Cardiac Drugs
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| Class For Nigroglycerine | Nitrate
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| Nitroglycerine - Actions | Relaxes smooth muscle, dilates coronary arteries and increases inotrophy.
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| Nitroglycerine - Dosage | .4mg up to 3 times.
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| Atropine - Class | Anticholinergic, Parasympatholytic
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| Atropine - Contraindications | Supraventricular >100, Ventricular >60, v-fib
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| Atropine - Dosage | .5 - 1 mg (Max .04 mg/kg)
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| Dopamine - Class | Catecholamine, Sympathomimetic
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| Dopamine - Actions | Increased inotrophic/chronotropic affects, increase O2 consumption, increased PVR, bronchodilation
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| Dopamine - Indications | Symptomatic bradycardias, pulseless arrests (VF, PVT, PEA, Asystole)
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| Dopamine - Contraindications | V-Tach, V-fib
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| Dopamine - Dosage | 5-20 mcg/kg/min
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| Epinephrine - Class | Catecholamine, Sympathomimetic
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| Epinephrine - Actions | Increases inotrophic/chronotropic/dromotropic affects, increases O2 consumption, increases PTV, bronchodilation
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| Epinephrine - Indications | Symptomatic bradycardias, pulseless arrests (VF, PVT, PEA, Asystole)
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| Epinephrine - Dosage | 2-10 mcg/min; 1 mg IV
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| Adenosine - Class | Anti-dysrhythmic; purine nucleoside
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| Adenosine - Actions | slows conduction through AV node
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| Adenosine - Indications | Stable PSVT refractory to vagal maneuvers
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| Adenosine - Dosage | 6mg, 12, mg, 12 mg
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| Cardiazem - Class | Calcium Channel Blocker
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| Cardiazem - Actions | Relaxes smooth muscle, decreases PVR, decreases AV conduction, dilates coronary arteries
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| Cardiazem - Indications | A-fib, A-flutter, SVT refractory to adenosine, hypertensive angina pectoris
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| Cardiazem - Dosgae | .25 mg/kg; 5-15 mg/hr
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| Furosemide - Class | Loop Diuretic
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| Furosemide - Actions | Venous dilation, inhibits reabsorption of sodium in Loop of Henle, Diuresis
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| Furosemide - Indications | Acute pulmonary edema
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| Furosemide - Dosage | 40-100 mg.
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| Morphine - Class | Narcotic Analgesic
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| Morphine - Actions | Analgesia/sedation, decreases CNS, arterial and venous dilation
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| Morphine - Indications | CP associated with acute coronary syndrome, acute pulmonary edema, pain relief
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| Morphine - Contraindications | Hypotension, volume depletion, head injury, abd. pain.
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| Morphine - Dosage | 2-5 mg (Up to 15 mg)
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| Vasopressin - Class | Antidiuretic Hormone
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| Vasopressin - Action | Stimulates V1 receptor sites causing vasoconstriction
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| Vasopressin - indications | Pulseless arrest (VF, PVT, PEA, Asystole)
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| Vasopressin - Dose | 40 IV IU
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| Amiodarone - Class | Atrial and Ventricular anti-dysrhythmic
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| Amiodarone - Action | Blocks the sodium, potassium, and calcium channels, blocks alpha and beta receptors, lengthens QT interval
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| Amiodarone - Indications | V-fib, pulseless v-tach, stable v-tach w/pulse, stable PSVT refractory to adenosine, WPW
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| Amiodarone - Contraindications | Junctional escape rhythm, 2 degree type II, 3 degree, Asystole.
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| 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.
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| Lidocaine - Class | Ventricular Anti-dysrhythmic
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| Lidocaine - Action | decreases vent. depolarization and automaticity, depresses vent. ectopy assoc. w/acute coronary syndrome, increases v-fib threshold
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| Lidocaine - Indications | V-fib, pulseless v-tach, stable v-tach w/pulse, malignant PVC's
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| Lidocaine - Contraindications | @ degree type II, 3 degree PEA, Asystole
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| Lidocaine - Dose | 1-1.5 mg/kg IVP q3-5 at 50% Maint: 2-4 mg/min Max: 3 mg/kg
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| Magnesium Sulfate - Class | Ventricular Antidysrhythmic, electrolyte, anti-convulsant
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| Magnesium Sulfate - Actions | increases QT interval, replenishes mag. cation, relaxes smooth muscle, depresses CNS
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| Magnesium Sulfate - Indications | Torsade D' Pointes, situations requiring bronchodilation (asthma, COPD), pregnancy induced HTN seizures
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| Magnesium Sulfate - Contraindications | 2 degree type II, 3 degree, PEA, Asystole
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| Magnesium Sulfate - Dose | 1-2 G in 50 ml over 5 mins.
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| Procainamide - Class | Atrial and Ventricular anti-dysrhythmic
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| Procainamide - Action | Reduces automaticity of pacemaker sites, slows intraventricular conduction
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| Procainamide - Indications | Recurrent V-Tach, PSVT refractory to adenosine
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| Procainamide - Contraindications | Sever conduction disturbances, 2 degree Type II, 3 degree AVB, Ventricular escape beats.
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| Procainamide - Dosage | 20-30 mg/min IV drip Max: 17 mg/kg, QRS increases by 50% hypotension
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| Labetalol - Class | Non-selective beta blocker, selective alpha 1 blocker
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| Labetalol - Action | Inhibits peripheral vasoconstriction, decreases cardiac output, causes peripheral vasodilation
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| Labetalol - Indications | Hypertensive crisis
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| Labetalol - Contraindications | Bronchial asthma, CHF, heart block, bradycardia, cardiogenic shock
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| Labetalol - Dosage | 10 mg IV over 2 mins, repeat at 10-20 mg after 10 mins.
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| Metaprolol - Class | Selective beta blocker
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| 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
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| Metaprolol -Indications | Acute MI, angina pectoris, hypertension
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| Metaprolol - Contraindications | Sinus Bradycardia, heart block, cardiogenic shock, systolic BP < 100, cardiac failure
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| Metaprolol - Dosage | 5 mg slow IVP every 5 mins x3 doses (max 15 mg)
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| Calcium Chloride - Class | Calcium supplement
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| 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.
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| Calcium Chloride - Indications | Hypocalcemia, hyperkalemia, calcium channel blocker toxicity, mag. sulfate toxicity.
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| Calcium Chloride - Contraindications | May precipitate digitalis toxicity in pts. taking Digoxin
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| Calcium Chloride - Dosage | 2-4 mg/kg slov IVP
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| Sodium Bicarbonate - Class | Alkalinizing Agent
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| Sodium Bicarbonate - Actions | Buffers metabolic acidosis, increases pH by providing bicarb buffer, makes urine alkaline enhancing tricyclic antidepressant excretion
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| Sodium Bicarbonate - Indications | Tricyclic antidepressant overdose, phenobarbital overdose, known hyperkalemia, sever acidosis refractory to hyperventilation
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| Sodium Bicarbonate - Contraindications | Alkalotic states
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| Sodium Bicarbonate - Dosage | 1 mEq/kg IVP
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