Cardiac Drug Card Flashcards
(67 cards)
1
Q
Class, effect and administration of dobutamine
A
Beta 1 agonist
Increases contractility and HR
Administered via peripheral line if no central line is available
2
Q
Class, effect and administration of Milrinone
A
- Phosphodiesterase inhibitor
- Increases cAMP to increase cardiac contractility, decrease PVR and decrease SVR/BP
- Administered via central line always
3
Q
Indications of milrinone
A
- Low EF/cardiac output
2. Pulmonary hypertension
4
Q
Class, effect and administration of epinephrine
A
- Alpha and beta agonist
- Increases contractility, HR and BP
- Central line if possible
5
Q
Class, effect and administration of dopamine
A
- Dopaminergic agonist, alpha and beta agonist
- Renal vasodilation, inc HR, inc BP
- Administered centrally always!!!
6
Q
Renal vasodilation dose for dopamine
A
2-5 mcg/kg/min
7
Q
Dopamine dose for inc HR
A
5-10 mcg/kg/min
8
Q
Dopamine dose for inc BP
A
> 10 mcg/kg/min
9
Q
Class, effects, administration of Levophed
A
- Alpha and beta agonist
- Powerful vasoconstriction on alpha receptors
- Inc contractility and HR
- Central line only!
10
Q
Dosing of levophed
A
- 4mg in 250 mL bag for 16 mcg/mL concentration infusion
- 10 mL syringe of 16 mcg/mL bolus, 0.25-1L mL (4-16 mcg) bolus
11
Q
Dosing of vasopressin
A
5 vials (100 units) into 100 mL bag for 1 unit/mL
12
Q
Administration of vasopressin
A
Central line
13
Q
Indications for calcium
A
- Treat hypocalemia (often due to massive blood transfusion)
- Inc cardiac contractility
14
Q
Difference between calcium chloride and calcium gluconate
A
- Calcium chloride should be given centrally, while calcium gluconate can be given peripherally
- Calcium gluconate is 1/3 as potent as calcium chloride
- Both should be given over 10 minutes
15
Q
Dose of potassium chloride through central line
A
20 mEq/hr
16
Q
Dose of potassium chloride through peripheral line
A
10 mEq/hr
17
Q
Effects of NTG
A
- Dec BP, short onset, short duration
- Dec myocardial O2 demand
- Inc myocardial O2 supply
- Inc pulmonary shunting
18
Q
Significance of Nipride
A
- More potent than NTG
- Emergency use only
- Sensitive to light, so use UV protective bag
19
Q
Calcium channel blocker that is a popular alternative to nitroglycerin
A
Cardene
20
Q
Dose of cardene bolus
A
5mg (2mL) placed into 8mL NS (0.5mg/mL concentration)
-0.5-1mL or 0.25-0.5mg bolus dose
21
Q
Dose of cardene infusion
A
25 mg vial into 250 mL saline (0.1 mg/mL)
infused at 5-15 mg/hr
22
Q
Insulin vial concentration
A
100 units/mL
23
Q
Insulin bolus tip
A
Use TB syringe
24
Q
Insulin infusion tip
A
add 1mL (100 units) to a 100 mL bag of NS
25
When are antiarrhythmics given?
1. Off pump CABGs prior to the surgeon lifting the heart
| 2. In CPB prior to cardioplegia washout
26
Tips for magnesium and amiodarone
Given slowly over 10 min
27
Amicar bolus dose
```
1 vial (20 mL, 5g) is drawn into 20 mL syringe
5 or 10g depending on site
```
28
Amicar infusion dose
```
2 vials (10 grams) into 500 mL LR
infusion run at 50 mL (1g)/hr
```
29
Purpose of DDAVP
Synthetic ADH
- treat diabetes insipidus
- certain coagulopathies during surgery
30
Mechanism of DDAVP
Stimulates clotting factor release (vWF) from vascular endothelium and increases factor VIII concentration
31
What can DDAVP stand for?
Deep down arterial venous pressure
32
Why must DDAVP be administered slowly?
