Pharmacology

Question 1

First drug choice for symptomatic bradycardia

Answer 1

Atropine Sulfate

Question 2

First drug for most forms of stable narrow-complex SVT. Effective in terminating those due to reentry involving AV node or sinus node.

Answer 2

Adenosine

Question 3

Because this drug is associated with toxicity, it is indicated for use in patients with life threatening arrhythmias when administered with appropriate monitoring.

Answer 3

Amiodarone

Question 4

Transient side effects of this medication include flushing, chest pain or tightness, brief periods of asystole or bradycardia, and ventricular ectopy

Answer 4

Adenosine

Question 5

May require a large dose of medication in patient’s taking theophylline or caffeine.

Answer 5

Adenosine

Question 6

You need to reduce initial dose to 3mg in patients receiving dipyridamole or carbamazepine, in heart transplant patients or if given by central venous access.

Answer 6

Adenosine

Question 7

Place patient in Trendelenburg before administration of this drug

Answer 7

Adenosine

Question 8

Give initial bolus of 6mg rapidly over 1 to 3 seconds followed by NS flush of 20ml then elevate extremity.

Answer 8

Adenosine

Can give second dose of 12mg in 1 to 2 minutes if needed.

Question 9

This medication has an extremely long half-life (40 days)

Answer 9

Amiodarone

Question 10

For VF/VT cardiac arrest, unresponsive to CPR, shock and vasopressor:
First dose 300mg IV/IO push
Second dose: 150mg IV/IO push

Answer 10

Amiodarone

Question 11

Maximum Cumulative dose of Amiodarone for life threatening arrhythmias.

Answer 11

2.2g IV over 24 hours
Administered as follows: 
Rapid infusion of 150mg IV over 10min.
Slow infusion 360mg IV over 6 hours
Maintenance Infusion: 540mg IV over 18 hours.

Question 12

In patients with organophosphate poisoning extremely large doses may be necessary

Answer 12

Atropine Sulfate (2-4mg or higher may be necessary)

Question 13

This medication increases myocardial oxygen demand and therefore should be used in caution in presence of myocardial ischemia and hypoxia.

Answer 13

Atropine Sulfate

Question 14

Atropine Dosages

Answer 14

0.5mg IV q 3 to 5 min as needed, not to exceed total dose of 0.04mg/kg (total 3mg)

Question 15

This is the second line drug for symptomatic bradycardia which can also be used to treat hypotension with signs and symptoms of shock

Answer 15

Dopamine

-Correct hypovolemia with volume replacement prior to using

Question 16

May cause tachyarrhythmias due to excessive vasoconstriction

Answer 16

Dopamine

Question 17

This medication should be used with caution in cardiogenic shock with CHF.

Answer 17

Dopamine

Question 18

Dopamine Dosage

Answer 18

2 to 20 mcg/kg/min

Titrate slowly to patient response.

Question 19

Indications for Epinephrine (4)

Answer 19

1. Cardiac Arrest (VF, pulseless, VT, asystole, PEA)
2. Symptomatic bradycardia (after atropine instead of dopamine)
3. Severe hypotension
4. Anaphylaxis, severe allergic reaction (combine with large fluid volume, corticosteroids, antihistamines)