Meds, dose, gtt Rate, Ect. Flashcards
Dose and administration for Cardiac EPI
Pulseless arrest.
Iv 1 mg Q 3-5 min. Follow with 20 mL NS.
Elevate arm.
Dose and administration for Cardiac EPI.
ET TUBE
2-2.5 mg diluted in 10 mL of NS
CARDIAC EPI PROFILE.
Catecholamine stimulates A&B ADRENERGIC receptors.
-rapid injection = rapid increase in bp, ventricular contraction, HR.
Vasoconstrictor.
EPI (cardiac epi) 1:10,000 (pg. 1589) What is the Class, Indication Contraindication
sympathomimetic
- Cardiac arrest, PEA, vFib, symptomatic Brady.
- hypovolemic shock. (Fill the tank first)
EPI is initial drug choice for:
Bronchoconstriction
Hypotension (from anaphylaxis)
All forms of cardiac arrest.
Dose and administration for Cardiac EPI
Continuous infusion for pulseless arrest.
Add 1 mg of EPI (1 ml of 1:1000) to 500 mL of NS or D5W.
Infuse at
0.1-0.5 mcg/kg/min titrate to responce.
ATROPINE.
Class
Indication
Contraindication
Anticholinergic agent
IN- symptomatic brady
- organophosphate poisening
CON- tachy, hypersensitivity,
-hypothermic brady.PROFILE: Atropine
Parasympatholytic: inhibits ACH at muscorinic receptor sites.
Blocks vagal effects to ⬆️ HR.
ATROPINE.
Dose and administration:
Symptomatic BRADY: 0.5mg Q 3-5 min max 3mg.
RSI: 0.01-0.02 mg/kg IV/IO max 0.5 mg
Poisening: 1-2 mg Q 5-15min until effect.
WHAT ARE SOME Special considerations for
ATROPINE?
Follow ET-T with PPV.
Makes pupils unreactive. Pupil response is not useful for neuro status.
Adenosine! (Adenocard)
Class
Indications
Contraindications
-Antidysrhythmic
Ind.
-PSVT (wpw),TRIAL in:wide complex tach.(May convert rhythm to sinus)
Cont.
-drug induced tach, 2nd or 3rd degree blocks, HYPERSENSITVITY,
A flutter, a fib, v tach, wpw with a fib/flutter. It will not convert to sinus.
Adverse effects
adenosine.
Shortness of breath, torsades, ventricular ectopy, light headedness, palpitations, chest pain. Hypotension.
DUH! Youre stopping their heart for a few seconds!
Dose and administration
Adenosine:
1st: 6 mL rapid iv. Follow with 20 mL flush.
2nd: 12 mg may be given in 1-2 min if needed.
Trandelenburg, clamp above injection port, flush, unclamp.
Some special stuff.
Adenosine.
May produce bronchoconstriction in pts with asthma or bronchopulmonary disease.
-Pt taking theophylline or caffeine ⬆️dose.
AMIODERONE!
class
indications
Contraindications
- C3 antidysrhythmic
- IND: 1st treatment and prophylaxis of recurring V-FIB, & V-TACH.
- CON: cardio shock, 2nd or 3rd block,brady, SENSITIVITY (also to iodine)
Amioderone (cordarone)
Profile
Beta adrenergic and calcium channel clocker activity.
Basically, slows down the heart.
AMIODERONE
Adverse reactions.
Hypotension, brady, headache, abnormal salivation.
Dose and administration:
Amioderone.
Adult: pulseless arrest- cpr,defib, vasopressors, 300 mg IVP, 2nd dose at 150 mg IVP.
Bad dysrhythmia: 150 mg IV / 10min Q 10 min.
Maintenance drip: 1 mg/ min for 6 hours.
Adenosine Profile.
Formed from ATP breakdown.
⬇️electrical conduction (inotropy)
⬇️chronotropy (hr)
Does not convert: a-fib, a-flutter, or vt.
Lidocain. (Xylocaine)
Class
Indications
Contraindications.
Local anesthetic& antidysrhythmic
IND- cardiac arrest: from vt or vFib.
Stable VT, and wide complex tach.
CON- hypersensitivity, 2nd or 3rd degree block with no pacemaker.
lidocaine:
Profile.
Decreases automaticity
Suppressing premature ventricular complexes.
Can switch with Amioderone in cardiac arrest from vT or vFib.
Lidocaine
Adverse reactions.
Hypotension, blurred vision, light headed, brady, low LOC, seizures.
Dose and administration:
Lidocaine
Cardiac arrest.
vTach or vFib cardiac arrest:
1-1.5 mg /kg Q 5-10 minutes. Max 3 mg/kg
Dose and administration:
Lidocaine
Stable vT- wide complex tach
.5 mg/kg max 1mg /kg max 3 mg
Lidocaine
Maintenance drip.
1-4 mg/min
Lidocaine
RSI
1-2 mg/kg (max 100mg)
Procainamide
Class
Indications
Contraindications
Antidysrhythmic
IND: Stable vTach & wide complex tach
Con: 2nd & 3rd AV block, torsades,digTox. Heart block.
PROCAINAMIDE: profile
Reduces ectopic beats
Slows ventricular conduction
Can help control PVC,
Procainamide
Adverse reactions.
Hypotension, brady, pvc, vTch, vFib, asystole. ⬇️cns.
Dose and administration:
Procainamide.
20-50 mg IV, max 17mg,
Maintainance drip at 1-4 mg/min (1g in 250 mL of NS or d5w.)
Dose and administration for Cardiac EPI. And continuous infusion.
Profound Brady or hypotension.
Adult: 2-10 mcg/min infusion titrate to responce.
C-I: 0.1-1 mcg/kg/min higher dose may be effective
Special considerations.
Do not use pre filled syringes for…..
EPI INFUSIONS!
DILTIZEM cardizem
class
indications
Contraindications
CCB
-Control V-rate in aFib and aFlutter
Atrial tach, and PSVT.
CON: wide QRS tach, 2nd or 3rd av block, hypotension, hypersensitivity, wpw, vTach, MI.
Diltiazem
Adverse reactions:
A flutter, av block, bradycardia, hypotenaion, chest pain, dysrythmias.
Diltiazem
Profile.
Slows conduction
Coronary and peripheral vasodilation
Use after adenosine in SVT pts with normal qrs and bp.
Dose and administration:
Diltiazem
.25mg/kg SIVP Q 15 minutes
Maintenance drip at
Dilute 125 mg in 100 mL of solution. Infuse 5-15 mg/ hr titrate to HR.
Special crap.
Diltiazem
Do not give with furozemide.
Caution with renal pts
Caution with a BB.
Conversion of SVT to NS = PAC.
Verapamil(isoptin)
Class
Indication
Contraindication
CCB
IND: SVT, a flutterRVR, a fibRVR, unstable angina.
CON: Hypersensitivity, sick sinus syndrome, 2nd or 3rd degree heart block.
Verapamil (isoptin)
Profile.
Antidysrhythmic, antianginal,& antihypertensive. Keeping Ca + ions from moving across cell membrane.
May be used after Adenosine as an alternate drug.
Verapamil (isoptin)
Adverse reaction.
Dizziness,
Headache,
N.V
Hypotension bradycardia
Do not give ———–
With Verapamil?
BB.
May increase serum level of dig.
May have a hypotensive effect.
Verapamil
Dose and administration.
.
2.5-5 mg SIVP Q 5-10 mg Q 15 max 30 mg
