meds Flashcards
An analgesic that relaxes smooth muscle & dilates peripheral arteries & veins; causes decreased venous return to heart to decrease preload
Nitroglycerin
A narcotic analgesic which causes venodilation and can lower heart rate by increased vagal tone; reduces myocardial O2 demand
Morphine
What type of drugs produce vasodilation by blocking conversion of angiotensin I to angiotensin II; since angiotensin is a potent vasoconstrictor it decreases peripheral vascular resistance reducing the pressure that heart must pump against which decreases myocardial workload. A. Beta blockers B. Calcium channel blockers C. Ace inhibitors D. Vasopressors
C. Ace Inhibitors
These type of drugs inhibit beta 1 adrenergic receptor sites to reduce myocardial contractility, SA node rate, and AV node conduction velocity to decrease cardiac work & myocardial O2 demand A. Beta Blockers B. Calcium Channel Blockers C. Ace inhibitors D. Vasopressors
A. Beta Blockers
Potent antiplatelet medications that act on GP receptors on platelet membrane to inhibit & prevent platelets from binding with fibrinogen?
Glycoprotein IIb/IIIa inhibitors
What is the dose of aspirin given?
162 to 325 mg orally
Clopidogrel is what type of medication?
Antiplatelet agent
This medication stimulates beta1 & beta2 receptors, produces vasodilation and has immediate onset of action; It is a beta-adrenergic receptor agaonist & anti-arrhythmic used when atropine not appropriate or while waiting for availability of pacemaker; is alternative to dopamine
Isoproterenol
Antidiuretic hormone & powerful vasoconstrictor; increases cerebral & cardiac blood flow
vasopressin
What is the dose of epinephrine?
1 mg flush every 3-5 min
T or F: Epinephrine will increase myocardial O2 demand
T
What is a dose for epinephrine for continuous infusion?
0.1 to .5 mcg/kg per minute or via ET tube 2 - 2.5 mg diluted in 10 ml of NS
This medication will increase CO by decreasing afterload; it directly depresses automaticity & inhibits alpha & beta receptors
Amiodarone
T or F: Lidocaine should be used as alternative medication in bradycardia or ventricular escape Rhythm
False: It can be lethal with bradycardia and Vent escape rhythms
T or F: Lidocaine should not be given with 3rd degree HB or bradycardia related PVC’s
True
What is the dose for Lidocaine?
1-1.5 mg/kg iv bolus; can repeate in 5-10 min at 0.5 - 0.75; not to exceed max dose of 3 mg/kg
What medication is indicated for torsades?
Mg Sulfate
This anti-arrhythmic medication can be used in asthmatics since it brings down respiratory drive.
Mg Sulfate
These medications are as effective as TCP in the bradycardia algorhythm & used after atropine?
Dopamine
Epinephrine
2-10 mcg /kg/min
What is atropine dose?
0.5 mg bolus every 3-5 min
repeat every 3-5 min
max dose of 3 mg
T or F: Atropine may be given & is effective in type II or III HB
False
This medication is a vagolytic and parasympathetic blocker, considered anticholinergic it relaxes bronchial smooth muscle to increase HR and increase conduction velocity?
Atropine
Antiarrhythmic drug with short half life; main use is to suppress SVT but does not work on a fib or a flutter or vt
Adenosine
What is the dose for Adenosine:
6 mg rapid IV push
12 mg if needed for 2nd dose
Antiarrhythmic used for stable wide QRS tachycardia
Procainamide
What is the dose for Procainamide?
20-50 mg/min until arrhythmia suppressed or
maintenance at 1-4 mg/min
A beta blocker or antiarrhythmic medication used to treat stable monomorphic VT, SVT’s & ventricular arrhythmias; is avoided with prolonged QT
Sotalol
Dose: 100 mg over 5 minutes
This is a calcium channel blocker which is used as an alternative to adenosine for SVT’s narrow complex tachycardia with adequate BP?
