Cardiac Flashcards
(141 cards)
1
Q
Adenosine Tarde name
A
Adenocard
2
Q
Adenosine generic name
A
Adenosine
3
Q
Adenosine classification
A
Antiarrhythmic
4
Q
Adenosine actions
A
Decreases electrical conduction through the AV node
5
Q
Adenosine onset and duration
A
Immediate/10 seconds (Half life)
6
Q
Adenosine indications
A
Supraventricular Tachcardia, Wolff-Parkinson-White (WPW). May administer to Ventricular Tachycardia with pulse if it does not convert with Amiodarone administration (SVT with aberrancy)
7
Q
Adenosine Contraindications
A
Drug-Induced tachycardia, second or third-degree AV block, hypersensitivity, April Flutter, Atrial Fibrillation, VT (unless SVT with aberrancy), WPW with Atril Fibrillation or Atril Flutter.
8
Q
Adenosine Side effects
A
Facial flushing, light-headedness, parenthesia, headache, diaphoresis, palpitations, chest pain, flushing, feeling of impending death or passing out, hypotension, shortness of breath; tra spent periods of bradycardia, sinus pause, asystole; ventricular ectopy, nausea, metallic taste. These side effects are usually limited die to short half-life of this drug (less than 10 seconds).
9
Q
Adenosine route
A
Rapid IV push- Followed by a 10-20 mL saline flush
10
Q
Adenosine dose adult
A
6mg rapid IV push, given over 1-3 seconds. May repeat within 1-2 minutes at 12 mg if needed.
11
Q
Adenosine dose peds
A
0.1mg/kg (max 6mg) rapid IV and IO followed by a 5-10mL saline flush. May repeat within 2 minutes at 0.2 mg/kg (max 12 mg).
12
Q
Adenosine supplied
A
3mg/mL in 2ml vials; prefilled syringes.
13
Q
Adenosine special considerations
A
Preg cat: C
A brief period of asystole (10-15 seconds) may occur following conversion. Pts taking theophylline or caffeine may require larger doses. Have pts on a monitor and assure IV line is patent. Administer Adenosine through the IV port closest to the patient followed by a rapid saline flush of 10-20mL. Begin recording the EKG before administration of Adenosine.
14
Q
Amiodrane trade name
A
Cordarone
15
Q
Amiodrane generic name
A
Amiodraone HCI
16
Q
Amiodrane classification
A
Class 3 A tidysrhythmic
17
Q
Amiodrane actions
A
Amiodrane blocks sodium, potassium, and calcium channels of the cardiac conduction cycle that slows conduction and prolongs the refractoriness of the heart.
18
Q
Amiodrane onset and duration
A
Within minutes and variables.
19
Q
Amiodrane indications
A
Ventricular Fibrillation and pulsless Ventricular Tachycardia, V tach with a pulse and some atrial dysrrythmias.
20
Q
Amiodrane contraindications
A
None in pulseless cardiac events.
Pts with predisposing hx of bradycardia or AV node blocks. Hypotension, hyperkalemia, cardiogenic shock.
21
Q
Amiodrane side effects
A
Hypotension, prolonged QT intrrval, dizziness,Bradycardia, AV conduction abnormalities, cardiac arrest, torsades de pointes,, heart failure.
22
Q
Amiodrane route
A
IVP, IV INFUSION, IO
23
Q
Amiodrane dose
A
For V-Fib and pulsless V-Tach:
300mg IV, IO. Repeat 150mg IV, IO undiluted.
Stable V-Tach with a pulse:
150mg over 10 minutes (15mg/min)
Max cumulative dose of 2.2g in 34 Hrs.
24
Q
Amiodrane dose peds
A
Refractory V-Fib and pulsless V-Tach:
5mg/kg IV or IO bolus. Can be repeated to a total of 15mg/kg. Max single.dose 300mg.
Perusing SVT and Ventricular dysrythmias:
5mg/kg IV or IO over 20-60 minutes.
Max cumulative dose of 2.2g in 24 hrs.
