Medication Flashcards
Beta Blocker (Metoprolol, Atenolol etc) act to block the body’s ______-__________ system and reduce ______ ______
Fight or flight system
heart rate
Labetalol is utilized to reduce _______ _____ acutely in patients suspected of acute stroke
blood pressure
Beta Blockers are utilized orally to control __________, decrease chronic ______ on the __________ and other cardiac indications.
hypertension, workload on the myocardium
Beta Blockers Contraindications
Do not give to patients with AMI if sign of ___________ __________ or low _______ _________ is present
Heart failure or low cardiac output
Beta Blockers should not be given with _________ or ___________ _________
Bradycardia or heart block
Beta Blockers should not be given simultaneously with _________ _________ ________ (such as Diltiazem or Verapamil) as severe hypotension and/or heart block can occur
calcium channel blocker
Beta Blockers can be given slowly while monitoring the patient’s response to the medication T/F
True
Acute care environment Dosage for Metoprolol
5 mg IV every 5 minutes as tolerated to a maximum of 3 doses. Titrate to Heart rate and blood pressure response.
Acute care environment Dosage for Atenolol
5 mg IV over 5 mins. 2nd dose after 10 minutes given over 5 minutes
Acute care environment Dosage for Propranolol (to slow the heart rate in SVT)
0.5-1.0 mg over 1 minute, repeat as needed to a total dose of 0.1 mg/kg
Acute care environment Dosage for Esmolol
0.5 mg/kg over 1 minute followed by an infusion of 0.05 mg/kg per minute to a maximum dose of 0.3 mg/kg
Acute care environment Dosage Labetalol
10 mg IV push over 1-2 minutes: may repeat or double every 10 minutes to a maximum dose of 150 mg
Digoxin is used to slow ventricular response in ________ _________.
atrial fibrillation
Digoxin is available as an oral preparation and is frequently used as a _______ __________ __________ medication
atrial fibrillation maintenance
Digoxin can be used as a 2nd or 3rd line medication for ________ ________________
re-entry Supraventricular Tachycardias
Digoxin Loading dose is
4-6 mcg/kg given slowly over 5 mins.
Diltiazem is a ___________ _________ Blocker
Calcium Channel
Diltiazem is used to control the rate in ________ _________ and ______ ________
Atiral Fibrillation and Atrial Flutter
Diltiazem can stop arrhythmias that require the AV node to continue such as __ ______ _______ ___
AV nodal Reentry SVT
Diltiazem cause ________ _______ relaxation that results in ___________, decreases the amount of force generated by myocardial contraction, and drecreases _______ ______ and decreases conduction at the AV nodal level
smooth muscle vasodilation, heart rate
Diltiazem Dosage
15-20 mg IV over 2 minutes. Another dose of 20-25 over 2 minutes and mantenance infusion at 5-15 mg/hour. Dose titrated to desired Heart rate
Diltiazem side effect is
Hypotension
Diltiazem should not be use in patients with
Wolff-parkinson-white (WPW), AV nodal blockif that patients does not have a pacemaker or with sick sinus syndrome
Lidocaine is used as an alternative in ________ ______ from __/_____
Cardiac arrest from VF/pVT
Lidocaine dosage For Cardiac Arrest
1-1.5 mg/kg IV or IO. It can be repeated at 5-10 min intervals to a maximum of 3 doses (2nd and 3rd dosese are given at half dose) or total of 3 mg-kg
Lidocaine can be given as a infusion for stake Ventricular Tachycardia what is the maintenance infusion rate
1-4 mg/kg
When is Magnesium Sulfate used
Torsades De Pointes with documented Prolonged QT interval during the Patients Normal Sinus Rhythm.
What is a side effect to Magnesium Sulfate?
Severe Hypotension
Procainamide is used for the treatment of a number of arrhythmia’s including…
stable Ventricular Tachycardia, Stable reentry SVT, Stable Wide complex rhythm that have unknown origin and Atrial fibrillation with a fast rate in patients with WPW.
Procainamide dosage is
20 mg/min via IV infusion until Arrhythmia subsides, Patient become hypotensive, QRS complex wides by 50% or the maximum dose of 17 mg/kg has been administered.
Procainamide cautions include
If renal or cardiac dysfunction the dose should be decreased to a maximum dose of 12 mg/kg
QT interval should be monitored closely.
Verapamil is what class of drug
Calcium Channel blocker
Verapamil is used to treat/terminate
reentry SVT (narrow complex tachycardia) in patients with good left ventricular function.
Verapamil intial dose dosage
2.5-5 mg IV bolus over 2 mins.
Verapamil 2nd dose dosage
repeat dose after 15-30 mins and is 5-10 mg given slowly
Maximum dose for Verapamil is
20 mg
Extreme caution must be exercised when verapamil is given in conjunction with beta blockers as severe what can occur?
Severe Bradycardia and Hypotension.