PHARM 1st semester Drugs Flashcards
!!!(Adenosine) Class:
Dynamics:
Administering notes:
= Nucleoside, Misc/ Antiarrhythmic
= binds to adenosine A1 receptors thus efflux of K & inhibits Ca influx (in AR cells), thus hyperpolarization/slows AV of ARcells (SA/AV node)
= rapid IVP followed by rapid flush(20ml) & can be accomplished best w/ utilizing 3-way stopcock
!!!(Adenosine) Indications:
Contra:
Side Effects:
1st dose:
2nd dose:
Dosage note:
= 1st line med w/ stable narrow complex SVT, Regular & monomorphic wide-complex tachycardia thought from reentry SVT (SVT w/ BBB)
= A-fib/ A-flutter, Torsades de pointes, Poison/drug-induced T-cardia, 2/3rd AVB, WPW, DOESNT CONVERT A-FIB/FLUTTER
= small period asystole & ventricular ectopy are common after admin
= 6mg rapid IV/O push followed w/ rapid flush of fluid
= 12mg rapid IV/O push followed w/ rapid flush of fluid
= half 1st dose in PTs receiving dipyridamole or carbamazepine, heart transplant, Or if by central access
!!!(Albuterol) Class:
Dynamics:
Indi:
Contra:
= B/Adrenergic agonist
= B agonist w/ preference for B2 receptors
= Bronchospasm, Allergies/anaphylaxis, Hyperkalemia
= hypersensitivity
!!!(Albuterol) Effects:
Adult Dose:
Pedi Dose:
= Palpitations, Anxiety, Jitters, H/A, Dizziness, Tachycardia
= 2.5mg/3ml SVN: Every 15-20 Mins as needed
= 1.25-2.5mg/1.5-3mL SVN: Every 15-20 Mins as needed
!!!(Amiodarone) Class:
Dynamics:
Indi:
B/c its toxicity indi:
W/ expert consultation may be used for:
Terminal elimination:
= Class III antiarrhythmic
= Slows K+ efflux delaying repolarization
= VF/Pulseless VT-no/response to shock CPR & Epi, Recurrent hemodynamically unstable VT w/ pulse
= PT w/ life-threatening arrhythmias w/ monitoring
= some atrial & ventricular rhythms w/ life-threatening hypoBP
= Extremely long (half-life lasts max 40 days)
!!!(Amiodarone) Contra:
Effects:
Caution b/c:
= Allergic, Bradycardias w/ AV blocks, Breastfeeding mothers
= Severe hypotension, Bradycardia, Prolong QT which can lead to TdP
= Toxicity, Causes severe BP drop, Prolong QT which can lead to TdP
!!!(Amiodarone) Max total dose per day:
Slow Infusion dose:
Maintenance Infusion dose:
VF/Pulseless & VT Cardiac Arrest Unresponsive 1st Dosage:
VF/Pulseless & VT Cardiac Arrest Unresponsive 2nd Dosage:
Life-Threatening Arrhythmia 1st Dosage:
Life-Threatening Arrhythmia 2nd Dosage:
= 2.2 grams
= 360 mg IV 6Hrs (1mg/min)
= 540 mg IV 18Hrs (0.5 mg/min)
= 1st Dose: 300 mg IV/O push
= 2nd Dose: 150 mg IV/O push if needed
= 1st Dose: Rapid Infusion 150 mg/10 mins (15 mg/min)
= 2nd Dose: 150mg/10 mins (15 mg/min) if needed
!!!(Atropine) Class:
Dynamics:
= Parasympatholytic
= Selectively blocks M-receptors inhibiting PSNS thus SNS takes over
!!!(Atropine) Ind:
Contra:
Caution w/ b/c med:
= 1st line med for sinus Bcardia, Maybe beneficial w/ AV nodal block, Organophosphate poisoning
=Allergic, caution w/ H. ischemia, hypothermBcardia (<84) <0.5mg dose make Parasympathomimetic effects
