Quiz 3 Flashcards
Amiodarone
Class: Class III Antidysrhythmic
Action: Prolongs duration of the action potential and prolongs the refractory period, also has beta adrenergic receptor and calcium channel blocking activity.
Indications: V-fib, hemodynamically unstable V-tach, treatment for some stable atrial rhythms
Contraindications: CHF, cardiogenic shock, bradycardia, 2nd or 3rd degree heart blocks w/ no pacemaker present, hypersensitivity to amiodarone or iodine
Side Effects: Bradycardia, hypotension, headache, CHF, abnormal liver/thyroid functions
Doses:
Adult–>Pulseless V-Tach/V-Fib arrest is 300mg IV/IO may repeat once at 150 mg IV/IO.
V-Tach w/ pulse is 150mg IV drip over 10 minutes up to max of 2.2g in 24 hours
Peds: Pulseless V-Tach/V-Fib is 5mg/kg IV/IO
V-Tach w/ pulse is 5mg/kg IV drip over 20-60 minutes w/ a max of 15mg/kg/day.
Atropine
Class: Anticholinergic; Parasympatholytic
Action: Inhibits actions of ACh, Increases HR, decreases salivation and bronchial cessations, decreases gastric motility
Indications: Hemodynamically unstable bradycardia, organophosphate poisoning
Contraindications: Hypersensitivity, tachycardia, hypothermia pt’s, caution for pt’s having active MI w/ hypoxia
Side Effects: Headache, dizziness, tachycardia, nausea/vomiting, mydriasis, bradycardia if pushed too slow or not enough,
Doses:
Adult (Bradycardia)- 0.5mg IV/IO
(Organo poisoning)- 1-5mg IV/IM/IO or until cessation of bronchial secretions
Pedi (Bradycardia)- 0.02mg/kg IV/IO if NOT responding to Epi
(Organo poisoning)- 0.02mg/kg-0.05mg/kg IV/IO or until cessation of bronchial secretions
Calcium Chloride
Class: Electrolyte, hypertonic solution
Action: Essential element for regulating the excitation threshold of nerves and muscles, normal cardiac contractility, and blood coagulation
Indications: Hyperkalemia, hypocalcemia, hypermagnesemia, calcium channel blocker overdose
Contraindications: V-fib during cardiac resuscitation, digitalis toxicity, hypercalcemia
Side Effects: Bradycardia, hypotension, metallic taste in mouth, local necrosis if given IM or IV infiltration
Doses:
Adult- 500-1000mg slow IV of 10% solution
Pedi- 20mg/kg slow IV of 10% solution
Onset: 5-15 mins and duration is dose dependent (up to 4 hours)
Diazepam (Valium)
Class: Benzodiazepine
Action: Increase activity of GABA, giving a sedative effect, relaxing skeletal muscles, and inducing sleep
Indications: Seizure activity, acute anxiety, skeletal muscle relaxation, sedation for pacing, acute alcohol withdrawal delirium tremors
Contraindications: Hypersensitivity, respiratory depression, schock, coma, head injury, use caution in pt’s w/ acute substance abuse
Side Effects: Respiratory depression, altered LOC, hypotension, amnesia, confusion, nausea/vomiting, blurred vision
Doses:
Adult (seizures)- 5-10mg IV over 2 mins every 10-15 mins as needed (max dose of 30mg)
(pacing)- 5-15mg
Pedi (1month to 5y/o)- 0.2-0.5mg slow IV push over 2 mins every 2-5 mins (max 5mg)
(5y/o or older)- 1mg slow IV push over 2 mins every 2-5 min (max 10mg)
Diltiazem (Cardizem)
Class: Calcium channel blocker
Action: Inhibits calcium ion influx through slow channels into the cell of myocardial and arterial smooth muscle. SLOWS AV AND SA NODAL CONDUCTION. Dilaties coronary arteries and arterioles thus inhibiting coronary artery spasms.
Indications: A-fib and A-flutter, multifocal atrial tachycardias, SVT/PSVT refractory (if Adenosine isn’t working) to Adenosine
Contraindications: Hypersensitivity, 2nd or 3rd degree heart block, hypotension, cariogenic shock, ventricular rhythms, sick sinus syndrome, Wolf-Parkinson-White syndrome
Side Effects: Headache, dizziness, hypotension, 1st and 2nd degree heart block, bradycardia, palpitations, CHF, chest pain, ventricular rhythms
Doses:
Adult- 0.25mg/kg IV over 2 mins, may be repeated in 15 mins at 0.35mg/kg IV over 2 mins
Pedi-Not recommended in pre-hospital setting
