ACLS Drugs Flashcards by Kirby Overstreet

what are indications for ASA

Chest pain and other S/S of acute MI
unstable angina
pain discomfort fever in adult pt only

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what are contraindications for ASA

bleedin ulcer, hemorrhagic state, hemophilia
hypersensitivity to salicylates or other non steroidal anti inflammatories that has led to hypotension and or bronchospasm
peds pts

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what are adverse reactions associated with ASA

anaphylactic reactions in sensitive pts, skin eruptions

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what is the normal onset of action for ASA

when are peak effects of ASA expected

20-30 mins

2 hours

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what is the MOA of adenosine

slows conduction time through AV node, can interrupt re entrant pathways through the AV node
slows sinus rate
larger doses decrease bp by decreasing pvr

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what are contraindications for adenosine

2nd 3rd degree block (except pts w/ functioning ventricular pacemaker
caution in pts with asthma
pts on theophylline and related methylxanthines
pts on dipyriamole or carbamazepine
known a fib or flutter
pregnancy

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why are dipyridamole and carbamazepine contraindications for adenosine

block uptake and potentiate effects

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what does theophylline and methyxanthines do to adenosine

decrease effectiveness

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what is the peds dose of adenosine

1mg/kg

0. 2mg/kg

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what is the duration of action of adenosine

10-12 seconds

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what are CV adverse reactions associated with adenosine

transient dysrhythmias (occur in 55% of pts)
palpitations
chest pressure/pain
hypotension
transient hypertension
facial flushing
sweating

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what are respiratory adverse reactions associated with adenosine

dyspnea

hyperventilation, bronchospasm

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CNS adverse reactions associated with adenosine

lighheadedness, headache, dizziness, paresthesias, apprehension, blurred vision, neck-back pain

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what are the indications of use for amiodarone

treatment of defib refractory vf/pvt, torsades,
control stable vtach when cardioversion unsuccessful
rate control in afib/flutter

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what conditions contraindicate amiodarone

bradycardia
2nd 3rd degree block unless pacemaker is present
cardiogenic shock
hpotension
pulmonary congestion

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what potential adverse reactions are associated with amiodarone

bradycardia, hypotension, asystole, av block, torsades, CHF
nausea, vomiting, abnormal liver function tests
blue skin pigmentation
fever, headache, dizziness, flushing, abnormal salivation, photophobia

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what drugs is amiodarone incompatible with

beta blockers, ca channel blockers, other anti arrhythmics can be pro arrhythmic
sodium bicarb, heparin, lasix

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when amiodarone is given for VF/pVT how is it administered

IV push over 30-60 seconds

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how is amiodarone given when used to treat wide complex tachycardias, afib/flutter, SVT w/cardioversion

mixed in 50ml bag D5W given over 10 mins, can repeat every 10 mins

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what is the max dose of amiodarone for peds in a day

15mg/kg/day

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what is the peds dose of amiodarone for VF/pVT and for VT w/ pulse

5mg/kg IV push can repeat every 5 mins twice

5mg/kg over 20 mins

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what is the half life for amiodarone

may exceed 40 days

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what temp must amiodarone be stored below

77F

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amiodarone MOA

prolongs action potential, refractory period
ventricular automaticity K
slows membrane depolarization and impulse conduction NA
negative chrono activity in nodal tissue, antisympathetic activity, dilate coronary arteries CA, Beta

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contraindications for atropine

``` 2nd 3rd degree block renal and hepatic disease glaucoma (relative) obstructive GI disease asthma thyrotoxicosis ```

atropine is pregnancy risk category

what are the major adverse reactions associated with atropine

tachydysrythmias, flushing, ventricular irritability, exacerbation/initiation of angina, acute narrow angle glaucoma, blurred vision, mydriasis, agitation to delirium, bloating, constipation

what is the pediatric dose of atropine for bradycardia

0.02 mg/kg (minimum 0.1 mg)

what is the expected time until onset of action for atropine

1 min

what is the half life of atropine | what is the terminal half life of atropine

2-3 hours | 12.5 hours

what are the indications of use for diltiazem

rapid ventricular rates associated with afib/flutter | psvt refractory to adenosine

what are the pharmacological efects of diltiazem

inhibits calcium influx during cardiac depolarization | decreases SA and AV conduction and dilates coronary and peripheral arteries and arterioles

what are the clinical effects of diltizaem

slows RVR associated with afib/flutter | reduces coronary and peripheral vascular resistance

what are contraindications for diltiazem

