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Cardio meds
Meds not including top 10 involving cardio
| Question | Answer |
|---|---|
| what is aspirin's class and what does it do | NSAID, COX inhibitor; anticoagulant prevents aggregation of blood for clots |
| indication for aspirin | cardiac S&S with ischemia etiology |
| contraindication for aspirin | allergic, bronchospasm, angioedema, active bleed |
| side effects of aspirin | bronchoconstriction, N/V/GI upset, allergic reaction |
| dose for aspirin | 160-325mg PO chew |
| what is calcium chloride | it is an element/mineral and electrolyte |
| how does calcium chloride work | plays a critical role as electrolyte to propagate nervous impulses and muscle contraction |
| indication for calcium | hyperK, hypocalcemia, treat adverse effects of calcium channel OD, and hypotension secondary to diltiazem |
| contraindication for calcium | cardiac arrest except when hyperk suspected (taking digoxin w/suspect ca channel blocker OD) |
| what side effects would you expect from calcium | severe bradycardia with rapid injection causing stone heart, severe coronary spasm and asystole, burning at the site, will precipitate with sodium bicarb |
| Dose of calcium normally given for hyperk and for diltiazem hypotension for adult and pedi | Adult: Normally: 0.5-1g slow IVP over 3-5min & hypotension following diltiazem: 250-500mg Pedi: 20mg/kg (0.2mL/kg) slow IV/IO push |
| What class of medication is captopril and what is it's action | ACE inhibitor, prevents production of angiotensin II by inhibiting ACE which causes vasodilation and reduces amount of H2O held back by kidneys |
| Why do we give captopril | severe CHF with HTN (with nitrates and CPAP) |
| Contraindications for captopril | pregnancy, angioedema, allergic |
| side effects of captopril | allergic reaction, dry cough, dizzy, taste change |
| dose for captopril | 25mg PO |
| What class of medication is diazepam | a benzo, binds type A GABA receptors causing sedation by increasing chloride influx = hyperpolarization |
| Indication for diazepam | anxiety, seizures, sedation, muscle relaxation, and tachycardia due to stimulant OD |
| why you shouldn't give diazepam | they are allergic |
| side effects of diazepam | hypotension, sedation, amnesia, respiratory depression, N/V |
| Adult and pedi dose for diazepam | A: 2.5-10mg at 2.5mg increments, max 5 all routes P: 0.1mg/kg max 5, 0.2mg/kg max 10 rectal |
| what class of medication is dobutamine | synthetic sympathetic agonist, alpha and beta adrenergic agonist greater inotropic effects |
| indication for dobutamine | congestive heart failure with hypotension |
| contraindication for dobutamine | hypovolemia until resuscitation and don't mix with sodium bicarb |
| Dose for dobutamine | Adult and pedi: 2-20 mcg/kg/min titrate so HR doesn't increase by >10% of baseline via IV |
| side effects of dobutamine | palps, anxiety, tremors, HA, dizzy, hyperT, worsen ischemia, reflex brady |
| What kind of drug is dopamine and how does it work | its a sympathetic agonist stimulates alpha and beta, more on beta 1 |
| indications for dopamine | normovolemic hypotension, second line for symptomatic bradycardia after atropine, septic shock and cardiogenic shock, CHF |
| contraindication for dopamine | not used in hypovol. hypoT until replaced, PHEOCHROMOCYTOMA |
| Dose of dopamine | Adult and pedi: 2-20 mcg/kg/min (5-10 inotropic effects) |
| side effects of dopamine | palps, anxiety, tremors, HA, dizzy, hyperT, worsen cardiac ischemia, reflex brady |
| What class of medication is enalapril and how does it work | ACE inhibitor which prevents angiotensin II production allowing vasodilation and decreased water retention by kidneys |
| Why do we give enalapril | for severe CHF with hypertension in conjunction with nitrates and CPAP |
| Contraindications for enalapril | pregnancy, angioedema, and allergic |
| side effects of enalapril | allergic reaction, dry cough, dizzy, taste change |
