Paramedic Cardiac Pharmacology

Question 1

ADENOSINE generic name

Answer 1

Adenocard

Question 2

ADENOSINE class

Answer 2

Endogenous Nucleotide

Question 3

ADENOSINE mechanism of action

Answer 3

Slows conduction time through the AV node, can interrupt re-entrant pathways, slows heart rate, acts directly on sinus pacemaker cells.

Drug of choice for PSVT

Question 4

ADENOSINE indications

Answer 4

Conversion of PSVT to sinus rhythm

May convert PSVT due to Wolff-Parkinson-White-Syndrome

Not effective converting AFib/AFlutter

Question 5

ADENOSINE contraindications

Answer 5

Second degree heart block
Third degree heart block
Sick sinus syndrome 
Atrial flutter
Atrial fibrillation
Ventricular tachycardia
Hypersensitivity to adenosine

Question 6

ADENOSINE adverse reactions

Answer 6

Facial flushing
shortness of breath
chest pain
headache
paresthesia
diaphoresis
palpations
hypotension
nausea
metallic taste

Question 7

ADENOSINE drug interactions

Answer 7

Methylxanthines (theophylline-like drugs) antagonize the effects of adenosine

Dipyridamole (Persantine) potentiates the effects of adenosine

Carbamazepine (Tegretol) may potentiate the AV node blocking effects of adenosine

Question 8

ADENOSINE dosage and administration

Answer 8

ADULT:
6 mg over 1-3 seconds

If no response after 1-2 minutes administer 12 mg over 1-3 seconds.

Max does of 18 mg

Question 9

ADENOSINE duration of action

Answer 9

Onset and peak effect in seconds

Duration 12 seconds

Question 10

ADENOSINE special considerations

Answer 10

Short half-life limits side effects in most patients

Pregnancy safety: Category C

Question 11

ALBUTEROL generic name

Answer 11

Proventil

Ventolin

Question 12

ALBUTEROL mechanism of action

Answer 12

Selective b-2 agonist which stimulates adrenergic receptors of the sympathomimetic nervous system resulting in smooth muscle relaxation in the bronchial tree and peripheral vasculature

Question 13

ALBUTEROL indications

Answer 13

Treatment of bronchospasm in patients with reversible obstructive airway disease

Question 14

ALBUTEROL countraindications

Answer 14

Known prior hypersensitivity reaction to albuterol

Tachycardia, dysrhythmias, especially those caused by digitalis

Synergistic with other sympathomimetic

Question 15

ALBUTEROL adverse reactions

Answer 15

Oftern dose-related and include restlessness, tremors, dizziness, palpations, tachycardia, nervousness, peripheral vasodilation, nausea, vomiting, hyperglycemia, increased blood pressure, paradoxical bronchospasm

Question 16

ALBUTEROL drug interactions

Answer 16

Tricyclic antidepressants ay potentiate vasculature effects

beta blockers are antagonistic

may potentiate hypokalemia caused by diuretics

Question 17

ALBUTEROL dosage and administration

Answer 17

ADULT:
Administer 2.5 mg. Dilute in 0.5 ml of 0.5% solution of inhalation with 2.5 ml normal saline in nebulizer and administer over 10-15 mins

Question 18

ALBUTEROL special considerations

Answer 18

Pregnancy safety: Category C

Antagonized by beta-blockers

May precipitate angina pectoris and dysrhythmias

Should only be administered by inhalation methodology in pre-hospital management

Question 19

AMIODARONE generic name

Answer 19

Cordarone

Question 20

AMIODARONE class

Answer 20

antidysrhythmic

Question 21

AMIODARONE mechanism of action

Answer 21

Prolongation of action potential

non-competitive alpha and beta sympathetic blocking effects

calcium channel blocking effects

Question 22

AMIODARONE indications

Answer 22

suppression of ventricular fibrillation

suppression of pulseless ventricular tachycardia refractory to defibrillation

suppression of ventricular tachycardia with a pulse