17 Cardiac Drugs (2)
Content
17 Cardiac Drugs
Cardiac Drugs
Question Class For Nigroglycerine Nitroglycerine Actions Nitroglycerine Indications Nitroglycerine Contraindications Nitroglycerine Precautions Nitroglycerine - Side effects Nitroglycerine Dosage Atropine - Class Atropine - Actions Answer Nitrate Relaxes smooth muscle, dilates coronary arteries and increases inotrophy. CP associated with acute coronary syndrome, acute pulmonary edema Hypotension, Increased ICP Systolic BP <100, protect from light and moisture Hypotension, tachycardia, headache, nausea/vomiting .4mg up to 3 times. Anticholinergic, Parasympatholytic Increased HR associated with hemodynamically significant bradycardias by blocking parasympathetic tone.
Atropine - Indications Symptomatic bradycardias Atropine Contraindications Atropine Precautions Atropine - Side Effects Atropine - Dosage Dopamine - Class Dopamine - Actions Dopamine Indications Dopamine Contraindications Dopamine Precautions Dopamine - Dosage Epinephrine - Class Supraventricular >100, Ventricular >60, v-fib Paradoxical bradycardia in 2 degree type II AVB, 3 degree AVB Tachycardia, CP, confusion, dry mouth, blurred vision, dilated pupils .5 - 1 mg (Max .04 mg/kg) Catecholamine, Sympathomimetic Increased inotrophic/chronotropic affects, increase O2 consumption, increased PVR, bronchodilation Symptomatic bradycardias, pulseless arrests (VF, PVT, PEA, Asystole) V-Tach, V-fib Atrial tachydysrhythmias, Ventricular dysrhythmias, CP, HTN 5-20 mcg/kg/min Catecholamine, Sympathomimetic
Epinephrine - Actions Epinephrine Indications Epinephrine Contraindications Epinephrine Precautions Epinephrine - Side Effects
Increases inotrophic/chronotropic/dromotropic affects, increases O2 consumption, increases PTV, bronchodilation Symptomatic bradycardias, pulseless arrests (VF, PVT, PEA, Asystole) Tachyarrythmias w/pulse, hypertensive states, cardiovascular disease. Atrial tachydysrhythmias, ventricular dysrhythmias, CP, HTN Tachycardia, CP, HTN
Epinephrine - Dosage 2-10 mcg/min; 1 mg IV Adenosine - Class Adenosine - Actions Adenosine Indications Adenosine Contraindications Adenosine Precautions Adenosine - Side Effects Adenosine - Dosage Cardiazem - Class Cardiazem - Actions Cardiazem Indications Cardiazem Contraindications Cardiazem Precautions Cardiazem - Side Effects Cardiazem - Dosgae Furosemide - Class Furosemide - Actions Furosemide Indications Furosemide Contraindications Anti-dysrhythmic; purine nucleoside slows conduction through AV node Stable PSVT refractory to vagal maneuvers 2 degree type II AVB, 3 degree AVB, Sick Sinus Syndrome Asthma Patients Facial Flushing, headache, SOB, Dizziness, nausea 6mg, 12, mg, 12 mg Calcium Channel Blocker Relaxes smooth muscle, decreases PVR, decreases AV conduction, dilates coronary arteries A-fib, A-flutter, SVT refractory to adenosine, hypertensive angina pectoris 2 degree AVB, 3 degree AVB, hypotensive states Hypotension, bradycardia, calcium chloride is antidote. Nausea/Vomiting, Dizziness, Headache, Heart Block, Hypotension, bradycardia .25 mg/kg; 5-15 mg/hr Loop Diuretic Venous dilation, inhibits reabsorption of sodium in Loop of Henle, Diuresis Acute pulmonary edema Allergy to sulfa drugs
Furosemide precautions Furosemide - Side Effects
Dehydration, hypotension, slow IV push, protect from light Dehydration, hypotension, electrolyte depletion
