Patho Pharm Test 2 Medications

Front 1

Argatroban (Argatroban injection)

Back 1

Slide 45. Protects platelets from “HITS” Heparin induced thrombocytopenia (Platelet 150,000-400,000 mm^3, <100,000/mm^3= thrombocytopenia)

Front 2

Ascorbic acid (Vitamin C)

Back 2

Slide 20. Needed for erythropoiesis. Converts folic acid to its active form. Helps w/ iron absorption.
Found in citrus fruits, geen leafy vegetables, strawberries, and cantaloupe

Front 3

Packed RBCs

Back 3

For severe or symptomatic anemia/acute blood loss.
-Prepared from whole blood by sedimentation or centrifugation. -Expected to increase pts hg level by 1 g/dL or Hct by 30%

Front 4

Frozen RBCs

Back 4

-Filteres remove WBCs. Use w/i 24 hrs. -Prepared from RBCs using glycerol for protection and frozen.
-Must be used w/I 24hrs of thawing. -Successful washing w/ saline solution remove majority of WBCs and plasma proteins -for autotransfusion; stockpiling or rare donors for pts w allonatibodies (infrequently used due to filters remove most WBCs)

Front 5

Platelets

Back 5

For bleeding caused by thrombocytopenia, contraindicated in thrombotic thrombocytopenic purpura and heparin induced thrombocytopenia. From fresh whole blod with in 4 hr after collection -Multiple units can be attained through plateletpheresis (may be kept at room temp) -Expected to icrease by 10,000 (failure to do so may be related to fever, sepsis, splenomegaly or DIC) (if they don’t respond, give leukocyte reduced, HLA or type specific to prevent alloimmunization to HLA antigens)

Front 6

Fresh frozen plasma

Back 6

For bleeding cause by deficiency in clotting factos( DIC, hemorrhage, massive transfusion, liver disease, vitamin K, deficiency, excess warfarin). Has no platelets. -Liquid portion separated from cells and
frozen (must use 2 hrs after thawing)

Front 7

Albumin

Back 7

For hypovolemic shock, hypoalbuminemia
-Prepared from plasma

Front 8

Cryoprecipitates and Commercial concentrates

Back 8

Replacement of clotting factors (especially factor 8, von willebrand’s disease, and fibrinogen)
-From fresh frozen plasma
-Once thawed, must use

Front 9

Blood transfusion administration

Back 9

-Administer w/i 30 min from blood bank. - 18 G or 20 G gauge needle - Reaction w/I 15 min of first 50ml
-Never add meds to blood products -Check crossmatch record with 2 nurse (ABO-group, RH type, pt name, ID blood band, hospital #, expiration date)
-Do NOT warm unless risk of hypothermic response THEN only by specific blood warming equipment
-Infuse Each unit over 2-4 hrs BUT no longer than 4 hours

Front 10

Blood Transfusion: Fibrile reaction

Back 10

chills, fever, headache, flushing, tachycardia, inc. aniety

Front 11

Blood Transfusion: Allergic reaction

Back 11

MILD- hives, pruritus, facial flushing. SEVERE- SOB, bronchospasms, anxiety

Front 12

Blood Transfusion: Hemolytic reaction

Back 12

anxiety, low back pain, hypotension, tachycardia, fever/chills, chest pain, tachypnea, hemoglobinuria, may have immediate onset Nursing implications: stop transfusion/notify physician, change IV tubing @ hub/ begin NS, treat symptoms if present → (O2, fluids, Epineprhine), check vitals every 15 min, recheck crossmatch record w/ unit and send blood bag/tubing to lab, obtain blood sample, monitor fluid/elec balance, evaluate serum calcium level

Front 13

Chlorambucil (Leukeran)

Back 13

Slide 54. Used for lymphocytic leukemia, Hodgkin’s Disease, Non-Hodgkin’s lymphomia, & Multiple myeloma. (WBC 30,000-50,000=leukemia)
Leukeran-kills by alkyalation of cell DNA. Caution if given w/I 1 month of radation therapy/myelosuppressive drug therapy.
Adverse effects: N/V, anorexia, diarrhea, alopecia, hair loss, BONE MARROW DEPRESSION (renal probs will be bone marrow depression reflected in hematoogic toxicity) During therapy- CBC, differential, platelet count, chest x-ray and pulmonary test.

