Week 6 Drugs Flashcards
Amiodarone Cordarone
Pharmacology and Actions
AIS
- Prolongs the action potential and refractory period.
- Inhibits adrenergic stimulation.
- Slows the sinus rate, increases PR and QT intervals, and decreases peripheral vascular resistance.
Amiodarone Cordarone
Class
Antiarrhythmic
Amiodarone Cordarone
Indications
V-Fib/Pulseless V tach
Wide complex tachycardia with pulse
Amiodarone Cordarone
Contraindications
Hypersensitivity Cardiogenie shock Bradycardia AV blocks Liver disease
Amiodarone Cordarone
Precautions and Side Effects
Hypotension Bradycardia Cardiogenie shock Headache/Dizziness AV Block
Amiodarone Cordarone
Dosage
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
Magnesium Sulfate
Class
Electrolyte
Magnesium Sulfate
Pharmacology and Actions
AD
- acts as a physiological calcium channel blocker, CNS depressant and anti-convulsant
- depresses the function of smooth, skeletal and cardiac muscles.
Magnesium Sulfate
Indications
HTEA
Hypomagnesaemia
Trosades de pointers
Eclamptic seizure
Adjunctive treatment in moderate to severe acute asthma
Magnesium Sulfate
Contraindications
Hypocalcaemia
Heart block
Myocardial damage
Anuria
Magnesium Sulfate
Precautions and Side Effects
ALOC
Hypotension
Heart block
Hypocalcemia
Magnesium Sulfate
Dosage
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
Pralidoxime 2 PAM
Class
Cholinesterase reactivator
Pralidoxime 2 PAM
Pharmacology and Actions
RDR
- Reactivates the cholinesterase inhibited by phosphate esters displacing the enzyme from its receptor sites.
- restores normal functions of neuromuscular transmission.
Pralidoxime 2 PAM
Indications
Organophosphate poisoning
Pralidoxime 2 PAM
Contraindications
Severe cardiac disease Peptic ulcer Asthma Myocardial infraction Hypersensitivity to procainamide/procaine
Pralidoxime 2 PAM
Precautions and Side Effects
THD
Tachycardia
Hypertension
Dizziness
Pralidoxime 2 PAM
Dosage
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
Sodium Bicarbonate
Class
Alkalinizing agent
Sodium Bicarbonate
Pharmacology and Actions
RPR
- 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.
Sodium Bicarbonate
Indications
PKTR
Prolonged cardiac arrest
Known hyperkalemia
Tricyclic antidepressant/barbiturates OD
Refractory metabolic acidosis
Sodium Bicarbonate
Contraindications
None in the emergency setting
Sodium Bicarbonate
Precautions and Side Effects
Extracellular alkalosis
Cardiac arrhythmias
Decreased cerebral and cardiac functioning
Sodium Bicarbonate
Doses
Adult
1mEp/kg IV/IO, may repeat at half dose every 10 min
Pedi
Same as adult
Verapamil Calan, Isoptin
Class
Calcium channel blocker
Verapamil Calan, Isoptin
Pharmacology and Actions
SC
- Slows AV conduction and suppresses reentry dysrhythmias.
- Causes dilation of the coronary arteries and reduces the oxygen demand of the heart.
Verapamil Calan, Isoptin
Indications
SVT refractory to adenosine
Atrial flutter
Atrial fibrillation
Verapamil Calan, Isoptin
Contraindications
Hypotension Cardiogenie shock Heart block Congestive heart failure WPW syndrome with atrial fibrillation
Verapamil Calan, Isoptin
Precautions and Side Effects
Hypotension Heart block CHF Headache Dizziness
Verapamil Calan, Isoptin
Doses
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