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Q5 ACLS > Meds > Flashcards

Meds Flashcards

1
Q

α does what?

A

Vasoconstrictor (SNS: Vascular bed))

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2
Q

β1 does what?

A

↑ HR (SNS: heart)
Speeds conduction
↑ contraction force

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3
Q

PNS does what?

A

↓ HR and conduction speed

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4
Q

Inotrope is?

Causes of + inotrope effect?

Causes of - inotrope effect?

A

Contractility

+ = digoxin, dopamine, epi

  • = verapamil (CCB), acidosis, hypoxemia
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5
Q

Chronotrope is?

Causes of + chronotrope effect?

Causes of - chronotrope effect?

A

Rate

+ = epi, atropine (antichol)

  • = adenosine (antiarrhy), diltiazem (CCB)
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6
Q

Dromotrope is?

A

Speed of AV conduction

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7
Q

Primary goal of tx is to optimize what first?

A

Rate/rhythm in diastole

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8
Q

Affecting Stroke Volume: Preload (volume)?

Afterload (resistance)?

Contractility (pump)?

A

NS

Norepi

Dopamine

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9
Q

Synchronized Countershock used for?

Used when?

Measured in?

A

Stop impulse during relative refractory (T’s)

Tachy: when pt has pulse but doesn’t respond to pharm

Joules

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10
Q

External Pacemaker used for?

Used when?

Measured in?

A

Take place of dysfxn’l pacemakers

To capture vents and get a QRS

Milliamps

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11
Q

Amiodarone class?

Action?

A

Antidysrhy multi-channel blocker

Blocks Na+, K+, Ca2+, α and β

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12
Q

Amiodarone used for what type of pts?

Why?

A

STABLE pts with normal QTI

Amio can make Long QTI’s become Torsades
Unstable pt’s need quick intervention, amio has 10 min lead

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13
Q

Amiodarone indications?

A 
Vent rhythms (all wide, ugly, bizarre)
Rate control of Af and AF
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14
Q

Amiodarone: Initial dose?

Repeat dose?

Special instructions?

A

150 mg

150 mg

Run minimum of 10 min @ 15mg/min

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15
Q

Amiodarone precautions?

A 
May cause:
Vasodilation and hypoTN
Torsades
Neg inotrope
Prolong QTI

t1/2 = 40 days

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16
Q

Lidocaine class?

Action?

A

Antidysrhy, weak Na+ channel block

Affects vents:
Blocks re-entry
↓ automaticity
↑ Vfib threshold

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17
Q

Lidocaine indications?

A

PULSELESS VT and Vfib
Stable VT
WCT
Control PVCs in infarct w/o brady

  • Only works on re-entry caused Vtach
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18
Q

Lidocaine: Initial dose?

Repeat dose?

Special Instructions?

A

1 to 1.5 mg/kg

1/2 initial dose

None

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19
Q

Lidocaine precautions?

A

Toxicity w/ CNS signs

20
Q

Loss of cardiac compensation is?

Sxs? (7)

A

Vtach takes over regardless of meds

↓BP
ST/T ∆s
Chest pain
Nausea
Diaphoresis
∆ in LOC
SOB
21
Q

Next step in loss of compensation?

A

electrical

22
Q

Electrical Intervention in Vtach: Mode?

Initial joules?

A

(Pt still has pulse)
Synchronized countershock

100 j

23
Q

Monomorphic Vtach Mgmt: Pharm?

Electrical?

A

Amiodarone 150 mg or
Lidocaine 1 mg/kg

Sedate
Synch @ 100j

24
Q

Wide Complex Tachy (WCT) is?

A

Same as Vtach but of uncertain origin

No normals on the ECG to compare to

25
Q

WCT mgmt: Pharm?

A

Same as Vtach + P Adenosine

26
Q

Adenosine used for WCT if pt meets all 4 criteria?

A

1) Stable (BP >90)
2) Rhythm undifferentiated (no normal to compare)
3) Rhythm regular
4) Monomorphic QRS’s

27
Q

Racing heart indicates rhythm from where?

A

Supervents

28
Q

Narrow Complex Tachy (NCT) with regular rhythm caused by? (4)

A

Re-entry SVT
Jxn’l tachy
Arial flutter
Ectopic atrial tachy

29
Q

NCT w/ reg rhythm tx? (3)

A

DOC = Adenosine* (if works, re-entry was cause)
CCB (if works, jxn’l was cause)
β-block

*must have HR > 160, narrow QRS and reg rhy to use,
otherwise use a blocker

30
Q

NCT w/ irregular rhythm caused by? (3)

A

Atrial fib
Atrial flutter
MAT (wandering)

31
Q

NCT w/ irregular rhythm tx? (2)

A

CCB

β-block

32
Q

Adenosine class?

Action?

A

Antidys

Effects on supravent tissue:
Interrupts RE-ENTRY
↓ SA and AV node
↓ conduction thru AV
↓ HR

t1/2 = 5 seconds

33
Q

Adenosine indications? (2)

Doesn’t help? (2)

A

NCT (SVT)
Stable, reg mono WCT

AF or Af

34
Q

Adenosine: Initial dose?

Repeat dose?

Special inst?

A

6mg

12mg x 2

Deliver in < 3 sec
Follow w/ flush

35
Q

NCT electrical mode?

Initial joules?

A

(Pt w/ s&s of decomp)
Sedate
Synchronized

50 j

36
Q

Cut off for needing O2?

A

<94% need O2

37
Q

Brady tx?

A

Atropine if:

1) HR <60
2) Pt symptomatic

38
Q

Atropine class?

A

Parasympatholytic

39
Q

Atropine action?

A

Indirect ↑ HR (inhibits PNS)
↑ AV conduction
Doesn’t fix problem, just buys time
Doesn’t work if issue is in tissue w/ low PNS innervation

40
Q

Atropine indication?

A

Brady

41
Q

Atropine dosing: Initial?

Repeat?

Special instructions?

A
  1. 5 mg
  2. 5 to 1 mg

None

42
Q

Electrical for brady?

Starting setting?

A

External pacemaker (TCP)

Lowest milliamps w/ 80 bpm rate

43
Q

Brady tx if pharm and electric don’t work?

A

Dopamine

2 to 10 ug/kg/min

44
Q

Brady w/ 2° Type II or 3° first line tx?

A

TCP

45
Q

Nitro should NOT be used when? (5)

A 
SBP < 90
SBP drop >30
HR 100
Recent Phosphodiaesterase Inhib use
Inf wall or RV MI

Q5 ACLS (8 decks)

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