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117 Cards in this Set

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Atropine

Trade Names
Atropair, Atropisol
Atropine

What do small amounts do?
Inhibit salivary/bronchial secretions.
Atropine

What do moderate amounts do?
Dilate pupils and increase heart rate.
Atropine

What do large amounts do?
Decrease GI motility, inhibit gastric acid secretion. Blocks vagal effects causing positive chronotropy/dromotropy.
Atropine

Why is it used in emergency care?
To increase heart rate in life-threatening bradycardias.
Atropine

What is it?
Parasympatholytic, anticholinergic, antidysrythmic, antimuscarinic, mydriatic.
Atropine

Indications
Asystole, sinus bradycardia and AV block.
Atropine

Contraindications
Acute hemorrhage, Glaucoma, myasthenia gravis, tachycardia due to cardiac insufficiency.
Atropine

Precautions
Active MI, chronic cardiac disease, geriatrics, pediatrics, pregnancy.
Atropine

Side Effects
Confusion, drowsiness, blurred vision, palpitations, tachycardia, constipation, dry mouth.
Atropine

Routes
IM, IV, PO, SQ, ET
Atropine

Onset
< 1 minute
Epinephrine Infusion

Indication
Severely symptomatic hypotension due to bradycardia
Dopamine

Trade Name
Intropin
Dopamine

What kind of drug is it?
Sympathomimetic
Dopamine

What does it do (actions)?
Increases cardiac contractility, causes peripheral vasoconstriction.
Dopamine

Indications
Hemodynamically significant hypotension (BP 70-100) not caused by hypovolemia. Cardiogenic shock.
Dopamine

Contraindications
Hypovolemic shock w/out complete fluid resuscitation. Pheochromocytoma.
Dopamine

Precautions
Tachyarrhythmias, v-fib
Dopamine

Side Effects
Ventricular tachyarrhythmias, hypertension, palpitations, vasoconstriction of renal arteries - renal failure.
Sodium Bicarbonate

What is it?
Alkalinizing agent, increases pH
Sodium Bicarb

Indications
Late management of cardiac arrest; hyperkalemia; tricyclic antidepressant OD; aspirin OD
Sodium Bicarb

Contraindications
Alkalotic states
Sodium Bicarb

Precautions
Can deactivate catecholamines; delivers large sodium load
Sodium Bicarb

Side Effects
Alkalosis
Oxygen

Contraindications
Paraquat exposure
Oxygen

Side Effects
May cause respiratory depression in COPD patients
Acetylsalicylic Acid

Trade Names
Aspirin, Excedrine, Bayer
Acetylsalicylic Acid

What is it?
Platelet aggregation inhibitor; anti-inflammatory; anti-pyretic.
Acetylsalicylic Acid

What does it do?
Slows platelet adhesion; reduces pain; reduces fever.
Acetylsalicylic Acid

Indication
Possible AMI
Acetylsalicylic Acid

Contraindications
Allergy to Aspirin or NSAIDs; Pediatrics
Acetylsalicylic Acid

Precautions
Previous ASA ingestion, pregnancy, gastric ulcers, bleeding disorders, hepatic/renal disease
Acetylsalicylic Acid

Side Effects
Dizziness, drowsiness, tinnitus, heartburn, nausea, vomiting, increased bleeding.
Acetylsalicylic Acid

Onset
10-30 min
Morphine Sulfate

Trade Names
Astramorph, Duramorph, MSIR, MS Contin, Oramorph
Morphine Sulfate

What is it?
Natural opium alkaloid; Analgesic; Peripheral vasodilator
Morphine Sulfate

What does it do?
Increases peripheral venous capacitance/decreases venous return. Decreases myocardial oxygen demand. Analgesia. Relieves cardiopulmonary congestion.
Morphine Sulfate

Indications
Relief of pain related to MI/ischemia; Pulmonary edema
Morphine Sulfate

Contraindications
Bronchial asthma; Respiratory depression; Upper airway obstruction
Morphine Sulfate

Precautions
Head trauma; alcoholism; increased intracranial pressure; pulmonary disease; renal disease
Morphine Sulfate

Side Effects
Respiratory depression; bradycardia; hypotension; nausea/vomiting.
Morphine Sulfate

Onset (IM and IV)
IM - 10-30 min
IV - < 1 min
Morphine Sulfate

Antidote
Naloxone (Narcan)
Nitroglycerin

What is it?
Potent vasodilator
Nitroglycerin

What does it do?
Relaxes vascular smooth muscle, reducing myocardial oxygen consumption.
Nitroglycerin

Indications
Angina, Acute MI, CHF w/ Pulmonary edema, HTN
Nitroglycerin

Contraindications
Erectile dysfunction medications, cerebral hemorrhage, hypotension, pericardial tamponade.
Nitroglycerin

Precautions
Anemia, hepatic disease, hypovolemia
Nitroglycerin

Side Effects
Headache, hypotension, syncope, local sensation/numbness
Nitroglycerin