25
Amiodrane supplied
150mg/3mL amplues (50mg/mL)
26
Amiodrane special considerations
Preg cat: D
Rapid infusing may cause hypotension. Continue ECG monitoring always. Slow infusion or DC if bradycardia or AV block occurs. Do not give with other drugs that prolong QT interval
(Procainamide)
27
Atropine Sulfate Generic name and trade name
Atropine Sulfate and no trade name
28
Atropine Sulfate Classification
Parasympatholytic, Anticholinergic
29
Atropine Sulfate Actions
Atropine blocks the action of acetylcholine (Ach) at the
neuromuscular junction of the parasympathetic nervous
system that increases the conduction through the SA and AV
nodes of the heart. With organophosphate poisoning,
atropine completes for postsynaptic receptors at
neuromuscular and neuro-glandular junctions that block the
action of the poison.
30
Atropine Sulfate Onset and duration
Rapid/2-6 hours
31
Atropine Sulfate Indications
Symptomatic bradycardias induced by increased vagal tone
including sinus bradycardia, 1st, 2nd, and 3rd degree AV heart
blocks, prolonged sinus block and organophosphate
poisoning.
32
Atropine Sulfate Contraindications
Hypertension, tachycardia. Not likely to be effective in 2nd
| degree Type II heart blocks or 3rd degree heart blocks.
33
Atropine Sulfate Side effects
Paradoxical bradycardias may occur if less than 0.5 mg is
given or if given too slowly. Pupil dilation, dry mouth,
blurred vision, tachycardia arrhythmias.
34
Atropine Sulfate Route
Rapid IV, Endotracheal, Rapid IO
35
Atropine Sulfate Dose
Bradycardias/Heart Blocks:
IV/IO: 0.5 mg initial dose, may repeat at 0.5 mg every 3-5
minutes up to a total of 3 mg.
Organophosphate Poisoning:
IV: 1-2 mg every 5-15 minutes until Atropine effects are
observed; then every 1-4 hours for 24 hours.
36
Atropine Sulfate Supplied
Prefilled syringes containing 1 mg/10 ml, 0.5 mg/5 ml,
| ampules of 1 mg/ml
37
Atropine Sulfate Special Con.
Pregnancy Category: C
Atropine dilated pupils, rendering them nonreactive.
Atropine is not effective in heart transplant patients.
38
Calcium Chloride Generic Name
Calcium Chloride
39
Calcium Chloride Class
Electrolyte
40
Calcium Chloride Actions
Essential component for the functional integrity of the
nervous and muscular systems, for normal cardiac
contractility, and for the coagulation of blood.
41
Calcium Chloride onset and duration
5-15 minutes / Dose-dependent (effects may persist for 4
| hours after IV administration)
42
Calcium Chloride Indications
Hyperkalemia, hypocalcemia, calcium channel blocker
| toxicity (overdose), hypermagnesemia
43
Calcium Chloride Contraindications
VF during cardiac resuscitation, digitalis toxicity (Digoxin),
hypercalcemia
44
Calcium Chloride Side effects
Bradycardia, hypotension, metallic taste, severe local
| necrosis and sloughing following IM use or IV infiltration.
45
Calcium Chloride site
IV/IO
46
Calcium Chloride route
500-1,000mg (5-10mL of a 10% solution)
47
Calcium Chloride supplied
10% solution in 10mL (100mg/mL) ampules, vials, and
| prefilled syringes
48
Calcium Chloride special considerations
Pregnancy Category: C
May produce vasospasm in coronary and cerebral arteries.
Do not use routinely in cardiac arrest.
Hypertension and bradycardia may occur with rapid
administration.
49
Diltiazem Trade name
Cardizem
50
Diltiazem Generic name
Diltiazem
51
Diltiazem Class
Calcium Channel Blocker
52
Diltiazem Actions
Slows conduction and increase the refractory period of the
AV Node. Controls ventricular response rate in atrial
fibrillation and atrial flutter.
