17 Cardiac Drugs

Description:	Cardiac Drugs
Category:	Paramedic/EMT
Created by:	SCBrins on 2009-03-30

Question	Answer
Class For Nigroglycerine	Nitrate
Nitroglycerine - Actions	Relaxes smooth muscle, dilates coronary arteries and increases inotrophy.
Nitroglycerine - Indications	CP associated with acute coronary syndrome, acute pulmonary edema
Nitroglycerine - Contraindications	Hypotension, Increased ICP
Nitroglycerine - Precautions	Systolic BP <100, protect from light and moisture
Nitroglycerine - Side effects	Hypotension, tachycardia, headache, nausea/vomiting
Nitroglycerine - Dosage	.4mg up to 3 times.
Atropine - Class	Anticholinergic, Parasympatholytic
Atropine - Actions	Increased HR associated with hemodynamically significant bradycardias by blocking parasympathetic tone.
Atropine - Indications	Symptomatic bradycardias
Atropine - Contraindications	Supraventricular >100, Ventricular >60, v-fib
Atropine - Precautions	Paradoxical bradycardia in 2 degree type II AVB, 3 degree AVB
Atropine - Side Effects	Tachycardia, CP, confusion, dry mouth, blurred vision, dilated pupils
Atropine - Dosage	.5 - 1 mg (Max .04 mg/kg)
Dopamine - Class	Catecholamine, Sympathomimetic
Dopamine - Actions	Increased inotrophic/chronotropic affects, increase O2 consumption, increased PVR, bronchodilation
Dopamine - Indications	Symptomatic bradycardias, pulseless arrests (VF, PVT, PEA, Asystole)
Dopamine - Contraindications	V-Tach, V-fib
Dopamine - Precautions	Atrial tachydysrhythmias, Ventricular dysrhythmias, CP, HTN
Dopamine - Dosage	5-20 mcg/kg/min
Epinephrine - Class	Catecholamine, Sympathomimetic
Epinephrine - Actions	Increases inotrophic/chronotropic/dromotropic affects, increases O2 consumption, increases PTV, bronchodilation
Epinephrine - Indications	Symptomatic bradycardias, pulseless arrests (VF, PVT, PEA, Asystole)
Epinephrine - Contraindications	Tachyarrythmias w/pulse, hypertensive states, cardiovascular disease.
Epinephrine - Precautions	Atrial tachydysrhythmias, ventricular dysrhythmias, CP, HTN
Epinephrine - Side Effects	Tachycardia, CP, HTN
Epinephrine - Dosage	2-10 mcg/min; 1 mg IV
Adenosine - Class	Anti-dysrhythmic; purine nucleoside
Adenosine - Actions	slows conduction through AV node
Adenosine - Indications	Stable PSVT refractory to vagal maneuvers
Adenosine - Contraindications	2 degree type II AVB, 3 degree AVB, Sick Sinus Syndrome
Adenosine - Precautions	Asthma Patients
Adenosine - Side Effects	Facial Flushing, headache, SOB, Dizziness, nausea
Adenosine - Dosage	6mg, 12, mg, 12 mg
Cardiazem - Class	Calcium Channel Blocker
Cardiazem - Actions	Relaxes smooth muscle, decreases PVR, decreases AV conduction, dilates coronary arteries
Cardiazem - Indications	A-fib, A-flutter, SVT refractory to adenosine, hypertensive angina pectoris
Cardiazem - Contraindications	2 degree AVB, 3 degree AVB, hypotensive states
Cardiazem - Precautions	Hypotension, bradycardia, calcium chloride is antidote.
Cardiazem - Side Effects	Nausea/Vomiting, Dizziness, Headache, Heart Block, Hypotension, bradycardia
Cardiazem - Dosgae	.25 mg/kg; 5-15 mg/hr
Furosemide - Class	Loop Diuretic
Furosemide - Actions	Venous dilation, inhibits reabsorption of sodium in Loop of Henle, Diuresis
Furosemide - Indications	Acute pulmonary edema
Furosemide - Contraindications	Allergy to sulfa drugs
Furosemide - precautions	Dehydration, hypotension, slow IV push, protect from light
Furosemide - Side Effects	Dehydration, hypotension, electrolyte depletion
Furosemide - Dosage	40-100 mg.
Morphine - Class	Narcotic Analgesic
Morphine - Actions	Analgesia/sedation, decreases CNS, arterial and venous dilation
Morphine - Indications	CP associated with acute coronary syndrome, acute pulmonary edema, pain relief
Morphine - Contraindications	Hypotension, volume depletion, head injury, abd. pain.
Morphine - Precautions	Addiction/abuse, resp. depression, Narcan as antidote.
Morphine - Side Effects	Nausea/Vomiting, hypotension, resp. depression, abd. cramps, constricted pupils, AMS
Morphine - Dosage	2-5 mg (Up to 15 mg)
Vasopressin - Class	Antidiuretic Hormone
Vasopressin - Action	Stimulates V1 receptor sites causing vasoconstriction
Vasopressin - indications	Pulseless arrest (VF, PVT, PEA, Asystole)
Vasopressin - Contraindications	V-tach w/pulse
Vasopressin - Precautions	May cause myocardial ischemia, CP, HTN
Vasopressin - Side Effects	Tachycardia, CP HTN
Vasopressin - Dose	40 IV IU
Amiodarone - Class	Atrial and Ventricular anti-dysrhythmic
Amiodarone - Action	Blocks the sodium, potassium, and calcium channels, blocks alpha and beta receptors, lengthens QT interval
Amiodarone - Indications	V-fib, pulseless v-tach, stable v-tach w/pulse, stable PSVT refractory to adenosine, WPW
Amiodarone - Contraindications	Junctional escape rhythm, 2 degree type II, 3 degree, Asystole.
