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42 Cards in this Set
- Front
- Back
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Oxygen
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Class: Gas
Description: odorless, colorless, tasteless gas necessary for life Mech. of Action: enters through respiratory system transported to cells by hemoglobin, Required for the breakdown of glucose. Onset: Immediate Peak: <1 min Duration: <2 min Half life: N/A Indications: Hypoxia, expected or present. Trauma, medical, chest pain, respiratory difficulty, labor and delivery. Contraindications: None Precautions: COPD patients, due to hypoxic drive, never with hold if needed, prolonged use in neonates it can cause retolental fibroplasia. Humidify to avoid drying Side Effects: drying and irritation Interactions: none, may increase toxicity with certain herbicides like paraquat or diaquat used on marijuanna plants. Dosage: based on patient, cardiac or critical- 100% COPD- 35% and up How Supplied: pressurized cylinders |
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Epinephrine
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Class: Sympathetic agonist
Description: naturally occuring catecholamine; alph and beta adrenergic stimulant: more profound on beta receptors Mech. of action: increase heart rate, increase cardiac contractile force, increased electrical activity, increase systemic vascular resistance, increase blood pressure, increased automaticity. Onset: <2 min IV or ET Peak: < 5 min IV/ET Duration: 5-10 MIn IV/ET Half Life: 5 min Indications: Cardiac arrest( asystole, V-fib, pulsless v-tach, PEA) severe anaphylaxis, severe reactive airway disease. Contraindications: Do not use 1:10000 unless resuscitative measures needed. Precautions: protect from light, can be deactivated by sodium bicarb. flush line well between. Side effects: palpitations, anxiety, tremors, headache, dizziness, nausea, vomiting. increases myocardial oxygen demand, only effective when o2 is adequate. Interactions: ph dependent drug, deactivated by bicarb, and intesified in patients taking antidepressants. Dosage: 1-10 000 IV, IO, ET Adult arrest, 1.0 mg 3-5 min in tube increase by 2x Child arrest, 0.01 mg/kg Adult Severe anaphylaxis or asthma, use 1:10 000 IV @ 0.3-0.5 mg every 5-15 min Child severe anaphylaxis or asthma use 1:10 000 @0.01 mg/ kg every 5-15 min |
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Dopamine HCL ( Intropin)
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Class: Sympathetic agonist
Description: naturally occuring catecholamine, chemical precursor of norepinephrine, acts on alpha, beta 1 and dopaminergic adrenergic receptors, effects on alpha are dosage dependent. Mech of action: increases bp by acting on both alpha and beta 1, causing positive inotropic effect but does not increase oxygen demand. Does not increase heart rate like epi. Acts on alpha causing peripheral vasoconstriction, will maintain renal and mesenteric blood flow in appropriate doses, most common vasopressor. increases both systolic and pulse pressure while less effects on diastolic. Onset: <5 min Peak 5-8 min Duration: < 10 min Half Life: 2 min Indications: hemodynamically significant hypotension 70-100 mmHg, (not from hypovolemia ) and in cardiogenic shock and septic shock Contraindications: Not used as sole agent for hypovolemic shock unless fluid resuscitaion is under way, also do not use in patients with pheochromocytoma( tumor of adrenal gland) Precautions: Increase in HR can induce or worsen SVT and ventricular dysrhythmias. When dose surpasses 20mcg/kg/min if prodominates Alpha and acts like norepinephrine, do not use in tachydysrhythmias or V-fib. Side effects: nervousness, headache, dysrhythmias, palpitations, chest pain, dyspnea, nausea and vomiting. Interactions: Deactivated by sodium Bicarb. If patient takes MAIOs reduce dose. It can cause hypotension when used with phenytoin( dilantin) Dosage: Initial infusion 2-5 mcg/kg/min, titrate up to 20 mcg/kg/min, IV drip only in piggyback. |
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Vasopressin ( Pitressin)
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Class: Hormone, vasopressor
Description: polypeptide hormone from posterior pituitary of animals, it possesses, pressor and antidiuretic hormone properties, Mech of Action: in higher doses it acts as a non alpha adrenergic vasoconstricor through stimulation of smooth muscle, used in place of epi, once in cardiac arrest Onset: Varies Peak: Varies Duration: 30-60 min Half Life: 10-20 Indications: increase peripheral vascular resistance during CPR Contraindications: not used in patients with chronic nephritis, ischemic heart disease, PVC's or advanced arteriosclerosis, these do not apply when used in CPR Precautions: use with cauton in patients with epilepsy, migraine, asthma, heart failure and angina, Side Effects: blanching of skin, abdominal cramps, nausea, hypertension, bradycardia, minor dysrhythmias Interactions: none in ACLS setting Dosage: Adult 40- units( single dose) |
