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60 Cards in this Set

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Xylocaine HCL
trade name and dose?
Lidocaine
bolus-50-100mg IV push(not to exceed 300mg)
drip premixed 2gm/500 D5W
delivered at drip rate
1mg/min=15ml/hr
2mg/min=30ml/hr
3mg/min=45ml/hr
4mg/min=60ml/hr
Procainamide HCL
trade name and dose?
pronestyl
bolus 50mg IV push
drip 1gm/250 D5W
delivered at drip rate
1mg/min=15ml/hr
2mg/min=30ml/hr
3mg/min=45ml/hr
4mg/min=60ml/hr
Procainamide
class, indications, effects on?
antiarrhythmics, sodium channel blocker(1A)
tx-PAC, PVC, PAT, maint of NSR post conversion from a-fib and a-flutter
decreases- HR, BP, contractility, conductivity, afterload
Lidocaine
class, indications, effects on?
antiarrhythmic, anesthetic
IV- ventricular arrhythmias
Local- anesthetic
decreases conductivity, pain
cordarone
trade name and dose?
amiodarone HCL
300mg IV push may consider 2nd dose of 150 mg
Amiodarone HCL
class, uses and effects on?
class III antiarrythmics
recurrent V-fib and recurrent unstable V-tach
decreases-HR, BP, afterload
increases- RR
vasodilates-relaxes vascular smooth muscle
Magnesium Sulfate
trade name and dose
mag. sulfate
1-2 grams diluted in 10ml D5W or NS over 1-2 min
Magnesium Sulfate
Tx of? effects on?
Tx of V-tach, V-fib and TORSADES DE POINTES
decreases HR, BP, RR
Atropine
dose?
.5-1.0mg IV push not to exceed 2mg
Atropine
class? tx? effects on? contraindications?
antiarrhythmic, anticholinergic, antimuscarinic
tx-symptomatic bradycardia and bradycardic dysrhythmias (heart block) and TO BLOCK VAGAL REFLEX.
increases- HR, BP
contraindicated-acute MI-may promote V-fib and increase O2 demand
Milrinone lactate
trade name and dose?
Primacor
loading dose=50mcg/kg.10min
infusion=.5mcg/kg/min
(usually mixed to 200mcg/ml concentration)
Primacor
class? indications? effects on?
inotropics
pts w/ acute decompensated Heart failure and AMI
increases CO, w/ mild increases in HR and MVO2
decreases PCWP and vascular resistance
Dopamine
brand? concentration, dose and effects with?
Inotropin
concentration 400mg/250 D5W
dopaminergic= 1-2 mcg/kg/min, may increase renal perfusion and decrease SVR
Beta-adrenergic= 5-15 mcg/kg/min increases CO and SV may also cause tachycardia
alpha adrenergic->20mcg/kg/min increases CO, SV, HR(tachycardia), contractility, decreases renal perfusion,
dopamine
class? uses?
inotropics, vasopressors, adrenergics
pts w/ low CO and renal insufficiency, severe hypotension and shock, effects are quick onset but short duration
Dobutrex
trade and dose?
dobutamine
dose- (mix 500mg/250 D5W or NS) 2.5-10 mcg/kg/min
dobutamine
class, indications, effects?
direct acting inotropics, adrenergics
short term mgmt of heart failure or depressed contractility from surgical procedures
increases CO and SV
decreases preload and afterload
contraindicated w/ hypertrophy and cardiomyopathies
phenylephrine
brand and dose
neosynephrine
mixed 10mg/100D5W=100mcg/ml
or 40mg/250=160mcg/ml
IV push 50-100 mcg
IV drip 40-60 mcg/min
Neosynephrine
class, indications, contraindications?
sympathomimetic, vasopressor
used for rapid vasoconstriction w/ rapid increase in BP, used in severe hypotension and shock
DO NOT use w/ severe HTN and V-tach
Norepinephrine
Brand and dose?
Levophed
dose=4mg/250 D5W or NS(16mcg/ml)Initial IV dose 8-12 mcg/min adjust to maintain normal BP
Levophed
class, uses, contraindications, effects?
sympahomimetic adrenergic agent, +inotropic and + chronotropic
used for potent peripheral and arterial vasoconstriction (shock and severe hypotension, cardiogenic shock)
contraindication-do not use w/ mesenteric or peripheral vascular thrombosis
increases- BP, SVR, pulmonary pressures and CO
**last drug of choice d/t potency**
epinephrine
brand and dose?
adrenaline
dose= mix 1mg/250 NS or D5W
infusion is 1-8 mcg/min(start w/ lower doses as effects are immediate)
adrenaline
class, indications, contraindications, effects?
antiasthmatic, bronchodilator, vasopressor, adrenergic
used w/ severe shock and cardiac arrest or for mgmt of airway w/ severe allergic rx
contraindications- Hx of HTN, hyperthyroidism and w/ digitalis
increases HR, contractility
*located in code cart*
Nipride
trade and dose?
nitroprusside
mix 50mg/250 D5W ONLY, infuse at rate of .5-10 mcg/kg/min, **always cover w/ foil to protect from light source**
Nitroprusside
class, indications, contraindications, effects?
antianginals, nitrates
used in HTN emergencies
potent vasodilator, decreases SVR, increases venous filling pressure
DO NOT use w/ coarctation of AO
prochlorperazine
brand and dose?
