Cardiology Drugs

Front 1

Albuterol: Class

Back 1

Sympathomimetic

Front 2

Albuterol: How Supplied

Back 2

Liquid

Front 3

Albuterol: Route

Back 3

Inhalation (nebulized), ETT (alternate route)

Front 4

Albuterol: Dose

Back 4

Adult: Neb-2.5 in 3cc over 5-15 mins
Pedi: Same as adult
***If pat is improving after the first alb dose, two addtn'l doses may be given.
***If no improvement after first dose, combine the 2nd and 3rd doses of albuterol w/ Atrovent.

Front 5

Albuterol: Drug Action

Back 5

Bronchodilation

Front 6

Albuterol: Indications

Back 6

1) Bronchospasm assoc w asthma and COPD
2) Bronchospasm from chemical toxins
3)Allergic reactions unresponsive to Epi or Benadryl

Front 7

Albuterol: Precautions

Back 7

Known heart disease

Front 8

Albuterol: Side Effects

Back 8

Restlessness
Hypertension
Tachycardia-palpitations

Front 9

Albuterol: Contraindications

Back 9

Pregnancy, except in life-threatning situations

Front 10

Atropine: Class

Back 10

Anticholinergic

Front 11

Atropine: Route

Back 11

Rapid IV Push
ETT (alternate route)

Front 12

Atropine: Dose (Adult)

Back 12

*PEA or asystole - 1 mg IVP (max 0.04 mg/kg)
*Symptomatic Brady - 0.5-1mg IVP (max 0.04 mg/kg)

Front 13

Atropine: Dose (Pedi)

Back 13

*Symptomatic Brady - 0.02mg/kg (max single dose = 0.1mg) IVP
*PEA or asystole - not used prehosp

Front 14

Atropine: Drug Action

Back 14

*Reverses suspected vagal tone in brady, asystole, and PEA
*Blocks acetylcholine in organophosphate poisoinings
*Reverses effects of nerve agents.

Front 15

Atropine: Indications

Back 15

*Symptomatic Brady
*Asystole
*Rates <60 in PEA rhythms
*Organophosphate Poisoning
*Chemical exposure due to nerveagents

Front 16

Atropine: Precautions

Back 16

*To avoid transient brady, administer rapidly and in the port closest to the IV site
*Notify Biotel prior to admin if pat has a hx of glaucoma, prostatic hypertrophy, or bladder neck obstruction

Front 17

Atropine: Side Effects

Back 17

*Tachycardia
*Dilated Pupils (may make pupil assessment unreliable)
*Anticholinergic effects: dry mouth, blurred vision

Front 18

Atropine: Contraindications

Back 18

Hypothermic Brady, PEA and asystole prior to rewarming

Front 19

Dobutamine: Dobutrex
Class

Back 19

Sympathomimetic

Front 20

Dobutamine: Dobutrex
Route

Back 20

IVPB

Front 21

Dobutamine: Dobutrex
Dose

Back 21

Adult: 2-20mcg/kg/min
***Dilution ratio = 250mg/250mL, etc...
Pedi: 2-20mcg/kg titrated to desired effect

Front 22

Dobutamine: Dobutrex
Drug Action

Back 22

*Stim Beta1 - inc contractility, volume, and CO
*Stim Beta2 - Bronchodilate and dec PVR

Front 23

Dobutamine: Dobutrex
Indications

Back 23

Pulmonary Edema with systolic BP of 70-100 and no S/S of shock

Front 24

Dobutamine: Dobutrex
Precautions

Back 24

*Do not admin through same line as other drugs
*Assure IV patency
*Continuously monitor HR, BP, and ECG
*Titrate so HR does not inc > 10% of baseline

Front 25

Dobutamine: Dobutrex
Side Effects

Back 25

*Phlebitis (inflammed vein)
*Tachycardia/tachyarrythmias
*In high doses-nervousness, n/v, cp, htn

Front 26

Dobutamine: Dobutrex
Contraindications

Back 26

*Suspected poison/drug induced shock
*systolic BP < 100 w/ s/s of shock
Concurrent beta-blocker use (may antagonize)

