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19 Cards in this Set
- Front
- Back
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most potent negative ionotrope of all CCBs?
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Verapamil
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what type of CCBs bind more selectively to vascular smooth muscle and therefore relax smooth muscle at a conc that produces almost no negative inotropy?
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Dihydropyridines
Nifedipine, amlodipine, etc |
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What type of CCB would you choose for HTN, prinzmetal angina, vasospam after SAH?
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Dihydropyridines
Nifedipine, amlodipine, etc |
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What type of CCB would you choose for HTN, rate control in a flutter/fib, and to abolish SVT
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Verapamil or Diltiazem
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most serious effects of CCB tox?
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Myocardial depression and peripheral vasodilitation
hypotension is most common physiologic abnormality after OD |
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adults receiveing long term therapy with CCBs can develop hypotension, brady, or cardiac conduction abnormalities if they ingest how much of their daily dose
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two times their daily dose
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symptoms of BB OD and CCB OD can be very similar, what lab can help you distinguish?
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CCB: Hyperglycemia
BB: Hypo/euglycemia |
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Hypotesni, bradycardia, and AV block can be seen in other conditions than CCB tox. What is your DD for these sx?
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Hypothermia
ACS Hyperkalemia Cardiac glycoside tox (dig) BB Antiarrhythmic class IA-C tox Central alpha agonist (clonidine) tox |
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if digoxin tox is a potential issue in a pt with suspected CCB tox, the clinician may reasonably avoid the of use what treatment
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Calcium
there is potential worsening tox |
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decreased level of consciousness following CCB ingestion is a result of what
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cerebral hypoperfusion or coingestion
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when should pacing be used in a pt with CCB OD?
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HR < 30
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life threatening tox can be seen with ingestion of just ONE tablet of which CCB in KIDS?
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Verapamil
so you should use activated charcoal on them if its an adult the evidence is lacking for the use of activated charcoal |
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what therapy should be considered for patients with large ingestion of sustained release agents?
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Whole bowel irrigation
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which type of calcium is preferred in CCB tox tx? (Ca Chloride or Ca Gluconate?)
what is the side effect of this drug if not administered properly? |
Calcium Chloride
must give through central line if given through peripheral IV can cause severe soft tissue necrosis |
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What is important to remember when giving Ca as a tx for CCB tox?
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the effect may be transient
repeat dosing is commonly required or you can use an infusion of 2-6 g hypercalcemia is acceptable in pts who are not responding |
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Patients with CCB tox who do not respond to Ca admin or who require repeated doses are usually given what?
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Adrenergic agonists
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if a pt doesnt respond to vasopressor therapy in CCB tox, what should be used
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hyperinsulin/euglycemia therapy
aka about 1 unit/kg with 50mL of 50% detrose |
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tx of choice for BB OD?
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Glucagon
bypass the B adrenergic receptor and stimulated cardiac activity |
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what therapy should be strongly considered prior to administering glucagon?
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ET Intubation
because the major side effects are vomiting and hyperglycemia |