Compazine
dose 5-10 MG IV push
compazine
class, indication, contraindications
antiemetics
used for pre op nausea control or severe vomiting, do not use w/ CHF, valvular disease or heart block
Metoclopramide
brand name, class, uses, dose?
Reglan, antiemetic
used for N/V, do not use w/ seizures, renal failure or pts w/ bowel perforations
Dose-10 mg over 2 min
Promethazine
brand name, class, uses, dose?
Phenergan, antiemetic
used as mild sedative, N/V
Do not use w/ pts w/ reactions to antihistamines, use caution w/ cardiac patients w/ tachycardia
Dose- 12.5-25 MG IV push
Heparin
dose?
in lab=50-80units/kg supplied in 1000u/ml.
IV drip is premixed 25000units/250D5W(100u/ml)
Heparin Sodium
class, indications, contraindication, reversed with, monitor what___and maintain at____?
anti-coagulant
anti-thrombolytic for interventional cases, facilitates thrombin and prevents conversion of fibrinogen to fibrin
contraindicated w/ bleeding disorders and open ulcerated wounds.
Monitor ACT keep >250secs
Protamine sulfate
uses, contraindications, dose?
reverses Heparin
do not use in pts w/ allergy to iodine or on diabetics on NPH insulin
Dose=1mg per 90units of heparin, max dose of 50mg in 10min, give slowly over 10min, stored in HCRU
Diphenhydramine
brand name, class, uses, dose?
Benadryl, H1 antagonist antihistamine, used for vertigo or motion sickness
dose 25-50mg IV push
Solumedrol
class, use and dose?
intermediate acting coritcosteroid, antiasthmatic, used to treat and prevent allergic reactions in the cath lab.
dose 125 mg IV over 3 min
Solucortef
class, use and dose?
antiasthmatic, short acting corticosteroid, used to treat and prevent allergic reactions in the cath lab
dose= 100mg over 3 min
Cimetadine
brand name, class, uses, dose?
Tagamet, histamine H2 antagonist used for symptomatic relief of gastroesophageal reflux, contraindicated w/ asthma
dose= 300mg/50ml D5W, administer slowly IV drip or tachycardia will result
Furosemide
brand name, class, uses, contraindications, dose, side effect, special consideration?
Lasix, loop diuretic
used for pts w/ acute pulm. edema, acute renal failure, mgmt of pts in CHF, HTN
Do not use w/ electrolyte depletion
dose= 20-40 mg slowly over 2-3min, repeat in 6 hours.
**rapid onset of action**
Do not store in light
**side effect=hypokalemia**
Mannitol
facilitate excretion of contrast, and prophylaxis for acute renal failure. Tx of closed head injury to decrease cerebral edema and intracranial pressure.
dose-12.5-25 grams, IV drip w/ filter at modest rate
IV nitroglycerine
uses and dose?
Potent vasodilator used to control symptomatic pt.
dose 10-100mcs/min. Titrate to control chest pain while keeping SBP > 100mmHG. Mixed 50mg/250ml to get 200mcg/ml
nitrostat
use and dose?
sublingual form of nitro to alleviate chest pain from angina. 1-2 tabs under tongue
nitropaste
use?
transdermal form of nitro used to control/prevent chest pain over long term
abciximab
brand name, class, indications, contraindications, dose?
Reopro, IIbIIIa inhibitor used for TX of acute coronary syndrome(unstable angina w/ non-Q wave MI) and in pts undergoing PCI.
Contraindicated w/ Hx of abnormal bleeding within 30 days, severe HTN, major surgery or hemorrhagic stroke last 6wks, HX or s/s of aortic dissection, acute pericarditis, dependency on renal dialysis, PLATELET COUNT <100,000, concomitant use of similar drug.
DOSE-use chart, FILTER!
**refrigerated**
Tirofiban
brand name, uses, contraindications, dose?
emory protocol?
aggrastat, platelet modifying drug, same as reopro, old school, check creatine clearance. Reduce dose by 1/2 in renal impairment.
