Misc Cardiac Flashcards
tPA
Another Name
Alteplase Recombinant
Alteplase Recombinant
Another Name
tPA, Activase
Alteplase Recombinant (tPA) Class
Thrombolytic
Alteplase Recombinant (tPA, Activase) Description
Recombinant DNA- derived from human tPA hormone, tPA promotes thrombolysis by forming plasmin. Plasmin in turn degrades fibrin and fibrinogen and ultimately the clot.
Alteplase Recombinant (tPA, Activase) Indication
To thrombolyse in acute myocardial infarction acute ischemic stroke and pulmonary embolism.
Alteplase Recombinant (tPA, Activase) Contraindication
Active internal bleeding, suspected aortic dissection, traumatic CPR, recent hemmorhagic stroke (6 months), intracranial or intraspinal surgery or trauma (2 months), pregnancy, uncontrolled hypertension, or hypersensitivity to thrombolytics
Alteplase Recombinant (tPA, Activase) Precautions
Recent major surgery, cerebral vascular disease, recent GI or GU bleeding, recent trauma, hypertension, patient > 75 years, current oral anticoagulants, or hemmorrhagic ophthalmic conditions
Heparin
Class
Anticoagulant
Heparin
Description
Rapid onset anticoagulant, enhancing the effects of antithrombin III and blocking the conversion of prothrombin to thrombin and fibrinogen to fibrin
Heparin
Indication
To prevent thrombus formation in acute MI
Norepinephrine Bitartrate
Another Name
Levophed
Levophed
Another Name
Norepinephrine Bitartrate
Norepinephrine Bitartrate (Levaphed) Class
Sympathomimetic, vasopressor
Norepinephrine Bitartrate (Levaphed) Description
Potent alpha agonist resulting in intense peripheral vasoconstriction, positive chronotropic and increased inotropic effects ( from 10% beta effect) with increased cardiac output. Alpha-adrenergic activity resulting in peripheral vasoconstriction and beta adrenergic activity leading to inotropic stimulation of the heart and coronary artery vasodilation
Norepinephrine Bitartrate (Levaphed) Indication
Cardiogenic Shock, unresponsive to fluid resuscitation, significant hypotension (<70 mm Hg) states
Norepinephrine Bitartrate (Levaphed) Contraindications
Hypotensive patients with hypovolemia, pregnancy
Norepinephrine Bitartrate (Levaphed) Precautions/Bradycardia
Bradycardia, hypertension, dysrhythmias, chest pain, peripheral cyanosis, tissue necrosis from extravasation
Norepinephrine Bitartrate (Levaphed) Dose/Route
Dilute 8 mg in 500mL of D5W or 4 mg in 250mL D5W (16 ug/mL). Infuse by IV piggy-back at 0.1-0.5 ug/kg/min tritrated to response (average dose for 70kg patient 7-35 ug/min)
Norepinephrine Bitartrate (Levaphed) Pedi Dose/Route
Begin at 0.1-2 ug/kg/min IV infusion, adjust rate to achieve desired change in blood pressure and systemic perfusion. Tritrated to patient response.
Tridil
Another Name
Nitroglycerin injection
Tridil (Nitroglycerin Injection)
Class
Vasodilator/Nitrate