Drugs

Front 1

Adenosine
A/m

Back 1

Decreases electrical conduction through the AV node.
Blocks reentry pathways through the AV & SA node in PSVT
Can restore NSR from PSVT (including WPW)

Front 2

Adenosine
Use

Back 2

PSVT (including WPW) that is refractory to common vagal manuevers.

Front 3

Adensoine
Contra

Back 3

2nd & 3rd degree heart block
Sick Sinus Syndrome
Known sensitivity
Concomitant Persantine or Tegretol use
Dysrhythmias other than PSVT
Reactive airway disease

Front 4

Adenosine
SE

Back 4

CNS: Dizziness, syncope
CV: PVCs, PACs, sinus tach, sinus brady, AV blocks, cp, facial flushing headache
R: SOB, bronchoconstriction
GI: Nausea

Front 5

Adenosine
Interactions

Back 5

Additive/potential reactions: Digoxin, calcium channel blockers, Presantine, Tegretol
Antagonize: methlyxanthines

Front 6

Adenosine
Dose

Back 6

6mg rapid IVP followed with 10-30cc NS flush IVP. 12mg IVP if not conberted in 1-2 min. May repeat 12mg again in 2 min prn.

Front 7

Adenosine
Admin/Notes

Back 7

Rapid IV bolus as close to vein as possible over 1-2 seconds. Must be given rapidly. IV dose must be followed immediately by 10-30ml NS flush.
N: Antecubital veins (large) are preferable to hand or forearm veins.

Front 8

Procainamide
A/M

Back 8

Reduces automaticity of pacemaker sites and slows intraventricular conduction to a larger degree than lidocaine.
Slightly decreases contractility of cardiac muscle tissue and reduces cardiac output. It can produce peripheral vasodilatation and hypotension.

Front 9

Procainamide
Uses

Back 9

Recurrent VF or pulseless VT refractory to lidocaine
Ventricular ectopy refractory to lidocaine (PVCs, stable VT)

Front 10

Procainamide
Contra

Back 10

High degree AV block (unless pacemaker present and functioning), significant bradycardia, Torsades de pointes, or other conduction system disturbances, hypersensitivity.
Use with caution in myocardial infarction, CHF, digitalis toxicity, hepatic and renal dysfunction.

Front 11

Procainamide
SE

Back 11

CNS: confusion, drowsiness, seizure
CV: brady, hypotension, heart blocks, dysrhythmias, VF
R: Arrest
GI: N + V

Front 12

Procainamide
Interaction

Back 12

May have either antagonistic or additive effects when combined with other antidysrhythmics. Additive effects occur with antihypertensive drugs.

Front 13

Procainamide
Dose

Back 13

20mg/min until: dysrhythmia is terminated OR QRS widens by 50% OR Heart block/hypotension result OR 17mg/kg is given.
Follow with maintenance dose of 1-4 mg/min

Front 14

Procainamide
Admin

Back 14

Adminsiter as IV solution as indicated. Inspect solution for discoloration. Monitor ECG, BP, singns of CNS toxicity.

Front 15

Procainamide
Notes

Back 15

Solution should be clear to pale yellow.
If cardiac rhythm disturbances are present in the setting of malignant hyperthermia, procainamide should be considered as primary agent.
Procainamide is no longer recommended by AHA for arrest protocol.