Quiz 4 Flashcards
Amiodarone
Class: Class III Antidysrhythmic
Action: Prolongs duration of action potential and refractory period, has beta adrenergic receptor and calcium channel blocking activity. Works on both the ventricles and atria.
Indications: V-Fib, hemodynamically unstable V-Tach, treatment for some atrial rhythms
Contraindications: CHF, cariogenic shock, bradycardia, 2nd or 3rd degree heart blocks with no pacemaker present, hypersensitivity to amiodarone or iodine
Onset/Duration: Within minutes and duration= 30-45 mins
Dose/Route:
Adult–> V-Tach/V-Fib arrest 300mg IV/IO may repeat once at 150mg IV/IO.
V-Tach w/ a pulse 150mg IV drip over 10mins up to max of 2.2g in 24 hours
Peds–> Pulseless V-Tach/V-Fib Arrest 5mg/kg IV/IO
V-Tach w/ a pulse 5mg/kg IV drip over 20-60mins w/ max of 15mg/kg/day
Side Effects: Bradycardia, hypotension, headache, CHF, abnormal liver/thyroid functions. Pulmonary fibrosis in rare cases.
D50
Class: Carbohydrate, hypertonic solution
Action: Dextrose increases available blood sugar to be used as energy by the body
Indications: Hypoglycemia. If protocol allows also for altered LOC, coma, and seizure of unknown origin
Contraindications: Intracranial hemorrhages increased intracranial pressure, known or suspected stroke in the absence of hypoglycemia
Onset/Duration: Onset= 1min, Duration= Variable depending on degree of hypoglycemia
Dose/Route:
Adult= 12.5 to 25g IV
Pedi= 0.5 to 1g/kg IV of D25%
Nenoates= 0.5 to 1g/kg IV of D10%
Side Effects: Hyperglycemia
Diltiazem (Cardizem)
Class: Calcium Channel Blocker
Action: Inhibits calcium ion influx through slow channels into the cell of myocardial and arterial smooth muscle. Slows SA and AV nodal conduction. Dilates coronary arteries and arterioles thus inhibits coronary artery spasms.
Indications: A-Fib and A-Flutter, multifocal atrial tachycardias, SVT/PSVT refractory (when Adenosine not working) to adenosine
Contraindications: Hypersensitivity, 2nd or 3rd degree heart block, hypotension, cariogenic shock, ventricular rhythms, sick sinus syndrome, Wolf-Parkinson-White syndrome
Onset/Duration: Onset= 2-5 mins, Duration= 1-3 hours
Dose/Route:
Adult= 0.25mg/kg IV over 2 min, may be repeated in 15 mins at 0.35mg/kg IV over 2 mins
Pedi= Not recommended in pre-hospital setting
Side Effects: Headache, dizziness, hypotension, 1st and 2nd degree heart block, bradycardia, palpitations, CHF, chest pain, ventricular rhythms
Diphenhydramine
Class: Antihistamine
Action: Blocks H1 and H2 receptors which block histamine release
Indications: Allergic reactions, anaphylaxis, actue extrapyramidal reaction (dystonia)
Contraindications: Hypersensitivity, its taking MAO inhibitors, newborns/nursing mothers, caution w/ glaucoma
Onset/Duration: Onset= 5-15mins w/ max effects in 1-3hr and Duration= 6-12hrs
Dose/Route:
Adult= 25-50mg IV/IM w/ a max of 400mg/day
Pedi= 1mg/kg IV w/ a max of 300mg/day
Side Effects: Drowsiness, palpitations, hypotension, tachycardia or bradycardia, disturbed coordination, dry mouth/throat
Dopamine
Class: Sympathomimetic, vasopressor
Action: Acts primarily on alpha 1 and beta 1 adrenergic receptors. At low doses (2-5mcg/kg/min) may act on dopaminergic receptors causing dilation. Moderate doses (5-10mcg/kg/min) stimulates mostly beta 1 receptors causing increased cardia contractility and output. High doses (10-20mcg/kg/min) has mostly alpha 1 stimulation effects causing peripheral constriction.
Indications: Hemodynamically significant hypotension in absence of hypovolemia (i.e. cardiogenic shock), neurogenic shock, septic shock. Considered a second-line pharmacological tx for bradycardia after atropine.
Contraindications: Hypovolemia, trauma, tachy-dysrhythmias, V-Fib, Pt-s w/ pheochromocytoma
Onset/Duration: Onset= 2-4mins, Duration= 10-15mins
Dose/Route:
Adult= 2-20mcg/kg/min IV drip and titrated to desired effect (piggyback drug)
Pedi= Same as adult
Side Effects: Tachycardia, hypertension, anxiety, headache, nausea/vomiting, increased myocardial oxygen demand, mydriasis, dose-related tachycardia-dysrhythmias.