Furosemide - Dosage 40-100 mg. Morphine - Class Morphine - Actions Morphine Indications Morphine Contraindications Morphine Precautions Morphine - Side Effects Morphine - Dosage Vasopressin - Class Vasopressin - Action Vasopressin indications Vasopressin Contraindications Vasopressin Precautions Vasopressin - Side Effects Vasopressin - Dose Amiodarone - Class Amiodarone - Action Amiodarone Indications Amiodarone Contraindications Amiodarone Precautions Amiodarone - Side Effects Amiodarone - Dose Narcotic Analgesic Analgesia/sedation, decreases CNS, arterial and venous dilation CP associated with acute coronary syndrome, acute pulmonary edema, pain relief Hypotension, volume depletion, head injury, abd. pain. Addiction/abuse, resp. depression, Narcan as antidote. Nausea/Vomiting, hypotension, resp. depression, abd. cramps, constricted pupils, AMS 2-5 mg (Up to 15 mg) Antidiuretic Hormone Stimulates V1 receptor sites causing vasoconstriction Pulseless arrest (VF, PVT, PEA, Asystole) V-tach w/pulse May cause myocardial ischemia, CP, HTN Tachycardia, CP HTN 40 IV IU Atrial and Ventricular anti-dysrhythmic Blocks the sodium, potassium, and calcium channels, blocks alpha and beta receptors, lengthens QT interval V-fib, pulseless v-tach, stable v-tach w/pulse, stable PSVT refractory to adenosine, WPW Junctional escape rhythm, 2 degree type II, 3 degree, Asystole. May cause hypotension, asystole, PEA, cardiogenic shock, CHF, Bradycardia, Ventricular tachycardia, AV block. Hypotension, asystole, PEA, cardiogenic shock, CHF, bradycardia, ventricular tachycardia, AV block. Pulseless: 300 mg IVP repeat in 5 min. 150 mg. Pulse: 150 mg/50 ml over 10 min Maint: 1 mg/min for 1st 6 hours, .5mg/min for next 18 max 2.2g/24 hours.
Lidocaine - Class Lidocaine - Action Lidocaine Indications Lidocaine Contraindications Lidocaine Precautions Lidocaine - Side Effects Lidocaine - Dose Magnesium Sulfate Class Magnesium Sulfate Actions Magnesium Sulfate Indications Magnesium Sulfate Contraindications Magnesium Sulfate Precautions Magnesium Sulfate Side Effects Magnesium Sulfate Dose
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
Cardiac Drugs
Question Class For Nigroglycerine Nitroglycerine Actions Nitroglycerine Indications Nitroglycerine Contraindications Nitroglycerine Precautions Nitroglycerine - Side effects Nitroglycerine Dosage Atropine - Class Atropine - Actions Answer Nitrate Relaxes smooth muscle, dilates coronary arteries and increases inotrophy. CP associated with acute coronary syndrome, acute pulmonary edema Hypotension, Increased ICP Systolic BP <100, protect from light and moisture Hypotension, tachycardia, headache, nausea/vomiting .4mg up to 3 times. Anticholinergic, Parasympatholytic Increased HR associated with hemodynamically significant bradycardias by blocking parasympathetic tone.
Atropine - Indications Symptomatic bradycardias Atropine Contraindications Atropine Precautions Atropine - Side Effects Atropine - Dosage Dopamine - Class Dopamine - Actions Dopamine Indications Dopamine Contraindications Dopamine Precautions Dopamine - Dosage Epinephrine - Class Supraventricular >100, Ventricular >60, v-fib Paradoxical bradycardia in 2 degree type II AVB, 3 degree AVB Tachycardia, CP, confusion, dry mouth, blurred vision, dilated pupils .5 - 1 mg (Max .04 mg/kg) Catecholamine, Sympathomimetic Increased inotrophic/chronotropic affects, increase O2 consumption, increased PVR, bronchodilation Symptomatic bradycardias, pulseless arrests (VF, PVT, PEA, Asystole) V-Tach, V-fib Atrial tachydysrhythmias, Ventricular dysrhythmias, CP, HTN 5-20 mcg/kg/min Catecholamine, Sympathomimetic
Epinephrine - Actions Epinephrine Indications Epinephrine Contraindications Epinephrine Precautions Epinephrine - Side Effects
Increases inotrophic/chronotropic/dromotropic affects, increases O2 consumption, increases PTV, bronchodilation Symptomatic bradycardias, pulseless arrests (VF, PVT, PEA, Asystole) Tachyarrythmias w/pulse, hypertensive states, cardiovascular disease. Atrial tachydysrhythmias, ventricular dysrhythmias, CP, HTN Tachycardia, CP, HTN
