Antidysrhythmis

Question 1

Adenosine (Adenocard)

Class

Answer 1

Antidysrhythmic

Question 2

Adenosine (Adenocard)

Description

Answer 2

Naturally occuring agent that can “chemically cardiovert” PSVT to a normal sinus rhythm. Half life of 10 secs. Does not cause hypotension.

Question 3

Adenosine (Adenocard)

Indications

Answer 3

Narrow, complex paroxysmal supraventricular tachycardia refractory to vagal maneuvers.

• Tachycardia

Question 4

Adenosine (Adenocard)

Contraindications

Answer 4

A-fib, 2nd and 3rd degree heart block

Question 5

Adenosine (Adenocard)

Adult Dose

Answer 5

Adult: 12 mg rapidly IV, then rapid IV flush with 10c saline. If ineffective, 12mg in 1-2mins may be repeated.

Question 6

Procainamide (Pronestyl)

Class

Answer 6

Anti-arrhythmic (Na+ blocker)

Question 7

Procainamide (Pronestyl)

Description

Answer 7

Prolongs ventricular repolarization, slows conduction, and decreases myocardial excitability

Question 8

Procainamide (Pronestyl)

Indications

Answer 8

Ventricular fibrillation and pulseless ventricular tachycardia refractory to lidocaine

Question 9

Procainamide (Pronestyl)

Contraindications

Answer 9

Hypersensitivity, myasthenia gravis, and 2nd or 3rd degree heart block

Question 10

Procainamide (Pronestyl)

Precautions

Answer 10

Hypotension, cardiac enlargement, CHF, AMI, ventricular dysrhythmias from digitalis, hepatic/renal impairment, bronchial asthma

Question 11

Procainamide (Pronestyl)

Dosage

Answer 11

Adult: 20-30 mg/min IV drip @6-8mg/kg
Stop Points (1) up to 17 mg/kg to effect, then 1-4 mg/min (2) ectopy resolves (3) QRS complex widens more than 50% from original (4) hypotension ensues
Pedi: 15 mg/kg IV/IO over 30-60 mins

Question 12

Lidocaine (Xylocaine)

Class

Answer 12

Antidysrhythmic (Na+ Blocker)

Question 13

Lidocaine (Xylocaine)

Description

Answer 13

an antidysrhythmis that suppresses automaticity and raises stimulation threshold of the ventricles. Also causes sediation, anticonvulsant, and analgesic effects.

Question 14

Lidocaine (Xylocaine)

Indications

Answer 14

Pulseless ventricular tachycardia, vfib, ventricular tachycardia with pulses

Question 15

Lidocaine (Xylocaine)

Contraindications

Answer 15

Hypersensitivity to amide-type local anesthetics, supraventricular dysrhythmias, bradycardia, fasicular blocks

Question 16

Lidocaine (Xylocaine)

Precautions

Answer 16

Hepatic/renal impairment, CHF, hypoxia, respiratory depression, hypovolemia, myasthenia gravis, schock, elderly

Question 17

Lidocaine (Xylocaine)

Dosage Cardiac Arrest

Answer 17

Adult: 1-1.5 mg/kg IV every 3-5 mins up to 3mg/kg. Consider 1/2 dose for elderly follow conversion with a drip of 2-4 mg/min. 1Gram/250cc
Pedi: 1 mg/kg IV every 3-5 min up to 3 mg/kg, following conversion with a drip of 20-50 mcg/kg/min

Question 18

Amiodarone (Cordarone, Pacerone)

Class

Answer 18

Antidysrhythmic (KCl Blocker)

Question 19

Amiodarone (Cordarone, Pacerone)

Description

Answer 19

Antidysrhythmic that prolongs the duration of the action potential and refractory period and relaxes smooth muscles, reducing peripheral vascular resistance, and increasing coronary blood flow

Question 20

Amiodarone (Cordarone, Pacerone)

Indications

Answer 20

V-fib/v-tach and wide complex tachycardia

Question 21

Amiodarone (Cordarone, Pacerone)

Contraindications

Answer 21

Heart block and profound bradycardia

Question 22

Amiodarone (Cordarone, Pacerone)

Adult dose

Answer 22

Pulses - 150mg over 10 mins.

Pulseless - 300 mg IVP, then 150mg IVP for recurrent episodes

Question 23

Adenosine

Pedi dose

Answer 23

0.1 mg/kg (max 6mg)
If ineffective, 0.2 mg/kg (max 12mg)
Flush with 5cc saline

Question 24

Amiodarone

Pedi dose

Answer 24

Pulses - 5 mg/kg over 5 mins.

Pulseless - 5 mg/kg IVP over 5 mins
Avoid in length color PINK