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17 Cardiac Drugs
Cardiac Drugs
| Question | Answer |
|---|---|
| Class For Nigroglycerine | Nitrate |
| Nitroglycerine - Actions | Relaxes smooth muscle, dilates coronary arteries and increases inotrophy. |
| Nitroglycerine - Dosage | .4mg up to 3 times. |
| Atropine - Class | Anticholinergic, Parasympatholytic |
| Atropine - Contraindications | Supraventricular >100, Ventricular >60, v-fib |
| 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 - 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 - 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 - 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 - 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 - 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 - 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 - 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 - 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 - 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 - 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 - 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 - 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 - 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 - 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 - Dosage | 1 mEq/kg IVP |