Week 5 Flashcards
Calcium Gluconate
CLASS: Electrolyte
MOA:
-Mineral component of bones/teeth
-Cofactor in enzymatic reactions
-Essential for neurotransmission, blood clotting & contraction of cardiac,smooth & skeletal muscles
INDICATIONS:
-Beta blocker & calcium channel blocker toxicity
-Topical use in hydrofluoric acid burn management
-Hypocalcemia
-Hyperkalemia
CONTRAINDICATIONS:
-Digoxin toxicity
-Hypercalcemia
-Suspected severe hypokalemia
DOSAGE:
Adult= 1.5-3g (15-30mL 10% solution) slow IV/IO push over 5min
Peds= 60mg/kg slow IV over 10min
Dopamine (intropin)
CLASS: (AEIV)
Adrenergic, Endogenous catecholamine, inotropic agent, vasopressor
MOA:
-Immediate metabolic precursor to norepinephrine
-Doses of 1-2mcg/kg/min stimulate dopamine receptors
-Doses of 2-10mcg/kg/min stimulate beta-1 receptors
-Doses of 10-20mcg/kg/min stimulate alpha receptors
-Doses greater then 20mcg/kg/min, alpha stimulations predominate
INDICATIONS:
-Cardiogenic or distributive shock
-Hypotension w/ low cardiac output
-2nd line for symptomatic bradycardia
CONTRAINDICATIONS:
-Hypovolemia
-Pheochromocytoma
-Uncorrected tachydysrhythmias
-VF
DOSAGE:
-Adult only
IV/IO infusion @ 5-20mcg/kg/min, slowly titrated
Phenylephrine (Neo-Synephrine)
CLASS: Adrenergic, alpha agonist, vasoconstrictor
MOA:
-Stimulates alpha adrenergic receptors in the arterioles of the nasal mucosa to cause vasoconstriction
INDICATIONS:
-Epistaxis
-Reduce bleeding from nasotracheal intubation
CONTRAINDICATIONS:
-Use extreme caution in geriatric pt w/ preexisting cardiovascular disease
DOSAGE:
Adult=
2 sprays in nose before nasotracheal tube insertion
Labetalol (Normodyne, Trandate)
CLASS:
-Selective alpha & nonselective beta-adrenergic blocker, antihypertensive
MOA:
-BP reduction w/out reflex tachycardia; total peripheral resistance reduced w/out significant change in cardiac output
INDICATIONS:
-Moderate to severe hypertension
CONTRAINDICATIONS: (BBCHS)
-Bronchial asthma
-Bradycardia
-Cardiogenic shock
-Heart failure
-2nd & 3rd degree heart block
DOSAGE:
-Adult
-10mg IV push over 1-2min; May repeat or 2x every 10min to a max dose of 150mg
-Infusion=
2-8mg/min, titrated to supine BP
Peds= NOT RECOMMENDED
Sodium Bicarb
CLASS:
-Systemic hydrogen ion buffer, alkalizing agent
MOA:
-Reacts w/ hydrogen ions to form H20 & CO2, correcting metabolic acidosis
-Increases blood & urinary pH by releasing a bicarbonate ion, which neutralizes hydrogen ion concentrations
INDICATIONS:
-Cardiac arrest which hyperkalemia or TCA overdose is suspected
-50%+ QRS prolongation in known or suspected TCA overdose
-Crush syndrome
CONTRAINDICATIONS: (HHHKU)
-Hypernatremia
-Hypocalcemia
-Hypokalemia
-Known metabolic or resp. alkalosis
-Use w/ caution for heart/ renal failure
DOSAGE:
-Adult/Peds= 1 mEq/kg slow IV/IO push
-Call med control for repeat dosing