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ACLS > Medications > Flashcards

Medications Flashcards

1
Q

DOPamine action

A

+ Chronotropic
+ Ionotropic
Increase HR
Increase Contractility

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2
Q

DOPamine indications

A

Bradyarrhythmia/hemodynamic compromise (2nd line)
After cardiac arrest

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3
Q

DOPamine dose

A

Bradyarrhythmia: 5-20 mcg/kg/min titrate to effect
After cardiac arrest: 5-20 mcg/kg/min

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4
Q

DOPamine cautions

A

can increase myocardial oxygen demand
can cause ventricular arrhythmias

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5
Q

Adenosine action

A

Slows conduction of impulses through the AV node

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6
Q

Adenosine indications

A

Regular narrow-complex tachyarrhythmias/no hemodynamic
compromise

Regular narrow-complex tachyarrhythmias/hemodynamic
compromise (do not delay cardioversion)

Regular monomorphic wide-complex tachyarrhythmias/no hemodynamic compromise

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7
Q

Adenosine dose

A

Has an extremely short half-life; administer over 1–2 s, at a site as
close to the heart as possible

6 mg by rapid IV/IO push follow by 10 to 20-mL NS flush

If not effective after 1–2 min, 12 mg by rapid IV/IO push followed by 10 to 20-mL NS flush

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8
Q

Adenosine cautions

A

Therapeutic effects can be blocked by the presence of caffeine or theophylline

VF possible if adenosine is administered for unstable, irregular or polymorphic wide complex tachycardias

Can temporarily evoke a transiently slow ventricular rate or complete cessation of electrical activity; as drug is eliminated, electrical activity resumes

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9
Q

Amiodarone action

A

Class III antiarrhythmic; delays repolarization and prolongs the QT interval

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10
Q

Amiodarone indications

A

Shock-refractory VF/pulseless VT

Refractory tachyarrhythmia with a pulse/hemodynamic compromise

Wide-complex tachyarrhythmia/no hemodynamic compromise

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11
Q

Amiodarone dose

A

For VF/pulseless VT:
* First dose: 300 mg IV/IO bolus
* Second dose: 150 mg after 3–5 min

For tachyarrhythmia with a pulse:
* 150 mg IV over 10 min; may repeat as needed if arrhythmia recurs
* Maintenance infusion: 1 mg/min for first 6 hours

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12
Q

Amiodarone cautions

A

Do not use with other drugs that prolong QT interval

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13
Q

Atropine action

A

Blocks the effect of acetylcholine released by the vagus nerve at muscarinic receptors, thereby increasing the rate of firing of the SA node and conduction through the AV node.

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14
Q

Atropine indications

A

Bradyarrhythmia/hemodynamic compromise

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15
Q

Atropine dose

A

1 mg IV bolus every 3–5 min, up to a max dose of 3 mg

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16
Q

Atropine cautions

A

Use in patients with acute coronary ischemia or myocardial infarction may have negative outcomes because of increased heart rate and myocardial oxygen demand

IV/IO doses of less than 0.1 mg may cause paradoxical bradycardia

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17
Q

Epinephrine action

A

Acts on both α- and ß-adrenergic receptors; induces systemic
vasoconstriction and increases heart rate and contractility

18
Q

Epinephrine indications

A

Cardiac arrest (VF, pulseless VT, pulseless electrical activity, asystole)

After cardiac arrest

Bradyarrhythmia/hemodynamic compromise (second-line agent)

19
Q

Epinephrine dose

A

For VF/pulseless VT/pulseless electrical activity/ asystole:
* 1 mg IV/IO followed by 10 to 20-mL NS flush every 3–5 min

For post–cardiac arrest care:
* 2-10 mcg/min IV/IO

For bradyarrhythmia:
* 2–10 mcg/min titrated to effect

20
Q

Epinephrine cautions

A

Increased blood pressure, heart rate and myocardial oxygen demand may cause myocardial ischemia

21
Q

Lidocaine action

A

Class Ib antiarrhythmic (sodium channel blocker); delays repolarization and slightly increases the QT interval

22
Q

Lidocaine indications

A

VF/pulseless VT

23
Q

Lidocaine dose

A

First dose: 1–1.5 mg/kg IV/IO followed by 10 to 20-mL NS flush

Subsequent doses: 0.5–0.75 mg/kg IV/IO followed by 10 to 20-mL NS
flush every 5–10 min, up to a max dose of 3 mg/kg

24
Q

Lidocaine cautions

A

Do not use prophylactically in patients with acute myocardial infarction

Monitor patient for toxicity

Reduce maintenance dose in patients with hepatic disease or left ventricular dysfunction

Do not alternate between amiodarone and this medication

25
Q

Naloxone action

A

Competitively binds to μ-opioid receptors

26
Q

Naloxone indications

A

Opioid overdose

27
Q

Naloxone dose

A

0.4–2 mg IV/IO/IM/IN/SC repeated every 2–3 min

28
Q

Naloxone cautions

A

may precipitate opioid withdrawal syndrome (rarely life threatening)

29
Q

NORepinephrine action

A

Acts on both a- and ß-adrenergic receptors to increase heart rate,
contractility and vasoconstriction; increases systemic blood pressure and coronary blood flow

30
Q

NORepinephrine indications

A

after cardiac arrest

31
Q

NORepinephrine dose

A

0.1-0.5 mcv/kg/min IV/IO

32
Q

NORepinephrine cautions

A

Potent vasoconstrictor; extravasation can lead to necrosis

33
Q

Procainamide action

A

Class Ia antiarrhythmic (sodium channel blocker); delays repolarization and prolongs the QT interval

34
Q

Procainamide indications

A

Refractory tachyarrhythmia with a pulse/hemodynamic compromise

Wide-complex tachyarrhythmia/no hemodynamic compromise

35
Q

Procainamide dose

A

20–50 mg/min until arrhythmia is suppressed, hypotension develops,
QRS duration increases by more than 50%, or max dose of 17 mg/kg is given

Maintenance: 1–4 mg/min

36
Q

Procainamide cautions

A

May induce torsades de pointes

Avoid in prolonged QT or congestive heart failure

37
Q

Sotalol action

A

Prolongs repolarization; also acts as a ß-blocker

38
Q

Sotalol indications

A

Refractory tachyarrhythmia with a pulse/hemodynamic compromise

Wide-complex tachyarrhythmia/no hemodynamic compromise

39
Q

Sotalol dose

A

100mg (1.5 mg/kg) over 5 min

40
Q

Sotalol cautions

A

Avoid in prolonged QT interval

ACLS (1 decks)

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