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From Flashcardlet > Cardiac > Flashcards

Cardiac Flashcards

0
Q

Precautions for adrenaline

A
  1. Pts taking monoamine oxidase inhibitors
  2. Hypovolemic shock
  3. Hypertension
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1
Q

Indications for adrenaline

A
  1. Anaphylaxis or severe allergic reaction
  2. Severe life threatening bronchospasm or silent chest - pt must be able to speak in only single words AND / OR have haemodynamic compromise AnD / OR have an ALOC.
  3. Cardiac arrest
  4. Croup with stridor at rest
  5. Bradycardia with poor perfusion unresponsive to atropine and top
  6. Shock excluding hemorrhagic causes unresponsive to adequate fluid therapy
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2
Q

Metabolism of adrenaline

A

The majority by sympathetic nerve endings.

It is subject to mitochondrial enzymatic breakdown by monoamine oxidase at the synaptic level.

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3
Q

Schedules of adrenaline

A

1: 1000 s3
1: 10000 unscheduled

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4
Q

Presentation of adrenaline

A

1mg in 1ml

1mg in 10mls

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5
Q

Half-life of adrenaline

A

2 mins

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6
Q

Drug class for adrenaline

A

Sympathomimetic

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7
Q

Paed dose of Adrenaline for Isolated facial swelling or angioedema with no stridor at rest

A

5 mg NEB, single dose only.

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8
Q

Contraindications for adrenaline

A

KSAR

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9
Q

Paediatric doses of adrenaline for Anaphylaxis or severe allergic reaction

A

> 1 y/o = 10 mcg / kg

IMI @ 5 mins

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10
Q

Paediatric doses of adrenaline for Cardiac arrest

A

< 1 = 100 mcg bolus IVI, > 1 = 10 mcg / kg repeatable every 3-5 mins NMD

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11
Q

Adult doses of adrenaline Anaphylaxis or severe allergic reaction

A
  • 250- 500mcg IMI repeatable every five mins whilst still indicated,
  • neb = 5 mg single dose only for isolated facial swelling / angioedema with no stridor at rest.
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12
Q

Adult doses of adrenaline for Cardiac arrest

A
  • 1mg IVI repeatable at 3-5 mins NMD
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13
Q

Special notes of adrenaline

A

1:1000 adrenaline should be used for all nebuliser doses
1:10000 adrenaline should be used for all low dose IV injections, e.g paediatric arrest
Repeated Im doses in the same location may cause tissue necrosis and Ischaemia
All cannulae must be flushed after admin

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14
Q

Pharmacology of adrenaline

A

A natural catecholamine acting on alpha and beta adrenoreceptors.
It increases heart rate (b1), increase force of myocardial contraction (b1), increase in irritability of the ventricles, bronchodilation (b2) and peripheral vasoconstriction (a1).

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15
Q

Side effects of adrenaline

A
  1. Tacharrythmias / palpatations
  2. Hypertension
  3. Anxiety
  4. Pupillary dilation
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16
Q

Duration of adrenaline

A

5-10 mins

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17
Q

Paediatric doses of adrenaline for Croup with stridor at rest

A

5 mg nebulised single dose only.

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18
Q

Paediatric doses of adrenaline for Severe life threatening bronchospasm

A

1 y/ o 10 mcg / kg IMI repeatable every 5 mins whilst still indicated.

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19
Q

Onset of adrenaline

A

IVI 30 secs

IMI 60 secs

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20
Q

Adult doses of adrenaline for Severe life threatening bronchospasm

A
  • 250 - 500 mcg IMI

repeatable at 5 min intervals NMD

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21
Q

Half life of aspirin

A

300- 650 mg = 3.2hrs

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22
Q

Precautions of aspirin

A
  1. Suspected aortic aneurysm or other condition requiring surgery
  2. Hx of GI bleed or peptic ulcers
  3. pregnancy
  4. Pts on concomitant anticoagulant therapy except for clopidogrel
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23
Q

Indications for aspirin

A
  1. ACS

2. Acute cardiogenic pulmonary oedema

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24
Q

Special notes for aspirin

A
  1. Should be administered following initial dose of GTN in ACS or cardiogenic APO.
  2. Indicated in ACS or cardiogenic APO even if pt is pain free
  3. Pt had < 300 mg of aspirin w/in 24 hrs should be administered a dose = 300-450 mg daily dose.
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25
Q

Contraindications for aspirin

A
  1. KSAR to aspirin or NSAIDs
  2. Bleeding disorders
  3. Current GI bleed or peptic ulcers
  4. pts < 18
  5. Chest pain secondary to psychostimulant overdose
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26
Q

Duration of Aspirin

A

anti platelet action lasts 7-10 days

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27
Q

Pharmacology for aspirin

A

Inhibits COX (inhibits platelet aggregation)
Reduces thrombaxane A2 synthesis for the life of the platelet.
Prevents platelets aggregating on exposed collagen fibres at the site of vascular injury.