Epinephrine - Dosage 2-10 mcg/min; 1 mg IV Adenosine - Class Adenosine - Actions Adenosine Indications Adenosine Contraindications Adenosine Precautions Adenosine - Side Effects Adenosine - Dosage Cardiazem - Class Cardiazem - Actions Cardiazem Indications Cardiazem Contraindications Cardiazem Precautions Cardiazem - Side Effects Cardiazem - Dosgae Furosemide - Class Furosemide - Actions Furosemide Indications Furosemide Contraindications Anti-dysrhythmic; purine nucleoside slows conduction through AV node Stable PSVT refractory to vagal maneuvers 2 degree type II AVB, 3 degree AVB, Sick Sinus Syndrome Asthma Patients Facial Flushing, headache, SOB, Dizziness, nausea 6mg, 12, mg, 12 mg Calcium Channel Blocker Relaxes smooth muscle, decreases PVR, decreases AV conduction, dilates coronary arteries A-fib, A-flutter, SVT refractory to adenosine, hypertensive angina pectoris 2 degree AVB, 3 degree AVB, hypotensive states Hypotension, bradycardia, calcium chloride is antidote. Nausea/Vomiting, Dizziness, Headache, Heart Block, Hypotension, bradycardia .25 mg/kg; 5-15 mg/hr Loop Diuretic Venous dilation, inhibits reabsorption of sodium in Loop of Henle, Diuresis Acute pulmonary edema Allergy to sulfa drugs
Furosemide precautions Furosemide - Side Effects
Dehydration, hypotension, slow IV push, protect from light Dehydration, hypotension, electrolyte depletion
Furosemide - Dosage 40-100 mg. Morphine - Class Morphine - Actions Morphine Indications Morphine Contraindications Morphine Precautions Morphine - Side Effects Morphine - Dosage Vasopressin - Class Vasopressin - Action Vasopressin indications Vasopressin Contraindications Vasopressin Precautions Vasopressin - Side Effects Vasopressin - Dose Amiodarone - Class Amiodarone - Action Amiodarone Indications Amiodarone Contraindications Amiodarone Precautions Amiodarone - Side Effects Amiodarone - Dose Narcotic Analgesic Analgesia/sedation, decreases CNS, arterial and venous dilation CP associated with acute coronary syndrome, acute pulmonary edema, pain relief Hypotension, volume depletion, head injury, abd. pain. Addiction/abuse, resp. depression, Narcan as antidote. Nausea/Vomiting, hypotension, resp. depression, abd. cramps, constricted pupils, AMS 2-5 mg (Up to 15 mg) Antidiuretic Hormone Stimulates V1 receptor sites causing vasoconstriction Pulseless arrest (VF, PVT, PEA, Asystole) V-tach w/pulse May cause myocardial ischemia, CP, HTN Tachycardia, CP HTN 40 IV IU Atrial and Ventricular anti-dysrhythmic Blocks the sodium, potassium, and calcium channels, blocks alpha and beta receptors, lengthens QT interval V-fib, pulseless v-tach, stable v-tach w/pulse, stable PSVT refractory to adenosine, WPW Junctional escape rhythm, 2 degree type II, 3 degree, Asystole. May cause hypotension, asystole, PEA, cardiogenic shock, CHF, Bradycardia, Ventricular tachycardia, AV block. Hypotension, asystole, PEA, cardiogenic shock, CHF, bradycardia, ventricular tachycardia, AV block. Pulseless: 300 mg IVP repeat in 5 min. 150 mg. Pulse: 150 mg/50 ml over 10 min Maint: 1 mg/min for 1st 6 hours, .5mg/min for next 18 max 2.2g/24 hours.
Lidocaine - Class Lidocaine - Action Lidocaine Indications Lidocaine Contraindications Lidocaine Precautions Lidocaine - Side Effects Lidocaine - Dose Magnesium Sulfate Class Magnesium Sulfate Actions Magnesium Sulfate Indications Magnesium Sulfate Contraindications Magnesium Sulfate Precautions Magnesium Sulfate Side Effects Magnesium Sulfate Dose
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
