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49 Cards in this Set

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Amiodarone - Names
Cordarone
Amiodarone - Classification
Class III antidysrhythmic
Amiodarone - Action
prolongs duration of action potential and effective refractory period
Amiodarone - Indications
(3)
recurrent V-fib

hemodynamically unstable V-tach refractory to other treatment

refractory PSVT in conjunction w/cardioversion
Amiodarone - Contraindications
(5)
b,c,h,p,s
bradycardia
cardiogenic shock
hypotension
pulmonary congestion
sensitivity to amiodarone
Amiodarone - Side Effects
(7)
2a,b,d,f,2h
abnormal salivation
AV conduction abnormalities
bradycardia
dizziness
flushing
headache
hypotension
Amiodarone - Adult Dose, Pulseless Arrest
300 mg IV push, diluted in 20 - 30 cc NS. Consider repeating 150 mg IV push in 3 - 5 minutes (max cumulative dose: 2.2 g IV/24 hours)
Amiodarone - Adult Dose, Wide Complex V-tach
rapid infusion: 150 mg IV over 10 minutes (15 mg/min), repeated every 10 minutes as needed.

slow infusion: 360 mg IV over 6 hours (1 mg/min)
Amiodarone - Adult Dose, Maintenance Infusion
540 mg IV over 18 hours (0.5 mg/min)
Amiodarone - Peds Dose, Pulseless Arrest
5 mg/kg rapid IV bolus
Amiodarone - Peds Dose, Perfusing Tachycardias
loading dose: 5 mg/kg IV/IO over 20 - 60 min (max dose: 15 mg/kg/day IV)
Amiodarone - Onset
within minutes
Amiodarone - Duration
variable
Amiodarone - Pregnancy Class
Class D
Amiodarone - Notes
(5)
must continuously monitor EKG

slow or discontinue infusion if bradycardia or AV block occurs

may potentiate bradycardia & hypotension w/beta blocker and calcium channel blockers

may increase risk of AV block & hypotension w/calcium channel blockers

may increase anticoagulant effects of warfarin
Atropine - Names
Atropine
Atropine - Classification
anticholinergic agent
Atropine - Action
(5)
antagonizes effects of organophosphate insecticides and chemical nerve agents

small doses inhibit salivary & bronchial secretions

moderate doses dilate pupils & increase heart rate

large doses decrease GI motility, inhibit gastric acid secretion, and may block nicotinic receptor sites at autonomic ganglia and the neuromuscular junction

blocked vagal effects result in increased heart rate and enhanced AV conduction w/limited or no inotropic effects
Atropine - Indications
(4)
a,p,o,u
asystole
PEA w/absolute bradycardia
organophosphate or nerve gas poisoning
unstable bradycardia
Atropine - Contraindications
(7)
h,n,2o,2t,u
hypersensitivity to atropine
narrow angle glaucoma
obstructive disease of GI tract
obstructive uropathy
tachycardia
thyrotoxicosis
unstable cardiovascular status in acute hemmorhage w/MI
Atropine - Side Effects
(10)
2a,2d,f,h,n,2p,t
anticholinergic effects
allergic reactions
dizziness
dysrhythmias
flushed hot dry skin
headache
palpitations
paradoxical bradycardia when pushed too slow or dose < 0.5 mg
tachycardia
Atropine - Pregnancy Class
Class C
Atropine - Onset
rapid
Atropine - Duration
2 - 6 hours
Atropine - Notes
(2)
follow ET adminstration with several positive pressure ventilations

dilates pupils and renders them nonreactive, so pupil response may not be useful in monitoring CNS status
Atropine - Adult Dose, Bradydysrhythmias
0.5 - 1 mg IV every 3 - 5 minutes for desired response

(max total dose: 0.04 mg/kg)
Atropine - Adult Dose, Asystole/PEA
1 mg IV, ET dose 2 - 3 mg diluted to total 10 cc MS, may repeat every 3 - 5 minutes

(max dose: 0.03 - 0.04 mg/kg)
Atropine - Adult Dose, Poison
1 - 2 mg IV push every 5 - 15 minutes until atropine effect is observed, then every 1 - 4 hours for at least 24 hours
Atropine - Peds Dose, Bradycardia
0.02 mg/kg/IV/IO/ET (diluted to 3 - 5 cc), (min dose - 0.1 mg; max single dose - 0.5 mg for child or 1 mg for adolescent), may be repeated in 5 minutes for max dose of 1 mg for child or 2 mg for adolescent
Atropine - Peds Dose Asystole/PEA
not established
Atropine - Peds Dose, Poisoning
0.02 mg/kg/dose IV, may be repeated every 10 - 20 minutes until atropine effect is observed, then every 1 - 4 hours for at least 24 hours.
Terbutaline - Names
Brethine
Bricanyl
Terbutaline - Classification
sympathetic agonist
synthetic sympathomimetic
Terbutaline - Indications
bronchial asthma
COPD bronchospasms
preterm labor
Terbutaline - Contraindications
hypersensitivity
Terbutaline - Side Effects
(4)
a,d,n,p
anxiety
dizziness
nausea
palpitations
Terbutaline - Action
causes bronchodilation w/less cardiac effect than epi

relaxes uterine smooth muscle
Terbutaline - Dose
12 yo or older only

two inhalations w/MDI, repeated once in one minute
Terbutaline - Pregnancy Class
Class B
Terbutaline - Notes
use caution w/cardiac and hypertensive patients
Bretylium - Names
Bretylol
Bretylium - Classification
antidysrhythmic
Bretylium - Action
releases norepi
depresses V-fib
reduces ectopy
suppresses ventricular tachydysrhythmias w/reenty mechanisms
Bretylium - Indications
V-fib refractory to lidocaine
V-tach refractory to lidocaine
Bretylium - Contraindications
none in presence of dysrhythmias
Bretylium - Side Effects
may induce postural hypotension
Bretylium - Adult Dose
5 mg/kg IV, then 10 mg/kg/15 - 30 minutes to a max of 30 mg/kg

following conversion: 1 - 2 mg/min drip
Bretylium - Peds Dose
5 mg/kg IV, repeat 10 mg/kg in 15 - 30 minutes
Bretylium - Pregnancy Class
Class C