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71 Cards in this Set
- Front
- Back
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VASOPRESSION Indications |
INDICATIONS: Pulseless arrest & Septic Shock |
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VASOPRESSION Actions |
ACTIONS: Naturally occurring ADH at high doses potent vaso constrictor |
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VASOPRESSION Dose |
DOSE: 40 units IV single dose as the 1st or 2nd dose of a vasoconstrictor |
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EPINEPHRINE Indications |
INDICATIONS:
VFIB, PEA, Asystole, Symptomatic Bradycardia |
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EPINEPHRINE Actions |
ACTIONS: ↑HR, automaticity, contractility, SVR, vasoconstriction & myocardial O2 DEMAND |
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EPINEPHRINE Dose |
Dose: Cardiac: 1mg IVP 1:10K q3-5mins Drip for symptomatic bradycardia @2-10mcg/min |
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EPINEPHRINE Other |
ET administration give 2 to 2.5x the IV does of 1:1000
Mix 1 mg in 500ml/NS for continuous infusion |
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Atropine Indications |
INDICATIONS:
Symtomatic Bradycardia |
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Atropine Actions |
↑ AV conduction, may restore cardiac rythem in asystole |
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Atropine Dose |
Bradycardia: .5mg q3-5 mins upto 3 mg |
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Atropine Other |
Contraindicated with type II AV block |
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Amiodarone (Cordoarone) Indications |
VFIB, VT, PSVT & rapid atrial rythems
Useful for tachydysrythmias w/ poor ejection fraction |
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Amiodarone (Cordoarone) Actions |
Effects NA+, K+, Ca+ channels as well as α and ß blocking effects |
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Amiodarone (Cordoarone) Dose |
(Dead Mans Dose): 300mg rapid push in 20-30ml of NS for VF or Pulseless VT
Repeat once in 5-10 min. intervals at 150mg
WITH PULSE - 150mg IV over 10 minutes followed by 1mg/min cont. infusion for 5 hours, then .5mg/min mixed as 1mg/ml |
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Amiodarone (Cordoarone) Other |
May be repeated at 150 mg or cont infusion at 1mg/min for 6 hours followed by .5 mg/min
Total daily dose not to exceed 2.2 gms
May cause ↓ B/P or bradycardia |
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Lidocaine How Supplied? |
2 Grams / 500cc
-OR-
4mg/cc |
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Lidocaine Indications |
Wide complex tachycardia VF & Pulseless VT |
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Lidocaine Actions |
↓ automaticity by decreasing the slope of phase 4 diastolic depolarization, local anesthetic properties suppress ventricular ectopy, affects conduction velocity |
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Lidocaine Dose |
VFIB: 1.1.5mg/kg repeated in 5 min as .5-.75 mg/kg to 3mg/kg
VTACH with + pulse: .5-.75mg/kg IV, repeat in 5-10 mins to 3mg/kg total bolus dose |
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Lidocaine Other |
Drip: 2Gms/500ml (4mg/ml) 2mg/min=1mg/kg bolus 3mg/min=1.5-2mg/kg bolus 4mg/min=2.5-3mg/kg bolus
Single loading bolus does of 1mg/kg: >70yrs; ↓ Cardiac output; known liver dysfunction |
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Procainamide (Pronestyl) Indications |
VTACH Conversion of Supraventricular dysrythmias |
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Procainamide (Pronestyl) Action |
Slow AV conduction ↓ automaticity of all pacemaker sites ↓ phase 4 diastolic depolarization |
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Procainamide (Pronestyl) Dose (total amount OR when to stop admin.) |
20mg/min UNTIL: 1. QRS widens by 50% OR 2. hypotension ensues OR 3. Dysrythmia abates OR 4. Total of 17mg/kg given |
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Procainamide (Pronestyl) Other (Drip Rate & how mixed) |
Drip: 2Gms/500 ML @ 1-4mg/min URGENT: may give upto 50 mg/min |
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Magnesium sulfate Indications |
Torsades des pointes Post Infarction Protection ↓ decreased uterine contractions - OB |
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Magnesium sulfate Action |
Essential for action of the Na/K pump Mag deficiency associated with cardiac dysrhythmias |
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Magnesium sulfate Dose |
TORSADES: 1 - 2 Grms over 1-2 mins in 10ml of D5W |
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Magnesium sulfate Other |
Can place pt. on a drip of .5-1gm / hr after loading dose for hypomagnesemia |
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Diltiazem (Calcium Ch. Blocker) Indications |
PSVT Atrial Fib & Flutter to slow ventricular response |
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Diltiazem (Calcium Ch. Blocker) Action |
Blocks slow inward flux of Ca & Na ↓ contractility & HR Slows AV nodal time & conduction ↓ MV02 (O2 consumption of left ventricle) Vasodilates |
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Diltiazem (Calcium Ch. Blocker) Dose |
Bolus of .25mg/kg (avg. 20 mg) over 2 mins Rebolus at .35 mg/kg if needed 5-15 mg/hr titrated to HR |
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Diltiazem (Calcium Ch. Blocker) Other |
Do not give concomittantly with IV beta blockers except Brevibloc |
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Adenosine Indications |
PSVT - Paroxysmal supraventricular tachycardia |
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Adenosine Actions |
Slows conduction through the AV node Interrupts AV nodal reentry pathways |
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Adenosine Dose |