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Lidocaine (Xylocaine)
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Class: Antidysrhythmic
Description: amide-type local anesthetic used to treat life threatening dysrhythmias Mech of Action: supressing PVC's, v-tach and v-fib. It depresses depolarization and automaticity in the ventricles. Little or no effect on arterial tissues. therapeutic dose does not slow AV conduction and does not depress contractility. Onset: < 3 min Peak: 5-7 min Duration: 10-20 min Half Life: 1.5-2.0 hours Indications: V-tach, V-fib, Malignant PVC's Contraindications: never use for second degree Mobitz II of 3rd degree, Precautions: CNS depression may occur when dose exceeds 300 mg/hr Side Effects: drowsiness, seizures, confusion, hypotension, bradycardia, heart blocks, nausea, vomiting, respiratory/ cardiac arrest. Interactions: use with caution with procainamide, phenytoin, quinidine, and beta blockers it may cause drug toxicity. Dosage: Refractory V-Fib/ pulsless V-Tach, initial dose of 1.0-1.5 mg/kg repeat 3-5 min @ half initial for a max of 3 mg/kg V-Tach w/ pulse or Malignant PVC's, initial dose 1.0-1.5 mg/kg, boluses of 0.5-0.75 mg/kg can be repeated every 10-15 min with max of 3 mg/kg then drip of 2-4mg/min For patients over 70 or with liver disease, heart failure, bradycardia and conduction disorders reduce dose by half |
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Adenosine ( Adenocard)
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Class: Antidysrhythmic
Description: Naturally occuring nucleoside ( purine nucleoside) present in all body cells Mech of Action: Decreases conduction of the electrical impulses through the Av node and interupts AV reentry pathways in PSVT. It is chemical cardioversion. Onset: 20-30 secs Peak: 20-30 secs Duration: 30 secs Half Life: 10 secs Indications: Used is PSVT refractory to vagal maneuvers Contraindications: Patients with Second and Third Degree heart blocks, sick sinus and hypersensitivity to drug Precautions: dysrhythmias at the time of conversion, asystole, use with caution in asthmatics Side Effects: facial flushing, headache, shortness of breath, dizziness, and nausea Interactions: Methyxanthines may decrease effects while Dipyridamole may increase the effects Dosage: initial dose is 6 mg rapid IV bolus, followed by rapid flush wait 1-2 min if needed follow with 12mg same push can repeat 12mg a second time |
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AmiodaroneHCL (Cordarone)
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Class: Antidysrhythmic agent
Description: class III antidysrhythmic agent used to treat ventricular dysrhythmias that dont respond to other agents Mech of Action: prolongs the action potential duration in all cardiac tissues. Onset: Peak: Duration: Half Life: Indications: life threatening dysrhythmias such as Vtach and Vfib Contraindications: breast feeding patients in cardiogenic shock, and those with severe sinus node dysfunction resulting in marked brady, 2nd and 3rd degree heart blocks and known hypersensitivity. Precautions: can worsen heart failure Side Effects: look for bradycardia, hypotension, increased ventricular beats, prolonged PR interval , QRS interval or QT interval. Look for signs of pulmonary toxicity (cough and dyspnea) Interactions: may react with warfarin, digoxin, procainamide, quinidine, and phenytoin Dosage: Adults Ventricular dysrhythmias, load with 150 mg over 10 min IV/IO repeat if needed. Maintenance dose of 1mg/min for 6 hours then 0.5 mg/min Arrest 300mg IV push after 5 min follow with 150 mg IV push |
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Norepinephrine (Levophed)
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Class: Sympathetic agonist
Description: works on both alpha and beta, prodominates alpha Indications: used in hypotension and neurogenic shock |
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Isoproterenol (Isuprel)
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Class: Sympathetic agonist
Description: catecholamine, Beta, pacing replaced this drug. This drug is used in bradycardia refractory to atropine |
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Dobutamine (Dobutrex)
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Class: Sympathetic Agonist
Description: Catecholamine, beta but less potent than Isoproerenol Indication: short tern for CHF |
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Metaraminol (Aramine)
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Class: Sympathetic Agonist
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Amrinone (Inocor)
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Class: Sympathetic Agonist, Inotrope
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Propranolol (Inderal)
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Class: Non selective beta blocker.
