• Shuffle
    Toggle On
    Toggle Off
  • Alphabetize
    Toggle On
    Toggle Off
  • Front First
    Toggle On
    Toggle Off
  • Both Sides
    Toggle On
    Toggle Off
  • Read
    Toggle On
    Toggle Off
Reading...
Front

How to study your flashcards.

Right/Left arrow keys: Navigate between flashcards.right arrow keyleft arrow key

Up/Down arrow keys: Flip the card between the front and back.down keyup key

H key: Show hint (3rd side).h key

A key: Read text to speech.a key

image

Play button

image

Play button

image

Progress

1/17

Click to flip

17 Cards in this Set

  • Front
  • Back
Oxygen
OXYGEN

INDICATIONS

♦ Acute Chest Pain
♦ Suspected hypoxemia of any cause or c/o SOB
♦ Cardiopulmonary Arrest

Mechanism of Action

Correct hypoxemia by O2 tension
↑ O2 content
↑ tissue oxygenation

Precautions

♦ O2 Toxicity with high FIO2s
♦ May cause ↑CO2 if a CO2 retainer

Dose

♦ 2 –6 LPM by NC for CP/mild distress
♦ NRB Mask for mod. Distress/ CHF
♦ Bag/Mask Ventilation
♦ Bag/ETT Ventilation or other advanced airway
Epinephrine
EPINEPHRINE

Indications

IVPush for ANY CARDIAC ARREST:
♦ Shock refractory VF & Pulseless VT
♦ Asystole
♦ PEA

IVDrip for Symp Brady

Mechanism of Action

↑ SVR, BP, HR, Contractility of heart, automaticity
↑ Bloodflow to heart & brain
↑ AV conduction velocity

Precautions

-none listed

Dose

CARDIAC ARREST:
1 mg IV Push (10 ml of 1:10,000 solution)
Repeat 1 mg q 3-5”
Endotracheal dose = 2-2.5 times IV dose

SYMPTOMATIC BRADY:
2 – 10 mcg/min
vasopressin

(Pitressin®)
**VASOPRESSIN**

INDICATIONS

Alternative Pressor to EPI for ANY CARDIAC ARREST:
♦ VF/Pulseless VT
♦ Asystole
♦ PEA
♦ Can replace 1st or 2nd dose of EPI
Also used for hemodynamic support in Septic Shock

MOA

Non-adrenergic Peripheral Vasoconstrictor
↑ Bloodflow to heart & brain

PRECAUTIONS

♦ Half life = 10 – 20”
♦ Not recommended in CAD

DOSE

♦ Any pulseless patient: 40 U IV single dose--1 time only

♦ To replace 1st or and dose of EPI

♦ ♦ ♦ Can defibrillate every 2 minutes after administration of Vasopressin

♦ Endotracheal dose = 2-2.5 times IV dose
Atropine
**ATROPINE**

INDICATIONS

♦ Symptomatic Bradycardia
♦ Ventricular Asystole (2nd line)
♦ PEA if rate is brady (2nd line)

MOA

Parasympatholytic action:
-accelerates rate of sinus node discharge
-improves AV conduction

PRECAUTIONS

♦ ↑ myocardial O2 demand: worsening ischemia

DOSE

Asystole or PEA 1 mg IV every 3-5”
Bradycardia 0.5 mg every 3-5”
Repeat to total dose of 0.04 mg/kg
Endotracheal dose = 2-2.5 times IV dose
amiodarone

(Cordarone®)
**AMIODARONE (CORDARONE)**

INDICATIONS

♦ VF/Pulseless VT (2nd line)
♦ Vent. Arrhythmias –Sympt PVCs
♦ Preferred over Lido

MOA

♦Anti arrhythmic
♦Possesses α- and β- adrenergic blocking properties
♦Prolongs action potential duration
♦Prolongs refractory period
♦ ↓ AV node conduction
♦ ↓ sinus node function

PRECAUTIONS

♦ Half life is long
♦ May prolongs QT

Monitor BP, HR, QT interval

CONTRAINDICATED IN:

Cardiogenic shock,
Marked Sinus Brady, 2nd or 3rd block

DOSE

♦ 300 mg IV Push in cardiac arrest (VF/VT)

♦ 150 mg IV Push for tachys with pulse (give over 10min)

♦♦♦♦♦♦ Can repeat ONE 150 mg in 5 mins.