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28
Q

Side effects of aspirin

A
  1. GI bleeding
  2. NSAID induced bronchospasm
  3. Nausea / vomiting
  4. Epigastric pain / discomfort
  5. gastritis
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29
Q

Metabolism of aspirin

A

Converted to salicyclic acid in many tissues
Primarily the GI mucousa and liver
Excreted by the kidneys.

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30
Q

Dose for aspirin

A

300 mg tablet single dose PO

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31
Q

Drug class for aspirin

A

Anti platelet

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32
Q

Aspirin schedule

A

S2 therapeutic poisons

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33
Q

Presentation of aspirin

A

300 mg tablet

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34
Q

Onset of aspirin

A

10 mins variable

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35
Q

Duration of GTN

A

20-30 mins

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36
Q

Onset of GTN

A

< 2 mins

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37
Q

Pharmacology of GTN

A

Increases venous capacity decreasing preload.
Pools venous blood in the peripheral veins.
Reduce ventricular filling pressures.
Decreasing arterial blood pressure.
Vasodilates coronary arteries that are in spasm.
May assist the redistribution of blood flow through collateral channels of the heart.

38
Q

Precautions of GTN

A
  1. Cerebral vascular disease
  2. Risk of hypotension / syncope
  3. Intoxicated pts
  4. Erectile dysfunction medications in last 4 days
  5. Suspected inferior AMI
39
Q

Half-life of GTN

A

5 mins

40
Q

Drug class of GTN

A

Vasodilator

41
Q

Contraindications for GTN

A
  1. KSAR
  2. Bp < 100 mmHg
  3. Heart rate < 50 or >150 bpm
  4. Erectile dysfunction medications in last 24 hrs
  5. Acute CVA
  6. Head trauma
42
Q

Indications for GTN

A
  1. Suspected ACS
  2. cardiogenic APO
  3. Autonomic dysreflexia with a systolic >= 160 mmHg
  4. Irrukandji syndrome with a systolic >= 160 mmHg
43
Q

Metabolism of GTN

A

Readily absorbed and metabolised by the liver

44
Q

Presentation of GTN

A

Sublingual spray 400 mcg

Ampoules 50 mg in 10 mls*

45
Q

Side effects of GTN

A
  1. Dizziness
  2. Hypotension
  3. Syncope
  4. Reflex tachycardia
  5. Vascular headache
46
Q

Special notes for GtN

A
  1. GTN first for ACS
    IV GTN should be considered for all pts unresponsive to sublingual GTN, narcotics and betablockers.
  2. normal or low left ventricular filling pressures may be hypersensitive to GTN.
  3. GTN first for autonomic dysreflexia
    morphine should be considered as Mx
  4. Cannular and lines must be flushed with saline.
47
Q

Indications for adrenaline

A
  1. Anaphylaxis or severe allergic reaction
  2. Severe life threatening bronchospasm or silent chest - pt must be able to speak in only single words AND / OR have haemodynamic compromise AnD / OR have an ALOC.
  3. Cardiac arrest
  4. Croup with stridor at rest
  5. Bradycardia with poor perfusion unresponsive to atropine and top
  6. Shock excluding hemorrhagic causes unresponsive to adequate fluid therapy
48
Q

Precautions for adrenaline

A
  1. Pts taking monoamine oxidase inhibitors
  2. Hypovolemic shock
  3. Hypertension
49
Q

Metabolism of adrenaline

A

The majority by sympathetic nerve endings.

It is subject to mitochondrial enzymatic breakdown by monoamine oxidase at the synaptic level.

50
Q

Schedules of adrenaline

A

1: 1000 s3
1: 10000 unscheduled

51
Q

Presentation of adrenaline

A

1mg in 1ml

1mg in 10mls

52
Q

Half-life of adrenaline

A

2 mins

53
Q

Drug class for adrenaline

A

Sympathomimetic

54
Q

Paed dose of Adrenaline for Isolated facial swelling or angioedema with no stridor at rest

A

5 mg NEB, single dose only.

55
Q

Contraindications for adrenaline

A

KSAR

56
Q

Paediatric doses of adrenaline for Anaphylaxis or severe allergic reaction

A

> 1 y/o = 10 mcg / kg

IMI @ 5 mins

57
Q

Paediatric doses of adrenaline for Cardiac arrest

A

< 1 = 100 mcg bolus IVI, > 1 = 10 mcg / kg repeatable every 3-5 mins NMD

58
Q

Adult doses of adrenaline Anaphylaxis or severe allergic reaction

A
  • 250- 500mcg IMI repeatable every five mins whilst still indicated,
  • neb = 5 mg single dose only for isolated facial swelling / angioedema with no stridor at rest.
59
Q

Adult doses of adrenaline for Cardiac arrest

A
  • 1mg IVI repeatable at 3-5 mins NMD
60
Q

Special notes of adrenaline

A

1:1000 adrenaline should be used for all nebuliser doses
1:10000 adrenaline should be used for all low dose IV injections, e.g paediatric arrest
Repeated Im doses in the same location may cause tissue necrosis and Ischaemia
All cannulae must be flushed after admin

61
Q

Pharmacology of adrenaline

A

A natural catecholamine acting on alpha and beta adrenoreceptors.
It increases heart rate (b1), increase force of myocardial contraction (b1), increase in irritability of the ventricles, bronchodilation (b2) and peripheral vasoconstriction (a1).