Amiodarone - Precautions	May cause hypotension, asystole, PEA, cardiogenic shock, CHF, Bradycardia, Ventricular tachycardia, AV block.
Amiodarone - Side Effects	Hypotension, asystole, PEA, cardiogenic shock, CHF, bradycardia, ventricular tachycardia, AV block.
Amiodarone - Dose	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	Ventricular Anti-dysrhythmic
Lidocaine - Action	decreases vent. depolarization and automaticity, depresses vent. ectopy assoc. w/acute coronary syndrome, increases v-fib threshold
Lidocaine - Indications	V-fib, pulseless v-tach, stable v-tach w/pulse, malignant PVC's
Lidocaine - Contraindications	@ degree type II, 3 degree PEA, Asystole
Lidocaine - Precautions	CNS Depression
Lidocaine - Side Effects	Irritability, confusion, muscle twitching, seizures, coma, death
Lidocaine - Dose	1-1.5 mg/kg IVP q3-5 at 50% Maint: 2-4 mg/min Max: 3 mg/kg
Magnesium Sulfate - Class	Ventricular Antidysrhythmic, electrolyte, anti-convulsant
Magnesium Sulfate - Actions	increases QT interval, replenishes mag. cation, relaxes smooth muscle, depresses CNS
Magnesium Sulfate - Indications	Torsade D' Pointes, situations requiring bronchodilation (asthma, COPD), pregnancy induced HTN seizures
Magnesium Sulfate - Contraindications	2 degree type II, 3 degree, PEA, Asystole
Magnesium Sulfate - Precautions	CNS depression, calcium chloride may be used as anitdote
Magnesium Sulfate - Side Effects	Hypotension, respiratory depression
Magnesium Sulfate - Dose	1-2 G in 50 ml over 5 mins.
Procainamide - Class	Atrial and Ventricular anti-dysrhythmic
Procainamide - Action	Reduces automaticity of pacemaker sites, slows intraventricular conduction
Procainamide - Indications	Recurrent V-Tach, PSVT refractory to adenosine
Procainamide - Contraindications	Sever conduction disturbances, 2 degree Type II, 3 degree AVB, Ventricular escape beats.
Procainamide - Precautions	Hypotension
Procainamide - Side Effects	Hypotension, seizures, bradycardia, heart blocks, respiratory and cardic arrest
Procainamide - Dosage	20-30 mg/min IV drip Max: 17 mg/kg, QRS increases by 50% hypotension
Labetalol - Class	Non-selective beta blocker, selective alpha 1 blocker
Labetalol - Action	Inhibits peripheral vasoconstriction, decreases cardiac output, causes peripheral vasodilation
Labetalol - Indications	Hypertensive crisis
Labetalol - Contraindications	Bronchial asthma, CHF, heart block, bradycardia, cardiogenic shock
Labetalol - Precautions	CHF, bradycardia, shock, heart block, bronchospasm, postural hypotension
Labetalol - Side Effects	Bradycardia, hypotension, lethargy, CHF, dyspnea, wheezing, weakness
Labetalol - Dosage	10 mg IV over 2 mins, repeat at 10-20 mg after 10 mins.
Metaprolol - Class	Selective beta blocker
Metaprolol - Action	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
Metaprolol -Indications	Acute MI, angina pectoris, hypertension
Metaprolol - Contraindications	Sinus Bradycardia, heart block, cardiogenic shock, systolic BP < 100, cardiac failure
Metaprolol - Precautions	Bronchospastic diseases, diabetes, hypoglycemia, thyrotoxicosis
Metaprolol - Side Effects	Hypotension, bradycardia, tiredness, dizziness, depression, confusion, short-term memory loss, headache, insomnia.
Metaprolol - Dosage	5 mg slow IVP every 5 mins x3 doses (max 15 mg)
Calcium Chloride - Class	Calcium supplement
Calcium Chloride - Actions	replaces calcium in hypocalcemia, increases myocardial contractile force, increases ventriular automaticity, antidote for mag. Sulfate, minimizes side efects of calcium channel blockers.
Calcium Chloride - Indications	Hypocalcemia, hyperkalemia, calcium channel blocker toxicity, mag. sulfate toxicity.
Calcium Chloride - Contraindications	May precipitate digitalis toxicity in pts. taking Digoxin
Calcium Chloride - Precautions	Flush IV line between calcium chloride and sodium bicarb to avoid precipitation
Calcium Chloride - Side Effects	Bradycardia, ventricular arrhythmias, syncope, nausea/vomiting, cardiac arrest
Calcium Chloride - Dosage	2-4 mg/kg slov IVP
Sodium Bicarbonate - Class	Alkalinizing Agent
Sodium Bicarbonate - Actions	Buffers metabolic acidosis, increases pH by providing bicarb buffer, makes urine alkaline enhancing tricyclic antidepressant excretion
Sodium Bicarbonate - Indications	Tricyclic antidepressant overdose, phenobarbital overdose, known hyperkalemia, sever acidosis refractory to hyperventilation
Sodium Bicarbonate - Contraindications	Alkalotic states
Sodium Bicarbonate - Precautions	Should be guided by arterial blood gas analysis, can cause metabolic alkalosis
Sodium Bicarbonate - Side Effects	Alkalosis
Sodium Bicarbonate - Dosage	1 mEq/kg IVP