Front 14

Cobalamin (Vitamin B12)

Back 14

Slide 20, 25. Needed for erythropoiesis. For RBC maturation. Found in red meats, especially liver, eggs, and enriched grain products. Parenteral administration Slide 8, 22, 23. Lack of Vit B12 leads to decreased RBC production due to defective DNA Synthesis. Causes Megaloblastic anemia. Cobalamin deficiency –Intrinsic factor is needed for cobalamin absorption in the small intestine.Slide 24. Signs & symptoms:
-anemia symptoms
-sore tongue anorexia
-N/V
-abdominal pain
-neuromuscular manifestations= (weakness, paresthesias of the feet and hands, decreased vibratory and positions senses, ataxia, muscle weakness, impaired thought process).
Dx: Slide 25. Large RBCs, abnormal shapes, structure contributes to erythrocyte destruction, decreased serum cobalamin level, schilling test, normal serum folate levels and decreased cobalamin =megalobastic anemia.

Front 15

Epoetin alfa (Epogen, Procrit)

Back 15

Slide 56, 60. Hematopoietic drug (helps produce RBCs). Procrit= synthetic erythropoietin which ↑ Hct/Hgb
For anemia that chemotherapy, renal failure, or zidovudine therapy (HIV inf) induced.
Reduction need for blood transfusions for surgical pt. Adm IV/sub-Q 2000-40,000 units, 1-3 x/wk.
S&S: Watch for hypertension, headache, nausea. Edema, anorexia, vomiting, diarrhea, alopecia, rash, cough, dyspnea, sore throat, fever, blood dyscrasias (imbalance), headache, bone pain
If H&H >12 DON’T GIVE → CLOTTING

Front 16

Factor VIII (Lewis Table 31-19 page 686)

Back 16

Slide 47. Missing clotting factor 8= HEMOPHILIA. Factors include ( advate, alphanate, autoplex t, bioclate, feiba VH immune, helixate FS, hemofil m, humate-p, hyate:c, koate- DVI, kogenate, monarc-m, monoclate p, recombinate, refacto, xyntha)

Front 17

Factor IX (Lewis Table 31-19 page 686)

Back 17

Clotting factor that treats hemophilia
Indludes: alphanine SD, bebulin VH, benefix, feiba VH immune, konyne 80, mononine, profilnine SD, proplex T, thrombate III

Front 18

Filgrastim (Neupogen)

Back 18

Slide 56. Hematopietic drugs. Colony-stimulating factor. Give IV/Sub-q 5-10 mcg/kg/day. Indicated for chemotherapy-induced leucopenia.
Side effects: edema, anorexia, N/V/D, alopecia, rash, cough, dyspnea, sore throat, fever, blood dyscrasias (imbalance), headache, bone pain

Front 19

Folic Acid (Folvite, Vitamin B9)

Back 19

Slide 20,28. For erythropoiesis RBC maturation (needed for DNA synthesis). Found in green leafy vegetables, liver, meat, fish, legumes, and whole grains. Usually 1mg/day (deficiency slide 27)

Front 20

Iron (oral: ferrous fumarate, ferric gluconate, ferrous sulfate; parenteral: iron dextran, ferric gluconate, iron sucrose)

Back 20

Slide 16,17. For iron-deficiency anemia. Hemoglobin synthesis. Take with vitamin C (helps w/ absorbtion), use straw if liquid iron, take 1 hr before meal, 1mg given orally ← check #, z-track for IM parenteral iron
Food sources: liver and muscle meats, eggs, dried fruits, legumes, dark green leafy begetable, whole-grain and enriched bread and cereals, potatoes.
Side effects: heartburn, constipation, diarrhea, back stool
* Ferrous salt adverse effects: GI: N/V, constipation, epigastric pain, black/tarry stools. Integumentary: discolored tooth enamel and eyes, pain on injection.

