Pharmacological Management

Question 1

Name 6 of the most commonly used antiarrhythmics

Answer 1

atropine, lidocaine, adenosine, amiodarone, magnesium sulfate, diltiazem

Question 2

What do antiarrhymics do?

Answer 2

control or suppess arrythmias

Question 3

Atropine sulfate

Class, Indications, dose

Answer 3

Parasympatholytic / anticholenergic
Used to treat symptomatic bradycardia
0.5 mg, repeated every 3-5 mins, for a total of 3.0 mg

Question 4

Lidocaine

Indications and dose

Answer 4

hemodynamically stable monomorphic v tach

1-1.5 mg/kg, repeated every 5-10 mins at a dose of .5-.75 mg/kg, up to 3.0 mg

Question 5

Adenosine

Indications, Contraindications, Dose

Answer 5

Used to manage stable narrow complex tachycardia, unstable narrow complex tachycardia while prepping for cardioversion, stable wide complex tachycardia
do not use in 2nd or 3rd degree block, asthma
6 mg rapid push followed by 20 mL flush
2nd dose of 12 mg, 3rd dose of 12 mg

Question 6

Amiodarone

Indications and dose

Answer 6

V-fib, V-tach, A-fib, tachycardias

300 mg followed by a single dose of 150 mg

Question 7

Diltiazem

Class, Indication, Dose

Answer 7

Calcium channel blocker
SVT
12-20 mg over 2 mins, after 15 mins repeat dose of 20-25 mg

Question 8

What do vasopressors do?

What class?

Answer 8

Constrict blood vessels , thus increasing arterial pressure

Sympathomimetic

Question 9

Name 6 of the most common vasopressors

Answer 9

Epinephrine, norepinephrine, isopreterenol, dopamine, dobutamine, vasopressin

Question 10

Epinephrine acts on which receptors?

Answer 10

both alpha and beta adrenergic receptors

Question 11

Epinephrine

Indications and dose

Answer 11

cardiac arrest

1 mg:10,000 every 3-5 mins

Question 12

Norepinephrine acts on which receptors?

Answer 12

Greater alpha agonist properties than beta agonist properties

Question 13

Norepinephrine

Indications and dose

Answer 13

hypotension, bradycardia, cardiogenic and septic shock

8-10 mcg/min to obtain BP of 80-100 mmHg systolic

Question 14

Dopamine stimulates which receptors?

How does it affect cardiac output?

Answer 14

Both alpha and beta

Increases cardiac output

Question 15

Dopamine

Indications and dose

Answer 15

bradycardia

2-10 mcg/kg/min

Question 16

Dobutamine increases cardiac output how?

Answer 16

By increasing stroke volume (makes contractions stronger)

Question 17

Dobutamine acts on which receptors?

Answer 17

Only beta, it has little effect on heart rate

Question 18

Dobutamine

Indications and dose

Answer 18

bradycardia

2-20 mcg/kg/min

Question 19

Vasopressin is a naturally occurring hormone commonly called what? Where is it secreted?

Answer 19

ADH (antidiuretic hormone)

Posterior pituitary

Question 20

Vasopressin

Indications and dose

Answer 20

bradycardia, cardiac arrest

40 units of vasopressin can replace the first or second dose of epe

Question 21

Name 4 most commonly used drugs to treat MI and relieve it’s pain.

Answer 21

oxygen, nitro, morphine, fentanyl

Question 22

How does nitro work?

Answer 22

Dilates peripheral arteries and veins, thus reducing preload, after load, and O2 demand

Question 23

How does morphine affect the heart?

Answer 23

Decreases myocardial O2 demand by reducing preload and afterload

Question 24

Morphine dose

Answer 24

3-5 mg increments slow IV push

Question 25

Fentenyl dose

Answer 25

50-100 mcg

Question 26

Aspirin

How does it work? Dose?

Answer 26

inhibits platelet aggregation 
325 mg (1 tablet)