UNIT 1- MEDS 2 KNOW Flashcards
What is Adenosine
It is an Antiarrhythmic (STATIC) used to treat certain arrhythimias such as SVT. Slows the electrical conduction through the AV node slowing down the heart. 1st line medication in the clinical setting to treat SVT. It can break down the electrical circuts that cause SVT this will restore the heart to the normal sinus rhythm.
“DENNOS DINNER”
When is Adenosine used?
“DENNOS DINER”
- Treats SVT (Fast tapping fingers): 1st line treatment in the clinical setting to tx SVT,
How is Adenosine administered?
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- Rapid IV push/acts quickly (fast-moving push cart)
- Followed by saline flush.
Rationale: Adenosine has a very short half life… less than 10 seconds because of this it has to be given in the hospital setting as a rapid IV push medication. This is UNIQUE for Adenosine.
What are the side affects of Adenosine?
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Remember due to the drugs short half life the side effects of this drug will only be short lived
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Induses Transient Asystole (TIME OUT). Should always have cardiac monitoring when this drug is administer. As the nurse do not be alarmed if this happens to your patient. The heart should restart on its own after a couple of mins. If the drug is successful the patient should be in normal sinus rythem if unsucessful the patient will continue to have SVT which means other measures are needed.
- Rationale: Adenosine works by slowing down the electrical impulses of the heart… it can actually completely stop the heart for a couple of seconds before it can actually convert the heart back to a normal sinus rythym… which is called transient asystole
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Chest Pain ( HIT IN THE CHEST)
- Rationale: R/T to heart stopping. Should only last a couple seconds.
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Sense of impending doom (WAITERS SCARED EXPRESSION)
- Rationale: Thought to be related to the transient asystole.
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Flushing (Red Face)
- Rationale: Adenisone causes vasodilation; flushing occurs when vasodilation happens closer to the surface of the skin.
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Dyspnea (OUT OF BREATH)
- Rationale: Patients may feel out of breath or unable to catch there breath. This can be dependant on the patient. Important to explain to the patient.
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What is Amiodarone
It is a class 3 antiarrhythmic (RADIO STATIC) drug used to treat arrythmias. It works by blocking postassium channels on the heart. Blocking potassium channels on the heart makes the cardiac muscle cells take longer to reset after contractioning which helps slow down the heart rate and break up the electrical circut that causes arrythmias specifically Ventricular arrhythmias (“v shapped antennae”) like ventricular fiberlation and ventricular tachycardia
(maybe used off label for AFIB)
SOILDERS- AMMO
What are the side effects of Amiodarone?
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Causes Pulmonary Toxicity (toxic fumes)
- May manifest as coughing, sob, chest pain as well as crackels or rales sounds in lungs. Can be fatal if not treated
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Causes OT prolongation (Long q-tips)
- Rationale: Amiodarone makes cardiac muscle cells take longer to reset after contraction which manifests on a EKG as a prolonged QT interval. QT interveal is measured from the beginning of the QRS complex to the end of the t wave. Important to catch early because it can lead to a rare and serious arrythmia called torsades de pointes. Will need cardiac monitoring
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Causes Hypothyroidism (Ruined TIE)
- Rationale: R/t the high iodine content which can directly affect the thyroid to cause it to lower thyroid production. If a patinet is taking amiodarone for a long time we will want to test for thryoid function
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Hepatotoxicity
- Rationale: Check PFT, TFT and LFTs, with amiodarone. Not as important of a side effect for exam.
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What is Epinephrine?
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It is a catecholamine used to treat anaphylactic shock and cardiac arrrest. Epinephrine is a naturally produced catecholamine during our fight or flight response. Its effects are designed to give our body it maximum capability to fight of a threat or run away if needed… Done by increased bp and hr which increases perfusion to our muscles and brain. Epinenphrine also dilates our airway which increases oxygen to our muscle and brain.
What are some side effects of epinephrine?
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Causes Vasoconstriction (Red CAN)
- Rationale: stimulates the alpha 1. adrenergic receptors, these receptors are located in the smooth muscle around blood vessels thereby causing the vessels to constrict. The contriction of blood vessels increases the resistence of blood flow there fore increasing blood pressure.
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Causes Bronchodilation (Fan)
- Rationale: opening of the airway making it easier to breath this is because epinephrine stimulates beta 2 adrenergic receptors on our broncholes. Extremely helpful in tx of resp. emergencies where the resp. tract close up. -
Increase HR
- Rationale: increase hr by stimulating beta 1 adregnergic receptors on the hr.
What are clinical uses of epinephrine?
- Treats anaphylactic shock (allergic reaction) which is characterised by a drop in bp and life threatening swelling.
- epinephriene is the drug of choice– r/t the drugs ability to dilate the airway helping keep it open during anaphylaxis. Also increases bp which reverses the effects of anaphylaxis. Import to educate on carrying epi pen.
- Treats cardiac arrest (defibilator)
- Epinephriene is believed to improve ciruclation and profusion to the organs. ACLS approved.
How often can an epi be repeated?
Every 5-15 mins if the 1st dose did not produce a response.
Usually given IM
How is amiodarone administered?
IV or orally
What is atropine?
Anticholenergic agent that is used to treat cardiac problems like bradycardia and heart block and reducing airway secreations. It works by inhibiting the actions of acetacholine atropine is a strong blocker of the parasympathetic nervous system which controls our rest and digest responses
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What are the side effects of atropine?
Pixorise- Tropics
- Anticholinergic (empty cola)
- Rationale: reduces the signaling of acetacholine. The signaling of acetacholine is crucial for activating the Parasympathic nervous response. Therefore blocking acetacholine signaling by atropine blocks the parasympathtic response.
- Decrease secretions (dry mouth/Tongue)
- Useful during surgery/anasethsia to reduce oral and respritory secretions. decreasing the risk of aspiration. Also helps tx the death rattle at the end of life. decreasing secreations comes with its own side effects like dry mouth, decrease sweating and dry eyes
- Other anticolinergic effects: Constipation, urinary retention, confusion, pupil dilation. Think about the anticolinergic effects on the body
What are the clinical uses of atropine?
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- Treats Bradycardia (looking at watch)
- by blocking acetacholine atropine blocks the PNS response. When the “rest and digest” response is blocked the heart rate will increase.
- Treats Heart Block (sunblock over heart)
- Heart block is caused by slowed conduction between the atria and ventricles of the heart through the AV node. Which is modulated by the PNS. By blocking the PNS Atropine increases a increases the conduction through the AV node thereby treating heart block
Atropine is contraindicated in patients who have….
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- Glaucoma (rubbing eyes)
- Rationale: Atropine causes pupil dilation which can increase intraoccular leading to glaucoma or worsening glaucoma this happens because the muscles responsible for pupil dilation block the outflow of fluid from the anterior chamber of the eye. this blocked fluid builds up therby increase intraoccular pressure.