53
Diltiazem onset and durration
2-5 minutes / 1-3 hours
54
Diltiazem Indications
Control ventricular rate in atrial fibrillation and atrial flutter.
Paroxysmal SVT.
55
Diltiazem Contraindications
Wide complex tachycardia of uncertain origin, Sick Sinus
Syndrome, AV Block, Wolff Parkinson White (WPW),
Hypotension (SBP <90mmHg), Cardiogenic Shock
56
Diltiazem Side effects
Decreased myocardial contractility, hypotension,
bradycardia, heart failure, chest pain, syncope,
nausea/vomiting, dyspnea, headache
57
Diltiazem Route
IVP
58
Diltiazem Dose
0.25mg/kg (15-20mg for average patient) IV over 2 minutes.
May repeat in 15 minutes at 0.35mg/kg (20-25mg for
average patient) IV over 2 minutes
59
Diltiazem Supplied
25mg (5mL vial) or 50mg (10mL vial)
60
Diltiazem Special Con
Pregnancy Category: C
Use caution in patients taking oral beta blockers.
Premature ventricular contractions may be present on
conversion of paroxysmal SVT.
Shelf life at room temperature is one month.
61
Epinephrine 1mg/ 10mL Trade Name
Adrenalin
62
Epinephrine 1mg/ 10mL Generic Name
Epinephrine
63
Epinephrine 1mg/ 10mL Classification
Endogenous catecholamine, sympathomimetic
64
Epinephrine 1mg/ 10mL Actions
Epinephrine contains both alpha and beta properties. Because
of these properties, epinephrine will increase the following:
heart rate, peripheral vascular resistance (PVR), myocardial
oxygen consumption, blood pressure and automaticity of the
heart.
65
Epinephrine 1mg/ 10mL Onset and duration
IV/ET: 1-2 minutes
66
Epinephrine 1mg/ 10mL Indications
Cardiac arrest, pulseless electrical activity (PEA), VF and
pulseless VT unresponsive to initial defibrillation,
symptomatic bradycardia, severe hypotension accompanied
by bradycardia when atropine and pacing fail, bronchial
asthma.
67
Epinephrine 1mg/ 10mL Contraindications
Hypersensitivity, hypovolemic shock (correct hypovolemia
| first), dilated cardiomyopathy
68
Epinephrine 1mg/ 10mL Side effects
Tachycardia, headache, nausea and vomiting, restlessness,
weakness, dysrhythmias, hypertension, precipitation of
angina pectoris
69
Epinephrine 1mg/ 10mL Route
IV, IO
70
Epinephrine 1mg/ 10mL Dose
Pulseless Arrest: 1 mg IV push repeated every 3-5 minutes, no
maximum dose.
ET: 2-2.5mg, every 3-5 minutes
Bradycardia: 2-10mcg/minute infusion; titrate to patient
response
71
Epinephrine 1mg/ 10mL Supplied
1 mg/10 ml, prefilled syringes
72
Epinephrine 1mg/ 10mL Special Con
Pregnancy Category: C
Do not use prefilled syringes for epinephrine infusions.
Syncope has occurred following epinephrine administration
to asthmatic children.
Epinephrine may increase myocardial oxygen demand
Epinephrine is safe for anaphylaxis when given at the correct
dose by IM injection.
Like other catecholamines, epinephrine should not be given
or mixed with sodium bicarbonate because it will be
deactivated. Epinephrine is light sensitive. IV, IO doses
should be followed by 20 ml saline flush.
73
Furosemide Trade
Lasix
74
Furosemide Generic
Furosemide
75
Furosemide Class
Loop diuretic
76
Furosemide Actions
Potent diuretic that inhibits the reabsorption of sodium and
| chloride in the proximal tubule and loop of Henle.
