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UTSW cardiac drugs
Semester 1 cardiac drugs
Term | Definition |
---|---|
Nitroglycerin Class | Vasodilator |
Nitroglycerin Actions | Dilates vessels,decreases PVR,Decreases 02 demand on hear and cardiac workload |
Nitroglycerin Indications | Chest pain, pulmonary edema w/CHF |
Nitroglycerin Side effects & precautions | Hypotension,reflex tach,syncope *IV and 12 lead first |
Nitroglycerin Contraindications | ICP, Systolic B/P <90,HR <50-100> Viagra,Cialis |
Nitroglycerin Dose | .4mg spray or tab sub-lingual repeatX2 every 5min |
Aspirin Class | NSAID anti platelet,analgesic,anti inflammatory, antipyretic |
Aspirin Actions | reduces platelet stickiness,blocks pain in CNS,dilates vessels,reduces coronary artery vasoconstriction |
Aspirin Indications | chest pain of cardiac origin |
Aspirin Side effects & Precautions | none |
Aspirin Contraindications | aspirin allergy, hemorrhagic stroke, aspirin induced asthma |
Aspirin Dose | 325mg adult or 4 81mg childrens |
Procainamide Class | Antiarrhythmic |
Procainamide Actions | depresses depolarization, slows automaticity and conduction velocity |
Procainamide Indications | PSVT uncontrolled by adenosine, a-fib w/ WPW, stable wide-complex tach |
Procainamide Side effects & Precautions | blocks,hypotension,bradycardia,VT/VF/Asystole,reflex Tach, Wide QRS |
Procainamide Contraindications | 2*&3* blocks,Torsades de Pointes, Dig Tox, Tricylic Antidepressant Toxicity |
Procainamide Dose | 1-4mg/min after lidocaine not w/amiodarone stop pushing when arrhythmia is suppressed,hypotension, widened QRS, max dose of 17mg/kg |
Epi 1:1 Class | Sympathomimetic |
Epi 1:1 Actions | Alpha-vasoconstriction,increases BP,Beta1-Increases HR,Incraeses contraction strength,Beta2-bronchodilation |
Epi 1:1 Indications | Asthmatic bronchospasm, allergic reaction/anaphylaxis, profound brady |
Epi 1:1 Side effects & Precautions | tach,hypertension,arrhythmias,CP,MI Restlessness,nausea/vomiting Headache |
Epi 1:1 Contraindications | Asthma Heart diseas or history of AMI,Arrhythmias, over 45, labor-NONE IN ALLERGIC REACTION |
Epi 1:1 Dose | .3-.5mgSQ Asthma or Anaphylaxis 2-10mcg/min IVP 1mg in 250mlNS |
Vasopressin Class | Antidiueretic Hormone |
Vasopressin Actions | noradrenergic vasoconstriction |
Vasopressin Indications | low resistance shock, alternate pressor for epi in CA |
Vasopressin Side effects & Precautions | watch for cardiac ischemia and angina |
Vasopressin Contraindications | responsive patients with coronary artery disease |
Vasopressin Dose | 40U IV |
Morphine Class | Narcotic |
Morphine Actions | Vasodilator, CNS depressant, Decreas Anxiety, Decrease cardiac Workload, Alleviates pain |
Morphine Indications | Pain control, Chest pain, pulmonary edema |
Morphine Side effects & Precautions | resp depression,hypotension,brady,nausea vomiting, itching,vertigo |
Morphine Contraindications | systolic b/p <90, sever resp depression, traumatic brain injury |
Morphine Dose | 2-4mg slow push |
Albuterol Class | Sympathomimetic |
Albuterol Actions | Bronchodilation |
Albuterol Indications | bronchospasm from asthma or COPD, allergic reation unresponsive to Epi or benadryl |
Albuterol Side effects & Precautions | heart disease may cause tach,hypertension,restlessness |
Albuterol Contraindications | pregnancy unless life threatening |
Albuterol Dose | 2.5mg/3ml nebulizer |
Dopamine Class | Sympathomimetic |
Dopamine Actions | increases perfusion to kidneys, stimulates beta 1 increase rate and force, high doses cause constiction |
Dopamine Indications | hypotension with cardiogenic shock, ROSC hypotension <90, symptomatic brady after atropine |
Dopamine Side effects & Precautions | tach,necrosis,nausea/vomiting,hypertension,anxiety,angina,arrhythmias,plapitations |
Dopamine Contraindications | hypovolemic shock,V-fib,tachydisrhthmias |
Dopamine Dose | IV piggy back**brady 2-10mcg/kg min Cardiogenic shock/ROSC hypo 5-10mcg/kg min |
Magnesium Sulfate Class | Electrolyte Anticonvulsant |
Magnesium Sulfate Actions | Reverse magnesium deficiency, CNS depressant, Calcium channel blocker, Vasodilator |
Magnesium Sulfate Indications | Asthma refractory to albuterol, eclamptic seizures, torsades de pointes, hypomagnesmia, dig tox dysrhythmias |
Magnesium Sulfate Side effects & Precautions | reduced hr,hypotension,resp depression,hypothermia,circulatory collapse |