Description; non selective S antagonist Mech of Action: causes reduction in heart rate, cardiac contractility, blood pressure and myocardial oxygen demand. |
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Sotalol HCL (Sotacor, Betapace)
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Class: Beta Blocker
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Metoprolol (Lopressor)
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Class: Selective beta blocker
Description: antagonist that blocks both beta 1 & 2 |
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Labetalol (Trandate, Normodyne)
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Class: Nonselective beta blocker
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Esmolol (Brevibloc)
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Class: Selective beta blocker
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Procainamide (Pronestyl)
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Class: Antidysrhythmic
Description: used to treat life threatening ventricular dysrhythmias refractory to lidocaine |
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Bretylium Tosylate (Bretylol)
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Class: Antidysrhythmia
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Verapamil (Isoptin, Calan)
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Class: Calcium Channel Blocker
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Diltiazem (Cardizem)
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Class: Calcium Channel Blocker
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Phenytoin (Dilantin)
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Class: Antidysrhythmia and anticonvulsant
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Edrophonium Chloride (Tensilon)
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Class: Antidysrhythmic and Cholinesterase inhibitor
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Digoxin (Lanoxin)
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Class: Cardiac glycoside
Used in the management of CHF, and to control rate od A-fib and A flutter |
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Heparin
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Class: Anticoaqulant
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Evoxaparin (Lovenox)
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Anticoagulant
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Aspirin
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Class: Platelet aggregator inhibitor and anti-inflammatory agent
Description: Anti-inflammatory used in treatment of various thromboembolic diseases such as MI Mech of action: Aspirin blocks the formation of the substance thromboxane A2 Onset: 5-30 min Peak: - 15-120 min Duration: 1-4 hours Half Life:- 15-20 min Indications: used for new chest pain suggestive of acute coronary syndrome and signs and symptoms of recent srtoke. Contraindications; known hypersensitivity and active ulcer disease Precautions: may cause gastrointestinal upset and bleeding, allergies to NSAID Side Effects: can cause heartburn,intestinal bleeding, nausea, vomiting, wheezing, prolonged bleeding Interactions: when given with other anti-inflammatory agents side effects can increase. When given with antacids the blood levels will decrease due to lack of absorbtion. Dosage: 160 mg- 325 mg |
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Streptokinase ( Streptase)
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Class: Fibrinolytic
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Anistreplase ( Eminase, Apsac)
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Class: Fibrinolytic
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Alteplase, Tissue Plasminogen Activator (Activase)
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Class: Fibrinolytic
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Retaplase Recombinant (Retavase)
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Class: Fibrinolytic
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Sodium Bicarbonate
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Class: Alkalinizing agent
Description: Sodium Bicarbonate is a salt that buffers metabolic acidosis Mech of action: Can be used in the treatment of certain types of overdoses. It can cause life threatening dysrhythmias in large doses, Can raise the pH. Onset: Immediate Peak: < 15 min Duration: 1-2 hours Half Life Not applicable Indications: Used in late cardiac arrest after 20 min, used in TCA overdose, phenobarbital overdose, severe acidosis refractory to hyperventilation, and known hyperkalemia Contraindications: No absolute contraindications Precautions: can cause metabolic alkalosis when given in excess..calculate by weigh and size of patient. Side Effects: few when used in the emergency setting Interactions: most catecholamines and vasopressors can be deactivated by alkaline solutions. Sodium bicarb does not need to be given with calcium chloride. Dosage: Should be administered only as IV bolus. 1mEq/kg body weight initially then followed by 0.5 mEg/kg of body weight every 10 min. |
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Morphine Sulfate
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Class: Narcotic analgesic