Draw 2 glass ampules through a large gauge needle diluted in 20-30 mL of D5W

Maintenance infusion:
1 mg/min over 6 hrs. then
0.5 mg/min over 18 hrs.
– max of 2.2 g over 24 hrs.
Lidocaine
**LIDOCAINE**

INDICATIONS

Alternative to Amiodarone in:
♦ Vtach (with pulse – stable)
♦ VF/Pulseless VT (2nd line)
♦ Symptomatic PVCs

MOA

Suppresses vent ectopy
↑ VF threshold
↓ Vent. Irritability
↓ excitability
Helps prevent VTach

PRECAUTIONS

♦ CNS Toxicity: muscle twitching, slurred speech, resp. arrest, altered consciousness, seizures
♦ Prophylactic use in MI no longer recommended.

DOSE

♦ For Vfib or Pulseless Vtach:
1 – 1.5 mg/kg repeat at 0.5 – 0.75 mg/kg in 3-5” for total dose of 3 mg/kg
♦ Vtach with pulse:
0.5 – 0.75 mg/kg repeat in 3-5” for total dose of 3 mg/kg
♦ Infusion:
Infusion of 1-4 mg/min after termination of vent arrhythm.
Ibutilide

(Corvert®)
**IBUTILIDE (CORVERT)**

INDICATIONS

♦ Rapid conversion of atrial fib or flutter of recent onset (< 48 hrs).

MOA

♦ Prolongs action potential by delaying repolarization

PRECAUTIONS

♦ Correct K & Mg before initiating Ibultilide

DOSE

♦ > 60 kg: 1 mg over 10 min
♦ < 60 kg: 0.01 mg/kg over 10 min

Can repeat with a 2nd dose
Procainamide
**PROCAINAMIDE**

INDICATIONS

♦ Stable monomorphic VTach with Normal QT and Normal LV function
♦ SVT uncontrolled by Adenosine & vagal if stable BP
♦ Atrial Fib with rapid rate in WPW
♦ Stable wide complex Tachy of unknown origin

MOA

♦ Supresses Ventricular Ectopy

PRECAUTIONS

♦ Monitor BP for Hypotension
♦ Monitor ECG for ↑ PR and QT Intervals, QRS widening, & heart block
♦ Use with caution with Amiodarone (prolongation QT)

DOSE

♦ 20 mg/min IV infusion
♦ urgent situations up to 50 mg/min (max 17 mg/kg)
♦ Stop if arrhythmia suppressed, ↓BP, or QRS duration ↑ by 50%
♦ Infusion: 1-4 mg/min
Magnesium SULFATE
**MAGNESIUM SULFATE**

INDICATIONS

♦ Cardiac Arrest only if torsades is present or low Magnesium is suspected
♦ Life threatening vent arrhythmias due to dig tox.

MOA

♦ Antiarrhythmic
♦ Restores electrolyte balance

PRECAUTIONS

♦ Prophylactic use in MI no longer recommended
♦ ↓ dose with impaired liver or LV dysfunction

DOSE

♦ For Cardiac Arrest due to low MG or Torsades
1-2 g/10 ml D5W Over 1-2”
Adenosine
**ADENOSINE**

INDICATIONS

♦ Stable SVT
♦ Undefined stable narrow complex tachycardia as a diagnostic maneuver

♦ Not effective in Afib, Aflutter, or VTach

MOA

♦ Depresses SA & AV node activity
♦ Slows AV conduction
♦ Half-life = 5 seconds

PRECAUTIONS

♦ Usually see brief of asystole after adm of drug
♦ Drug interactions with Theophylline, Dipyridamole, & Carbamazepine
♦ Pts. feel flushing, dyspnea, transient CP

