Medications

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Adenosine; adenocard Class 5 antiaarhytmic

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decreases conduction of the eletrical impulse through the AV node and interupts the AV re-entry pathways in PSVT. Effectively terminate rapid PSVT referred to as chemical cardioconversion. single bolus converting PSVT to NSR 90%. does not cause Hypotension to same degree as verapamil

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Adenosine Pharmacokinetics

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Onset 20-30 seconds. Peak 20-30 seconds. duration 30 seconds halflife 10 seconds

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adenosine indications

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preferred in treatment for tachyarrhythmias refractory to vagal maneuvers. SVT Narrow complex and stable V-tach wide complex

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adenosine side effects

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facial flushing, headache, Shortness of Breath, dizziness, nausea

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adenosine contraindications

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A FIB or polymorphic torsade de pointes tachyarrhythmia2nd and 3rd degree heart block sick sinus syndrome asthma hypersensitivity

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Aspirin Bayer class

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platelet aggregation inhibitor and anti inflammatory agent

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Aspirin MOA

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blocks formation of thromboxane A2 causes platelets to aggregate and arteries to constrict. reduce rate of nonfatal reinfarction and nonfatal stroke

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Aspirin pharmacokinetics

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onset 5-30 minutes. peak 15-20 minutes. duration 1-4 hours half life 15-20 minutes

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aspirin indications

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new chest pain suggestive of ACS and signs and symptoms of recent stroke

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aspirin contraindications

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hypersensitivity. active ulcer. asthma.

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aspirin side effects

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heart burn. G.I. bleed. nausea. vomiting, wheezing, prolong bleeding

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Diltiazem Cardizem class

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Calcium channel blocker Class IV antiarrhythmic

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Diltiazem MOA

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causes vascular dilation and slows conduction through the AV node. Slows rapid ventricular rate associated with A FIB and A Flutter. Used in treatment of Angina because negative Inotropic effect dilates the coronary arteries

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Diltiazem pharmacokinetics

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onset 3 minutes. peak 7 minutes duration 1-3 hours half life 2 hours

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diltiazem indications

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narrow complex tachycardia

stable narrow complex uncontrolled or unconverted by adenosine or vagal maneuvers or SVT is recurrent

control ventricular rate in patients with A fib or A Flutter

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Diltiazem contraindications

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sever hypotension, CHF, cardiogenic shock V-TACH wide complex, before A fib or A flutter check for Wolff-Parkinson-White syndrome

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Diltiazem side effects

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nausea, vomiting, dizziness, headache, bradycardia, heart block, hypotension, asystole

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Amiodarone Cordarone Class

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class 3 antiarrhythmic

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Amiodarone MOA

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prolongs the action potential duration in all cardiac tissues. it affects sodium, potassium, calcium channels and has alpha and beta adrenergic blocking properties

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Amiodarone pharmacokinetics

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onset 2-3 days (oral) peak 3-7 hours (oral) duration varies half life 40-55 days

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Amiodarone indications

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life threatening cardiac arrhythmias such as V-tach and V-Fib. stable irregular narrow complex tachycardia A FIB,

stable narrow complex tachycardia

control rapid ventricular rate due to accessory pathway

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amiodarone contraindication

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breast feeding; cardiogenic shock; severe sinus node dysfunction resulting in marked sinus bradycardia, 2nd or 3rd degree AV block, symptomatic bradycardia, hypersensitivity

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Amiodarone side effects

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monitor Patients ECG and be alert for hypotension, bradycardia, increased ventricular beats, prolonged PR interval QRS complex, and QT interval. pulmonary toxicity, dyspnea and cough

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Atropine Sulfate Class

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anticholenergic

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atropine MOA

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potent parasympatholytic Anti-cholinergic

causes bronchodilation and drying of respiratory tract secretions. Blocks acetylcholine receptors, thus inhibiting parasympathetic stimulation.

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Atropine indications

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bronchial asthma reversible bronchospasm associated with chronic bronchitis and emphysema

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Atropine Pharmacokinetics

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onset 5-30 minutes peak 1-4 hours duration 2-4 hours half life 2-3 hours

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atropine contra indications

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hypersensitivity; acute treatment of bronchospasm

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atropine side effects

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palpitations, anxiety, dizziness, headache, nervousness, rash, vomiting, nausea

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Ipratropium (Atrovent) class

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anticholenergic

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ipratropium MOA

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parasympatholytic used in treatment of respiratory emergencies. bronchodilation, dries respiratory tract secretions, blocks acetylcholinereceptors, thus inhibiting parasymapthetic stimulation

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ipratropium pharmacokinetics

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onset varies. peak 1.5 - 2 hours. duration 4-6 hours. half life 1.5-2 hours

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pH

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Potential of Hydrogen

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Normal values of pH

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range of 0-14 distilled water 10-7 is neutral

Blood is 10-8 normal value is 7.35 - 7.45

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ipratropium indications

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bronchial asthma reversible bronchospasm associated with chronic bronchitis and emphysema

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Ipratropium contraindications

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hypersensitivity; acute treatment of bronchospasm

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Ipratropium side effects

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palpitations, anxiety, dizziness, headache, nervousness, rash, vomiting, nausea

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Lidocaine Xylocaine class

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Antiarrhythmic

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Lidocaine MOA

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lidocaine depresses depolarization and automaticity in the ventricles. very little effect on atrial tissues. supress ventricular arryhthmias

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lidocaine Pharmacokinetics

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onset < 3minutes peak 5-7 minutes duration 10-20 minutes half life 1.5-2 hours

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lidocaine indications

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V-tach and V-FIB refractory to to amiodarone

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lidocaine contraindications

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2d degree MOBITZ 2 and third degree blocks

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lidocaine side effects

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drowsiness, slurred speech, seizures, confusion, hypotension, bradycardia, heart blocks, nausea, vomiting respiratory arrest cardiac srrest

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Furosemide (LASIX) class

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Diuretic

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Furosemide MOA

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loop diuretic that inhibits the reabsorption of both sodium and chloride in the kidneys. Causes venous dilation usually occurs within 5 minutes and causes a reduction in preload decreasing cardiac workload

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Furosemide pharmacokinetics

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onset 5-10 minutes (vasodilation) 5-30 minutes diuresis Peak: 30 minutes dilation 20-60 minutes diuresis duration 2 hours vasodilation 6 hours diuresis half life 30 minutes

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furosemide indications

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adjunct to nitroglycerine and ACE inhibitors in CHF and pulmonary edema