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Fifth Set
Medications
| Question | Answer |
|---|---|
| Atenolol, also known as | Tenormin |
| Atenolol Class | Beta adrenergic antagonist Antiaginal Antihypertensive Class II antiarrhythmic. |
| Atenolol Actions | Inhibits the strength of the heart’s contractions and heart rate, resulting in a decrease in cardiac oxygen consmption. Also saturates the beta receptors and inhibits dilation of bronchial smooth muscle (beta2 receptor). |
| Atenolol Indications | ACS, AF, Atrial flutter, Hypertension, SVT. |
| Atenolol Adverse Effects | Bradycardia, Hypotension, Bronchospasm. |
| Atenolol Contraindications | Cardiogenic shock, AV block, Bradycardia, known sensitivity. Use with caution in hypotension, chronic lung disease (asthma and COPD). |
| Atenolol Dosage: Adult: | 5mg IV, IO over a 5 min period. Repeat in 5 minutes. |
| Atenolol Dosage: Pedi: | Not recommended. |
| Atenolol Special Considerations | Pregnancy class D. |
| Digoxin, also known as | Lanoxin |
| Digoxin Class | Cardiac Glycoside. |
| Digoxin Actions | Inhibits sodium-potassium-adenosine triphosphatase membrane pump, resulting in increase in calcium inside heart muscle cell which causes increase in force of contraction of heart. |
| Digoxin Indications | CHF, to control ventriular rate in chronic A fib A flutte and narrow complex PSVT. |
| Digoxin Adverse Effects | Headache, weakness, GI disturbances, arrhythmias, nausea/vomiting, diarrhea, vision disturbances. |
| Digoxin Contraindications | Digitalis allergy, VT &VF, heart block, sick sinus synd, tachycardia w/o heart failure, pulse lower than 50-60 beats/min, MI, ischemic hefart disease, ppl w/ peexcitation AF or atrial flut (delta wave, chartrstc of Wollf-Parkinson_White syndrome, vi |
| Digoxin Dosage | Dosage is individualized. |
| Digoxin Special Considerations | Low levels of serum potassium can lead to digoxin toxicity and bradycardia. Conditions such as adminstr’n of steroids or diuretics or vomiting and diarrhea can produce low levels of potassium and subsequent digoxin tox. *Pregnancy class C. |
| Metoprolol, also known as | Lopressor, Toprol XL |
| Metoprolol Class | Beta adrenergic antagonist, antianginal, antihypertensive, class II antiarrhymic. |
| Metoprolol Actions | Inhibits the strength of the heart’s contractions as well as heart rate. This results in a decrease in cardiac oxygen consumption. Also saturates the beta receptors and I nhibits dilation of bronchial smooth muscle (beta2 receptor). |
| Metoprolol Indications | ACS, hypertension, SVT, atrial flutter, AF, throtoxicosis. |
| Metoprolol Adverse Effects | Tiredness, dizziness, diarrhea, heart block, bradycardia, bronchospasm, drop in blood pressure. |
| Metoprolol Contraindications | Cardiogenic shock, AV block, bradycardia, known sensitivity. Use with caution in hypotension, chronic lung disease (asthma and COPD). |
| Metoprolol Dosage: Adult: | 5mg IV, IO over a 5 min period; repeat at 5 minute intervals to a total of 3 infusions totaling 15mg IV, IO. |
| Metoprolol Dosage: Pedi: | Not recommended. |
| Metoprolol Special Considerations | Blood pressure, heart rate, and ECG should be monitored carefully. *Use with caution in patients with asthma. *Pregnancy class C. |
| Phenytoin, also known as | Dilantin |
| Phenytoin Class | Anticonvulsant |
| Phenytoin Actions | Depresses seizures by affecting the movement of sodium and calcium into neural tissue. |
| Phenytoin Indications | Generalized tonic-clonic seizures. |
| Phenytoin Adverse Effects | Nausea/vomiting, depression of cardiac conduction, sedation, nystagmus, tremors, ataxia, dysarthria, gingival hypeertrophy, hirsutism, facial coarsening, hypotension. |