Front 21

Methyldopa (Aldomet)

Back 21

Slide 42 in hypertension. Central-acting alpha adrenergic antagonist. Instruct pt about daytime sedation and avoidance of hazardous activites. Admin single daily dose at bedtime
Side effects: sedation, fatigue, orthostatic hypotension, decreased libido, erectile dysfunction, dry mouth, hemolytic anemia, hepatotoxicity, sodium and water retention, depression

Front 22

Oprelvekin (Neumega)

Back 22

Slide 56. Hematopoietic drug, synthetic human interleukin analogue. Chemotherapy-induced thrombocytopenia. ADULTS only, Subcut- 50mcg/kg daily up to 21 days. Side effects: edema, anorexia, N/V/D, alopecia, rash, cough, dyspnea, sore throat, fever, blood dyscrasis (imbalance), headache, bone pain

Front 23

Pyridoxine (Vitamin B6)

Back 23

Slide 20. For erythropoiesis hemoglobin synthesis. Found in meats, wheat germ, legumes, potatoes, cornmal, and bananas.

Front 24

Sargramostim (Leukine)

Back 24

Slide 56. Hematopoietic drug, colony-stimulating factor. For chemotherapy-induced leucopenia. Give IV: 250 mcg/m^2/day. Side effects: edema, anorexia, N/V/D, alopecia, rash, cough, dyspnea, sore throat, fever, blood dyscrasis (imbalance), headache, bone pain

Front 25

Doxazosin (Cardura)
Prazosin (Minipress)
Terazosin (Hytrin)

Back 25

Alpha1 Adrenergic Blockers
→produces peripheral vasodilation (decreases SVR and BP) →take during bedtime to reduce risks associated with orthostatic hypotension
Side effects: Orthostatic hypotension depending on plasma volume, retention of salt and water, tachycardia, vertigo, sexual dysfunction, nasal congestion, dry mouth, palpatations

Front 26

Clonidine (Catapres)
Methyldopa (Aldomet)

Back 26

Alpha2 Adrenergic Antagonists
Side effects: Anemia, orthostatic hypotension, Sedation, fatigue, decreased libido, erectile dysfunction. Dry mouth, Hepatotoxicity, sodium and water retention, depression →no hot tubs or alcohol due to vasodilation →do not discontinue BP meds sudden, may cause rebound hypertension →used for pregnancy

Front 27

Angiotension Converting Enzyme (ACE)
Inhibitors (memory aid ends in pril) (slide 50 & 51)

Back 27

→suppresses formation of Angiotensin II from the rennin-angiotensin-aldosterone system, reduce peripheral resistance, and improves CO →decreases peripheral vascular pressure →doesn’t increase CO, increase HR, increase cardiac contractility →inhibits the breakdown of bradykinin which produces a dry, hacking cough (contraindicated for asthmatics and renal failure) →metallic taste →conserves K+ →can be given to pts with DM →give on empty stomach →contraindicated in pts with history of angioedema, 2nd and 3rd trimesters of pregnancy, and renal artery stenosis →aspirin and NSAIDS may reduce drug effectiveness Side Effects: Dizziness, orthostatic hypotension, GI distress, nonproductive cough, headache, rash, angioedema

Front 28

Benazepril (Lotensin)
Captopril (Capoten)

Back 28

May be given oral for hypertensive crisis

Front 29

Enalapril (Vasotec)
Fosinopril (Monopril)

Back 29

May cause hypertension, decrease peripheral arterial resistance, pulmonary capillary wedge pressure

Front 30

Losartan (Cozaar)
Valsartan (Diovan)

Back 30

Angiotensin II Receptor Blockers (ARBs) →for hypertension, adjunctive drugs for treatment of HF, may be used alone or with other drugs such as diuretics, used primarily in patients who cannot tolerate ACE inhibitors →May cause occasional dizziness, inability to sleep, diarrhea, dyspnea, heartburn, nasal congestion, back pain, fatigue
→hyperkalemia much less likely to occur→should be used cautiously in elderly patients and in patients with renal dysfunction →increases sensitivity to the drug’s effects and increases risk for adverse effects
Side effects: URI, headache

