds

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5
Q

What should you let the patient know before giving them adenosine (if able)?

A

chest pressure after giving the medication is common

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6
Q

Adenosine injection

A

antecubital close to heart not on bone prominences

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7
Q

Adenosine IV is given

A

rapid (1-2 secs)
followed by 20 mL flush rapidly
stop cock setup

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8
Q

Adenosine half-life IV

A

2-3 seconds

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9
Q

The nurse give the PSVT patient 6mg of adenosine. After giving it IV, the patient’s rhythm goes asystole, what should the nurse do?

A

continue to monitor as asystole immediately after injection is okay

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10
Q

What equipment should be in the room when receiving adenosine?

A

BP cuff
12 lead
cardiac monitor
defibrillator and AID-ready

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11
Q

What does the nurse need to assess for on an adenosine patient?

A

flushing
dizziness
chest pain
palpation
can faint

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12
Q

Adenosine doses

A

6mg (1st) - 12 mg (2nd)
HCP can continue or go to cardioversion

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13
Q

Adenosine is less effective in patients taking

A

caffeine
theophylline

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14
Q

T/F: Adenosine is safe for pregnant women.

A

True

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15
Q

For a rapid IVP of adenosine, place the patient in what position

A

reverse trendelenburg (mild)

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16
Q

Amiodarone MOA

A

blocks K, Na ions channels and antagonizing alpha and beta-adrenergic receptors(prolonging repolarization)
- slows nerve impulses of the heart and into normal rhythm

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17
Q

Amiodarone used for

A

VFib
VTach unresponsive to shock delivery
CPR
Vasopressor
VTach unstable hemodynamically

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18
Q

Amiodarone drug interactions

A

Beta-blockers
procainamide
iodine
pregnant women
grapefruit juice

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19
Q

Amiodarone do not give to

A

pregnant women or people with iodine allergies

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20
Q

Amiodarone ACLS doses
1 -
2 -

A

1st = 300 mg
2nd = 150 mg

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21
Q

CPR algorithm SHOCKABLE

A

Call help
start CPR (30:2)
attach defibrillator
SHOCKABLE (VTach or VFib)
- Shock
- CPR 2 minutes
- IV/IO access
- SHOCK
- CPR 2 min
- Epinephrine 3-5 minutes
- SHOCK - CPR 2 minutes
- Amiodarone or lidocaine
- Repeat

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22
Q

What is the ratio of CPR and breaths

A

30:2

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23
Q

CPR Quality
- depth
- rate
- allow for

A

2 inches
100-120 bpm
chest recoil

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24
Q

If you are the person giving CPR, count

A

out loud

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25
Q

CPR Algorithm NONSHOCKABLE

A

Call help
start CPR (30:2)
attach defibrillator
NONSHOCKABLE (Asystole/PEA)
- Epinephrine ASAP
- CPR 2 minutes
- Epinephrine 3-5 minutes
Repeat until causes reversed

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26
Q

Biphasic Shock

A

120-200 J

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27
Q

Monophasic Shock

A

360 J

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28
Q

Epinephrine dosages in CPR

A

1 mg every 3-5 minutes

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29
Q

Amiodarone dosages in CPR

A

1st = 300 mg Bolus
2nd = 150 mg

30
Q

Lidocaine dosages in CPR

A

1st = 1-1.5 mg/kg
2nd = 0.5-0.75 mg/kg

31
Q

When an advanced airway has been placed then the ratio is moved to

A

1 breath every 6 seconds (10 bpm) with continuous chest compression

32
Q

Reversible Causes of Asystole/PEA

A

Hs and Ts
- Hypovolemia
- Hypoxia
- Hydrogen ions (acidosis)
- Hypo/Hyperkalemia
- Hypoglycemia
- Hypothermia
- Tension Pneumothorax
- Tamponade, cardiac
- Toxins
- Thrombosis, pulmonary
- Thrombosis, coronary

33
Q

Maximum amiodarone dose over 24 hours

A

2.2 g

34
Q

Rapid infusion of amiodarone may lead to

A

hypotension

35
Q

Epinephrine is given for

A

Cardiac arrest: VFib, pulseless VTach, asystole, PEA
Symptomatic bradycardia
Severe hypotension
Severe allergic reaction

36
Q

Epinephrine is given every ________ in a code

A

3-5 minutes

37
Q

Epinephrine raises

A

BP and HR
- causing Myocardial ischemia, angina, increased O2 demand

38
Q

T/F: Epinephrine improves survival post-resuscitation.