Description: it is a central nervous system depressant and a potent analgesic. It has hemodynamic properties. Mech of Action: A CNS depressant that acts on the opiate receptors in the brain, provides both analgesic and sedation. It increases peripheral venous capacitance and decreases venous return. This is called chemical phlebotomy. It also decreases myocardial oxygen demand. Can work in the treatment of pulmonary edema. Onset: Immediate (IV) 15-30 min ( IM) Peak: 20 min (IV) 30-60 min (IM) Duration: 2-7 hours Half life: 1-7 hours Indications: Severe pain associated with MI, kidney stones pulmonary edema, burns. Contraindications: not used in patients with volume depletion or severe hypotension and hypersensitivity to the drug, also do not use in patient with suspected head injury or abdominal pain. Precautions: derivative of opium. highly addictive.It is a Schedule II drug. It can cause severe respiratory depression, narcan can be administered if needed. Side Effects: Can cause nausea, vomiting, abdominal cramps, blurred vision, constricted pupils, altered mental status, headache and respiratory depression Interactions: effects can be enhanced by antihistamines, antiemetics, sedatives, hypnotics, barbiturates and alcohol. Dosage: Initsl dose is 2-10 mg IV, with additional doses of 2 mg every few min. IM doses of 5-15 mg can be given with an antiemetic for nausea and an increase in effect. |
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Nitrous Oxide (Nitronox, Entonox)
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Class: Analgesic and anesthetic gas
Description: Nitronox is mix of 50/50 nitrous and O2. Entonox one tank containing both , must shake before use Mech of action: CNS depressant with analgesic properties. It is inhaled and is self administered, treats many types of pain related to trauma. The O2 contained in the mixture help to fight hypoxia. Onset: 2-5 min Peak: 2-5 min Duration: 2-5 min Half Life: unknown Indications: Used for musculoskeletal pain, burns, ischemic chest pain, severe anxiety with hyperventilation. Contraindications: not used in patients unable to comprehend commands or intoxicated. Not used for head injury patients with altered mental status, Not for use in COPD patients. Patient with possible pneumothorax, severe abdominal pain and distention should not use nitrous. Precautions: Use in well ventilated areas Side effects: can cause dizziness, light headedness, altered mental status, hallucinations, nausea and vommiting. Interactions: can potentiate the effects of cns depressants like narcotics, sedatives, hypnotics and alcohol. Dosage: Self administered until pain subsides or patient drops the mask. |
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Furosemide (Lasix)
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Class: Diuretic
Description: It inhibits sodium and chloride reabsorption in the kidneys and causes venous dilation. Mech of action: First you get venous dilation within 5 min reducing preload then a diuretic effect in 15 min. Onset: 5-10 min Peak: 30 min Duration: 2-6 hours Half life: 30 min Indications: Congestive heart failure and pulmonary edema Contraindications: Use in pregnancy only as last resort, allergy to sulfa Precautions: Dehydration, electolye depletion, hypotension. Protect from light Side effects: headaches, dizziness, hypotension, volume depletion, dysrhythmias, diarrhea, nausea, and vomiting. Interactions: Do not administer in the same line as amrinone( Inocor) Use with other diuretics can cause voulume depletion. Dosage: 40 mg slow IV push for patients on 20mg orally, 20 mg for patients not taking it already, usually twice the oral dose of patient. |
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Bumetanide (Bumex)
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Class:Diuretic
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Nesiritide (Natrecor)
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Class:Natriuretic peptide
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Nitroglycerin ( Nitrostat)
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Class: Nitrate
Description: potent smooth muscle relaxant. can come in paste and spray Mech Of Action: reduces cardiac work and dilates coronary arteries. Results in increased coronary blood flow and improved prefusion Onset: 1-3 min(SL), 30 min (topical) Peak: 5-10 min (SL), varies (topical) Duration: 20-30 Min (SL), 3-6 hours (topical) Half Life: 1-4 Min (SL), Indications: Chest pain associated with angina pectoris, chest pain with MI, acute pulmonary edema without hypotension. Contraindications: hypotensive and Increased ICP. Not for shock patients. Precautions: tolerance can develop, headache is side effect, protect from light and monitoe BP closely Side effects: headaches, dizziness, weakness, dry mouth, tachycardia, hypotension, orthostasis, skin rash, nausea, vomiting. Interactions: severe hypotension with alcohol. Can cause orthostatic hypotension with beta blockers. Dosage: (SL) 0.4 mg every 3-5 for 3 doses |
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Nifedipine (Procardia, Adalat)
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Class:Calcium channel blocker
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Sodium Nitroprusside (Nitropress, Nipride)
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Class: Antihypertensive and Vasodilator
Found in black bag |
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Hydralazine ( Apresoline)
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Class: Antihypertensive and Vasodilator
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Calcium Chloride
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Class; calcium supplement
Description: provides elemental calcium Mech of action: cause increased myocardial contractile force, increases ventricular automaticity, Antidote for mag sulfate and can minimize effects of calcium channel blockers. Calcium gluconate conteracts mag. Onset: Immediate Peak: unknown Duration: varies Half Life: not applicable Indications: used for hyperkalemia, acute hypercalcemia, calcium channel blocker toxicity. Contraindications: use caution with digitalis patients Precautions: Flush line between admin of this and sodium bicarb. Calcium chloride can cause tissue necrosis, Side effects: can cause bradycardia, dysrhythmias, syncope, nausea, vomiting and cardiac arrest. Interactions: Interacts with sodium bicarb, can elevate digitalis toxicity Dosage: 2-4 mg/kg IV may repeat in 10 min. |