Front 31

Atenolol (Tenormin)
Carvedilol (Coreg)
Labetatol (Trandate)
Metoprolol (Lopressor)

Back 31

Beta1-adrenergic Blockers (BBs) (memory aid ends in olol)
46. B-beta blocker. (slide 41 dys.) Used for IV beta-adrenergic blocker for sinus tachycardia.
⇒ Specifically for Lopressor: used for angina and hypertension

Front 32

Nadolol (Corgard)
Propranolol (Inderal)

Back 32

→used for angina, hypertension, and dysrhythmias
→given for hyperthyroidism in response to tachycardia
→contraindicated for a person with asthma

Front 33

Sotalol (Betapace)

Back 33

→used to decrease HR and contractility, decrease velocity of impulse conduction at the AV node, and dysrhythmias (suppress sinus and atrial tachydysrhythmias) → caution with diabetes: may interact with hypoglycemic agents leading to heart failure →blocks SNS catecholamines, resulting in reduced rennin and aldosterone release and fluid balance; Vasodilation of arterioles leads to a
decrease in pulmonary vascular resistance and blood pressure →take medication before meals →assess vital sign; monitor closely if given with a CCB
→hold if BP is <90 and HR is <60 →Masks some symptoms of hypoglycemia Side Effects: Hypotension, coughing, SOB, edema, fatigue, Bradycardia, cardiac block, hypotension, Lethargy, drowsiness, GI Disturbance, CHF, Decreased BP, Depression

Front 34

Amlodipine (Norvasc)
Diltiazem (Cardizem)
Felodipine (Plendil)
Nifedipine (Procardia)
Verapamil (Calan, Isoptin)

Back 34

Calcium Channel Blockers→contraindicated in 2nd or 3rd degree heart block
→decrease contractility, decrease conductivity of the heart, decrease demand for oxygen
Side Effects: Decrease BP, Bradycardia, may precipitate A-V Block, headache, abdominal discomfort (constipation, nausea), peripheral edema

Front 35

Bumetanide (Bumex)
Chlorothiazide (Diuril)
Hydrochlorothiazide (Hydrodiuril)

Back 35

Diuretics [Thiazide and related diuretics]
→Inhibit NaCl reabsorption in the distal convoluted tubule; increase excretion of Na+ and Cl-. Initial decrease in ECF; sustained decrease in SVR. Lower BP moderately in 2-4 wks.
Side effects: Fluid and electrolyte imbalances; volume depletion, hypokalemia, hyponatremia, hypochloremia, hypomagnesemia, hypercalcemia, hyperuricemia, metabolic alkalosis; CNS effects: vertigo, headache, weakness, GI effects:anorexia, nausea, vomiting, diarrhea, constipation, pancreatitis, sexual problems: erectile dysfunction, decreased libido, dermatologic effects: photosensitivity, skin rash, blood dyscrasias; decreased glucose tolerabce.

Front 36

Furosemide (Lasix)

Back 36

[Loop Diuretics] →inhibits NaCl reabsorption in the thick asending limb of the loop of Henle. Increase excretion of Na+ and Cl-.
→more potent diuretic effect than thiazides, but shorter duration of action. Less effective for hypertension. Side effects: Fluid and electrolyte imbalances as with thiazides, except no hypercalcemia, ototoxicity; hearing impairment, deafness, vertigo, that are usually reversible, Metabolic effects: hyperuricemia, hyperglycemia, increased LDL cholesterol and triglycerides, decreased HDL cholesterol.

Front 37

Spironolactone (Aldactone)

Back 37

[Aldosterone Receptor Blockers]→Inhibit the Na+ retaining and K+ excreting effects of aldosterone in the distal and collecting tubules.
Side effects: Same as amiloride and triamterene. Mat cause gynecomastia, erectile dysfunction, decreased libido, menstrual irregularities.

