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pharm(from shared cardio doc) Flashcards

1
Q

What is the class of Oxygen?

A

Medical Gas

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2
Q

What is the dose range for Oxygen via nasal cannula?

A

1-6 lpm NCL (24%-44%)

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3
Q

What is the mechanism of action (MOA) of Oxygen?

A

Increases the amount of oxygen available to the body’s tissues and saturation in the blood.

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4
Q

What are the indications for administering Oxygen?

A
  • Hypoxia
  • Cardiac Arrest
  • Angina
  • Stroke
  • Respiratory distress
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5
Q

What is a contraindication for using Oxygen?

A

Severe COPD (hypoxic drive vs hypercarbia drive)

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6
Q

What is the class of Normal Saline?

A

Isotonic Solution

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7
Q

What is the typical dose for Normal Saline?

A

250cc, 500cc, 1000cc IV, IO

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8
Q

What is the MOA of Normal Saline?

A

Provides fluid resuscitation and restores blood volume.

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9
Q

What is a contraindication for using Normal Saline?

A

Heart and kidney failure

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10
Q

What is the class of Aspirin?

A

NSAID (Non-steroidal anti-inflammatory drugs)

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11
Q

What is the dose for Aspirin?

A

81mg x 4 = 324mg chew

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12
Q

What is the MOA of Aspirin?

A

Prevents platelets from clumping together (blood = slippery).

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13
Q

What are the indications for administering Aspirin?

A
  • Angina
  • Suspected MI
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14
Q

What is a contraindication for using Aspirin?

A
  • Ulcer
  • Asthma
  • Hypersensitivity
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15
Q

What is the class of Nitroglycerin?

A

Vasodilator

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16
Q

What is the dose of Nitroglycerin?

A

0.4mg SL q 3-5min

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17
Q

What is the MOA of Nitroglycerin?

A

Vasodilation (coronary arteries) and reduces myocardial oxygen demand.

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18
Q

What are the indications for Nitroglycerin?

A
  • Angina
  • ACS
  • Heart failure with pulmonary edema
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19
Q

What is a contraindication for using Nitroglycerin?

A
  • ED drugs
  • Hypotension
  • Right Ventricular Infarction
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20
Q

What is the class of Atropine?

A

Parasympatholytic, anticholinergic

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21
Q

What is the dose of Atropine?

A

1mg IVP (max 3 doses)

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22
Q

What is the MOA of Atropine?

A

Competes with acetylcholine at receptors on the AV and SA node.

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23
Q

What are the indications for Atropine?

A

1st line treatment for sinus bradycardia

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24
Q

What is a contraindication for using Atropine?

A

Acute MI

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25
Q

What is the class of Clopidogrel (Plavix)?

A

Antiplatelet

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26
Q

What is the dose for Clopidogrel?

A

300-600mg loading dose

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27
Q

What is the MOA of Clopidogrel?

A

Block ADP binding site (makes it slippery)

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28
Q

What are the indications for Clopidogrel?

A
  • Angina
  • Suspected STEMI
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29
Q

What is a contraindication for using Clopidogrel?

A

Increased risk of bleeding

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30
Q

What is the class of Epinephrine?

A

Catecholamine, Sympathomimetic, bronchodilator, vasopressor

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31
Q

What is the dose range for Epinephrine?

A

2-10mcg/min (titrate to patient response)

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32
Q

What is the MOA of Epinephrine?

A

Alpha/Beta agonism increases inotropy, chronotropy, systemic vascular resistance.

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33
Q

What are the indications for Epinephrine?

A
  • 1st line treatment for cardiac arrest
  • Treatment of severe symptomatic hypotensive sinus bradycardia
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34
Q

What is a contraindication for using Epinephrine?

A

Active arrhythmias with a pulse

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35
Q

What is the class of Heparin?

A

Anticoagulant

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36
Q

What is the dose for Heparin?

A

60u/kg up to 4,000U

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37
Q

What is the MOA of Heparin?

A

Prevents conversion of fibrinogen to fibrin.

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38
Q

What are the indications for Heparin?

A
  • Acute STEMI
  • ACS
  • DVT
  • PE
  • Ischemic stroke
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39
Q

What is a contraindication for using Heparin?

A

Active bleeding

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40
Q

What is the class of Dopamine?

A

Inotropic agent, vasopressor, adrenergic

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41
Q

What is the dose range for Dopamine?

A
  • 1-3 mcg/kg/min for Dopaminergic effect
  • 3-10 mcg/kg/min for Beta 1 & 2 and Dopaminergic effect
  • 10+ mcg/kg/min for Alpha, Beta 1, Beta 2, and Dopaminergic effect
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42
Q

What is the MOA of Dopamine?