| Phenytoin Contraindications | Sinus bradycardia, sinoatrial block, 2nd and 3rd degree heart block, Adams-Stokes syndrome, known sensitivity to hydantoins. |
| Phenytoin Dosage: Adult: | 15-20mg/kg IV, IO should be admin’d slowly at a rate not exceeding 50mg/min (this requires a pprox 20 minutes in a 70kg patient). |
| Phenytoin Dosage: Pedi: | 15-20mg/kg IV, IO, admin’d at a rate of 1-3mg/kg/min. |
| Phenytoin Special Considerations | Continuously monitor the ECG and blood pressure during adminstration. *Pregnancy class D. |
| Propranolol, also known as | Inderal |
| Propranolol Class | Beta adrenergic antagonist, antiaginal, antihypertensive, antiarrhythmic, class II. |
| Propranolol Actions | beta antagonist that binds with both the beta1 and beta2 receptors. Inhibits the strength of the heart’s contractions, as well as heart rate. This results in a decrease in cardiac oxygen consumption. |
| Propranolol Indications | Angina; narrow-complex tachycardias that originate from either a reentry mechanism (reentry SVT) or an automatic focus (junctional, ectopic, or multifocal tachycardia) uncontrolled by vagal maneuvers and adenosine in ppl with preserved ventricular func |
| Propranolol Adverse Effects | AV block, Bradycardia, hypotension, bronchospasm. |
| Propranolol Contraindications | Cardiogenic shock, heart failure, AV block, bradycardia, pulmonary edema, sick sinus syndrome, known sensitivity. Use with caution in chronic lung disease (asthma and COPD). |
| Propranolol Dosage: Adult: | 1-3mg IV, IO at a rate of 1mg/min; may repeat the dose 2 minutes later. |
| Propranolol Dosage: Pedi: | 0.01-0.1mg/kg slow IV, IO over a 10 minute period. |
| Propranolol Special Considerations | Monitor blood pressure and heart rate closely during adminstration. *Pregnancy class C. |
| Valproic Acid, also known as | Depakote |
| Valproic Acid Class | Anticonvulsant, antimanic. |
| Valproic Acid Actions | the exact mechanism of action is unknown, it is suggested that it increases brain concentrations of GABA. |
| Valproic Acid Indications | Seizures, mood disorders. |
| Valproic Acid Adverse Effects | transient hair loss, weight gain, weight loss. |
| Valproic Acid Contraindications | Liver disease. |
| Valproic Acid Dosage: | Dosing is individualized. |
| Valproic Acid Special Considerations | Although generally well tolerated, valproic acid does require regular monitoring of blood levels to ensure maintenance of therapeutic levels while minimizing adverse drug reactions. *Pregnancy class D. |
| Warfarin, also known as | Coumadin |
| Warfarin Class | Anticoagulant |
| Warfarin Actions | Inhibit the synthesis of vitamin K depent clotting factors. |
| Warfarin Indications | Treatment and/or prophylaxis of thrombosis related to acute coronary syndromes, stroke, deep venous thrombosis, pulmonary embolism, atrial fibrillation, cardiac valve replacement. |
| Warfarin Adverse Effects | Bleeding, angina, edema, rash, abdominal cramps, gastrointestinal bleeding, vomiting, hematuria, retroperitoneal hematoma, anaphylactoid reactions, skin necrosis. |
| Warfarin Contraindications | Bleeding tendencies, recent/potenial surgery of eye or CNS, major regional lumbar block anesthesia or surgery resulting in lg., open surfaces, pp who have history of falls or is significant fall risk, unsupervised senile or psychotic ppl, eclampsia/preec |
| Warfarin Dosage: | Dosage is individualized. |
| Warfarin Special Considerations | Pregnancy class X. |
| Phenobarbitol, also known as | Luminal |
| Phenobarbitol Class | Anticonvulsant, barbiturate, schedule C-IV. |
| Phenobarbitol Actions | Depresses seizure activity in the cortex, thalamus, and limbic system; increases threshold for electrical stimulation of motor cortex; produces state of sedation. |