Front 27

Dopamine: Intropin
Class

Back 27

Sympathomimetic

Front 28

Dopamine: Intropin
Route

Back 28

IVPB

Front 29

Dopamine: Intropin
Dose

Back 29

Adult: 2-10mcg/kg/min per Biotel order
***Dilution Ratio-400mg/250mL, 800mg/500mL
Pedi: Not used prehosp

Front 30

Dopamine: Intropin
Drug Action

Back 30

*Low Doses: Inc perfusion to kidneys and abd organs (dopa)
*Mod Doses: Inc Beta1 (HR&For)
*High Dose: Inc Alpha

Front 31

Dopamine: Intropin
Side Effects

Back 31

*tissue necrosis w/ infiltration
*HTN
*Tachycardia
*Arrythmias

Front 32

Dopamine: Intropin
Contraindications

Back 32

Hypovolemic shock

Front 33

EPI 1:1000
Class

Back 33

Sympathomimetic

Front 34

EPI 1:1000
Route

Back 34

SQ
ETT (alt route)

Front 35

EPI 1:1000
Dose (Adult)

Back 35

Adult:
*Asthmatic bronchospasm unrelieved by albut or Atrov - .3-.5mgSQ
*Allergic reaction/ anaphylactic shock .3-.5mgSQ

Front 36

EPI 1:1000
Dose (Pedi)

Back 36

*Asthmatic Bronchospasm unrelieved by Albut or Atrov - .01mg/kg (max is .3mg/dose)
*Allergic reaction/ anaphylactic shock is same.

Front 37

EPI 1:1000
Drug Action

Back 37

A: Inc PVR which a)inc coronary & cerebral perf b)inc BP in anaphylaxis
B1: Inc HR & Force
B2: Bronchodilation

Front 38

EPI 1:1000
Indications

Back 38

*Allergic reaction/anaphylaxis
*Asthmatic bronchospasm unrelieved by Albut & Atrov
*Pedi cardiac arrest (ETT Tube Only

Front 39

EPI 1:1000
Precautions

Back 39

*CPR: None
*Allergic reaction/ anaphylactic shock/asthma: monitor ECG closely
*Pats on Beta-Blockers may need Glucagon or higher doses of Epi
*Massage the injection site after SQ injections

Front 40

EPI 1:1000
Side Effects

Back 40

*Tachycardia
*Ventric Arrythmias
*CP
*Headache
*N/V
*Flushing

Front 41

EPI 1:1000
Contraindications

Back 41

*CPR: None
*Asthma: heart disease, hx of
AMI, >45, arrythmias, labor
*Allergic Reaction: None

Front 42

EPI 1:10,000
Class

Back 42

Sympathomimetic

Front 43

EPI 1:10,000
Route

Back 43

IVP
ETT (alt route for adult CPR)

Front 44

EPI 1:10,000
Dose (Adult)

Back 44

*CPR: 1mgIVP
*Anaphylaxis: .1-.2mg slow IVP(over 1 min)

Front 45

EPI 1:10,000
Dose (Pedi)

Back 45

*CPR: 0.01mg/kgIVP
*Anaphyl: 0.01mg/kgslowIVP(max is .3mg/dose)
*Brady: 0.01mg/kgslowIVP(max is .3mg/dose)

Front 46

EPI 1:10,000
Drug Action

Back 46

*A: Inc PVR which inc coronary & cerebral perf / inc BP in anaphylaxis
*B1: Inc HR & force
*B2: Bronchodilate

Front 47

EPI 1:10,000
Indication

Back 47

*Cardiac arrest
*Anaphylaxis that has not responded to Epi 1:1SQ
*Pedi Brady unresponsive to other treatment

Front 48

EPI 1:10,000
Precautions

Back 48

*CPR: None
*Anaphylaxis: Use cautiously in pats w/ COPD, CHF, Hx AMI or heart disease, >45, HTN, arrythmias, & labor
*Monitor ECG closely
*Pats on Beta Blockers may need Glucagon or higher doses of Epi
*Do not mix with Sodium Bicarb