6-12-12 6mg RAPID IVP (1-2 seconds) → 20ml saline flush Repeat action at 12 MG two for every 1 - 2mins IV site must be proximal to core as possible |
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Adenosine Other |
Transient bradycardia, asystole or ventricular arrythmias can occur PSVT may reoccur Do not give if pt taking carbamazepine or dipryidamole |
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Sodium Bicarbonate Indications |
Metabolic Acidoses Tricyclic Antidepressant Overdose (TCA OD) Chronic renal failure ↑ K+ |
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Sodium Bicarbonate Action |
Alkalanizing agent Indicated for drug overdoses (TCA) to alkanlinize urine |
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Sodium Bicarbonate Dose |
1meq/kg Repeat at half the initial dose in 10 mins as needed |
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Sodium Bicarbonate Other |
No indication for routine use in cardiac arrest may produce a deleterious acidoses |
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Morphine Indications |
Chest pain with ACS unresponsive to nitrates OR Acute cardiogenic pulmonary edema |
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Morphine Action |
Analgesic effect (reduces pain) ↓ venous return ↑ venous capacitance Mild arterial vasodialation |
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Morphine Dose |
2 - 4 mg IV q5 Mins titrated to effect |
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Morphine Other |
May cause respiratory depression Possible hypotension in hypovolemic pts |
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Calcium Chloride Indicaitons |
Hyperkalemia Calcium Channel blocker adverse side effects (Calcium Channel Blocker overdose) Hypocalcemia Hypermagnesemia |
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Calcium Chloride Actions |
Increases the force of contractility Allows for cellular level exchanges of ions |
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Calcium Chloride Dose |
Hyperkalemia an Ca Channel Blocker OD: 8-16mg/kg Prophylaxis of Ca Channel blockers: 2-4mg/kg |
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Dopamine Indications |
Hemodynamically signifigant hypotension pulmonary congestion ↓ cardiac output |
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Dopamine Action |
<2mcg/kg/min - renal perfusion 2-10 mcg/kg/min - beta & alpha effects >10 mcg/kg/min - alpha effects predominate |
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Dopamine Dose |
5-20 mcg/kg/min |
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Dopamine Other |
Avoid w/ MAO inhibitors Tissue Necrosis w/ infiltration |
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Dopamine How Supplied / Base Concentration |
Supplied: 800mg / 500cc 1600mcg/ml |
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Lasix Indications |
Pulmonary Edema |
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Lasix Actions |
Inhibits reabsorption of sodium at the loop of henle & in proximal and distal tubules Venodilates and reduces CVP |
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Lasix Dose |
.5-1 mg/kg IV May repeat up to 2mg/kg total |
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Lasix Other |
Observe for hypovolemia Hypotension Hypokalemia |
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Nitroglycerin Indications |
Unstable Angina ACS Sublingual: Angina, MI IV: Acute MI pulmonary edema |
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Nitroglycerin Actions |
↑ blood supply ↓ work Smooth muscle relaxation |
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Nitroglycerin Dose |
Sublingul: .3-.4 mg up to 3 doses IV: Initial dose of 10-20 mcg/min titrated to effect |
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Nitroglycerin Other |
Expect: Headaches Hypotension Syncope Bradycardia |
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Nitroglycerin Base conentration in fluid |
50mg / 250cc 200mcg/ml |
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Fibrinolytics Indications |
ACS, Pulomonary emboli & Stroke Consider for ACS <12 hrs of onset Consider for acute ischemic stroke < 3 hours of symptoms |
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Fibrinolytics Action |
Alter the coagulation pathways to cause clot lysis and establish perfusion to area of low or no flow |
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Fibrinolytics Dose |
ACS/AMI: tPA 100 mg total Eminase: 30 mg Tenecteplase (TNK) 30-50 mg IVP Stroke: tPA only at .9mg/kg not to exceed 90 mg 10% over 1 min remainder over an hour |
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Fibrinolytics Other |
May cause bleeding / hemmorage Contraindications: Uncontrolled HTn > 180/100 Surgery < 3 months Hx of hemorrhagic CVA Hx of ischemic CVA < 6 months Prolonged CPR |
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Fibrinolytics Trade Names |
Eminase Tenecteplase (TNK) |
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GP IIbIIIa inhibitors Indications |
Acute Coronary Syndrome (ACS) Percutaneous Coronary Intervention (PCI) |
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GP IIbIIIa inhibitors Action |
IIb/IIIa receptor the final pathway to platelet aggregation |
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GP IIbIIIa inhibitors Dose |
ReoPro: .25mg/kg before PCI → .125 mg/kg Integrillin: ACS 180mcg/kg/min then 2mcg/kg/mn Aggrastat: ACS for PCI .4mcg/kg/min for 30min then .1 mcg/kg/min IV |
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GP IIbIIIa inhibitors Other |
Need to use some other anti-platelet agent with these drugs or in some case within 4 hours of discontinuing the drug |
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GP IIbIIIa inhibitors Trade Names |
ReoPro Integrillin Aggrastat |