Front 38

Hydralazine (Apresoline)

Back 38

[Vasodilators] Side effects: Headache, nausea, flushing, pappitation, tachycardia, dizziness, angina, hemolytic anemia, vasculitis, and rapidly progressive glomerulonephritis.
→reduces SVR and BP by direct arterial vasodilation

Front 39

Isosorbide dinitrate (Isordil)
Minoxidil (Loniten)

Back 39

[Vasodilators] Side effects:
Reflex tachycardia, marked sodium and fluid retention (may require loop diuretics for control), and hirsutism. May cause ECG changes (flattened or inverted T waves) not related to ischemia.
→Reduces SVR and BP by direct vasodilation

Front 40

Nitro ointments (Nitro-Bid)

Back 40

[Nitrates (Nitroglycerin) Side effects: Severe Headache (do to complete vasodialtion) -Nitro sustained release tablets -NTG sublingual tabs →quick release -NTG translingual spray →quick release Side Effects: Severe hypotension, tachycardia, dizziness, headache and syncope, dry mouth, blurred vision →used for relief of angina pain and (with BB and CCB) suppress tachycardia →don’t rub in for patches or ointment, will absorb in skin too quickly. →after opened 6 mons, toss it →brown bag over IV nitro to keep the light out (which deactivates it) →vasodilates coronary arteries
→1 nitro (5 mins pass) call 911 and take another nitro (5 mins pass) take another nitro, 3 nitros don’t fix pain give morphine IM, if these don’t work set on IV nitro
→don’t take with VIAGRA or other vasodilators (BP will drop too low) or with severe anemia

Front 41

Sodium nitroprusside (Nipride)

Back 41

Side effects:
Acute hypertension, nausea, vomiting, muscle twitching, signs of thiocyanate toxicity including anorexia, nausea, fatigue, disorientation.

Front 42

NO grapefruit juice drugs

Back 42

Buspirone (Buspar)
Carbamazepine (Tegretol)
Lovastatin (Mevacor)

Front 43

Enoxaparin (Lovenox)
Heparin (Heparin)

Back 43

Anticoagulants
→Prevent conversion of fibrinogen to fibrin and prothrombin to thrombin

Front 44

Antiplatelets

Back 44

→first line of therapy in treatment of angina
→ASA is drug of choice
→Acts by inhibiting platelet aggregation (prevents platelets from sticking and embolus formation)

Front 45

Asprin (ASA low dose)

Back 45

Antiplatelet
→Low-dose aspirin for men >45 yrs and high-risk women unless contraindicataed. In healthy women > or equal to 65 years,aspirin therapy should be considered if BP is controlled and the benefit for MI prevention outweighs the risk of GI bleed or hemorrhagic stroke

Front 46

Clopidogrel (Plavix)

Back 46

Anti-platelet
→Can be substituted for high risk women who are intolerant of aspirin

Front 47

Cholestyramine (Questran) (slide 23)

Back 47

Bile-Acid Sequestrants
→Binds with bile acids in intestine, forming insoluble complex and excreted in feces. Binding results in removal of LDL and cholesterol →interfere with absorption of other drugs: digoxin, thiazides, b-adrenergic blockers, fat-soluble vitamins, folic acid, vancomycin →Give other drugs an hour to absorb before giving questran (better choice)
→Give questran 4 hrs to absorb before giving other drugs

Front 48

Ezetimibe (Zetia) (slide 26)

Back 48

Cholesterol Absorption Inhibitor
→Inhibits absorption of dietary and biliary cholesterol across the intestinal wall

Front 49

Fenofibrate (TriCor)
Gemfibrozil (Lopid)

Back 49

Fibric Acid Derivatives (slide 27)→inhibits reduce triglyceride and VLDL lipoproteins
⇒ may increase the risk of bleeding in patients taking Warfarin (Coumadin)
⇒ may increase the effects of antihyperglycemic drugs (e.g. prandin)

Front 50

Recombinant plasminogen activator [rPA; reteplase (Retavase)]
Streptokinase (Streptase)
Tissue plasminogen activator [(tPA; alteplase (Activase)]
Urokinase

Back 50

Fibrinolytics (Thrombolytics)→Breaks up fibrin meshwork in clots →Used only in ST- segment-elevation MI →Active internal bleeding or bleeding diathesis (excluding menstruation)
→give clot busters within 4.5 hrs from the time the symptoms start →Previous cerebral hemorrhage
TABLE 34-14