77
Furosemide Onset
15-20 minutes / 2 hours
78
Furosemide Indications
Acute pulmonary edema, hypertensive emergencies,
| hyperkalemia
79
Furosemide Contraindications
Anuria, hypersensitivity, hypovolemia/dehydration,
| hypokalemia
80
Furosemide Side effects
Hypotension, dry mouth, hypokalemia, hyponatremia,
| hypocalcemia, hyperglycemia
81
Furosemide Route
IV
82
Furosemide Dose
0.5-1mg/kg over 1-2 minutes (or 20-40 mg)
83
Furosemide Supplied
10mg/mL in 2, 4, or 8mL ampules
| 10mg/mL in 10mL vial
84
Furosemide Special Con
Pregnancy Category: C
85
Heparin Trade no generic name
Heparin
86
Heparin Class
Anticoagulant
87
Heparin Actions
Inhibits the clotting cascade by activating thrombin and
| activated X factor. Prevents clot extension and reformation.
88
Heparin Onset
Immediate / Approximately 12 hours
89
Heparin Indications
Acute MI, STEMI
90
Heparin Contraindications
Active bleeding; recent intracranial, intraspinal, or eye
surgery; severe hypertension; bleeding tendencies; severe
thrombocytopenia
91
Heparin Side effects
```
Allergic reaction (chills, fever, back pain);
Thrombocytopenia; hemorrhage, bruising, rash
```
92
Heparin Route
: IV/IO
93
Heparin Dose
STEMI:
<75 years old: Initial dose 30mg IV; 2nd dose 15 minutes late
of 1mg/kg SQ. Max of 100mg for first 2 doses
>75 years old: No initial IV bolus; 0.75mg/kg SQ q 15
minutes. Max 75mg dose for first dose
94
Heparin Supplied
Dilute 1mg of powdered medication in 1mL of normal saline
| or sterile water for injection.
95
Heparin Special Con
Pregnancy Category: C
Monitor patient for bleeding.
Active pathologic bleeding may occur (peptic ulcer)
Use with caution in patients with liver disease.
Use with caution following major surgery; can cause fatal
bleeding
96
Labetalol Trade no Generic name
Labetalol
97
Labetalol Class
Vasodilator, alpha and beta adrenergic blocker
98
Labetalol Actions
Reduces blood pressure by decreasing peripheral vascular
| resistance.
99
Labetalol Onset
Within 5 minutes; peaks in 15 minutes / Duration up to 18
| hours
100
Labetalol Indications
Hypertensive emergencies
101
Labetalol Contraindications:
Hemodynamically unstable patients, bradycardia,
hypotension, heart block greater than first degree, asthma,
sick sinus syndrome, heart failure
102
Labetalol Side effects
Hypotension, bradycardia, dizziness, fatigue, arrhythmias
103
Labetalol Route
: IV, IO
104
Labetalol Dose
10-20mg slow IV over 2 minutes, first bolus. May repeat or
| double dose q 10 minutes to max dose of 200mg
105
Labetalol Supplied
20mg/4mL vial
106
Labetalol Special Con
Pregnancy Category: C
Monitor blood pressure, pulse rate and ECG continuously.
Administer only with patient in supine position.
Reduce BP to 185 systolic or 110 diastolic but never greater
than 20% from baseline.
May worsen CNS depression in patients with myasthenia
gravis, psoriasis, or psychiatric illness.
107
Lidocaine Trade
Xylocaine
108
Lidocaine Generic
Lidocaine
109
Lidocaine Class
Antiarrhythmic, local anesthetic
110
Lidocaine Actions
Decreases ventricular ectopy by suppressing spontaneous
depolarization of ventricular pacemaker cells and raises
fibrillation threshold level.
111
Lidocaine Onset
45-90 seconds/10-20 minutes
112
Lidocaine Indications
Cardiac arrest from pulseless Ventricular Tachycardia or
Ventricular Fibrillation, more than 6 PVC’s a minute,
multifocal PVC’s, coupled or paired PVC’s, runs of two or
more PVC’s
113
Lidocaine Contraindications:
Third degree heart blocks, idioventricular rhythms, sinus
| bradycardia with escape PVC’s
114
Lidocaine Side effects
Light-headedness, confusion, blurred vision, hypotension,
| bradycardia, seizures, altered LOC
115
Lidocaine Route
: IV, IO, IV infusion, Endotracheal
116
Lidocaine Dose
Pulseless VT or VF: 1-1.5 mg/kg IV.