Front 49

EPI 1:10,000
Side Effects

Back 49

*CPR: None
*Anaphylaxis: Tachy, V-arryth, CP, Flushing, Headache, N/V

Front 50

EPI 1:10,000
Contraindications

Back 50

None

Front 51

Furosemide (Lasix)
Class

Back 51

Loop Diuretic

Front 52

Furosemide (Lasix)
Route

Back 52

Slow IVP (20mg/min)

Front 53

Furosemide (Lasix)
Dose

Back 53

*Adult: 40mg (if pat is taking Furosemide @ home, admin twice the pat's usual single, daily dose, up to a max of 100mg
*Pedi: not used prehosp

Front 54

Furosemide (Lasix)
Drug Action

Back 54

*Dec PVR (Vasodilator)
*Dec Cardiac workload and o2 demand on heart
*Inc H2O excretion by inhibiing reabsorp of water, sodium and chloride in the kidneys.

Front 55

Furosemide (Lasix)
Indications

Back 55

Pulmonary Edema due to CHF or kidney disease

Front 56

Furosemide (Lasix)
Precautions

Back 56

*Must be preceded by NTG
*Monitor ECG and BP closely
*Doc any urine output

Front 57

Furosemide (Lasix)
Side Effects

Back 57

*Hypotension
*Arrythmias secondary to electrolyte imbalances
*Deafness if given too rapidly

Front 58

Furosemide (Lasix)
Contraindications

Back 58

*systolic >110
*pregnancy

Front 59

Ipratropium Bromide (Atrovent)
Class

Back 59

Topical Anticholinergic

Front 60

Ipratropium Bromide (Atrovent)
How

Back 60

Liquid

Front 61

Ipratropium Bromide (Atrovent)
Route

Back 61

Inhalation (Neb)
ETT (alt route)

Front 62

Dose

Back 62

*All doses are combined with 2.5mg Albuterol
*Adult:Neb .5mg in 2.5mLNS
*Pedi:Neb
~<1yo - 0.25mg in 2.5mLNS
~>=1yo - 0.5mg in 2.5mLNS

Front 63

Ipratropium Bromide (Atrovent)
Drug Actions

Back 63

*Bronchodilator
*Dries Resp Tract Secretions

Front 64

Ipratropium Bromide (Atrovent)
Indications

Back 64

*Bronchospasm assoc w/ asthma or COPD, that does not respond to the first dose of albuterol
*Bronchospasm from chemical toxins.

Front 65

Ipratropium Bromide (Atrovent)
Precautions

Back 65

*Notify Biotel prior to admin if pts have a Hx of glaucom, prostatic hypertrophy, or bladder neck obstruction

Front 66

Ipratropium Bromide (Atrovent)
Side Effects

Back 66

Dry Mouth
Cough, worsening of symptoms
Skin Rash

Front 67

Ipratropium Bromide (Atrovent)
Contraindications

Back 67

*Sensitivity to soy lecithin products (soybeans, peanuts)
*Sensitivity to Atropine
*Bronchoconstriction taht is caused by allergic reaction

Front 68

Morphine Sulfate
Class

Back 68

Narcotic Analgesic

Front 69

Morphine Sulfate
Route

Back 69

Slow IVP

Front 70

Morphine Sulfate
Dose

Back 70

*Adult: Admin in titrated doses of 2-4mg, up to max of 10mg
*Pedi: 0.1mg/kg

Front 71

Morphine Sulfate
Drug Action

Back 71

*Alleviates pain
*Dec PVR - Vasodilator
*Dec Card workload & O2 dem on heart
*Coronary artery dilator

Front 72

Morphine Sulfate
Indications

Back 72

*pain & anxiety secondary to AMI
*CP unrelieved by Nitro
*Pulmonary Edema
*Pain Secondary to amputations or fractures

Front 73

Morphine Sulfate
Precautions

Back 73

*Monitor resp status and BP closely
*Notify Biotel prior to admin if pat is >65yo, debilitatd, has alt LOC, or sysBP<110
*CHF: be prepared to intubate
*Have Nalaxone (Narcan) readily available