``` hypotension acute mi cardiogenic shock Vtach 2nd 3rd block WPW SSS Beta blocker use ```

what is the adult dose of diltiazem

initial 0.25 mg/kg IVP over 2 mins may repeat w/ 0.35 mg/kg IVP over 2 mins maintenance infusion: 5-15 mg/hr

what is the pediatric dose for diltiazem

not used for kids

what is the expected onset of action for diltiazem

immediate

when are the peak effects of diltiazem

2 hours or less

when is administration of dopamine indicated

symptomatic bradycardia | hemodynamically significant hypotension in absence of hypovolemia

what are contraindications for dopamine

hypovolemia phenochromocytoma MAO inhibitors such as marplan nardil parnate

what adverse reactions are associated with dopamine

``` arrythmias (due to increased myocardial O2 demand) hypertension hypotension at low doses nausea/vomiting renal shutdown tissue necrosis ```

why is dopamine contraindicated in the presence of MAO inhibitors

will cause hypertensive crisis

dopamine is incompatible with any __________ solution

alkaline

dopamine: onset of action, peak effects, duration of action

almost immediate, upon intro to central circulation 5-10 mins effects cease almost immediately when infusion is shut off

what are the adverse reactions associated with epinephrine

hypertension, ventricular disrhythmias, tachycardia, angine anxiety, agitation nausea/vomiting

what are the notes about incompatibilities/ drug interactions for epienephrine

potentiates other sympathomimetics | reacts with alkaline solutions, such as sodium bicarb, should not be mixed with alkaline agents

what is the pediatric dose of epinephrine for cardiac arrest

0.01 mg/kg 1:10,000 repeat every 3-5 minutes, max single dose of 1mg

in a cardiac arrest situation what is the dose of epinephrine that is administered via ET tube for peds and neonates

0.1 mg/kg 1:1,000

what is the MOA of lidocaine

decreases automaticity by slowing rate of spontaneous phase 4 depolarization terminates re-entry by decreasing conduction in re-entrant pathways increases v-fib threshold

what are the indication for use of lidocaine

suppression of ventricular arrhythmias prevent recurrence of vtach/vfib pain management after IO insertion

what are the contraindications for the use of lidocaine

hypersensitivity 2nd 3rd blocks warrant extreme caution ectopic beats when HR is less than 60

what adverse reactions are associated with lidocaine

SA depression or conduction problems and hypotension in large doses or if given too rapidly large doses can cause drowsiness, disorientation, paresthesias, decreased hearing acuity, muscle twitching, agitation, focal or generalized seizures

what is the dose of lidocaine for cardiac arrest

1-1.5 mg/kg every 3-5 minutes | ROSC: drug 2-4 mg/min

what is the dose of lidocaine for arrhythmias with a pulse

0. 5-0.75 mg/kg initial | 0. 5-0.75 additional every 5-10 minutes

what is the pediatric dose of lidocaine

1 mg/kg may repeat 1 time in 3-5 mins of vf/pvt or in 15 mins for refractory dysrhythmias with a pulse

what is the expected onset of action for lidocaine

5-10 minutes

what is the duration of action for lidocaine

20 mins (bolus only)

what is the MOA of verapamil

calcium blockade causes (-) inotropic effect reduces coronary and peripheral vascular resistance slows conduction and prolongs refractory period in the AV node slows SA node discharge

what are the indication of use for verapamil

SVT | RVR associated with afib/flutter

what are contraindications for verapamil

``` AV block SSS wide complex tachycardia WPW shock severe CHF IV beta blocker hypotension ```

what adverse reactions are associated with verapamil

``` extreme bradycardia asystole AV block hypotension CHF ```

what drugs is verapmil incompatible with

beta blockers

what is the adult dose of verapamil

2.5-5 mg slow iv push over 2-3 mins may repeat in 15-30 mins with 5-10 mg max dose of 30mg

what is the pediatric dose of verapamil

not used for kids

what is the on set of action for verapamil

1-3 mins

what is the duration of action for verapamil

2-5 hours

ACLS Drugs Flashcards

(66 cards)