| Phenobarbitol Indications | Seizures |
| Phenobarbitol Adverse Effects | Depression, agitation, respiratory depression, accelerated metabolism of several other medications. |
| Phenobarbitol Contraindications | Liver dysfunction, porphria, agranulocytosis, known sensitivity to barbiturates. Use with caution with respiratory dysfunction. |
| Phenobarbitol Dosage: Adult: | 15-18mg/kg IV, IO; infuse at a rate not faster than 60mg/min. |
| Phenobarbitol Dosage: Pedi: | 15-20mg/kg IV, IO; infuse at a rate not faster than 2mg/kg/min. |
| Phenobarbitol Special Considerations | Be prepared to manage the patient’s airway. Pregnancy class D. |
| Prednisone Class | Corticosteroid |
| Prednisone Actions | Reduces inflammation. |
| Prednisone Indications | Inflammatory conditions such as asthma with bronchospasms. |
| Prednisone Adverse Effects | adverse effects of steroid use are not related to short-term use, but typically are seen with long-term use and during withdrawal. |
| Prednisone Contraindications | Cushing’s syndrome, fungal infections, measles, varicella, known sensitivity. |
| Prednisone Dosage: | Dosage is individualized. |
| Prednisone Special Considerations | None. |
| Potassium Chloride Class | Electrolyte replacement. |
| Potassium Chloride Actions | Slight alterations in extracellular potassium levels can cause serious alterations in both cardiac and nervous function. |
| Potassium Chloride Indications | Hypokalemia |
| Potassium Chloride Adverse Effects | Hyperkalemia; AV block; cardiac arrest; GI bleeding, obstruction, or perforation; tissue necrosis if the infusion infiltrates into the soft tissues. |
| Potassium Chloride Contraindications | Use with caution in patients with cardiac arrhythmias, renal failure, muscle cramps, severe tissue trauma.Dosage: |
| Potassium Chloride Dosage: Adult: | Must be individualized according to patient serum potassium concentration. |
| Potassium Chloride Dosage: Pedi: | Must be individualized according to patient serum potassium concentration. |
| Potassium Chloride Special Considerations | Pregnancy class C. |
| ACE - Angiotension-Converting Enzyme Inhibitors, also known as | Captopril [Capoten] Enalpril [Vasotec] Lisinopril [Prinivil, Zestril] Ramipril [Altace] |
| Ace - Angiotension-Converting Enzyme inhibitors Class | Angiotension-converting enzyme (ACE) inhibitors. |
| ACE - Angiotension-Converting Enzyme inhibitors Actions | Blocks the enzyme responsible for the production of angiotensin II, resulting in a decrease in blood pressure. |
| ACE - Angiotension-Converting Enzyme inhibitors Indications | CHF, hypertension, post-myocardial infarction.. |
| ACE - Angiotension-Converting Enzyme inhibitors Adverse Effects | Headache, dizziness, fatigue, depression, chest pain, hypotension, palpitations, cough, dyspnea, upper respiratory infection, nausea/vomiting, rash, pruritis, angioedema, hypot4ension, renal failure. |
| ACE - Angiotension-Converting Enzyme inhibitors Contraindications | Angioedema related to previous Tx w/ an ACE inhibitor, known sensitivity. Use w/ caution in aortic stenosis, bilateral renal artery stenosis, hypertrophic obstructive cardiomyopathy, pericardial tamponade, elev. Serum potassium lvls, acute kidney fail. |
| ACE - Angiotension-Converting Enzyme inhibitors Dosage: Adult: | is administered orally. Dosage is individualized. |
| ACE - Angiotension-Converting Enzyme inhibitors Dosage: Pedi: | is administered orally. Dosage is individualized. |
| ACE - Angiotension-Converting Enzyme inhibitors Special Considerations | Pregnancy class D. |
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