= Myocardial ischemia & hypoxia b/c med +myocardial O2 demands
!!!(Atropine) Effects:
Max dose:
Bradycardia (w/ or w/o ACS) dose:
Severe clinical conditions dose:
Organophosphate Poisoning Dose:
= Blurred vision, Dry mouth, Mydriasis, Confusion
= 0.04 mg/kg or 3 mg
= 1 mg IVP 3-5 mins as needed w/ max dose 3mg or 0.04 mg/kg
= 1 mg IVP every 3 mins w/ max dose 3mg or 0.04 mg/kg
= 2-4 mg (or higher) IVP
!!!(Ipratropium/Atrovent) Class:
Dynamics:
Indi:
Contra:
= Selective-Parasympatholytic
= Anticholinergic Selectively block M-receptors: Synergism w/ Albuterol
= Bronchospasm w/ obstructive lung-disease (asthma,COPD)
= hypersensitivity, No/Lil effect given by itself
!!!(Ipratropium/Atrovent) Effects:
Adult Dose:
Pedi Dose:
= Blurry-vision, Dry mouth, Dilated pupils, Dry Cough, Confusion
= 500 mcg/2.5 mL via neb
= 250-500 mcg/1.25-2.5 mL via neb
!!!(Dextrose) Class:
Dynamics:
Indi:
Contra:
Effects:
= Carbohydrate
= Water-soluble monosaccharide
= Correction of hypoglycemia
= Known hyperglycemia
= Tissue necrosis w/ extravasation, May worsen hyperglycemia
!!!(Dextrose) Adult Dose:
Pedi Dose:
= 25G IV/IO or D10 in 50 mL(5G) IV/IO boluses (max 250 mL)
= 5-10 mL’s/kg of D10
!!!(Diltiazem) Class:
Dynamics:
Indi:
Contra:
= Class IV Antiarrhythmic (Ca Channel Blocker)
= Slows AP of autorhythmic cells by blocking Ca-channels
= 1st line med for A-Fib/Flutter with RVR (>150BPM), 2nd line med for SVT after adenosine admin/
= SBP<90, CHF/Cardio Shock, Wide-Complex T/cardia, WPW, Hypersensitivity
!!!(Diltiazem) Effects:
1st dose:
2nd dose:
= HypoBP, Severe CHF used w/ Beta-Blockers, N/V/D, Dizziness, H/A
= 0.25 mg/kg (max dose 20 mg)
= 0.35 mg/kg (max dose 25 mg)
!!!(Dopamine) class:
Action:
= Sympathetic agonist
= A/B-adrenergic agonist, Rate dependent, vasopressor. +/otropics
!!!(Dopamine) Indi:
Contra:
DONT:
= CHF, HypoBP/shock signs, 2nd-line Bcardia (after Atropine w/Adult)
= hypovolemic PTs til Vol replacement, Pheochromocytoma his
= MIX W/ Sodium-Bicarb!!! & open WIDE OPEN!
!!!(Dopamine) Effects:
Dosing:
Adult & Pedi Cardiac dose:
Adult & Pedi Vasopressor dose:
= Hypertension, Palpitations, H/A, Dizziness, Can worsen cardiac ischemia, Tissue necrosis W/ Extravasation
= 2–20 mcg/kg/min Titrate to patients response
= 5-10mcg/kg/min
= 10-20 mcg/kg/min
!!!(Epi 1:10,) Class: SNS agonist, Sympathomimetic
Dynamics:
Indications:
Contraindications:
= SNS agonist, Sympathomimetic
= Powerful Alpha and Beta agonist
= Cardiac arrest, Bcardia, Normovolemic hypoBP, Anaphylaxis, Asthma
= rewards over risks so really none
!!!(Epi 1:10,) Effects:
Admin via:
(Adult) Cardiac Arrest dose:
(Adult) Bradycardia dose:
(PEDI) Bradycardia/Cardiac Arrest dose:
(PEDI) Hypoperfusion & Severe anaphylaxis dose:
= Palpitations, Anxiety, Jitters, H/A, Dizziness, HyperBP, Tcardia, Can worsen cardiac ischemia
= IV infusion drip
= 1mg IVP/IOP every 3-5 mins
