Pharm 28-30 (Adenosine, Amiodarone, Atropine) Flashcards
Adenosine (Adenocard): Class?
Misc. antidysrhythmic, endogenous nucleoside
Adenosine (Adenocard): Action?
Decreases electrical conduction through the AV node without causing negative inotropic effects
Adenosine (Adenocard): Indications?
Supraventricular tachycardias (SVT/PSVT)
Adenosine (Adenocard): Contraindications? (8)
1.Hypersensitivity 2.Bradycardia 3.Drug induced tachycardia 4.2nd or 3rd degree heart blocks 5.A-Fib 6.A-Flutter 7.V-Tach 8.WPW with A-Fib/flutter.
Adenosine (Adenocard): Onset/Duration?
Onset: Immediate
Duration/half-life: 10 seconds
Adenosine (Adenocard): Dose/Route?
Adult: 6 mg rapid IV/IO push followed by 20 cc saline flush. May repeat in 1-2 min at 12mg rapid IV push followed by 20 cc saline flush.
Peds: 0.1mg/kg (max 6mg) IV/IO followed by 5-10 cc saline flush. May repeat in 1-2 min at 0.2 mg/kg (max 12mg) IV/IO followed by 5-10 cc saline flush.
Adenosine (Adenocard): Side effects? (8)
1.Dizziness 2.Headache 3.Nausea/Vomiting 4.Shortness of breath 5. Flushing 6.Hypotension 7.Palpitations 8.Chest pain
Adenosine (Adenocard): Notes?
Methylxanthine classified stimulants (caffeine & theophylline) usage will antagonize adenosine
Amiodarone (Cordarone): Class?
Class III antidysrhythmic
Amiodarone (Cordarone): Action?
Prolongs duration of the action potential and prolongs the refractory period, also has beta adrenergic receptor and calcium channel blocking activity. Works on both the ventricles and the atria
Amiodarone (Cordarone): Indications? (3)
1.V-Fib 2.Hemodynamically unstable V-Tach 3.Treatment for some stable atrial rhythms
Amiodarone (Cordarone): Contraindications? (5)
- Hypersensitivity to amiodarone or iodine 2.CHF 3.Cardiogenic shock 4.Bradycardia 5.2nd or 3rd degree heart blocks with no pacemaker present
Amiodarone (Cordarone): Onset/Duration?
Onset: within minutes
Duration: Variable but considered 30 – 45 days
Amiodarone (Cordarone): Dose/Route?
Adult: Pulseless V-Tach/V-Fib arrest - 300mg IV/IO may repeat once at 150mg IV/IO. V-Tach with a pulse 150mg IV drip over 10 minutes up to max of 2.2g in 24 hours
Peds: Pulseless V-Tach/V-Fib arrest - 5mg/kg IV/IO. V-Tach with a pulse 5mg/kg IV drip over 20-60 minutes with a max of 15mg/kg/day.
Amiodarone (Cordarone): Side effects? (6)
1.Bradycardia 2.Hypotension 3.CHF 4.Headache 5.Abnormal liver/thyroid functions. 6.In rare cases can cause pulmonary fibrosis
Amiodarone (Cordarone): Notes?
None
Atropine Sulfate: Class?
Anticholinergic, Parasympatholytic
Atropine Sulfate: Action?
Inhibits actions of acetylcholine (mostly at muscarinic receptor sites) causing decreased salivation and bronchial secretions, increased heart rate and decreased gastric motility.
Atropine Sulfate: Indications? (2)
1.Hemodynamically unstable bradycardia 2.Organophosphate or nerve gas poisoning
Atropine Sulfate: Contraindications? (4)
1.Hypersensitivity 2.Tachycardia 3.Avoid use with hypothermic pts 4.Caution in pts with an active MI and hypoxia
Atropine Sulfate: Onset/Duration?
Onset: Rapid
Duration: 2-6 hours
Atropine Sulfate: Dose/Route?
Adult: Bradycardia – 0.5 mg IV/IO q 3-5 min up to max total of 3 mg
Organophosphate poisoning – 1 to 5mg IV/IM/IO repeated 3-5 min until cessation of bronchial secretions
Peds: Bradycardia NOT responding to Epi- 0.02mg/kg IV/IO (min dose of 0.1 mg and max single dose 0.5 mg) with maximum total of 1 mg for a child and 3 mg for an adolescent.
Organophosphate peds < 12 yrs old - 0.05mg/kg IV/IM/IO may be repeated every 20-30 mins until cessation of bronchial secretions.
Atropine Sulfate: Side effects? (9)
1.Tachycardia 2.Paradoxical bradycardia if given too slow or too small of dose 3.Dysrhythmias 4.Mydriasis (dilated pupils) 5.Headache 6.Nausea/vomiting 7.Dizziness 8.Flushed 9.Anticholinergic effects (dry mouth/nose/skin, blurred vision, urinary retention, constipation)
Atropine Sulfate: Notes?
Effects of atropine may be potentiated by antihistamines, procainamide, quinidine, antipsychotics, antidepressants, and thiazides
