EXAM 2 meds Flashcards
A-fib treatment
diltiazem, amiodarone, digoxin, metoprolol, esmolol
clot prevention
warfarin, dabigatran, rivaroxaban, apixaban
PVC’s tx
lidocaine, amiodarone
lidocaine
antiarrhythmic
used in urgent treatment
assess for lidocain toxicity: confusion, blurred vision, tremors, n/v, ringing in ears
monitor lidocaine levels via bloodwork
diltiazem
CCB, antiarrhythmic
acute care: continuous infusion, maybe bolus before starting infusion
non acute: oral
amiodarone
antiarrhythmic
acute: bolus medication, and continuous infusion
non acute- PO
SE: QT prolongation, bradycardia, hypotension
digoxin
antiarrhythmic, digitalis glycoside, inotrop
a-fib and heart failure
IVP or PO
toxicity*** bradycardia, hypotension, halos
metoprolol
beta blocker
IVP or PO
esmolol
beta blocker
IV
lithium carbonate
effective for acute mania
blood levels: 0.4-0.8 mEq/L (toxic if >1.5)
contra: renal funcion and thyroid, also liver
decrease NA= toxicity
increased Na= subtheraputic
toxicity: large amount dilute urine, then oliguria, EKG changes, uncoordinated, ataxia, seizures, death, course tremor
Maintenance therapy- 9-12mo/ lifelong
anticonvulsant mood stabalizers
valproate (acute phase, prevention from mania)
carbamazepine (druge interactions)
lamotrigine (pregnant, risk SJS)
monitor platlets and liver function
second generation antipsychotics
olanzapine
risperidone
aripiprazole
asenaprine
cariprazine
lurasidone
quetiapine
ziprasidone
dopamine
inotrope, vasopressor, titrate keep MAP >65
increase CO, SV, HR and contractility (low dose)
increase afterload and BP (high dose)
SE: tachycardia, ectopy, increased SVR, peripheral vasoconstriction, low urine ouptut
Norepinephrine
vassopressor, titrate
increase contractility and HR, vasoconstriciton, increase BP, coronary blood flow, increase afterload
SE: tachycardia, increased myocardial oxygen demands, renal/cutaneous/visceral/internal organs vasoconstriction
Vasopressin
ADH, set dose infusion
vasoconstriction, increase BP, decreased blood flow to visceral/internal organs, coronary GI, skin, and muscular systems
SE: abdominal cramps, diarrhea, peripheral vasoconstriction
consider: risk of tissue necrosis if extravasation occurs; central line
epinephrine
adrenaline, vasopressor, titrate
increased HR, SV< cardiac stimulation icnreaseing myocardial oxygen consumption, increase SVR, vasoconstriction at high doses
SE: arrhythmias, peripheral vasoconstriciton, lower doses can increase cardiac output
consider: necrosis with extravasation, central line, monitor bP and ECG
symptoms of serotonin syndrome
delirium
agitation
tachycardia
sweating
myoclonus
hyperreflexia
shivering
coarse tremors
hyperthermia
rhabdomyolysis
renal failure
cardiac dysrhythmias
DIC
Tricyclic antidepressants
second line
block reuptake of neurotransmitters serotonin and norepinephrin causing accumulation at the nerve ending- increased neurotransmitters
amitriptaline, nortriptalyne
TCA adverse effects
sedation, anticholinergic, impotence, orthostatic hypotension, ataxia
Overdose lethal- may use activated charcoal
TCA indications
depression
childhood enuresis
ocd
adjunctive analgesics for chronic pain conditions
MAOIs
phenelzine and tranylcypromine
moa: inhibits MAO enzyme
rarely for depression, more Parkinsons
potential cause hypertensive crisis if taken with tyramine (charcuterie board items)
second generation antidepressants
SSRI, SNRI, bupropion, NDRI, SDNI
fewer effects then MAOI or TCA
4-6wks to reach maximum clinical effectivnes
highly protein bound
second gen antidepressant adverse effects
insomnia, weight gain, anxiety, dizziness, drowsiness, sexual dysfunction, discontinuation syndrome, increased risk bleeding, serotonin syndrom
second gen antidepressant indications
depression, BPD, obesity, eating disorders, OCD, pani attacks, social anxiety, PTSD, premenstrual dysphoric disorder, neurologic disorder myoclonus, substance abuse
