Week 6 Drugs

Question 0

Amiodarone Cordarone

Pharmacology and Actions
AIS

Answer 0

• Prolongs the action potential and refractory period.
• Inhibits adrenergic stimulation.
• Slows the sinus rate, increases PR and QT intervals, and decreases peripheral vascular resistance.

Question 1

Amiodarone Cordarone

Class

Answer 1

Antiarrhythmic

Question 2

Amiodarone Cordarone

Indications

Answer 2

V-Fib/Pulseless V tach

Wide complex tachycardia with pulse

Question 3

Amiodarone Cordarone

Contraindications

Answer 3

Hypersensitivity 
Cardiogenie shock 
Bradycardia 
AV blocks 
Liver disease

Question 4

Amiodarone Cordarone

Precautions and Side Effects

Answer 4

Hypotension 
Bradycardia 
Cardiogenie shock
Headache/Dizziness 
AV Block

Question 5

Amiodarone Cordarone

Dosage

Answer 5

Adult
V-Fib/Pulseless V tach: 300mg IV/IO repeat at 150mg after 3-5 min
Wide complex tachycardia: 150mg IV/IO over 10 min
Post resuscitation maintenance: 1mg/min over 6 hr
Max dose: 2.2g IV/IO over 24 hr
Pedi
VF/Pulseless V tach: 5mg/kg IV/IO
Wide complex tachycardia: 5mg/kg IV/IO over 20-60 min
Max dose : 15mg/kg

Question 6

Magnesium Sulfate

Class

Answer 6

Electrolyte

Question 7

Magnesium Sulfate

Pharmacology and Actions
AD

Answer 7

• acts as a physiological calcium channel blocker, CNS depressant and anti-convulsant
• depresses the function of smooth, skeletal and cardiac muscles.

Question 8

Magnesium Sulfate

Indications
HTEA

Answer 8

Hypomagnesaemia
Trosades de pointers
Eclamptic seizure
Adjunctive treatment in moderate to severe acute asthma

Question 9

Magnesium Sulfate

Contraindications

Answer 9

Hypocalcaemia
Heart block
Myocardial damage
Anuria

Question 10

Magnesium Sulfate

Precautions and Side Effects

Answer 10

ALOC
Hypotension
Heart block
Hypocalcemia

Question 11

Magnesium Sulfate

Dosage

Answer 11

Adult
Torsades de pointes: 1-2g IVP over 1-2 min
Eclamptic seizure: 4-5g IVP concurrently with up to 5g IM in each buttock then 4-5g every 4 hr
Bronchodilation: 2g IVP
Pedi
Torsades de pointes: 25-50mg/kg/dose max dose of 2g
Bronchodilation: 25mg/kg/dose max 2g

Question 12

Pralidoxime 2 PAM

Class

Answer 12

Cholinesterase reactivator

Question 13

Pralidoxime 2 PAM

Pharmacology and Actions
RDR

Answer 13

• Reactivates the cholinesterase inhibited by phosphate esters displacing the enzyme from its receptor sites.
• restores normal functions of neuromuscular transmission.

Question 14

Pralidoxime 2 PAM

Indications

Answer 14

Organophosphate poisoning

Question 15

Pralidoxime 2 PAM

Contraindications

Answer 15

Severe cardiac disease
Peptic ulcer 
Asthma
Myocardial infraction 
Hypersensitivity to procainamide/procaine

Question 16

Pralidoxime 2 PAM

Precautions and Side Effects
THD

Answer 16

Tachycardia
Hypertension
Dizziness

Question 17

Pralidoxime 2 PAM

Dosage

Answer 17

Adult
1-2g in 250-500ml NS infused over 15-30 min; if no IV access is available then 1-2g IM/SC
Pedi
20-40mg/kg IV/IM/SC

Question 18

Sodium Bicarbonate

Class

Answer 18

Alkalinizing agent

Question 19

Sodium Bicarbonate

Pharmacology and Actions
RPR

Answer 19

• Raisesthe pH of blood plasma by buffering excess hydrogen ions.
• Provides vascular bicarbonate to assist the buffer system, reducing the effects of metabolic acidosis and in the treatment of some overdose.

Question 20

Sodium Bicarbonate

Indications
PKTR

Answer 20

Prolonged cardiac arrest
Known hyperkalemia
Tricyclic antidepressant/barbiturates OD
Refractory metabolic acidosis

Question 21

Sodium Bicarbonate

Contraindications

Answer 21

None in the emergency setting

Question 22

Sodium Bicarbonate

Precautions and Side Effects

Answer 22

Extracellular alkalosis
Cardiac arrhythmias
Decreased cerebral and cardiac functioning

Question 23

Sodium Bicarbonate

Doses

Answer 23

Adult
1mEp/kg IV/IO, may repeat at half dose every 10 min
Pedi
Same as adult

Question 24

Verapamil Calan, Isoptin Class

Answer 24

Calcium channel blocker

Question 25

Verapamil Calan, Isoptin | Pharmacology and Actions SC

Answer 25

- Slows AV conduction and suppresses reentry dysrhythmias. | - Causes dilation of the coronary arteries and reduces the oxygen demand of the heart.

Question 26

Verapamil Calan, Isoptin Indications

Answer 26

SVT refractory to adenosine Atrial flutter Atrial fibrillation

Question 27

Verapamil Calan, Isoptin Contraindications

Answer 27

``` Hypotension Cardiogenie shock Heart block Congestive heart failure WPW syndrome with atrial fibrillation ```

Question 28

Verapamil Calan, Isoptin Precautions and Side Effects

Answer 28

``` Hypotension Heart block CHF Headache Dizziness ```

Question 29

Verapamil Calan, Isoptin Doses

Answer 29

Adult 2.5-5.0mg pushed over 2-3 min may repeat at double dose every 15-30 min to a max total dose of 20mg Pedi Newborn-1year: 0.1-0.2mg/kg slow IVP to a max of 2mg 1-15 years old: 0.1-0.3mg/kg slow IVP to a max of 5mg