= 2-10 mcg/min IV/IO infusion
= 0.01 mg/kg or 0.1 mL/kg
= 0.1-1 mcg/kg/min infusion by Mixing 1mg of Epi 1:10 into 1L IV bag
!!!(Epi 1:1,) Class:
Dynamics:
Indi:
Contra:
= Sympathomimetic, SNS
= Potent A/B-agonist
= Severe bronchospasm, Allergies/anaphylaxis
= Few in emergent setting, Benefits>Risks, NEVER WITH-HOLD
!!!(Epi 1:1,) Effects:
Admin/ via:
Adult Dose:
Pedi Dose:
= Can worsen H-ischemia, Palp/s, Anxiety, Jitters, H/A, Dizzy, Tcardia
= IM
= 0.3 mg(Asthma/COPD) & Up to 0.5 mg for anaphylaxis
= 0.01 mg/kg IM w/ max dose of 0.3 mg
!!!(Glucagon) Class:
Action:
= Hormone
= +BGL w/ lysis of glycogen to glucose (IM route) Binds to Glucagon receptors & stim/s adenyl cyclase raising cAMP (IV route). Increase cAMP makes up-regulation of Ca-channels in SA & AV nodal cells
!!!(Glucagon) Indi:
Contra:
Effects:
= Hypoglycemia w/ IV/IO not obtainable, Bradycardia suspected from Beta-Blocker or Ca-Channel Blocker OD
= Hypersensitivity & Bradycardia from other etiology
= Anxiety, Palp/s, H/A, N/V, Increased BGL(can led to hyperglycemia)
!!!(Glucagon) Hypoglycemia Adult Dose:
Hypoglycemia Pedi Doses:
= 1 mg IM/IN
= <20Kg 0.5 mg IM/IN & >20Kg 1mg IM/IN
!!!(Lidocaine) Class:
Dynamics:
= Class Ib Antiarrhythmic
= Blocks Na channels in cardiac cells thus depolarization slows & decreases automaticity
!!!(Lidocaine) Ind:
Contra:
Effects:
= Stable monomorphic VT w/ preserved LVF & Alternative to Amiodarone in cardiac arrest by VF/pVT
= Shouldn’t use if PT already received IV Ca channel blockers, Not given prophylactically in AMI setting
= Drowsiness, Slurred Speech, Confusion, Seizures, Hypotension
!!!(Lidocaine) Max dose:
Cardiac Arrest from VF/pVT dose:
Refractory VF dose:
Perfusing Arrhythmia dose:
Maintenance Infusion dose:
= 3 mg/kg
= 1-1.5 mg/kg IV/IO
= may give additional 0.5-0.75 mg/kg IV/IO in 5-10 mins
= may give additional 0.5-0.75 mg/kg IV/IO in 5-10 mins
= 1-4mg/min (30-50 mcg/kg/min)
!!!(Mag-Sulfate) Class:
Dynamics:
= Misc. Airway med, Mineral, powerful noradrenergic bronchodilator
= Organic Salt act as a physiologic Ca-channel blocker Bronchodilator
!!!(Mag-Sulfate) Indi:
Contra:
Effects:
= cardiac arrest only if Torsades de Pointes (Tdp) suspected, Tdp w/ pulse
= AMI not recommended, High degree AV block, HypoBP, VFib/Tach
= Bcardia, HypoBP, Diaphoresis, Resp/ depres/, Hypothermia
!!!(Mag-Sulfate) Effects:
Bronchodilation Adult Dose:
Bronchodilation Pedi Dose:
= Flushing, Sweating, B-cardia, Resp/ depres/, Hypothermia
= 1-2G IV/IO over 10-20 mins (Infusion)
= 25-50 mg/kg IV/IO (max 2G) over 15-30 mins (Infusion)
!!!(Narcan) Class:
Dynamics:
Indi:
Contra:
Effects:
Dose:
= Competitive opiate antagonist
= Finds & fights for opiate receptor spot
= Dilated pupils & resp/ depres/ suspected from opiate OD
= SBP<100 or DBP30<, SBP# drops 10/>, B-cardia (<50BPM), T-cardia (>100BPM), ingested ED meds in last 48 hours
= H/A, Hypotension,
= 0.4mg IN/IM w/ max 2ml