A

Stimulates both alpha and beta-adrenergic receptors.

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43
Q

What are the indications for Dopamine?

A
  • 2nd line drug for symptomatic bradycardia
  • Use for hypertension SBP <70-100 with signs of shock
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44
Q

What is a contraindication for using Dopamine?

A

Tachycardia

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45
Q

What is the class of Furosemide (Lasix)?

A

Loop diuretic

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46
Q

What is the dose range for Furosemide?

A
  • 20 to 40 mg IV, IO administered slowly over 1-2 minutes
  • Begin with 40 mg in emergent situations
  • Max single IV dose is 160 to 200 mg
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47
Q

What is the MOA of Furosemide?

A

Inhibits the absorption of sodium and chloride ions and water in the loop of Henle.

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48
Q

What are the indications for Furosemide?

A
  • Pulmonary edema
  • CHF
  • Hypertensive emergency
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49
Q

What is a contraindication for using Furosemide?

A

Known sensitivity to sulfonamides or furosemide

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50
Q

What is the class of Procainamide?

A

Antiarrhythmic, Class IA

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51
Q

What is the dose for Procainamide?

A

20mg/min IV infusion (max 17mg/kg)

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52
Q

What is the MOA of Procainamide?

A

Blocks the influx of sodium through membrane pores.

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53
Q

What are the indications for Procainamide?

A
  • A-fib with RVR in WPW syndrome
  • V-Tach
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54
Q

What is a contraindication for using Procainamide?

A

AV block

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55
Q

What is the class of Lidocaine?

A

Class 1b Antiarrhythmic (Sodium Channel Blocker)

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56
Q

What is the dose for Lidocaine in cardiac arrest?

A

1 - 1.5mg/kg IV

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57
Q

What is the MOA of Lidocaine?

A

Blocks sodium channel channels decreasing slope of phase 0 of depolarization.

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58
Q

What are the indications for Lidocaine?

A
  • V-Tach
  • V-Fib
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59
Q

What is a contraindication for using Lidocaine?

A

Normally not given to patients who are awake

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60
Q

What is the class of Metoprolol?

A

Class II antiarrhythmic (Beta-Blocker)

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61
Q

What is the dose for Metoprolol?

A

5mg IV q 5min slow over 2min (max 3 doses)

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62
Q

What is the MOA of Metoprolol?

A

Decreased HR, cardiac contractility, BP, and myocardial O2 demand.

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63
Q

What are the indications for Metoprolol?

A
  • ACS
  • Hypertension
  • SVT
  • Atrial Flutter
  • AFib
  • Thyrotoxicosis
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64
Q

What is a contraindication for using Metoprolol?

A
  • Pulmonary edema
  • Cardiogenic shock
  • Hypotension
  • Bradycardia
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65
Q

What is the class of Amiodarone?

A

Class III Antiarrhythmic, Potassium Channel Blocker

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66
Q

What is the dose for Amiodarone in V-Tach with pulse?

A

150mg over 10min

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67
Q

What is the MOA of Amiodarone?

A

Blocks sodium, potassium, and calcium channels which prolongs the cardiac action potential.

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68
Q

What are the indications for Amiodarone?

A
  • V-Tach with pulse
  • Cardiac Arrest
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69
Q

What is a contraindication for using Amiodarone?

A

Hypersensitivity

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70
Q

What is the class of Diltiazem?

A

Calcium channel blocker (Class IV antiarrhythmic)

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71
Q

What is the dose for Diltiazem?

A

15-20 mg (0.25 mg/kg) over 2 min SLOW IV PUSH

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72
Q

What is the MOA of Diltiazem?

A

Calcium channel blockade inhibits calcium transport into the cell.

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73
Q

What are the indications for Diltiazem?

A
  • Ventricular rate control in AFib RVR
  • A-flutter
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74
Q

What is a contraindication for using Diltiazem?

A

It may cause hypotension

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75
Q

What is the class of Adenosine?

A

Antiarrhythmic (regular)

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76
Q

What is the dose for Adenosine?

A

6mg Rapid IVP (IO) followed by 20cc NS flush

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77
Q

What is the MOA of Adenosine?

A

Slows the conduction of the electrical impulses of the AV node.

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78
Q

What are the indications for Adenosine?

A

SVT (AVNRT)

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79
Q

What is a contraindication for using Adenosine?

A

Sick sinus syndrome

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80
Q

What is the class of Etomidate?

A

Anesthetic induction agent, Sedative, Hypnotic

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81
Q

What is the dose range for Etomidate?

