ACLS Drugs Flashcards Preview

Pharm 512 Drugs > ACLS Drugs > Flashcards

Flashcards in ACLS Drugs Deck (28):
1

Indications for epinephrine

symptomatic bradycardia, anaphylaxis, cardiac arrest.

2

Epi mechanism of action

B1AR stimulation increases chorno, ino, and dromo tropy
B2AR causes bronchodilation in anaphylaxis

3

Precautions with the use of epi

Increased myocardial O2 demand, arrhythmias (increased risk with concurrent volatile anesthetic use)

4

Epi dose: IV and continuous infusion

1 mg IV Q3-5 min, 2-20 mcg/ min continuous

5

Mechanism of action of vasopressin

Increases water reabsorption at the kidney and causes non adrenergic mediated vasoconstriction

6

Vasopressin dose: IV and continuous

40 U IV once to replace 1st or 2nd epi dose in ACLS, 0.02-0.04 U/ min continuous for septic shock

7

1/2 life of vasopressin

10-20 min

8

Indications for sodium bicarb

ph < 7.10, HCO3< 15, hyperkalemia

9

Precautions for sodium bicarb

Ensure adequate ventilation because it combines with H+ to form CO2 which could potentiate the acidosis if unable to ventilate; monitor pH an HCO3 levels frequently

10

Sodium bicarb dose: IV and continuous

1 mEq/kg IV, 2-5 mEq/kg titrated to pH and HCO3

11

Dobutamine mechanism of action

B1AR increases inotropy; B2AR decreases SVR

12

Clinical uses of Dobutamine

cardiogenic shock, decompensated heart failure

13

Dobutamine dose: continuous infusion

2-20 mcg/kg/min

14

Why can you not mix Dobutamine or Dopamine with sodium bicarb?

They are inactivated in alkaline solutions

15

Uses for Atropine and MOA

symptomatic bradycardia, RSI, organophosphate poisoning, and when reversing ND - NMB, used with edrophonium to block parasympathomimetic effects

MOA: aCh competitive antagonist- anticholinergic

16

Atropine dose

0.5mg q 3-4 min to max of 3 mg

17

Atropine precautions

mydriasis (pupil dilation), paradoxical bradycardia at low doses, asystole, hypotension, bronchospasm

18

Adenosine uses and MOA

Used for SVT
Stimulate adenosine receptors in heart and vascular sm. muscle to briefly interrupt AV node conduction

19

Adenosine dose

6 mg then 12 mg if needed

20

Amiodarone uses and MOA

used for VF and pulseless VT
MOA: Non- competitively inhibits A-AR's and B-AR's to prolong action potential duration and refractory period

21

Amiodarone dose

150-300 mg over 10 min then 150 mg if needed

22

Amiodarone precautions

Prolongs QT- torsades, coagulopathies, pulmonary toxicities, CYP450 inhibitor

23

Amiodarone duration of action

2 weeks to months after d/c'd

24

Dopamine MOA and uses

MOA Stimulate AAR's and BAR's to increase HR and SVR
Used in symptomatic bradycardia, distributive shock, ventricular dysfunction

25

Dopamine dose

2-20 mcg/kg/min continuous infusion

26

Dopamine precautions

Tissue necrosis if infiltrates- use phentolamine, SVT, VT, HTN, ARF

27

T/F Atropine crosses the BBB?

True

28

What causes paradoxical bradycardia after Atropine use?

Low-dose atropine causes bradycardia either by acting on the sinoatrial node or by its effects on central muscarinic receptors increasing vagal activity