Meds II Flashcards
An anti-arrhythmic used in treatment of SVT arrhythmias & ventricular arrhythmias in pts without structural heart disease
Sotalol
1st drug for most forms of stable, narrow SVT
Adenosine
Dose:
100 mg over 5 min (1.5 mg/kg)
Sotalol
Blocks platelet aggregation by blocking formation of thromboxane; reduces ACT mortality and reinfarction
Aspirin
Used in respiratory and neurologic depression from opiates
Narcan or
Naloxone Hydrochloride
A calcium channel blocker used for hypertensive emergency
Nicardipine
Anti angina for suspected ischemic pain
Nitroglyceride
Prevents conversion of angiotensin I to angiotensin II to reduce mortality and improve LV dysfunction in post AMI
Ace Inhibitors
This drug will cause toxicity in patients with renal failure; it is an antiarrhythmic
Sotalol
Dose: 6 mg rapidly over 1-3 seconds; 2nd dose 12 mf in 1-2 minutes
Adenosine
Dose 160 mg - 325 mg non enteric coated by chewing
Aspirin
Adjuvant therapy of acute pulmonary edema without symptoms of shock
Lasix or Furesomide
Alternative to amiodarone in cardiac arrest from VT/VF in stable monomorphic VT with preserved left ventricular function
Lidocaine
These are given with low doses orally and steadily increased to achieve full dose in 24-48 hrs; within 1st 24 hrs of onset of AMI
Should be given orally
Ace inhibitors
Administered to all patients with suspected myocardial infarction or unstable angina
Beta Blockers
This is a beta blocker which is the only one that can be used with SV
Propranolol
IV bolus: 12.5 - 25 mcg
Infusion: 10 mcg/min
Nitroglycerine
Reduces afterload in heart failure and acute pulmonary edema and mitral or aortic valve regurgitation
Nitroprusside
This medication cannot be used with phosphodiesterase inhibitors for ED
nitroglycerine
Inhibits myocardial and smooth muscle contraction to reduce vascular resistance and BP
CA channel blockers
This medication can be used for pump problems associated with CHF or pulmonary congestion with SBP > 70-100 mmHG & no signs of shock
Dobutamine
Beta Adrenergic Agonist
Temporizing agent if external pacer not available for symptomatic bradycardia
Isoproterenol
Used in severe CHF refractory to diuretics, vasodilators, or inotropics
Inamrinone
ADP antagonist
Adjunctive anti platelet therapy for ACS used in STEMI or high risk of non ST elevation
Clopidogrel
Very short duration of action & treats SVT arrhythmias such as A Fib or A Flutter that is less than 48 hrs old
Ibultilide
Used in post op Cardiovascular surgical patients with CHF
Milrinone
Hypertensive Crisis
Reduces afterload
Nitroprusside
Used to slow ventricular response in A Fib or A flutter; toxic effects common with serious arrhythmias
Digoxin
Used in refractory torsades unresponsive to Mg Sulfate; not used for cardiac arrest treatment
Isoproterenol
Used in increased ICP pressure in neurological emergencies
Mannitol
Used in cardiac arrest when torsades is present
Mg Sulfate
Used in respiratory depression and due to effects of benzodiazepines
Flumazenil
Not for routine use in cardiac arrest; used with ST elevation or new BBB when less than 12 hrs from onset
rtPA
Alternative drug for reentry SVT with narrow QRS, adequate BP, and LV function
Verapamil
Not recommended for routine use in cardiac arrest but may be used if prolonged resucitation
Sodium Bicarb
Mechanism of action is ascending loop of henle
loop diuretics: bumex (bunetomide), Ederin, Furosemide
Works on tubules in kidneys and interferes with Na and Cl reabsorption
K Sparing Diuretics: Spironolactone, amiloride
Doses come in strengths of 5, 10, 15, 20, 25%
Mannitol
Loading dose: 300-600 mg orally, then maintenance
Clopidegrel