A

0.2 to 0.6 mg/kg slow IV, IO

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82
Q

What is the MOA of Etomidate?

A

Enhances the activity of the GABA receptors in the central nervous system.

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83
Q

What are the indications for Etomidate?

A
  • Procedural Sedation
  • Induction for rapid sequence intubation
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84
Q

What is a contraindication for using Etomidate?

A

Hypersensitivity

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85
Q

What is the class of Ketamine?

A

Analgesic, Sedative

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86
Q

What is the dose for Ketamine in RSI?

A

1.5mg/kg (0.75mg/kg IV in shock)

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87
Q

What is the MOA of Ketamine?

A

NMDA Receptor stimulator.

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88
Q

What are the indications for Ketamine?

A
  • Pain
  • Anesthesia for procedures of short duration
  • RSI Induction agent
89
Q

What is a contraindication for using Ketamine?

A

Hypoglycemia or known sensitivity

90
Q

What is the class of Versed (Midazolam)?

A

Benzodiazepine

91
Q

What is the dose range for Versed?

A

0.2-0.3mg/kg

92
Q

What is the MOA of Versed?

A

Binds to drug-specific receptors of the GABA complex.

93
Q

What are the indications for Versed?

A

To promote amnesia and sedation

94
Q

What is a contraindication for using Versed?

A

Use caution in volume-depleted or hemodynamically compromised PTs.

95
Q

What is the class of Fentanyl?

A

Opioid Analgesic

96
Q

What is the dose range for Fentanyl?

A

50-100mcg/min (max total 300mcg)

97
Q

What is the MOA of Fentanyl?

A

Binds to mu-opioid receptors in the central nervous system.

98
Q

What are the indications for Fentanyl?

A
  • Moderate to severe pain
  • Procedural sedation
99
Q

What is a contraindication for using Fentanyl?

A

Hypersensitivity

100
Q

What is the class of Propofol?

A

Anesthetic

101
Q

What is the dose for Propofol?

102
Q

What is the MOA of Propofol?

A

Enhances GABA activity at the GABA receptor complex.

103
Q

What are the indications for Propofol?

A

Induction agent of choice for pregnant PT’s

104
Q

What is a contraindication for using Propofol?

A

Use caution in PTs with egg allergy

105
Q

What is the class of Morphine?

A

Opioid Analgesic

106
Q

What is the dose for Morphine?

107
Q

What is the MOA of Morphine?

A

Binds to the mu-opioid receptors in the central nervous system.

108
Q

What are the indications for Morphine?

A
  • Moderate to severe pain
  • Angina
  • CHF
  • Pulmonary edema
109
Q

What is a contraindication for using Morphine?

A

Hypotension

110
Q

What is the class of Succinylcholine?

A

Depolarizing neuromuscular blocker

111
Q

What is the dose for Succinylcholine?

A

2mg/kg rapid onset

112
Q

What is the MOA of Succinylcholine?

A

Competes with ACH receptors of the motor end plates on the muscle cells.

113
Q

What are the indications for Succinylcholine?

A

To induce paralysis for the facilitation of ET intubation

114
Q

What is a contraindication for using Succinylcholine?

A

Malignant hyperthermia

115
Q

What is the class of Rocuronium?

A

Non-depolarizing NM blocker

116
Q

What is the dose for Rocuronium?

A

1.5mg/kg IV/IO push

117
Q

What is the MOA of Rocuronium?

A

Competitive NMBA, Non-depolarizing.

118
Q

What are the indications for Rocuronium?

A

Provides skeletal muscle relaxation to facilitate ET intubation.

119
Q

What is a contraindication for using Rocuronium?

A

Known sensitivity to bromides.

120
Q

What is the class of Vecuronium?

A

Non-depolarizing NMBA

121
Q

What is the dose for Vecuronium?

122
Q

What is the MOA of Vecuronium?

A

Antagonizes ACH receptors at the neuromuscular junction.

123
Q

What is the onset time for IO push medications?

A

40 seconds

124
Q

What is the duration of action for IO push medications?

A

40-60 minutes

125
Q

What is the mechanism of action for non-depolarizing neuromuscular blocking agents (NMBA)?

A

Competitive NMBA

126
Q

What is the primary indication for using non-depolarizing NMBA?

A

Provides skeletal muscle relaxation to facilitate ET intubation

127
Q

What is a contraindication for non-depolarizing NMBA?

A

Known sensitivity to bromides

128
Q

What is the dose of Vecuronium?

129
Q

What is the onset time for Vecuronium?

A

1-2 minutes

130
Q

What is the duration of action for Vecuronium?

A

25-30 minutes

131
Q

What is the mechanism of action for Vecuronium?