Must be diluted-12.5mg/50ml vial and 250ml bag(remove 50 from bag and inject 50 from vial.)=50mcg/ml
Dose-use chart, EMORY protocol-for interventional procedures--> loading dose of 10mcs/kg over 3min(from bag) followed by maint. drip of 0.1 mcs/kg/min for 12-24 hrs post procedure.
Dosing protocol for unstable angina=0.4 mcg/kg/min over 30 mins from the bag followed by 0.1 mcg/kg/min for 12 hours(verify w/ DR.)
**refrigerated?**
Eptibatide
uses and dose?
integralin, platelet modifier similar to reopro and aggrastat with like contraindications-add creatine >4.0!
dose-acute coronary syndrome and PCI=180 mcg/kg followed by infusion of 2.0 mcg/kg/min for 18-24 hrs
DO NOT DILUTE!
supplied in 10ml bolus vial and 100ml infusion vials.
**refrigerated?**
What do you need to do before administration of anticoagulants?
check serum creatinine and platelet account.
Creatinine clearance formulas?
male= (140-age)(wt in kg)/ 72x(serum creatine)
females= (140-age)(wt in kg)(0.85)/ 72x(creatinine)
To safely administer sedation you must have what 4 things?
oxygen, suction, crash cart, airway kit
Meperidine
brand name, class, schedule, indications, dose?
demerol-narcotic analgesic
for moderate to severe pain. CNS depressant class II
dose-IV 25-50mg, onset 1-5min, lasting 2-4hr.
Morphine Sulfate
class, schedule, use, dose?
narcotic analgesic(opioid)-schedule II.
used for severe pain
drug of choice for chest pain
CNS depressant
dose-2-10mg IV q4-6hrs peak effects in 15-20 min, duration 3-7 hrs
**vaso and veno dilator**
Sublimaze
brand name, class, schedule, uses, dose?
Fentanyl-narcotic(opioid analgesic), schedule II
used for severe pain and anxiety, synthetic-stronger than morphine
Dose-25-50 mcg, IV slowly over 2 min max dose 100mcg, onset of action 1 min.
check pts weight
Innovar
AKA, indications, dose?
fentanyl/droperidol-used for sedation/analgesia for surgical and diagnostic procedures. CNS depressant. synthetic opioid.
Dose- .5-2 ml slowly over 2 min, onset immediate, lasts 30-60 min
Narcotic antagonist?
uses and dose?
Narcan(naloxone)
to reverse respiratory and CNS depression d/t narcotic overodosage
Dose-0.1-1 mg,IV. onset 1-2 min
Midazolam
brand name, class, uses, dose?
Versed-benzodiazepines
used for sedative as well as analgesic effects(short diagnostic procedures)
dose-1-2mg,IV slowly.
max dose is 4 mg, short acting CNS depressant
Diazepam
brand name, class, uses, dose?
Valium- benzodiazepine
An anxiolytic, muscle relaxant, a sedative/hypnotic and CNS depressant.
Dose- 2-5 mg,IV slowly max dose is 10mg.
What does CNS depressant mean? What are side effects of narcotics and benzo's?
these drugs decrease HR, RR, BP and respirations, compromise airway and may cause confusion, restlessness, nausea and vomiting.
Benzodiazepine antagonist?
Romazicon(flumazenil)
Used for complete or partial reversal of the effects of benzodiazepines.
Dose-0.2 mg, administered over 15secs, repeated, if necessary every 60 seconds until desired level of consciousness is achieved. No more than 1mg at a time or no more than 3mg in one hour.
drip rate calculation formula?
dose x 60 x kg/ supply

example: dopamine 400mg/250ml=1600mcg/ml(concentration)
order:11mcg/kg/min

11mcg X 60 x 50kg/1600mcg/ml=20ml/hr
delivery dependent on body weight?
delivered in mcg/kg/min
dopamine=400mg/250ml=1600mcg/ml
dobutrex=500mg/250ml=2000mcg/ml
nipride=50mg/250ml=200mcg/ml
primacor=50mg/250ml=200mcg/ml
delivery independent on body weight?
deliverd in mg or mcg/min
Nitro=50mg/250ml=200mcg/ml
Neo=10mg/100ml=100mcg/ml
Epi=1mg/250ml=4mcg/ml
Lidocaine=2grams/500ml=4mg/ml
Pronestyl=1gram/250ml=4mg/ml
Levophed=4mg/250ml=16mcg/ml
CLcr and CRs
What do they stand for and what is the unit of measurement?
creatinine clearance in ml/min
serum creatinine in mg/dl
1mg=____mcg
1gram=______mg
1kg=_____lbs
1mg=1000mcg
1gram=1000mg
1kg=2.2lbs