Verapamil
A Chronotripic/Ionotropic: This medication increases the strength & vigor of heart contractions and useful in heart failure; alternative drug to reentry SVT to slow vent response in A fib/A flutter but toxic effects are common
Digoxin
This medication can be used in torsades if MG sulfate not available; also used at temporizing measure if external pacer not available but should not be used in cardiac arrest;
Isoproterenol
Name medications used in treatment of ACS according to the guidelines?
O2 Aspirin Nitroglycerin Morphine Fibrinolytics Heparin Beta blockers
What medications are used in treatment of acute stroke per guidelines?
tPA (tissue plasminogen activator) Glucose Labetalol Nitroprusside Nicardipine Aspirin
What medications can be given via ET tube in cardiac emergencies?
Lidocaine epinephrine Vasopressor Narcan Atropine
Enalapril, captopril, lisinopril, ramipril are all what type of medication?
ACE inhibitors or angiotensin converting enzyme inhibitors
What does of aspirin should be administered?
160 mg to 325 mg non enteric coated tablet asap
Any person experiencing pressure, heavy weight, squeezing, crushing suggestive of ischemic pain should be given?
aspirin
What is the IV/IO dose of epinephrine?
1 mg every 3-5 minutes or 1:10,000 solution
Medication given for respiratory depression from sedative effects of benzo OD?
Flumazenil
Used to slow ventricular response in A Fib or A-flutter; alternative to reentry SVT but carries toxic effects and electrical cardioversion must be avoided
Digoxin
This medication can be used for pump problems associated with CHF or pulmonary congestion with no signs of shock?
Dobutamine
Can be used for toxic effects of calcium channel blocker or beta blocker?
Glucagon
This medication used in ACS especially for UA/NSTEMI; it inhibits thrombin generation
Heparin
Phosphodiesterase enzyme inhibitor used in severe congestive heart failure refractory to diuretics, vasodilators, conventional inotripic agents? A. Isoproterenol B. Inamrinone C. Beta blockers D. Alpha adrenergic agent
B: Inamrinone
Used in intracranial pressure management in neurological emergencies? A. Lidocaine B. Aspirin C. Mannitol D. Milrinone
C. Mannitol
Often used in CHF post op patients and can be used with shock with high systemic vascular resistance? A. Lidocaine B. Aspirin C. Mannitol D. Milirinone
D. Milrinone
Reduces afterload in heart failure and acute pulmonary edema, indicated in HTN crisis but contraindicated for patients who have taken ED medications? A. Naloxone B. Nitroprusside C. Norepinphrine D. Adenosine
B. Nitroprusside
Can be used in ketoacidosis, hyperkalemia, prolonged resuscitation efforts but not recommended for routine use in cardiac arrest patients
Sodium Bicarbonate
These types of drugs inhibit movement of CA ions across cell membranes in the heart & vascular smooth muscle resulting in relaxation, dilation, & decreased myocardial O2 demand?
CA channel blockers
Adenosine is an example of what type of medication? A. CA channel blocker B. Beta Blocker C. Antiarrhythmic D. ACE inhibitor
C. Antiarrhythmic
Diltiazem or verapamil, Isoptin is an example of what type of medication? A. CA channel blocker B. Beta Blocker C. Antiarrhythmic D. ACE inhibitor
A. CA channel blockers
During a ventricular escape rhythm ______ should not be given because it may cause asystole by abolishing ventricular activity.
Lidocaine
What medication in the bradycardia algorhythm are given if atropine is ineffective & are as effective as TCP?
Dopamine & Epinphrine
2-10 mcg kg/min
What dose of atropine is given?
0.5 mg bolus with max dose of 3mg
What medications are given in ROSC, and what dose?
IV bolus of normal saline or lactated ringers; 1-2 l;
epinephrine IV infusion 0.1 to 0.5 mcg/kg/min
dopamine IV infusion 5-10 mcg/kg/min
Norepinephrine 0.1 to 0.5 mcg/kg per min
A substance that increases heart rate is
chronotropic
A substance that increases force of contraction?
