Medication Study Guide ICU/SDU

Question 1

What’s the mechanism of action of adenosine (Adenocard)?

Answer 1

Antidysrhythmic that is naturally occurring nucleoside that:

1. *Acts on the AV node to slow conduction, *
2. Interrupts AV nodal re-entery pathways
3. Restores NSR in patients with PSVT​

IT DOES NOT TERMINATE NON-RE-ENTERY DYSRHYTHMIAS

        Ex. (a-fib, a-flutter, atrial or ventricular tach)

But it may produce transient AV block which may clarify the Dx.

Question 2

What is the half-life for adenosine? Why?

Answer 2

< 10 seconds

• Produces short-lived response because it is rapidly sequestered by the RBCs.

Question 3

What’s the appropiate dosage for Adenocard?

Answer 3

1. 6 mg rapid IVP (over 1-3 secs) followed by a saline bolus
2. If PSVT doesn’t convert after 1-2 mins, give 12 mg rapid IVP
3. May repeat 12 mg dose x1 if doesn’t convert

****USE THE IV PORT CLOSEST TO THE PATIENT **

Question 4

What are some adverse effects of adenosine?

Answer 4

1. Transient flushing, dyspnea, crushing CP (usually resolve within 1-2 minutes)
2. Brief period of asystole (up to 15 secs, common after rapid administration)
3. Transient periods of sinus brady and ventricular ectopy are common after termination of the dysrhythmias

Question 5

Due to Adenocard’s short duration there is _______ (more/less) chance for __________(HTN/Hypotension)

Answer 5

less

hypotension

Question 6

Therapeutic concentrations of _______________ or _______________ ingestion block the receptor responsible for effects of adenosine.

Answer 6

Theophylline

Caffeine

Question 7

What’s the initial drug choice for diagnosis/treatment of SVTs?

Answer 7

adeonisne (Adenocard)

Question 8

______________ blocks the uptake and potentiates the effects of Adenocard

Answer 8

dipyridamole (Persantine)

antiplatelet agents, diagnostic agents (coronary vasodilators)

Produces coronary vasodilation by inhibiting adenosine uptake.

Question 9

True/False

Repeat episodes of PSVT may be treatred with additional doses, but other drugs may be preferable due to their longer duration of action

Answer 9

True

Question 10

What are the (3) actions of Lopressor (metoprolol)?

Answer 10

1. Blocks B₁ receptors in the heart to slow HR
2. Reduces elevated RENIN levels
3. Blocks B₂ receptors in bronchial & smooth muscle only at high doses

Question 11

What is Lopressor used for? (4)

Answer 11

1. Tx for mild to moderate HTN
2. Agina
3. To provide Myocardial Protection during AMI
4. Tx Class II, Class III HF

Question 12

**Whats the dosage for Lopressor: **

1. For Adult HTN?
2. Adult AMI?

Answer 12

1. Adult HTN: 50-100 mg daily
2. Adult AMI early Tx: 5 mg IVP q 2-5 mins x 3 followed by 50 mg PO 15 mins after the last dose and q 6 hours x 48 hrs

Question 13

What are the adverse effects of Lopressor? (5)

Answer 13

1. Hypotension
2. Bradycardia
3. Pulmonary Edema
4. Depression
5. Bronchospasm especially in asthmatics

Question 14

There is a(an) _____________ (Increased/Decreased) hypoglacemic effect with oral antidiabetic drugs during Beta Blockers therapy

Answer 14

Increased

Question 15

Is it okat to ever give Beta Blockers for AMI with a slow HR and _BP<90 mmHg _?

What to do about the BP? (2)

Answer 15

YES

1. Adjust rate of administration
2. or use **IV bolus of NS **

Question 17

Whats the Vasopressin IV dosage for cardiac arrest?

Answer 17

40 units IVP

**Wait 10 minutes before giving any other pressor agents such as epinephrine**

Supplied in two (2) 20 unit vials

Question 18

What drug is considered to be equivalent altrenative to epinephrine in pulseless VT/VF tx?

Answer 18

Vasopressin

Question 19

What’s Vasopressin used to tx? (3)

Answer 19

1. Neurogenic (DI)
2. GI Hemorrhage
3. Pulseless VT/VF

Question 20

IM or SQ Vasopressin dose?

Answer 20

**5-10 units at 3-4 hour intervals undiluted* **