Front 51

Atorvastatin (Lipitor)
Simvastatin (Zocor)

Back 51

HMG-CoA Reductase Inhibitors (Statins) (memory aid ends in statin) (slide 25)
→increased risk for rhabdomyolysis when also used with Lopid or niacin →Signs of rhabdomyolysis: increase creatine kinase levels, muscle tenderness

Front 52

Rosuvastatin (Crestor)

Back 52

HMG-CoA Reductase Inhibitors (Statins) (memory aid ends in statin) (slide 25)→reduce the synthesis of cholesterol and increase LDL receptors in liver
→block synthesis of cholesterol in liver
→lowers LDL and triglycerides →increases HDL
→decreases inflammation

Front 53

Niacin B3 (Niacin, Nicobid, Slo-Niacin) (slide 24)

Back 53

→inhibit synthesis and secretion of VLDL and LDL and increases HDl levels →instruct patient that flushing (especially of face and neck) may occur within 20 mins after taking drug and may last for 30-60 mins -Can premedicate with aspirin or NSAIDs 30 mins before to reduce flushing

Front 54

Nitrates (see HTN list) (slide 55-56)

Back 54

→Prevents/treats angina dilates venous and arterial vessels- which decreases preload and afterload
→dilates coronary artery vessels, lowers BP, short and long acting

Front 55

Morphine Sulfate

Back 55

Opiod analgesics
→Functions as an analgesic and sedative →acts as a vasodilator to reduce preload and myocardial O2 consumption
-Slide 21. Decreases afterload of ADHF and improves CO and decreases pulmonary congestion.

Front 56

ACE Inhibitors (see HTN list):

Back 56

prevent sodium/water resorption by inhibitiong aldosterone secretion. Diuresis results which decreases preload, or the left ventricular end-volume, and the work of the heart.

Front 57

Digitalis glycoside [digoxin (Lanoxin)]

Back 57

Positive Inotropes [inc. force of myocardial contraction]

Slide 22/lilley. Improves cardiac function in pts who do not respond to convetional pharmacotherapy.
S&S: Narrow therapeutic windo. Drug level 0.5-2 ng/mL. Low K+ level increases its toxicity (watch electrolyte level). Cardiovascular: Dysrhythmias (including bradycardia or tachycardia). CNS: headaches, fatigue, malaise, confusion, convulsions. Eye: colored vision( seeing green, yellow, purple), halo vision, flickering lights. GI: anorexia, N/V/D. Dig toxicity: digoxin immune fab (digibind) therapy. → hyperkalemia>5mEq/L, life-threatening cardiac dysrhythmias, & life-threatening digoxin overdoes

Front 58

[dopamine (Intropin); dobutamine (Dobutrex)]

Back 58

B adrenergic agonists
Slide 22. Improves cardiac function for pt who do not respond to conventional pharmacotherapy.

Front 59

[inamrinone (Inocor), milrinone (Primacor)]

Back 59

Phosphodiesterase inhibitors
Slide 22. Improves cardiac function for pt who do not respond to conventional pharmacotherapy.

Front 60

Adenosine (Adenocard)

Back 60

Antidysrhythmics [ALL antidys hypersensitivity rxn, N/V/D/ dizziness, blurred vision, headache]
Slide 43/lilley. →1st choice for PSVT or SVT. For supraventricular tachycardia when there is good perfusion. Start with 6mg then 12mg. Slows conduction through the AV node. Used to convert paroxysmal supraventricular tachycardia to sinus rhythm. Very short half-life <10sec. Give by IV push. May cause asystole for few seconds. Slide 112. S&S Bradycardia, dyspnea, facial flushing, chest discomfort, digoxin-cardiotoxicity Slide 114. Toxic effect: self-limiting due to short half-life. Treat w/ antagonist caffeine or theophylline.