Front 74

Morphine Sulfate
Side Effects

Back 74

*Resp depression
*hypotension
*Bradycardia
*N/V

Front 75

Morphine Sulfate
Contraindications

Back 75

*systolic BP<110, unless auth by biotel
*Head Injury
*Severe resp depression

Front 76

Morphine Sulfate
Antidote

Back 76

Naloxone (Narcan)

Front 77

Norepinephrine Bitartrate (Levophed)
Class

Back 77

Sympathomimetic

Front 78

Norepinephrine Bitartrate (Levophed)
Class

Back 78

sympathomimetic

Front 79

Norepinephrine Bitartrate (Levophed)
Route

Back 79

IVPB

Front 80

Norepinephrine Bitartrate (Levophed)
Dose

Back 80

Adult: 8-12mcg/min
***Dilute Add 4mg/250mLNS
OR Dilute Add 8mg/500mLNS
Pedi: Not used prehosp

Front 81

Norepinephrine Bitartrate (Levophed)
Drug Action

Back 81

*Potent Peripheral vasoconstrictor (primarily A; minimally B)
*Inc myocardial contractility

Front 82

Norepinephrine Bitartrate (Levophed)
Indications

Back 82

*Cardiogenic shock when sys BP is <70
*Post resuscitation hypotension after medical CPR's when systolic BP < 90

Front 83

Norepinephrine Bitartrate (Levophed)
Precautions

Back 83

*Assure IV Patency
*Continually monitor BP
*Do not mix with Sodium Bicarb

Front 84

Norepinephrine Bitartrate (Levophed)
Side Effects

Back 84

*Tissue necrosis with infiltration
*Hypertension

Front 85

Norepinephrine Bitartrate (Levophed)
Contraindications

Back 85

Hypovolemia

Front 86

Vasopressin (Pitressin)
Class

Back 86

Naturally occurring antidiuretic hormone

Front 87

Vasopressin (Pitressin)
Route

Back 87

IVP

Front 88

Vasopressin (Pitressin)
Dose

Back 88

Adult: CPR - 40U one time only; the replaces the first or second dose of EPI
Pedi: Currently not recommended

Front 89

Vasopressin (Pitressin)
Drug Action

Back 89

Potent Peripheral vasoconstrictor

Front 90

Vasopressin (Pitressin)
Indications

Back 90

*Alternate pressor for EPI for pats in cardiac arrest
*Low resistance shock

Front 91

Vasopressin (Pitressin)
Precautions

Back 91

In responsive pats, watch for the development of cardiac ischemia and angina

Front 92

Vasopressin (Pitressin)
Side Effects

Back 92

Chest Pain
Abdominal distress
Bronchocontriction

Front 93

Vasopressin (Pitressin)
Contraindicatiosn

Back 93

Responsive pats with coronary artery disease

Front 94

Amiodarone (Cordarone)
Class

Back 94

sodium, potassium and calcium channel blocker / Antiarrythmic Sympatholytic

Front 95

Amiodarone (Cordarone)
Route

Back 95

IVP

Front 96

Amiodarone (Cordarone)
Dose

Back 96

1.VFib/plessVtach First:300mg Second:150mg
2.SustainedVTach w/ pulse- 150mg over 10 mins

Front 97

Amiodarone (Cordarone)
Drug Action

Back 97

Alters the mvmt of Na,K,andCA through normal channels in all cardiac tissue which:
1)Increase the refractory period of all cardiac tissue 2)Slow repolarization. 3)Dec automaticity

It is an Alpha and Beta blocker.

Front 98

Amiodarone (Cordarone)
Indication

Back 98

VFib or PlessVTach refractory to shocks.
OR Sustained VTach w/ pulse

Front 99

Amiodarone (Cordarone)
Precautions

Back 99

Prevent foaming, do not shake and draw w/ large bore.
Protect from light.
Avoid contact with plastic.

Front 100

Amiodarone (Cordarone)
Side Effects

Back 100

Bradycardia
Hypotension
Heart Block

Front 101

Amiodarone (Cordarone)
Contraindications

Back 101

Trauma Patients
Not down ETT!