A

False, high doses do not guarantee neurological outcome

39
Q

Epinephrine dosage

A

1 mg in 10 mL NS every 3-5 minutes in a Code

40
Q

Epinephrine side effects

A

Tachycardia
HTN
HA
anxiety
palpations
sweat
N/V
weakness
tremors

41
Q

Atropine Sulfate MOA

A

increases the heart rate and improves the atrioventricular conduction by blocking the parasympathetic influences on the heart.

42
Q

Atropine is used for

A

symptomatic bradycardia
- not in AV Heart Blocks
PEA/asystole
Organophosphate poisoning

43
Q

Atropine caution with

A

myocardial ischemia
hypoxia
increase O2 demand
not for hypothermia bradycardia

44
Q

Atropine dosages for bradycardia

A

0.5 mg IV every 3-5 minutes

45
Q

Atropine dosages for organophosphate poisoning

A

2-4mg (Disaster Mgmt)

46
Q

Atropine should not exceed

A

0.04mg/kg (total 3mg)

47
Q

Dopamine

A

2nd line drug to symptomatic bradycardia (after atropine)
- hypotension (SBP < 70-100) with s/s of shock

48
Q

Dopamine caution with

A

cardiogenic shock with CHF

49
Q

Dopamine should not be mixed with

A

sodium bicarbonate

50
Q

Dopamine may cause

A

tachyarrhythmias
excessive vasoconstriction

51
Q

What should be used before atropine with hypovolemia

A

volume replacement

52
Q

What can be substituted for atropine in a code

A

Lidocaine

53
Q

Lidocaine is used in

A

VFib
pVTach
stable polymorphic VTach
QT prolongation if torades suspected

54
Q

Lidocaine can be given during a code only if

A

doctor says to give

55
Q

Lidocaine is contraindicated if

A

reduce dose due to impaired liver function

56
Q

Dosage for Lidocaine

A

1-1.5 mg/kg every 5-10 minutes max 3 doses

57
Q

Magnesium Sulfate is given for

A

Torsades de Pointes
suspect hypomagnesium

58
Q

Mag occassionally has what with rapid infusion

A

BP falling

59
Q

Use Mag cautiously if

A

renal failure

60
Q

What do you need before giving Mag even in a code?

A

Mag level

61
Q

Endotracheal tube drugs if IV is not available or started

A

Lidocaine
Epinephrine
Atropine
Narcan

62
Q

Levetiracetam is given for

A

controlling seizures
tx epilepsy

63
Q

Levetiracetam can have an increased risk of side effects with

A

Carbamazepine
Ginkgo

64
Q

Levetiracetam SIDE EFFECTS

A

aggression, delusions
anxiety, depression
personality change
chills
cough
cry
tachypnea with dizziness
dry mouth
N/V/D
INSOMNIA/sleepiness

65
Q

Levetiracetam adverse effects

A

unusual thoughts and behaviors
- dizzy, drowsy,

66
Q

Levetiracetam monitoring

A

renal dysfunction

67
Q

Simvastatin

A

Tx cholestrol and high triglyceride levels
- help prevent clogged blood vessels

68
Q

Simvastatin adverse effects

A

rhabdomyolysis (paralytic)
- muscle breakdown and kidney damage
- tea/red colored urine
- dysrhythmias
muscle pain
tenderness
weakness
cramps

69
Q

Simvastatin patients should avoid drinking

A

grapefruit juice

70
Q

Simvastatin is given

A

At night ( Flushing )

Module 7 (Critical Care) (22 decks)

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