| Dose of enalapril | initial is 2.5mg PO titrated to 20mg |
| what is fentanyl and how does it work | it's a synthetic opioid narcotic, schedule II it binds opiate receptors causing sedation and is more potent than morphine |
| indications for fentanyl | moderate to severe pain, anesthetic |
| contraindication for fentanyl | allergic, uncorrected hypotension <90 |
| Dose for fentanyl | Adult & pedi: 1mcg/kg slow with a max of 100mcg every 5-10 minutes as needed IV/IM/IN/SQ |
| Side effects of fentanyl | N/V, cramps, chest wall rigidity, respiratory depression, AMS, bradycardia, prolonged QT, increased vagal tone, hypotension |
| what is furosemide and how does it work | it is a loop diuretic which blocks absorption of sodium, chloride, water from kidney tubules which increases urine output |
| indication for furosemide | acute pulmonary edema in patients with >90 to 100mmHG (without signs of shock), hypertensive emergencies |
| contraindications for furosemide | hypovolemia, hypotension, hypokalemia, or other electrolyte abnormality |
| side effects of furosemide | dehydration, acute electrolyte imbalance |
| Dose for furosemide | 0.5-1 mg/kg over 1-2min; if no response then double to 2mg/kg over 1-2min slow new onset pulmonary edema with suspected hypovolemia give <0.5mg/kg |
| what is glucagon and how does it work | hormone; it increases BGL through conversion of glycogen to glucose from liver stores when give IM; when given IV it binds glucagon receptors and stimulates adenyl cyclase increasing cAMP upregulating Ca channels in SA/AV cells = impulse and contraction |
| indications to give glucagon | hypoglycemia with IV/IO not attainable, bradycardia suspected beta blocker/Ca channel blocker OD |
| contraindications of glucagon | known allergy, bradycardia from other etiology |
| side effects of glucagon | anxiety, chest palps, HA, N/V, hyperglycemia |
| adult and pedi dose for glucagon for hypoglycemia adult/pedi dose for beta/ca channel blocker | adult hypoglycemia 1mg IM/IN, pedi: 0.5(<20kg)-1mg beta/Ca blocker OD adult : 3-10mg IV over 3-5min; infusion: 3-5 mg/hr pedi: 0.05-0.15mg/kg; infusion: 0.05-0.1 mg/kg/hr |
| what is norepinephrine and what does it do | sympathetic agonist, alpha and beta adrenergic agonist greater effects on alpha |
| indications for norepinephrine | normovolemic hypotension, septic shock, cardiogenic shock |
| contraindication for norepi | hypovolemia until corrected |
| dose of norepi adult and pedi | Adult: 0.1-0.5 mcg/kg/min IV Pedi: 0.05-2mcg/kg/min infusion |
| side effects of norepi | palps, anxiety, tremors, HA, dizzy, hypertension, worsen cardiac ischemia, reflex bradycardia |
| what is magnesium sulfate and how does it work | its an organic salt that acts as a physiologic Ca channel blocker, bronchodilator |
| what are the indications for magnesium sulfate | bronchial asthma, TdP with a pulse or during cardiac arrest but only if present, and eclampsia |
| contraindication for mag sulfate | high-degree of heart block, shock, dialysis, hypocalcemia, v-fib/pulseless v-tach |
| side effects of mag sulfate | flushing, sweating, bradycardia, respiratory depression, hypothermia |
| adult and pedi dose for mag sulfate bronchodilation, eclampsia TdP and maintenance infusion | Adult: 1-2g IV/IO over 10-20 min infusion in 50-100mL; Cardiac arrest 10ml pedi: 25-50mg/kg IV/IO max 2g over 15-30min TdP w/pulse: 1-2g over 5-60min, pedi = 25-50mg/kg max 2g Eclampsia 4g over 4min; Maintenance: 0.5-1g/hr |
| what class of med is labetalol and what does it do | its a class II antiarrhythmic beta blocker, downregulates Ca channels blocking beta effects of the heart decreasing HR |
| indication for labetalol | severe hypertension, second line med for SVT after admin of adenosine, a-fib/flutter with RVR >150 |
| contraindication for labetalol | don't give to STEMI pt if signs of heart failure, low CO, increased risk cardiogenic shock; hypotension, or bradycardia |
