Cardiac - Antiarrhythmics Flashcards

1
Q

MOA of Adenosine

A

Slows conduction time through the AV node, interrupting the re-entry pathways through the AV node, restoring normal sinus rhythm.

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2
Q

Adenosine adult dosage

A

Peripheral IV: 6 mg, 12 mg, 12 mg
Central line: 3 mg, 6 mg, 6 mg

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3
Q

Adenosine indications

A

Conversion and termination of supraventricular tachycardias

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4
Q

Adenosine pharmacokinetics

A

Onset: Rapid
Duration: Brief
Half life: <10 seconds

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5
Q

Adenosine contraindications

A

Hypersensitivity
2nd or 3rd degree AV node block
Sick sinus syndrome without artificial pacemaker

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6
Q

Adenosine - how supplied

A

6 mg/2 ml ampoule

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7
Q

Atropine MOA

A

competitively antagonizes acetylcholine at muscarinic receptors, producing parasympatholytic and vagolytic effects

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8
Q

Atropine dosage

A

Bradycardia: 0.6 mg, repeat up to ~3 mg (Handbook)
1 mg, repeat up to 3 mg (UpToDate)
Organophosphate toxicity: 1-2 mg IM/IV, repeat till symptoms resolve

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9
Q

Atropine pharmacokinetics

A

Onset: <2 mins
Peak: 3 mins
Duration: 2-6 hours

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10
Q

Atropine contraindications

A

Tachycardia, narrow angle glaucoma, thyrotoxicosis, prostatic hypertrophy, myasthenia gravis

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11
Q

Atropine - how supplied

A

Preload 1 mg/10 mL

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12
Q

Labetalol MOA

A

competitively blocks adrenergic stimulation of beta1 receptors within the myocardium and beta2 receptors within bronchial and vascular smooth muscle and alpha1 receptors within vascular smooth muscle.

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13
Q

Labetalol adult bolus dosage

A

Start at 20 - 80 mg slow IV push
Additional doses can be given (20-80 mg) at 10 min intervals until desired supine B/P is achieved or total cumulative dose of 300 mg.
Goal is to reduce mean arterial B/P by no more than 25% in first hour, then aim for 160/100-110 mmHg.

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14
Q

Labetalol infusion dosing

A

0.5-2 mg/min. Adjust based on B/P response.
Max cumulative dose of 300 mg.

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15
Q

Labetalol pharmacokinetics

A

Onset (IV): within 5 mins
Peak (IV): 5-15 mins
Duration (IV): 16-18 hours

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16
Q

Labetalol infusion prep

A

Pump preset: 200 mg in 250 mL fluid = 0.8 mg/ml
VCH/Providence/BCCH: 200 mg in 100 mL = 2 mg/mL

17
Q

Labetalol contraindications

A

Bronchospastic airway disease
Obvious CHF
2nd or 3rd degree AV block
Cardiogenic shock
Severe bradycardia

18
Q

Lidocaine MOA

A

Sodium channel blocker. Class 1b. Decreases the membrane’s permeability to sodium, hyperpolarizing the membrane, inhibiting depolarization resulting in blockade of conduction of impulse.

19
Q

Lidocaine adult dosage

A

1-1.5 mg/kg IV bolus
Repeat at 0.5 -1 mg/kg.
Max dose of 3 mg/kg.

20
Q

Lidocaine pharmacokinetics

A

Onset: 45-90 seconds
Peak: 5-10 mins
Duration: 10-20 mins

21
Q

Lidocaine infusion prep

A

Pump preset: Dilute 1g in 250 mL fluid = 4 mg/mL
Premixed solutions available are 1 g in 250 mL D5W or 2g in 500mL D5W = 4 mg/ml

22
Q

Lidocaine contraindications

A

Wolff-Parkinson-White
3rd degree AV block
Ventricular escape rhythm

23
Q

Labetalol - how supplied

A

100 mg/5 ml vial

24
Q

Lidocaine - how supplied

A

Preload: 100 mg/5 mL