Onset
2 min
Epinephrine

What is it?
Sympathomimetic
Epinephrine

First drug of choice for what?
ALL PULSELESS RHYTHMS
Epinephrine

What does it do?
Cardiac stimulation, bronchodilation, decongestion.
Epinephrine

Indications
Cardiac arrest
Epinephrine

Contraindications
None in cardiac arrest
Epinephrine

Precautions
Narrow angle glaucoma, pregnancy.
Epinephrine

Side Effects
Cerebral hemorrhage, urinary retention, anxiety, fatal v-fib.
Epinephrine

Routes and Concentrations
IV: 10:000

ET: 1:1000
Amiodarone

Trade Names
Cordarone, Pacerone
Amiodarone

What is it?
Alpha and beta adrenergic blocker
Amiodarone

What does it do?
Increases myocardial cell action potential and refractory period. (A strong/slow heart).
Amiodarone

Indications
V-fib/V-tach arrest. Certain tachycardias.
Amiodarone

Contraindications
None in cardiac arrest. Marked bradycardia, 2nd/3rd degree HB, Cardiogenic shock
Amiodarone

Precautions
Sensitive in geriatric pts.
Amiodarone

Amount needed to cause side effects
> 400 mg/day
Amiodarone

Side Effects
Pulmonary edema, CHF, hypotension, worsening arrhythmia, bradycardias, headache, n/v, dizziness, fatigue, constipation, photosensitivity, bleeding disorders
Amiodarone

Maximum Plasma Effect time
3-7 hours after initial dose
Amiodarone

Duration
Several days, up to 1-3 wks
Lidocaine

Trade Name
Xylocaine
Lidocaine

What does it do?
Shortens refractory period/supresses automaticity of ectopic foci. Does not effect conduction.
Lidocaine

Indications
Acute Ventricular Arrhythmias
Lidocaine

Contraindications
None in cardiac arrest. WPW.
Lidocaine

Precautions
CHF, respiratory depression, liver/kidney disease.
Lidocaine

Side Effects
Malignant hyperthermia, aggrevation of arrhythmias, dizziness, "doom anxiety" convulsions, LOC, difficulty breathing/swallowing
Lidocaine

Onset
45-90 sec
Lidocaine

Drug interactions
Beta Blockers, Phenytoin, Procainamide, Succinylcholine
Procainamide

Trade Names
Pronestyl, Procainabid
Procainamide

What is it?
Anticholinergic drug
Procainamide

What does it do?
Prolongs refractory period of the atria
Procainamide

Indications
Sustained/recurrent V-fib/V-tach
Procainamide

Contraindications
Lupus, Torsades de Pointes, Amiodarone use
Procainamide

Precautions
Increased risk of death in non life-threatening arrhythmias, CHF, liver/kidney dysfunction, cytopenia
Procainamide

Side Effects
Lupus-like symptoms, hypotension, Ventricular asystole/v-fib, n/v, diarrhea, dizziness, hepatitis, fever
Procainamide

Onset
1-5 minutes
Procainamide

Duration
3 hours
Magnesium Sulfate

Trade Name
Epsom Salt
Magnesium Sulfate

What is it?
Electrolyte.
Magnesium Sulfate

What does it do?
Depresses CNS, controlling convulsions.
Magnesium Sulfate

Indications
Hypomagnesemia, Torsades de Pointes
Magnesium Sulfate

Contraindications
Heartblock, myocardial damage
Magnesium Sulfate

Precautions
Renal patients
Magnesium Sulfate

Side Effects
CNS depression, hypotension, circulatory collapse, muscle paralysis, respiratory failure
Magnesium Sulfate

Onset
Immediate
Magnesium Sulfate

Duration
30 min
Adenosine

Trade Names
Adenocard, Adenoscan
Adenosine

What is it?
Antiarrythmic, coronary artery dilator
Adenosine

What does it do?
Slows tachycardias associated with the AV node, restores sinus rhythm, slows condutions time through SA/AV nodes
Adenosine

Indications
Converstion of PSVT or SVT when vagal maneuvers don't work
Adenosine

Contraindications
2nd/3rd degree AV blocks, WPW
Adenosine

Precautions
Asthma, hepatic failure, caffeine, renal failure, SVT induced by OD
Adenosine

Side Effects
Headache, lightheadedness, transient asystole/bradycardia/dyspnea, chest pain
Adenosine

Onset
20-30 sec
Adenosine

Duration
10 sec
Diltiazem

Trade Name
Cardizem
Diltiazem

What is it?
Calcium channel blocker
Diltiazem

What does it do?
Slows conduction through the AV node, reduces ventricular rates, reduces BP
Diltiazem

Indications
Control of tachycardic rates
Diltiazem

Contraindications
WPW, cardiogenic shock, CHF, 2nd/3rd degree HB, severe hypotension
Diltiazem

Precautions
Severe hepatic/renal impairment, lactation, pediatrics, pregnancy
Diltiazem

Side Effects
Dizziness, headache, hypotension, bradycardia, tachycardia, chest pain, n/v
Diltiazem

Onset
2-5 min
Furosemide

Trade Name
Lasix
Furosemide

What is it?
Loop diuretic, vasodilator
Furosemide

What does it do?
Inhibits sodium (and thus water) reapsorption in renal tuble and loop of Henle. Vasodilates.
Furosemide

Onset of vasodilation
5 min
Furosemide

Onset of diuresis
5-15 min