62
Q

Side effects of adrenaline

A
  1. Tacharrythmias / palpatations
  2. Hypertension
  3. Anxiety
  4. Pupillary dilation
63
Q

Duration of adrenaline

A

5-10 mins

64
Q

Paediatric doses of adrenaline for Croup with stridor at rest

A

5 mg nebulised single dose only.

65
Q

Paediatric doses of adrenaline for Severe life threatening bronchospasm

A

1 y/ o 10 mcg / kg IMI repeatable every 5 mins whilst still indicated.

66
Q

Onset of adrenaline

A

IVI 30 secs

IMI 60 secs

67
Q

Adult doses of adrenaline for Severe life threatening bronchospasm

A
  • 250 - 500 mcg IMI

repeatable at 5 min intervals NMD

68
Q

Duration of GTN

A

20-30 mins

69
Q

Onset of GTN

A

< 2 mins

70
Q

Pharmacology of GTN

A

Increases venous capacity decreasing preload.
Pools venous blood in the peripheral veins.
Reduce ventricular filling pressures.
Decreasing arterial blood pressure.
Vasodilates coronary arteries that are in spasm.
May assist the redistribution of blood flow through collateral channels of the heart.

71
Q

Precautions of GTN

A
  1. Cerebral vascular disease
  2. Risk of hypotension / syncope
  3. Intoxicated pts
  4. Erectile dysfunction medications in last 4 days
  5. Suspected inferior AMI
72
Q

Half-life of GTN

A

5 mins

73
Q

Drug class of GTN

A

Vasodilator

74
Q

Contraindications for GTN

A
  1. KSAR
  2. Bp < 100 mmHg
  3. Heart rate < 50 or >150 bpm
  4. Erectile dysfunction medications in last 24 hrs
  5. Acute CVA
  6. Head trauma
75
Q

Indications for GTN

A
  1. Suspected ACS
  2. cardiogenic APO
  3. Autonomic dysreflexia with a systolic >= 160 mmHg
  4. Irrukandji syndrome with a systolic >= 160 mmHg
76
Q

Metabolism of GTN

A

Readily absorbed and metabolised by the liver

77
Q

Presentation of GTN

A

Sublingual spray 400 mcg

Ampoules 50 mg in 10 mls*

78
Q

Side effects of GTN

A
  1. Dizziness
  2. Hypotension
  3. Syncope
  4. Reflex tachycardia
  5. Vascular headache
79
Q

Special notes for GtN

A
  1. GTN first for ACS
    IV GTN should be considered for all pts unresponsive to sublingual GTN, narcotics and betablockers.
  2. normal or low left ventricular filling pressures may be hypersensitive to GTN.
  3. GTN first for autonomic dysreflexia
    morphine should be considered as Mx
  4. Cannular and lines must be flushed with saline.
80
Q

Half life of aspirin

A

300- 650 mg = 3.2hrs

81
Q

Precautions of aspirin

A
  1. Suspected aortic aneurysm or other condition requiring surgery
  2. Hx of GI bleed or peptic ulcers
  3. pregnancy
  4. Pts on concomitant anticoagulant therapy except for clopidogrel
82
Q

Indications for aspirin

A
  1. ACS

2. Acute cardiogenic pulmonary oedema

83
Q

Special notes for aspirin

A
  1. Should be administered following initial dose of GTN in ACS or cardiogenic APO.
  2. Indicated in ACS or cardiogenic APO even if pt is pain free
  3. Pt had < 300 mg of aspirin w/in 24 hrs should be administered a dose = 300-450 mg daily dose.
84
Q

Contraindications for aspirin

A
  1. KSAR to aspirin or NSAIDs
  2. Bleeding disorders
  3. Current GI bleed or peptic ulcers
  4. pts < 18
  5. Chest pain secondary to psychostimulant overdose
85
Q

Duration of Aspirin

A

anti platelet action lasts 7-10 days

86
Q

Pharmacology for aspirin

A

Inhibits COX (inhibits platelet aggregation)
Reduces thrombaxane A2 synthesis for the life of the platelet.
Prevents platelets aggregating on exposed collagen fibres at the site of vascular injury.

87
Q

Side effects of aspirin

A
  1. GI bleeding
  2. NSAID induced bronchospasm
  3. Nausea / vomiting
  4. Epigastric pain / discomfort
  5. gastritis
88
Q

Metabolism of aspirin

A

Converted to salicyclic acid in many tissues
Primarily the GI mucousa and liver
Excreted by the kidneys.

89
Q

Dose for aspirin

A

300 mg tablet single dose PO

90
Q

Drug class for aspirin

A

Anti platelet

91
Q

Aspirin schedule

A

S2 therapeutic poisons

92
Q

Presentation of aspirin

A

300 mg tablet

93
Q

Onset of aspirin

A

10 mins variable

From Flashcardlet (28 decks)

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