Bc of its potential to cause hypotension
33
Concentration and infusion rate of dobutamine
- Premixed 1mg/mL (250mg/250 mL D5W)
| - 2-20 mcg/kg/min
34
Concentration, bolus dose and infusion rate of epi
- 16 mcg/mL (4mg in 250 mL bag)
- bolus 10-50 mcg, up to 1 mg in emergency
- infusion of 0.01-0.3 mcg/kg/min
35
Concentration, loading dose, bolus and infusion rate of milrinone (Primacor)
- 20 mg in 100mL D5W
- Loading 50mcg/kg
- Bolus 1-2 mg
- Infusion rate 0.375-0.75 mcg/kg/min
36
Concentration and bolus dose of calcium
100 mg/mL (10%)
| -250 mg-1g
37
Concentration and infusion rate of vasopressin
1 unit/mL (100 units in 100 mL bag)
| -1-6 units/hr
38
Concentration, bolus and infusion rate for norepi (levophed)
16 mcg/mL (4 mg in 250 mL bag)
- bolus 4-16 mcg
- infusion 0.02-0.2 mcg/kg/min
39
Concentration and infusion rate for phenylephrine
80 mcg/mL (20 mcg/250 mL)
| 10-100 mcg/min
40
Concentration, bolus dose and infusion rate for NTG
100 mcg/mL
- 10-100 mcg
- 0.1-2 mcg/kg/min initial and up to 5mcg/kg/min max
41
Nipride concentration, bolus dose and infusion rate
0. 2 mg/mL (50mg/250 mL bag)
- Half NTG dose for emergencies
- 0.1-2mcg/kg/min initial and up to 10 mcg/kg/min max
42
Cardene concentration, bolus and infusion rate
- 2.5 mg/mL in vial (0.5 mg/mL for bolus, 0.1 mg/mL infusion)
- 0.25-0.5mg (0.5-1mL)
- 5-15 mg/hr
43
Amiodarone concentration and bolus dose
- 50 mg/mL (3mL vial)
| - 150 mg over 10 min
44
Magnesium concentration and bolus
0.5 g/mL
| 1-2g over 10 min
45
Insulin concentration, bolus and infusion rate
1 unit/mL (100 units/100mL bag)
- sliding scale
- 2-6 units/hr titrated PRN
46
Dextrose concentration, loading dose, bolus
50% dextrose (500 mg/mL) 50 mL = 25g
- 25g (1 amp 50%) loading
- 0.5g/kg (1g raises BG 3-4 mg/dl)
47
Amicar concentration, loading dose, infusion rate
- 10g in 500 mL LR
- 5g liberty, 10g at MAHI
- 1g/hr, continue 4hrs in ICU
48
Desmopressin (DDAVP) concentration, infusion rate
- 4 mcg/mL
| - 0.3 mcg/kg in 50 mL NS over 20 min
49
Alternative to double lumen tube
Bronchial blocker
50
How many ports does a bronchial blocker have?
4
51
What is the bottom port of a bronchial blocker for?
The ETT
52
What is the side port of a bronchial blocker for?
Connection of the ventilation circuit
53
What is the top port of a bronchial blocker for?
Fiberoptic bronchoscope
54
What is the angled side port of a bronchial blocker for?
The actual bronchial blocker itself
55
What is another method for placement of a bronchial blocker?
A univent ETT
56
Lumen of the univent ETT for the bronchial blocker
Anterior
57
What is the posterior lumen of the univent ETT used for?
Ventilation and the fiberoptic bronchioscope
58
Disadvantage to univent ETT
You cannot ventilate the pt until the scope is removed
59
Which direction do you turn the bronchial blocker to block the R lung?
Clockwise
60
The name of the blue lumen of a double lumen tube that sits in the bronchus
Bronchial lumen
61
The name of the clear lumen of a double lumen tube that sits in the trachea
Tracheal lumen
62
What are most double lumen tubes?
L double lumen tubes where the bronchial is designed to sit in the L mainstem
63
Why shouldn't you use a L double lumen tube for a R mainstem ventilation of the bronchial lumen?
The R lung has an upper lobe that wouldn't be ventilated well by the L double lumen tube
64
Where does the stylet go in a DLT?
In the bronchial lumen
65
If the L DLT is placed and the bronchial lumen is clamped, where should you hear breath sounds?
On the R side
66
If a L DLT is placed and the tracheal lumen is clamped, where should you hear breath sounds?
On the L side
67
What is the size of the central line cordis?
8.5 F
