Ventricular Anti-dysrhythmic decreases vent. depolarization and automaticity, depresses vent. ectopy assoc. w/acute coronary syndrome, increases v-fib threshold V-fib, pulseless v-tach, stable v-tach w/pulse, malignant PVC's @ degree type II, 3 degree PEA, Asystole CNS Depression Irritability, confusion, muscle twitching, seizures, coma, death 1-1.5 mg/kg IVP q3-5 at 50% Maint: 2-4 mg/min Max: 3 mg/kg Ventricular Antidysrhythmic, electrolyte, anti-convulsant increases QT interval, replenishes mag. cation, relaxes smooth muscle, depresses CNS Torsade D' Pointes, situations requiring bronchodilation (asthma, COPD), pregnancy induced HTN seizures 2 degree type II, 3 degree, PEA, Asystole CNS depression, calcium chloride may be used as anitdote Hypotension, respiratory depression 1-2 G in 50 ml over 5 mins.
Procainamide - Class Atrial and Ventricular anti-dysrhythmic Procainamide Action Procainamide Indications Procainamide Contraindications Procainamide Precautions Procainamide - Side Effects Procainamide Dosage Labetalol - Class Labetalol - Action Reduces automaticity of pacemaker sites, slows intraventricular conduction Recurrent V-Tach, PSVT refractory to adenosine Sever conduction disturbances, 2 degree Type II, 3 degree AVB, Ventricular escape beats. Hypotension Hypotension, seizures, bradycardia, heart blocks, respiratory and cardic arrest 20-30 mg/min IV drip Max: 17 mg/kg, QRS increases by 50% hypotension Non-selective beta blocker, selective alpha 1 blocker Inhibits peripheral vasoconstriction, decreases cardiac output,
causes peripheral vasodilation Labetalol - Indications Hypertensive crisis Labetalol Contraindications Labetalol Precautions Labetalol - Side Effects Labetalol - Dosage Metaprolol - Class Metaprolol - Action Metaprolol Indications Metaprolol Contraindications Metaprolol Precautions Metaprolol - Side Effects Metaprolol - Dosage Calcium Chloride Class Calcium Chloride Actions Calcium Chloride Indications Calcium Chloride Contraindications Calcium Chloride Precautions Calcium Chloride Side Effects Calcium Chloride Dosage Bronchial asthma, CHF, heart block, bradycardia, cardiogenic shock CHF, bradycardia, shock, heart block, bronchospasm, postural hypotension Bradycardia, hypotension, lethargy, CHF, dyspnea, wheezing, weakness 10 mg IV over 2 mins, repeat at 10-20 mg after 10 mins. Selective beta blocker Slowing of sinus rate and AV conduction, decreased heart rate and cardiac output, decrease of systolic BP, decrease reflex orthostatic tachycardia, inhibition of catecholamine induced tachycardia Acute MI, angina pectoris, hypertension Sinus Bradycardia, heart block, cardiogenic shock, systolic BP < 100, cardiac failure Bronchospastic diseases, diabetes, hypoglycemia, thyrotoxicosis Hypotension, bradycardia, tiredness, dizziness, depression, confusion, short-term memory loss, headache, insomnia. 5 mg slow IVP every 5 mins x3 doses (max 15 mg) Calcium supplement replaces calcium in hypocalcemia, increases myocardial contractile force, increases ventriular automaticity, antidote for mag. Sulfate, minimizes side efects of calcium channel blockers. Hypocalcemia, hyperkalemia, calcium channel blocker toxicity, mag. sulfate toxicity. May precipitate digitalis toxicity in pts. taking Digoxin Flush IV line between calcium chloride and sodium bicarb to avoid precipitation Bradycardia, ventricular arrhythmias, syncope, nausea/vomiting, cardiac arrest 2-4 mg/kg slov IVP
Sodium Bicarbonate Alkalinizing Agent Class Sodium Bicarbonate - Buffers metabolic acidosis, increases pH by providing bicarb buffer, Actions makes urine alkaline enhancing tricyclic antidepressant excretion
Sodium Bicarbonate - Tricyclic antidepressant overdose, phenobarbital overdose, known Indications hyperkalemia, sever acidosis refractory to hyperventilation Sodium Bicarbonate Alkalotic states Contraindications Sodium Bicarbonate - Should be guided by arterial blood gas analysis, can cause Precautions metabolic alkalosis Sodium Bicarbonate Alkalosis Side Effects Sodium Bicarbonate 1 mEq/kg IVP Dosage