Pharmacologic Stress Agents

Question 1

what are pharmacologic stress agents?

Answer 1

• dipyridamole
• adenosine
• regadenoson (lexiscan)
• dobutamine

Question 2

when Coronary steal phenomenon occurs?

Answer 2

the coronary steal phenomenon usually occurs when the administration of pharmacologic stress agents that cause coronary vasodilation

Question 3

identify the patient prep for Dipyridamole. dose of Dipyridamole and infusion process?

Answer 3

• Patient prep: NPO 4-6 hours, xanthine-containing drugs withheld for 36 hours. No caffeine for 24hrs.
• Dose: 0.57 mg/kg infused over 4mins (142ug/kg/min)
• Rp inject 3-5 mins after infusion

Question 4

what is the side effect of dipyridamole?

Answer 4

chest pain, headache, dizziness, ischemic ST changes, and nausea

Question 5

what is the half life of dipyridamole?

Answer 5

30-45 mins

Question 6

what is antidote for dipyridamole?

Answer 6

aminophylline 50-250 mg given 2mins after Rp

Question 7

Identify the contraindications for dipyridamole

Answer 7

• Bronchospasm or severe obstructive lung disease
• unstable angina
• recent myocardial infarction
• hypotension
• AV block without pacemaker
• Xanthine-containing drugs caffeine in the last 24hrs
• allergy to dipyridamole or adenosine

Question 8

what is patient prep of Adenosine, dose?

Answer 8

• patient prep: NPO 4-6 hr, Xanthine containing drug withheld for 36 hours, no caffeine 24hr, oral dipyridamole withheld for 24hrs
• Dose: 140 ug/kg/min infused for 6min. Rp injected 3 min after start infusion

Question 9

what is the side effect of Adenosine?

Answer 9

chest pain, headache, dizziness, ischemic ST changes, and nausea

Question 10

what is antidote for adenosine?

Answer 10

discontinue

Question 11

what is half life for adenosine

Answer 11

10 secs

Question 12

what is contraindication for adenosine?

Answer 12

1. severe bronchospastic pulmonary disease
2. unstable angina
3. recent myocardial infarction within last 2 days
4. hypotension
5. AV block without pacemaker
6. sick sinus syndrome
7. 2nd or 3rd degree AV block
8. severe congestive heart failure

Question 13

what is adenosine increase the demand of myocardial?

Answer 13

oxygen

Question 14

what is patient prep of regadenoson and dose?

Answer 14

Patient prep: NPO 4-6hrs, no methylxanthine for 12hr, no dipyridamole for 2 days
Dose: 0.4mg/5ml in 10-20 second. Rp injected 15-20 sec after

Question 15

what is the side effect of regadenoson

Answer 15

Headache, flushing, dyspnea, chest, discomfort, chest pain tightness in the chest, and nausea

Question 16

what is antidote of regadenoson?

Answer 16

caffein

Question 17

what is contraindication of regadenoson?

Answer 17

1. 2nd and 3rd degree AV block of sinus in absence of pacemaker
2. bronchoconstriction and COPD, asthma, hypotension with systolic less than 90 mmhg

Question 18

what is patient prep and dose for dobutamine?

Answer 18

Patient prep: NPO 4 hr, beta blocker medication withheld 48 hrs,
DOse: 5 ug/kg/min for 3 mins then 10,20,30,40 ug/kg/min for 3 min each. Rp given 1 min afet maximum dose initiated

Question 19

what is the side effect of dobutamine?

Answer 19

headache, flushing, dyspnea, chest pain, cardiac arrhythmia, nausea

Question 20

what is the antidote for dobutamine?

Answer 20

esmolol (beta blocker)

Question 21

what is half life of dobutamine?

Answer 21

2mins

Question 22

what is contraindication for dobutamine?

Answer 22

severe hypertension (BP 150/90)
2. recent MI
3. unstable angina

Question 23

what are xanthine and methylxanthine?

Answer 23

caffeine, theophylline, aminophylline
soda, tea, chocolate