Interfers with reabsorption in distal tubule and early collecting duct
Thiazide
Carbonic Anyhydrase Inhibitor, not a primary diuretic but can be used in glaucoma, met alkalosis, altitude sickness
Diamox, Acetazolamide
Is a diuretic that is freely filtered at glomerulus which slows absorption
Glucose, osmotics, isosobide, mannitol, urea
Used for chest pain when unresponsive to nitrates;
Morphine
Dose: 2-20 mcg/kg/min with low SBP below 70-100 mmHg
Dopamine
Dose: 40 units IV
Vasopressin
Dose: 20-50 mg/min with max dose of 17 mg/kg
Procainamide
Dose: 1 mg every 3-5 minutes (1:10,000 solution)
Epinephrine
Dose: 300 mg IV/IO can be followed by 150 mg after 3-5 min
Amiodarone
This anti-arrhythmic should be avoided if a prolonged QT interval is present or CHF
Procainamide
Infusion dose: 0.1 - 0.5 mcg/kg/min
Epinephrine or norepinephrine
2-10 mcg/kg per minute via IV infusion
Dopamine
IV infusion of 2-10 mcg/min
Epinephrine IV infusion dose for bradycardia
First dose 0.5 mg bolus; repeat every 3-5 min; max 3 mg
Atropine
Has alpha & beta blocking properties & used in patients with life threatening arrhythmias and hemodynamically unstable VT
Amiodarone
Dose: VF/VT 300 mg
Followed by 150 mg every 3-5 min
Amiodarone
This drug can be used in anyphalaxic shock
Epinephrine
Can be used in cardiogenic shock or vasopressor; used in hemodynamically significant hypotension as agent of last resort
Norepinephrine or levophed
Anti cholinergic medicine; may be beneficial in AV nodal block
Atropine
Has half life of 10-20 min and can be used in septic shock, or vasodilatory shock
Vasopressin
Doses can range from 0.5 mg if mild to 1.0 mg if urgent in IV push up to 3 mg max
Atropine
Used in cardiogenic shock
norepinephrine
Used in symptomatic bradycardia as alternative to dopamine when atropine fails
Epinephrine
This antiarrhythmic should be avoided if prolonged QT or CHF
Procainamide
Alternative vasopressor to epinephrine in adult shock or refractory VFf
Vasopressin
Dose: 6 mg rapidly over 1-3 seconds; 2nd dose 12 mg in 1-2 min
Adenosine
Alternative to amiodarine in cardiac arrest from VF/VT
Lidocaine
Dose: IV is .04 to .4 mg/min
Narcan
Given with low dose orally and steadily increased to achieve full dose in 24-48 hrs
Ace inhibitors
Anti angina for suspected ischemic pain
Nitroglyceride
IV bolus dose: 12.5 to 25 mcg
nitroglyceride
Do not use for wide QRS tachycardia of uncertain origin or drug induced tachycardia
Diltiazem
Used in severe CHF that is refractory to normal treatments
Inamrinone
Anti coagulant therapy used in ACS for UA/STEMI that inhibits thrombin indirectly by factor X and forms antithrombin III
Heparin
Effective for conversion of A Fib or A flutter for brief duration which should be monitored on ECG constantly; monitor ECG continuously up to 4-6 hrs after and have defib nearby
Ibutilide
Phosphodiesterase inhibitor
Inamrinone
Another name for Levophed is?
norepinephrine
Can be used in stable wide complex tachycardia of unknown origin
Procainamide
May be used as alternative vasopressor to epinephrine during a shock refractory VF
Vasopressin
Max dose total is 17 mg/kg
Procainamide
An antiarrythmic that does not convert a fib or a flutter or VT
Adenosine
What are the 5 H’s?
Hypoxia Hypovolemia Hyper/Hypo kalemia Hydrogen Ion Hypothermia
What are the 5 T’s?
Toxins
Cardiac Tamponade
Thrombosis: Pulmonary or Coronary
Tension pneumothorax
First dose is 150 mg over 10 minutes
Amiodarone
100 mg over 5 minutes
Sotalol
Max dose is 17 mg/kg or if QRS duration increases
Procainamide
This antiarrhythmic should be avoided if prolonged QT or CHF
Procainamide
If your LV ejection factor is less than 40%
Ace inhibitors