Front 61

Amiodarone hydrochloride (Cordarone)

Back 61

Antidysrhythmics 43. For supraventicular tachycardia. Use when there is poor perfusion and sedation (cardiovert) is not converting. Or use if there is good perfusion and CHF or LV failure occurs. Slide 49. For A fib/flutter when HR >150 and WPW syndrome or early conversion to sinus rhythm is desired. Slide 112. Potassium channel blocker. S&S: Pulmonary toxicity, visual impairment, AV block, GI upset

Front 62

Atropine

Back 62

Antidysrhythmics Slide 36. Anticholinergic drug & potent belladonna alkaloid. Reverses cholinergic-mediated decreases in HR, SVR, and BP. So it INCREASES HR. Give 0.5mg IVP or endotracheally with a max does of 3mg. Slide 35. For bradycardia w/ pulse. Take 0.5 mg when s&s of poor perfusion. If needed, repeat every 3 min up to 3 mg. Not likely to succeed in type II 2nd degree AV or 3rd- degree AV block. (OD slide 37) Adverse effects: blurred vision, dizziness, drowsiness, dilation of eyes, dry mouth, constipation, difficulty urinating.

Front 63

Digitalis glycoside (Digoxin)

Back 63

Antidysrhythmics
Slide 49. Use for atrial fibrillation and flutter when HR>150, poor cardiac function and not candidate for cardioversion. Slide 50. Used to decrease HR if ventricular HR is uncontrolled or >100. Slide 51. Get baseline vital signs, 1 min apical pulse, check lab for digitals and potassium levels. **Dig levels 0.5-2.0 mg/ml HR will go low if they get dig toxic. S&S: Fatigue, dysrhythmias, visual disturbances, anorexia, hypokalemia Slide 112. S&S Bradycardia, dyspnea, facial flushing, chest discomfort, digoxin-cardiotoxicity. Slide 114. Toxic effect: decreased clearance due to drug interactions w/ other antidyshythmic drus (quinidine, verapamil, amiodarone) T

Front 64

Ditiazem (Cardizem)

Back 64

Antidysrhythmics Slide 43. For supraventicular tachycardia. Use when there is poor perfusion and sedation (cardiovert) is not converting. Also use for good perfusion with a healthy heart.
Used for A fib/flutter with HR >150. Slide 112. Calcium channel blocker. S&S: Bradycardia, AV block, peripheral edema, hyptension, constipation

Front 65

Lidocaine hydrochloride (Xylocaine)

Back 65

Antidysrhythmics
Slide 73. For PVC (ventricular ectopy) treatment when ectopic beats are dangerous.
Slide 75 lidocaine toxicity “SAMS” (slurred/diff speech, alt cardio vascular sys., muscle twitching, seizures).
Slide 82. For v-fib and pulseless v-tach when epi doesn’t work and second 5 cycles of CPR aren’t working. Slide 114. Toxic effect: convulsions. Treat w/ diazepam or thiopental.

Front 66

Procainamide (Pronestyl)

Back 66

Antidysrhythmics Slide 73. For PVC (ventricular ectopy) treatment when ectopic beats are dangerous.
Slide 114. Toxic effect: cardiac depression (treat w/ IV pressor drugs and supporitive measure), convulsions (treat w/ diazepam and mechanically assisted respiration)

Front 67

Propranolol hydrochloride (Inderal)

Back 67

Slide 112. Beta blocker (antidysrrhythmic)
S&S: Hypotension, bradycardia, AV block, bronchospasm. Slide 114. Toxic effect for: cardiac dysrhythmias (treat w/ sodium lactate, lidocaine).

Front 68

Quinidine sulfate (Quinidex)

Back 68

Slide 112. Sodium channel blocker
S&S: Diarrhea, cinchonism, cardiotoxicity, arterial embolism

Front 69

Epinephrine (Adrenaline)

Back 69

For bradycardia with pulse w/ poor perfusion and atropeine doesn’t work.
Slide 82. For V-fib and pulseless V-tach. Give after 02,CPR and shock. Slide 96. Epi 1mg IVP every 3-5 min for asystole. Slide 100. Give for pulseless electrical activity.

Front 70

Vasopressin

Back 70

Slide 96. Give 40U IVP to replace 1st or 2nd dose of epi for Asystole.
Slide 100. Give for pulseless electrical activity.