| Side effects of labetalol | severe hypotension if given with Ca channel blockers, bradycardia, heart blocks, CHF |
| Dose of labetalol | 10mg IV/IO push over 1-2 min every 10min (max150mg) |
| class of med nitroglycerine and how it works | it is a nitrate that vasodilates including coronary vessels which improves blood flow to myocardium to decrease overall workload of the heart and afterload |
| indication for nitroglycerine | symptoms suggesting myocardial ischemia, CHF |
| Contraindications for nitroglycerine | hypotension <90 or 30 below baseline, severe bradycardia <50 or tachycardia >100, RVI, ED meds w/n 48hrs, increased ICP |
| side effects of nitroglycerine | HA, dizzy, weak, tachy, hypotension |
| dose of nitroglycerine | 0.4mg SL up to 3 dose (1.2mg) q 5 min |
| what class of medication is sodium bicarb and how does it work | alkalinizing agent, increases plasma bicarb and buffers excess proton concentration, increases pH and reverses medical causes of acidosis |
| indication for sodium bicarb | suspect hyperK or bicarb-responsive acidosis (DKA, OD TCA's, aspirin or cocaine) |
| contraindication for sodium bicarb | cardiac arrest |
| side effect of sodium bicarb | may precipitate given with other meds, alkalosis, hyperirritable tetany |
| dose of sodium bicarb for acidosis and hyperK | acidosis: 1mEq/kg IV bolus HyperK: 50mEq IV bolus |
| what class of medication is procainamide and how does it work | its a class I(a) antiarrhythmic that blocks Na channels in cardiac cells decreasing depolarization and automaticity |
| indication for procainamide | v-tach with pulse, pre-excitation rhythms = WPW |
| contraindication for procainamide | already given IV Ca channel blocker |
| side effects of procainamide | drowsy, slurred speech, confusion, seizures, hypotension |
| 4 stopping points for procainamide | termination of rhythm, widen QRS >50%, hypotension, or max total dose |
| Adult: dose of procainamide for recurrent VF/VT, urgent cases, maintenance infusion Pedi SVT a-flutter, VT w/pulse | Adult: recurrent VF/VT: 20mg/min max 17mg/kg, urgent: up to 50mg/min total 17mg/kg, maintenance infusion: 1-4mg/min Pedi: 15mg/kg IV/IO over 30-60min |
| what is ondansetron's class and function as a medication | its selective serotonin 5-HT3 receptor blocker |
| indication for ondansetron | prevention and control of nausea and vomiting |
| contraindication for ondansetron | allergic |
| side effects of ondansetron | hypotension, tachycardia, dizzy/lightheaded, extrapyramidal rxn, prolonged QT |
| dose for ondansetron adult and pedi | Adult : 4-8mg IV/IM/PO Pedi: 0.1mg/kg IV slow, IM, PO- max 8mg |
| what is verapamil and how dose it work | its a class IV antiarrhythmic Ca channel blocker which slows AP in autorhythmic cells |
| indication for verapamil | 2nd line a-fib/flutter w/RVR and alternative to adenosine for narrow complex tachy |
| contraindication for verapamil | hypotension, CHF (cardiogenic shock. wide-complex tachy, WPW) and allergic |
| side effect of verapamil | more profound hypotension than diltiazem, severe CHF if used with b-blocker, N/V/D, dizzy, HA |
| dose of verapamil 1st, 2nd, max | first: 2.5-5mg IV/IO bolus over 2-3min 2nd: 5-10mg over 2-3min max total 20mg |
| morphine class of medication and action | schedule II narcotic; analgesic and sedation through binding opiate receptors; releases histamine which causes vasodilation and hypotension |
| indication for morphine | moderate-severe pain, ischemic chest pain not relieved by nitro |
| contraindication for morphine | hypotension uncorrected <90, allergic |
| dose of morphine for adult and pedi and max STEMI and NSTEMI-ACS | 2-10mg or 0.1mg/kg (max 20mg) pedi: 0.1mg/kg up to 10mg STEMI: 2-4mg IV/IO add 2-6mg at 5-10 min intervals NSTEMI-ACS: 0.1mg/kg IV/IO/IM up to 10 |
| side effects of morphine | hypotension, syncope, tachy/bradycardia, apnea, N/V/D, respiratory depression |
Created by:
Lindsey.George