Brady Flashcards

0
Q

Atropine

P-Dyn

A

Blocks Acetylcholine at post-ganglion
Blocks vagus nerve
-increased chrono, dromo
Bronchodilation

Decreased parasympathic stuff
Esp. SLUDGE

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1
Q

Atropine

Class

A

Parasympatholytic

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2
Q

Atropine

Dose

A

Adult-0.5 mg, q 3-5, max 3

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3
Q

Atropine

Indications

A

Symptomatic sinus brady
Consider in narrow M1&2
Nerve agent, organophosphate, carbamate poisoning

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4
Q

Atropine

Contraindications

A

Hypothermia induced brady
Tachycardia
Thyroid storm
Obstructive GI/uro stuff

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5
Q

Adult Epi

Indications

A

Severe refractory symptomatic brady
-atropine, TCP
Severe refractory hypotension
-fluid, dopamine

Dopamine is alternative

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6
Q

Atropine

Peds Dose

A

Peds- 0.02mg/kg diluted in 3-5
Max kid 0.5, 1
Adolescent 1, 3

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7
Q

Epi Infusion

Dose

A

2-10 mcg/min

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8
Q

Epi Infusion

Peds Infusion

A

0.1-1 mcg/kg/min

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9
Q

Dopamine

Class

A

Sympathomimetic

Catecholamine

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10
Q

Dopamine

P-Dyn

A

Naturally occurring precursor to NE
Pharm effects based on dosage
Stimulates dopaminergic, beta, alpha receptors

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11
Q

Dopamine

Dopaminergic effects

A

0.5-2 mcg/kg/min
Dilation of renal, mesenteric, coronary, cerebral vascular beds
Increased renal blood flow, increased urinary output

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12
Q

Dopamine

Beta effects

A
2-10 mcg/kg/min "cardiac dose"
Direct action on B1
Increased
-inotropic
-chronotropic
-dromotropic
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13
Q

Dopamine

Alpha effects

A

10-20 mcg/kg/min “pressor dose”
A1/2 receptors

Increased vasoconstriction
Increased BP/systemic vascular resistance

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14
Q

Dopamine

High Alpha effects

A

> 20 mcg/kg/min
Effects are essentially NE
May increase HR and myocardial O2 demand beyond reasonable limits

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15
Q

Dopamine

Indications

A

Severe symptomatic bradycardia refractory to other interventions
-Atropine, TCP, Epi

Severe hypotension refractory to other interventions
-fluid, Epi
Cardiogenic shock; SBP 70-100

16
Q

Dopamine

Contraindications

A
Allergy
Hypovolemia
Adrenal tumor
Tachydysrythmia
VF
17
Q

Dopamine

Interactions

A

A/B blockers may blunt effects
Deactivated by alkaline solutions (bicarb, lasix)
MAOIs may potentiate alpha effects
Dilantin may cause hypotension

18
Q

Dopamine

Peds Dose

A

2-20 mcg/kg/min

19
Q

Isoproterenol

Peds Dose

A

0.1-1 mcg/kg/min

Titrate to effect

20
Q

Isoproterenol

Class

A

Sympathomimetic

B1 and B2 agonist

21
Q

Isoproterenol

P-Dyn

A

Increased

  • Chronotropic
  • Inotropic
  • Bronchial dilation
  • Arterial dilation
22
Q

Isoproterenol

Indications

A
TdP unresponsive to mag sulfate
-chem overdrive pacing
Brady due to beta blocker OD
-EMS uses glucagon
Brady
-denervated heart transplants with TCP ineffective
23
Q

Isoproterenol

A/S

A

Dysrhythmias
Hypotension, hypertension
Restlessness
Flushing

24
Q

Isoproterenol

Contraindications

A

Allergy
VT/VF
Cardiac arrest

25
Q

Isoproterenol

Dose

A

2-10 mcg/min