Refractory VT or VF: Repeat 0.50-0.75 mg/kg every 5-10 min.
Max cumulative dose 3mg/kg.
ETT: 2 times the IV dose
PVC’s or VT with a pulse: 0.5-0.75 mg/kg (up to 1-1.5 mg/kg)
IV repeated at 0.75 mg/kg IV every 5 to 10 minutes up to total
of 3 mg/Kg.
Maintenance Infusion: 4 mg/min. (Give half of this for patients
with an acute MI, CHF, shock, age greater than 70, or those
with hepatic dysfunction).
117
Lidocaine Supplied
100 mg/5 mL (20 mg/mL) in prefilled syringes and 1 or 2
grams/20 mL prefilled syringes and ampules for adult
infusion preparation.
1g in 250mL normal saline bag or 2g in 500mL normal saline
bag for infusions. Both equal concentration of 4mg/mL.
118
Lidocaine Special Cons
Pregnancy Category: B
All IV, IO doses should be followed by a 20mL fluid bolus.
Treat Lidocaine toxic seizures with Valium.
If bradycardia occurs along with PVC’s, always treat the
bradycardia first with atropine.
119
Magnesium Sulfate Generic name no trade name
Magnesium Sulfate
120
Magnesium Sulfate Class
Anticonvulsant; Electrolyte
121
Magnesium Sulfate Actions
CNS depressant, anticonvulsant, and elevates magnesium
levels. Reduces striated muscle contractions and blocks
peripheral neuromuscular transmission by reducing
acetylcholine release at the myoneural junction.
122
Magnesium Sulfate Route
IV: Immediate, IM: 3-4 hours / IV: 30 minutes, IM 3-4
| hours
123
Magnesium Sulfate Indications
Seizures of eclampsia (toxemia of pregnancy), known
| hypomagnesemia, Torsades de Pointes, Asthma.
124
Magnesium Sulfate Contraindications:
Heart blocks or recent MI, hypotension, patients on digitalis
or other cardiac glycoside, respiratory depression,
hypermagnesemia or hypercalcemia
125
Magnesium Sulfate Side effects
Hypotension, respiratory and neurologic depression,
hypermagnesemia, heart blocks, facial flushing, diaphoresis,
bradycardia
126
Magnesium Sulfate Route
IM, IVP, IV infusion
127
Magnesium Sulfate Dose
Eclampsia: 4 grams diluted in 100mL normal saline given slow
IV push or infusion (15-20 minutes).
Torsades de Pointes: 1-2 grams diluted in 10mL slow IV push.
128
Magnesium Sulfate Supplied
500mg/mL in 10mL vials
129
Magnesium Sulfate Special con
Pregnancy Category: A
Calcium chloride should be readily available as antidote for
respiratory depression.
Do not mix Magnesium with Sodium Bicarbonate
130
Ticagrelor Trade
Brilinta
131
Ticagrelor Generic name
Ticagrelor
132
Ticagrelor Class
Antiplatelet
133
Ticagrelor Actions
Platelet inhibitor that reduces the rate of thrombotic events
in acute coronary syndrome and STEMI patients.
134
Ticagrelor onset
< 30 minutes / 1-2 days
135
Ticagrelor Indications
STEMI patients
136
Ticagrelor Contraindications:
Stroke, GI bleed, trauma, intracranial hemorrhage.
137
Ticagrelor Side effects
Bleeding, difficulty breathing
138
Ticagrelor Route
PO
139
Ticagrelor Dose
180mg (two 90mg tablets)
140
Ticagrelor Supplied
90mg tablets
141
Ticagrelor Special Con
Pregnancy Category: C
Use within caution in patients who are also taking other
antiplatelet medications such as coumadin, aspirin, xarelto