Magnesium Sulfate Contraindications | heart blocks, myocardial damage |
Magnesium Sulfate Dose | 1-4mg IV seizure,torsades w/pulse 1-2g in50-100ml D5W w/.5-1ghr following dose, pulseless arrest and status asthmaticus 1-2g in 10ml D5W |
Furosemide Class | loop diuretic |
Furosemide Actions | decreases osmotic gradient, diuretic that inhibits sodium and chloride reabsorption |
Furosemide Indications | acute pulmonary edema |
Furosemide Side effects & Precautions | hypotension,ototoxity,electrolyte imbalance |
Furosemide Contraindications | anuria,severe electrolyte depletion,dehydration |
Furosemide Dose | .5-1mg/kg then double dose if no response |
Levophed Class | sympathomimetic |
Levophed Actions | alpha and beta1 adrenergic agonist, vasoconstrictor |
Levophed Indications | neurogenic shock,inotropic support,cardiogenic shock,rosc w/BP less than 90, BP less than 70 |
Levophed Side effects & Precautions | fetal anoxia,large vein |
Levophed Contraindications | hypovolemia |
Levophed Dose | 8-12mcg/min IV piggyback |
Epi 1:10 Class | sympathominetic |
Epi 1:10 Actions | alpha vasoconstriction,beta 1 HR increase, Beta 2 bronchodilation, increases BP |
Epi 1:10 Indications | aArdiac arrest, anaphylaxis refractory to epi 1:1, pedi brady |
Epi 1:10 Side effects & Precautions | caution w/ anaphylaxis COPD,CHF,over 45 |
Epi 1:10 Contraindications | none |
Epi 1:10 Dose | 1mg IV for Cardiac arrest, .1mg-.mg anaphylaxis, brady 2-10mcg |
Lidocaine Class | ventricle anti arrhythmic |
Lidocaine Actions | suppress excitabilty and automaticity |
Lidocaine Indications | Ventricular rhythms of irritability PVCs with AMI,Runs of Vtac,Prophylaxis, cardioversion vtach after defib |
Lidocaine Side effects & Precautions | reduce dose in older than 65 or CHF, treat Bradys first caine allergies |
Lidocaine Contraindications | ventricular escape beats,bradys, heart blocks |
Lidocaine Dose | vfib pulesless v tach-1.5mg/kg, unstable v tach 1-1.5mg/kg, stable v tach 1mg/kg, salvos runs of vtach or PVCs 1mg/kg repeat doses .5-.75mg/kg |
Atrovent Class | anticholinergic(againts parasympathetic) |
Atrovent Actions | bronchodilations,drys secretions |
Atrovent Indications | bronchospasm after albuterol dose |
Atrovent Side effects & Precautions | rash,blurred vision---glaucoma |
Atrovent Contraindications | allergies to soy/nuts or atropine, bronchoconstriction due to allergic reaction |
Atrovent Dose | .5mg in 2.5ml NS with albuterol |
Sodium Bicarb Class | buffer, alkalanizing agent, electrolyt supplement |
Sodium Bicarb Actions | buffers metabolic acidosis,pushes potassium into cells,neutralizes acidosis,urinary excretion |
Sodium Bicarb Indications | tricyclic overdose,crush injuries,CArdiac arrest in PEA/asys and ROSC, hyperkalemic cardiac arrest with renal failure, DKA, aspirin overdose,methanol ingetsion |
Sodium Bicarb Side effects & Precautions | metabolic alkalosis,necrosis |
Sodium Bicarb Contraindications | alkalosis, pulmonary edema, not used in all cardiac arrest |
Sodium Bicarb Dose | 1mEq/kg |
Fentanyl Class | synthetic narcotic, opioid analgesic |
Fentanyl Actions | binds w/ receptor sites for analgesic effects,concious sedation |
Fentanyl Indications | pain control, RSI |
Fentanyl Side effects & Precautions | resp depression,brady,hypo/hypertension |
Fentanyl Containdications | resp depression,brady,cardiac dysrhythmias,hypotension,head injury |
Fentanyl Dose | 1-2mcg/kg |
Calcium Chloride Class | electrolyte |
Calcium Chloride Actions | helps electrical current in heart,helps muscle contraction, vasoconstriction,increases BP |
Calcium Chloride Indications | hyperkalemia,hypoalcemia,magnesium OD,Calcium channel blocker OD |
Calcium Chloride Side effects & Precautions | brady,hypotension,necrosi,svasospasm |
Calcium Chloride Contraindications | cardiac arrest,dig tox,hypercalemia |
Calcium Chloride Dose | 5-10ml of a 10%solution |
Amiodarone Class | antiarrhythmic |
Amiodarone Actions | slows repolarization,decreases automaticity,alpha beta blocker, inhibits sympathetic |
Amiodarone Indications | VF/VT cardiac arrest unresponsive to shock and vasopressor, unstable VT,wide QRS tach |
Amiodarone Side effects & Precautions | hypotension,block,brady |
Amiodarone Contraindications | trauma,dont give w/ drugs that prolong QT,iodine allergy,pulmonary/hepatic/thyroid disease,2nd3rd degree block |
Amiodarone Dose | 300mg then 150mg 150mg for wide QRS |