A

Antagonizes ACH receptors at the neuromuscular end plates, inducing paralysis

132
Q

What are the indications for Vecuronium?

A

NMB for ET intubation

133
Q

What is the dose range for Diazepam (Valium)?

A

2-5 mg IV/IM

134
Q

What is the onset time for Diazepam?

A

1-5 minutes

135
Q

What is the duration of action for Diazepam?

A

15-60 minutes

136
Q

What is the primary mechanism of action for Diazepam?

A

Benzodiazepine that depresses CNS

137
Q

What are the indications for Diazepam?

A

Post-intubation sedation

138
Q

What is a contraindication for Diazepam?

A

Inadequate pulmonary function, hypotension, and apnea

139
Q

What class of medication is Albuterol?

A

Adrenergic bronchodilator

140
Q

What is the dose of Albuterol for nebulization in COPD/Asthma?

141
Q

What is the duration of action for Albuterol?

142
Q

What is the mechanism of action for Albuterol?

A

Relaxes airways and smooth muscles, causing bronchodilation

143
Q

What are the indications for Albuterol?

A

COPD, Asthma

144
Q

What is a contraindication for Albuterol?

A

Known hypersensitivity

145
Q

What class of medication is Dexamethasone?

A

Corticosteroid

146
Q

What is the dose of Dexamethasone?

A

0.6 mg/kg up to 10 mg IV

147
Q

What is the mechanism of action for Dexamethasone?

A

Suppresses inflammation and immune response

148
Q

What are the indications for Dexamethasone?

A

Anaphylaxis, Asthma

149
Q

What is a contraindication for Dexamethasone?

A

Untreated infections, Hypersensitivity

150
Q

What class of medication is Diphenhydramine (Benadryl)?

A

Antihistamine

151
Q

What is the dose range for Diphenhydramine?

A

25-50 mg IV/IM

152
Q

What is the mechanism of action for Diphenhydramine?

A

Antagonizes histamine effects

153
Q

What are the indications for Diphenhydramine?

A

Allergic reaction

154
Q

What is a contraindication for Diphenhydramine?

A

Known hypersensitivity, Asthma (controversial)

155
Q

What class of medication is Epinephrine?

A

Bronchodilator

156
Q

What is the dose range for Epinephrine in anaphylaxis?

A

0.3-0.5 mg SQ/IM of epi 1:1,000

157
Q

What is the mechanism of action for Epinephrine?

A

Beta-2 adrenergic effects causing bronchodilation

158
Q

What are the indications for Epinephrine?

A

Anaphylaxis, Severe Asthma

159
Q

What is a contraindication for Epinephrine?

A

Known hypersensitivity

160
Q

What class of medication is Ipratropium Bromide (Atrovent)?

A

Anticholinergic bronchodilator

161
Q

What is the dose of Ipratropium Bromide?

A

0.5 mg nebulized

162
Q

What is the mechanism of action for Ipratropium Bromide?

A

Inhibits bronchial secretions and constriction by blocking parasympathetic response

163
Q

What are the indications for Ipratropium Bromide?

A

Asthma/COPD

164
Q

What is a contraindication for Ipratropium Bromide?

A

Known hypersensitivity

165
Q

What class of medication is Magnesium Sulfate?

A

Electrolyte

166
Q

What is the dose range for Magnesium Sulfate?

A

1.2-2 g over 20 mins

167
Q

What is the mechanism of action for Magnesium Sulfate?

A

Smooth muscle relaxant, bronchodilator

168
Q

What are the indications for Magnesium Sulfate?

A

Asthma exacerbation

169
Q

What is a contraindication for Magnesium Sulfate?

A

Known hypersensitivity, Heart blocks

170
Q

What class of medication is Methylprednisolone (Solu-Medrol)?

A

Corticosteroid

171
Q

What is the dose of Methylprednisolone?

A

2 mg/kg IV/IM, 125 mg IV/IM

172
Q

What is the mechanism of action for Methylprednisolone?

A

Suppresses inflammation and immune response

173
Q

What are the indications for Methylprednisolone?

A

Severe asthma

174
Q

What is a contraindication for Methylprednisolone?

A

Known hypersensitivity, Untreated infection

175
Q

What class of medication is Epinephrine used in cardiac arrest?

A

Catecholamine, adrenergic agent, vasopressor, bronchodilator

176
Q

What is the dose of Epinephrine for cardiac arrest?

A

1 mg (1:10,000) IV/IO q3-5mins

177
Q

What is the mechanism of action for Epinephrine in cardiac arrest?

A

Beta 1 & 2 agonist, Alpha 1 agonist

178
Q

What are the indications for Epinephrine in cardiac arrest?