Front 102

Aspirin (Actylsalicylate Acid)
Class

Back 102

anti-platelet aggregator, analgesic, anti-inflammatory, antipyretic

Front 103

Aspirin (Actylsalicylate Acid)
Route

Back 103

Orally

Front 104

Aspirin (Actylsalicylate Acid)
Dose

Back 104

324mg either 4 baby aspirin (chewed) OR 1 adult aspirin.

Front 105

Aspirin (Actylsalicylate Acid)
Drug Action

Back 105

Decrease platelet stickiness
Blocks pain impulses in the CNS
Reduces fever and inflammation

Front 106

Aspirin (Actylsalicylate Acid)
Indication

Back 106

Chest Pain believed to be of cardiac origin.

Front 107

Aspirin (Actylsalicylate Acid)
Precautions

Back 107

Any significant bleeding

Front 108

Aspirin (Actylsalicylate Acid)
Side Effects

Back 108

None for prehospital

Front 109

Aspirin (Actylsalicylate Acid)
Contraindications

Back 109

ASA Allergy
ASA Induced Asthma

Front 110

Calcium Chloride
Class

Back 110

Electrolyte

Front 111

Calcium Chloride
Route

Back 111

CPR - IVPush
Live - SLOW IVPush (1mL/min)

Front 112

Calcium Chloride
Dose

Back 112

10-15mg/kg of a 10% solution
PEDI:SAA

Front 113

Calcium Chloride
Drug Action

Back 113

Inc myocardial contractile force and ventricular automaticity. 2)Aids in the re-entry of calcium into muscle when given for calcium channel blocker or mag sulf toxicity. 3)Balances hyperkalemia

Front 114

Calcium Chloride
Indications

Back 114

Calcium Channel Blocker tox and Mag Sulf Tox are the main reasons for this drug. Other reason is Beta Blocker Toxicity.

Front 115

Calcium Chloride
Precautions

Back 115

Incompatible with all meds. Flush well. Assure IV patent. Notify Biotel if pat is on Digoxin.

Front 116

Calcium Chloride
Side Effects

Back 116

1)Tissue necrosis with infiltration
2)forms precipitate if given with Sod Bicarb
3)Causes dig tox if given to a pat on dig.
4)Rapid infusion cause:brady, hypotension, and asystole.

Front 117

Calcium Chloride
Contraindications

Back 117

Non

Front 118

Lidocaine Bolus (Xylocaine)
Class

Back 118

Ventricular antiarrythmic

Front 119

Lidocaine Bolus (Xylocaine)
Route

Back 119

IVPush (no faster than 50mg/min in conscious pats)

Front 120

Lidocaine Bolus (Xylocaine)
Dose

Back 120

1)VFib or PLessVTach - 1.5mg/kg
2)Unstable VTach - 1.5mg/kg
3)Stable VTach - 1.0mg/kg
4)Non-sustained VTach or treatable PVCs - 1.0mg/kg

Front 121

Lidocaine Bolus (Xylocaine)
Drug Action

Back 121

Suppresses ventricular ectopy

Front 122

Lidocaine Bolus (Xylocaine)
Indication

Back 122

1)Ventricular Rhythms of irritability (PVCs,VTach, VFib)
2)Prevent recurrence of VFib or VTach after initial Defib or cardioverts

Front 123

Lidocaine Bolus (Xylocaine)
Precautions

Back 123

1)Consider reduced dose in pats >65 or those w/ hx of liver dis or CHF
2)Notify Biotel of any "caine" allergies
3)If successful and converts a ventricular arrythmia, it must be followed with a drip.

Front 124

Lidocaine Bolus (Xylocaine)
Side Effects

Back 124

Toxicity
1)Early:drowsy,lightheaded,blurred vision
Late:hypotension,chg in loc, seizures

Front 125

Lidocaine Bolus (Xylocaine)
Contraindications

Back 125

lifesustaining vent escape rhythms assoc with brady or 2 or 3 degree heart blocks.