DOSE

♦ 6 mg IV over 1 – 3 seconds followed by 20 cc saline flush then elevate arm (attach both syringes to same port)
WAIT 1-2”
♦ Repeat 12 mg IV rapid push
WAIT 1-2”
♦ Repeat 12 mg IV rapid push
Verapamil
**VERAPAMIL**

INDICATIONS

♦ Alternative Drug after Adenosine for SVT

MOA

♦ Systemic vasodilation
♦ Negative Inotropic effect
♦ Prolongs AV nodal conduction time
♦ Ca++ channel blocker

PRECAUTIONS

♦ Expect ↓ BP – can counteract with IV Ca
♦ Do not use with wide complex

DOSE

2.5 – 5.0mg IV bolus over 2 minutes

2nd dose:
5 – 10 mg in 15-30”
Digoxin
**DIGOXIN**

INDICATIONS

Slows ventricular response in
♦ Afib or Aflutter
♦ CHF

MOA

♦ Inotropic effect
♦ Slows AV conduction

PRECAUTIONS

♦ Toxic effects can cause serious arrhythmias

DOSE

10 – 15 mcg/kg IV loading dose
Cardizem

(Diltiazem)
**CARDIZEM (DILTIAZEM)**

INDICATIONS

Controls vent rate in:
♦ Afib & Aflutter
♦ Refractory SVT (after Adenosine)

MOA

♦ Ca++ channel blocker
♦ Prolongs effective refractory period

PRECAUTIONS

♦ BP may ↓
♦ DO NOT use for wide QRS Tachy, WPW with Afib, sick sinus syndrome, or β blockers

DOSE

♦ 15-20 mg (0.25 mg/kg) IV over 2”
May repeat in 15” at 20-25 mg (0.35mg/kg) over 2”

♦ Infusion 5-15 mg/h titrate to HR.
Morphine Sulfate
**MORPHINE SULFATE**

INDICATIONS

♦ CP with ACS unresponsive to nitrates
♦ Cardiogenic Pul. Edema

MOA

↓ Preload
↓ Afterload

PRECAUTIONS

♦ Administer slowly and titrate to effect.
♦ Caution with RV infarction
♦ May cause ↓BP & Respiratory compromise – reverse with Narcan

DOSE

2-4 mg IV (over 1-5 mins) every 5 to 30 minutes
Aspirin
**ASPIRIN**

INDICATIONS

♦ All ACS

MOA

Prevents platelet aggregation

PRECAUTIONS

♦ Contraindicated in acute ulcer disease, asthma, or ASA sensitivity.

DOSE

♦ 160 mg to 325 mg tablet (chewing is preferable) – give immediately
Nitroglycerin
**NITROGLYCERIN**

INDICATIONS

♦ Sublingual:
Suspected ischemic pain

♦ IV
Unstable Angina pectoris
Acute MI
CHF
Hypertension

MOA

♦ ↓ Pain in ischemic tissue
♦ ↑ Venous dilation
♦ ↓ Preload & O2 consumption
♦ Dilates Coronary Arteries
♦ ↑ Collateral flow in MI

PRECAUTIONS

Contraindicated with Hypotension BP < 90 or severe brady < 50.

DOSE

♦Sublingual: 1 tablet (0.3-0.4 mg)
– repeat Q5”

♦Spray: oral mucosa 1 – 2 sprays
– repeat Q5”

♦Topical: 1-2” of 2% ointment
Sodium Bircarb
**SODIUM BICARB**

INDICATIONS

♦ Pre-existing hyperkalemia
♦ Drug Overdose
♦ Known ketoacidosis
♦ Prolonged cardiac arrest with adequate ventilation

PRECAUTIONS

♦ Adequate ventilation & CPR are best “buffer agents”

DOSE

1 mEq/kg IV bolus