A

Cardiac arrest or symptomatic bradycardia

179
Q

What is a contraindication for Epinephrine in cardiac arrest?

A

Known hypersensitivity or to Patient with cardiac arrhythmias

180
Q

What class of medication is Amiodarone?

A

Class III antiarrhythmic

181
Q

What is the dose for Amiodarone in V-Fib/pV-Tach?

A

300 mg IV/IO followed by a second dose of 150 mg IV/IO

182
Q

What is the mechanism of action for Amiodarone?

A

Prolongs action potential and refractory period; slows sinus rate

183
Q

What are the indications for Amiodarone?

A

Ventricular fibrillation/ventricular tachycardia

184
Q

What is a contraindication for Amiodarone?

A

Known hypersensitivity, Cardiogenic shock

185
Q

What class of medication is Lidocaine?

A

Class IB antiarrhythmic

186
Q

What is the dose of Lidocaine for cardiac arrest?

A

1-1.5 mg/kg IV/IO

187
Q

What is the mechanism of action for Lidocaine?

A

Suppresses automaticity and spontaneous depolarization of ventricles

188
Q

What are the indications for Lidocaine?

A

Alternative to amiodarone in cardiac arrest from VF/VT

189
Q

What is a contraindication for Lidocaine?

A

3rd degree AV block

190
Q

What class of medication is Magnesium?

A

Mineral/Electrolyte

191
Q

What is the dose of Magnesium in cardiac arrest due to TdP?

A

1-2 g IV/IO diluted in 10 mL of D5 or NS

192
Q

What is the mechanism of action for Magnesium?

A

Essential for the activity of many enzymes

193
Q

What are the indications for Magnesium?

A

Polymorphic V-Tach with Torsades de Pointes

194
Q

What is a contraindication for Magnesium?

A

Heart block, Hypocalcemia

195
Q

What class of medication is Calcium Chloride?

A

Electrolyte, positive inotrope

196
Q

What is the dose of Calcium Chloride for hyperkalemia?

A

500-1000 mg IV/IO

197
Q

What is the mechanism of action for Calcium Chloride?

A

Returns Ca++ levels to normal for optimal function of nerves and muscles

198
Q

What are the indications for Calcium Chloride?

A

Hyperkalemia, Hypocalcemia

199
Q

What is a contraindication for Calcium Chloride?

A

None in the emergent setting

200
Q

What class of medication is Sodium Bicarbonate?

A

Alkalizing agent

201
Q

What is the dose of Sodium Bicarbonate?

A

1 mEq/kg IV bolus

202
Q

What is the mechanism of action for Sodium Bicarbonate?

A

Acts as a buffer to hydrogen ions, reduces acidosis

203
Q

What are the indications for Sodium Bicarbonate?

A

Hyperkalemia, acidosis, prolonged downtime

204
Q

What is a contraindication for Sodium Bicarbonate?

A

Lack of effective ventilation

205
Q

What class of medication is Lorazepam (Ativan)?

A

Benzodiazepine, Schedule C-IV

206
Q

What is the dose range for Lorazepam?

A

1-2 mg IV/IM

207
Q

What is the mechanism of action for Lorazepam?

A

Enhances the effects of GABA, resulting in sedation and anticonvulsant activity

208
Q

What are the indications for Lorazepam?

A

Pre-procedure sedation induction, Anxiety, Status Epilepticus

209
Q

What is a contraindication for Lorazepam?

A

Known sensitivity to lorazepam, COPD, Shock

210
Q

What class of medication is Midazolam (Versed)?

A

Benzodiazepine, Schedule C-IV

211
Q

What is the dose range for Midazolam?

A

5-10 mg IV/IM

212
Q

What is the mechanism of action for Midazolam?

A

Enhances the effects of GABA, producing CNS depression

213
Q

What are the indications for Midazolam?

A

Sedation, Anxiety, Skeletal muscle relaxation

214
Q

What is a contraindication for Midazolam?

A

Acute-angle glaucoma, pregnant women, known sensitivity

215
Q

What class of medication is Diazepam (Valium)?

A

Benzodiazepine, Schedule C-IV

216
Q

What is the dose range for Diazepam?

A

2-5 mg IV/IM

217
Q

What is the mechanism of action for Diazepam?

A

Enhances the effects of GABA, producing CNS depression

218
Q

What are the indications for Diazepam?

A

Seizures, Anxiety, Alcohol withdrawal

219
Q

What is a contraindication for Diazepam?

A

Children younger than 6 months, Acute-angle glaucoma, CNS depression

TCC pm pharm (4 decks)

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