Drug Set 3A

Front 1

Epinephrine Class

Back 1

Sympathomimetic

Front 2

Amiodarone Class

Back 2

Antiarrhythmic agent

Front 3

Lidocaine Class

Back 3

Antiarrhythmic, local anesthetic

Front 4

Epinephrine M.O.A.

Back 4

-Alpha agonist-- vasoconstriction

-Beta 1 agonist-- positive inotropic effect, positive chronotropic effect, and positive dromotropic effect.

-Beta 2 agonist-- relaxes bronchial smooth muscle (bronchodilation)

-Increased myocardial workload and O2 demand

-Blocks histamine release

Hint 4

5 points

Front 5

Amiodarone M.O.A.

Back 5

-Prlongs action potential, refractory period.

- Potassium channel blockade-- decreases ventricular automaticity

-Sodium channel blockade-- slows depolarization and impulse conduction

-Calcium channel and Beta blockade-- negative chronotropic activity (rate reduction)

-Dilates coronary artieries due to calcium channel and alpha-adrenergic blocking action

Hint 5

5 points

Front 6

Lidocain M.O.A.

Back 6

-Decreases automaticity

-Increases ventricular fibrillation threshold

-Slows conduction in ischemic tissue

Front 7

Epinephrine Indications

Back 7

-Cardiac arrest-- VF/pulsless VT, asystole, pulseless electrical activity (PEA)

-Bronchospasm (bronchiolitis, asthma)

-Anaphylaxis

-Bradycardia

-Hypotension unresponsive to other therapy

-Croup

Hint 7

6 points

Front 8

Amiodarone Indications

Back 8

-Defibrillation-- refractory VF/pulseless VT, polymorphic VT, and wide complex tachycardia of uncertain origin

-Hemodynamically stable VT (VT with a pulse) when cardioversion unsuccessful

-Adjunct to cardioversion of SVT/PSVT

-Rate control in A-fib and Atrial flutter

Hint 8

4 points

Front 9

Lidocaine Indications

Back 9

-Suppression of ventricular arrhythmias (VT,VF,PVC's)

-Prophylaxis against recurrence after conversion from VT or VF

-Pain management after IO insertion in conscious patients

Hint 9

3 points

Front 10

Epinephrine Adult Dose

Back 10

Pulsless arrest:

--IV/IO: 1mg of 1:10,000 solution every 3-5 min

--ET: 2-2.5mg of 1:10,000 via ET tube

Infusion for Hypotension or Symptomatic Bradycardia:

--1mg added to 500ml of NS administered at 1mcg/min titraited to desired hemodynamic response (range 2-10mcg/min)

Anaphylaxis and Asthma:

--0.3-0.5 IM, SC, SL may repeat every 15-20 min

--In extreme cases, may give 0.1mg of 1:10,000 solution every 5 min IV/IO or continuous IV/IO infusion of 1-4mcg/min

Hint 10

5 points

Front 11

Amiodarone Adult Dose

Back 11

VF/Pulseless VT:

--300mg IV push over 30-60 seconds, may repeate in 5-5 min with 150mg IV push

Wide Complex Tachycardias, A-fib, A-flutter, SVT:

--150mg IV over 10 min (mix in 50ml bag of D5W), may repeat every 10 min

Maintenance Infusion Post Resuscitaion/Cardioversion:

--1mg/min IV infusion for 6 hours, then 0.5mg/min IV infusion for up to 18 hrs. Max daily dose is 2.2 grams. (mix 450mg in 250ml bag of D5W)

Hint 11

3 points

Front 12

Lidocaine Adult Dose

Back 12

Pulseless VF/VT:

--Initial bolus of 1.0-1.5mg/kg IV push every 3-5 min to a total of 3mg/kg

Antidysrhythmic or Rhythms with a pulse:

--0.5-0.75mg/kg, up to 1.0-1.5mg/kg IV push, with repeat boluses of 0.5-0.75mg/kg every 5-10 min to a total of 3 mg/kg

Maintenance infusion after return of spontaneous rhythm:

--2-4mg/min

IO Pain Management:

--20-40mg very slow IO push

Hint 12

4 points

Front 13

Epinephrine Bonus Answers

Back 13

Onset -- seconds

Peak -- minutes

Duration -- several minutes

Drug Box -- 1:10,000 prefilled syringes --5mg

1:1,000 -- 2mg

optional -- 1:1,000 multidose vial 30mg

Front 14

Amiodarone Bonus Answers

Back 14

Onset -- Variable

Peak -- Variable

Duration -- Half life may exceed 40 days

Drug Box -- 300mg

Special notes:

-Must draw with at least 18ga needle. Amiodarone is mixed in a soap like vehicle subjecting it to excessive foaming.

-May not exceed 77 degrees ferenheight where drug is stored.

-Patient must be on a cardiac monitor

-Administer on IV pump for interfacility transports

Front 15

Lidocaine Bonus Answers

Back 15

Onset -- 1-5min

Peak -- 5-10min

Duration -- Bolus-20 min

Drug Box -- 3 pre-filled syringes, total 300 mg

-- 1 G vial or premixed infusion, total 2 G