Inotrope
Are natural catecholamines, adrenergic agonists and work on alpha and beta receptors
epinephrine
Dopamine
When beta 1 receptors are stimulated the release of renin occurs which promotes production of angiotensin; this works to cause?
A. Vasodilation
B. Vasoconstriction
C. Smooth muscle of bronchi dilation
A. Vasoconstriction
When beta 2 sites are stimulated which are found in heart lungs, and skeletal muscles which occur
A. Vasodilation
B. Vasoconstriction
C. dilation of bronchi when smooth muscle is stimulated
C. dilation of bronchi
When alpha 1 receptors are stimulated what results?
A. Vasodilation
B. constriction
b. constriction
When alpha 1 is stimulated ______ results; when beta 1 receptors are stimulated ______ results; when beta 2 receptors are stimulated then _____ results.
Alpha 1= constriction
Beta 1 = vasoconstriction
Beta 2= dilation
Angiotensin is a powerful _____.
A. Vasodilator
B, Vasoconstrictor
A. Vasoconstrictor
______ promotes production of angiotensin.
Renin
What are the 5 main sympathetic receptors?
A1, A2, B1, B2, dopamine
A drug that is alternative to adenosine?
verapamil
Used in cardiogenic shock, increases myocardial O2 demand, causes peripheral vasoconstrictor & severe hypotension not caused by hypovolemia?
Norepinephrine: .1 to .5 mcg/kg
Blocks parasympathetic nervous system; allows heart to return to own inherent rate used in bradycardia but does not work on HB
Atropine
Suppresses SA & AV node activity but does not work on A fib or A flutter; not useful for 2nd or 3rd HB; can use in wide monorphic vt; has quick action time of 5 seconds
adenosine
Furosemide is an example of_____.
diuretic
Used in chest pain unresponsive to nitrates with ACS;
Morphine, 2-4 mg IV over 1-5 min every 5-30 min
List medications that may be administered in tachycardia?
Adenosine Diltiazem Beta blockers Amiadarone digoxin verapamil Mg sulfate
This medication is also known as ______.
ADH
If you have a wide QRS that does not respond to vagal maneuvers or adenosine if regular than ______ or ______ can be given.
Beta blockers or calcium channel blockers
What is the dose for sotalol via IV
100 mg over 5 minutes
According to ACS algorhythm \_\_\_\_\_ can be given for ST depression. A. Adenosine B. Atropine C. Amiodarone D. Clopidogrel
D. clopidogrel
In hemorrhagic stroke \_\_\_\_\_\_ should be administered. A. Clopidogrel B. morphine C. Beta blockers D. Aspirin
D. aspirin
Indications for this diuretic include glaucoma, metabolic alkalosis, altitude sickness. A. Lasix B. Isosorbide C. Diamox D. Ringers solution
C. Diamox
______ can be used in hydration, replacement therapy of D5W.
Crystalloids
What is the formula for FR?
Vt X RR x (I + E)
What is RSBI formula?
Frequency/VT
What is formula for duration of E tank?
Pressure x 0.28/ flow (lpm)
What is formula for desired PaCO2 for known Ve?
Known Ve x known PaCo2= desired Ve x desired PaCO2
What is formula for MAP?
Systolic + 2(diastolic) / 3
What rhythm should not be given with lidocaine? A. 2nd degree HB B. Ventricular escape rhythms C. Bradycardia D. All of the above E. Both B & C F. A & B
B & C
What medication is used for unstable heart block?
epinephrine
Digitalis should not be used in the treatment of ______.
AVRT
Nebulized albuterol can be used in treatment of ____.
Hyperkalemia
Digoxin may be of limited use but can be used in _____ or _______ and is alternative drug for SVT. Toxic effects are common will react with amiodarone.
A fib, A flutter
What is the dose for amiodarone?
1st dose is 150 mg
2nd dose is 300 mg
