The 50 Flashcards
ADRENALINE
Drug Class
MOA
Indications
Common adverse Effects
Contraindications / cautions
Adrenergic / Sympathomimetic
Stimulates B-1 receptors: increasing cardia contractility and output;
Stimulates B-2 receptors: bronchodilation, cardiac and CNS stimulation
Anaphylaxis and allergic reactions
Acute Asthma attacks and bronchospasm
Cardiac Arrest
Shock
Headache, tremors, anxiety
Tachycardia, palpitations
Dyspnoea
N&V
Hyperglycaemia
Extravasation / tissue necrosis/ gangrene
Pregnancy and Breastfeeding
Elderly
Hypertension, Heart disease (increased risk of arrhythmias, MI, angina)
Close-angle glaucoma
non-anaphylactic shock
Pheochromocytoma - contraindicated
NORADRENALINE
Drug Class
MOA
Indications
Common adverse Effects
Contraindications / cautions
Considerations
Adrenergic / Sympathomimetic
Stimulates B-1 receptors: increasing cardia contractility and output;
Stimulates alpha receptors: vasoconstriction and increased BP
Restore BP in acute hypotensive states
Headache, anxiety
Palpitations, hypertension, bradycardia (reflex)
N&V
Extravasation = tissue necrosis and gangrene
Cautions: hypovolaemia, hyperthyroidism ischaemic heart disease (increase rsik of adverse cardiac events), preg and Breast feed
Contraindicated: Hypertension
Considerations: Infusion via central line, constant monitoring during, extravasation reversal phentolamine, reversal = norepinephrine
ASPRIN
Drug Class
MOA
Indications
Common adverse Effects
Contraindications / cautions
Considerations
NSAID & anti-platelet
Irreversibly inhibits Cox-1 & Cox-2 enzymes: reduce thromboxane synthesis by platelets - reducing activation and aggregation
Reduces prostaglandin synthesis
Mild pain and fever
Inflammatory conditions
rheumatoid arthritis
Prophylaxis and treatment of CV disorders
Tinnitus, ototoxicity (chronic)
bronchoconstriction / wheezing
Prolonged / undue bleeding time
Gastritis / gastric ulcers
Rash
Renal insufficiency (chronic use)
Contraindications
G6PD deficiency
Coagulopathies
Active / suspected bleeding
Before major surgery
Pregnancy/ breast feeding
3 months after trauma, ischaemic stroke, intracranial haemorrhage
Cautions: peptic ulcer, renal or hepatic impairment, asthma/ copd
Considerations: Stopped 5 - 7 dayes before surgery, monitor signs for unusal bleeding, blood checked with prolonged use
AMIODARONE
Drug Class
MOA
Indications
Common adverse Effects
Contraindications / cautions
Class III antiarrhythmic / Potassium Channel Blocker
***
Blocks potassium channels (causes repolarisation); increases action potential and repolarisation duration
Ventricular tachycardia/ fibrillation, supraventricular tachycardias
Arrhythmias, bradycardia, hypotension
N&V
Thyroid problems, bluish skin discolouration
Contraindicated: Thyroid dysfunction, 2nd or 3rd heart block (without pacemaker), grapefruit
Cautioned: Preexisting CV disorders, preg and breastfeeding, children and elderly, hepatic and renal disease
GLYCERYL TRINITRATE (GTN)
Drug Class
MOA
Indications
Common adverse Effects
Contraindications / cautions
Regular dose
Nitrate
Converted into NO in smooth muscle cells; reducing venous return and preload to heart, reducing myocardial oxygen requirements
Prophylaxis and treatment of angina
peri-operative hypertension (IV)
Headache, dizziness, tiredness
Flushed face, palpitations, ortho hypotension, fainting
Nausea
CI: Anaemia, raised ICP, hypovolaemia, hypotension, PDE5 inhibitors, aortic/ mitral stenosis, cardiac tamponade
400 - 800 micrograms
METOPROLOL
Drug Class
MOA
Indications
Common adverse Effects
Contraindications / cautions
Considerations
Cardio selective B1 blocker
Decreases cardiac output and cardiac O2 requirements; depresses renin secretion
Hypertension, angina, tachyarrhythmias, MI, migraine prophylaxis
Dizziness, Fatigue, abnormal vision
Bradycardia, hypotension (incl ortho), cold extremities
Bronchospasm, dyspnoea
N+V and diarrhoea
CI: Cardiogenic and hypovoleamic shock, bradycardia, 2nd or 3rd degree AV block, SSS 9without pacemaker), severe hypotension, poorly controlled asthma
Cautioned: Phaechromacytoma, hyperthyroidism, diabetes (mask symptoms), respiratory or hepatic disease
Apical pulse before admin (>60bpm); BGL monitoring in diabetic patients,
HEPARIN (also Clexane/ Enoxaparin and Dalteparin)
Drug Class
MOA
Indications
Common adverse Effects
Contraindications / cautions
Considerations
Anticoagulants
Activates antithrombin-III, which inactivates factors IIa (thrombin) and Xa thus prventing conversion fibrinogen to fibrin
Prophylaxis and TReatment of DVT, MI, PE, and patency maintenance of indwelling IV vannulas and catheters
Prolonged/ undue bleeding, mild and reversible thrombocytopenia
Hyperkalaemia
Contraindications:
Active or suspected bleeding
Coagulation disorders
Severe hypertension
Subacute bacterial endocarditis
During or after brain, eye or spinal surgery
Spinal tap/ anaesthesia, continuous abdo drainage
Other anticoagulants/ antiplatelets
Hepatic disease
Signs and symptoms of excessive, unusual, masked bleeding
Cautioned with conditions with increased risk of bleeding, renal impairment, elderly
