Cardiac Drugs

Question 1

Adenosine - Class, Use, Dosage

Answer 1

Class - Anti-Arrythmic
Use - SVT/PSVT associated with WPW
Dose - 12mg RIVP followed by 20 MG RIVP

Question 2

Contraindications of Adenosine

Answer 2

Known Hypersensitivity, 
Pre-existing 2nd/3rd degree block
Symptomatic Bradycardia
Afib/Aflutter
Severe Asthma or Active Bronchospasm
Pt taking carbamazepine or dypyridamole

Question 3

Amiodarone - Class, Use, Dosage

Answer 3

Class - Anti-Arrhythmic
Use - V -fib / pulseless v-tach arrest with prolonged resus
Dosage - 300mg IV/IO diluted in 20ml D5W
(repeat)150mg q5 to a total of 450mg

Question 4

Amiodarone - Contraindications

Answer 4

NONE WHEN USED IN AN EMERGENCY
Must be diluted prior to admin
Foaming may occur when drawing up/diluting

Question 5

Atropine - Class, Use, Dosage

Answer 5

Class - Anticholinergic
Use - Asystole/PEA less than 60, Symptomatic sinus Bradycardia or Symptomatic 2nd degree block

Dosage - (Asystole)1mg IV q 5 to a max of 3mg or 0.4mg/kg
(Sinus Brad - 2nd degree block) 0.5mg IV q 5 to max of 3mg

Question 6

Atropine - Contraindications

Answer 6

Hypersensitivity, or PEA greater then 60bpm

Question 7

Calcium Chloride - Class, Use, Dosage

Answer 7

Class - Antiarrhythmic

Use - Asystole/PEA in Hyperkalemic,hypocalcemia, or hypermagnesia

• Beta Blocker and Calcium Channel Blocker OD
• V-Fib/ Pulseless Vtach

Dosage-(Asystole/PEA)1g SIVP q10 to a max 2g

• (BB/CCB OD) 500mg IV in 50ml Saline over 10 mins q10 to max of 1000mg
• (Vfib/Pulseless Vtach)1g SIVP q10 to total 2g

Question 8

Calcium Chloride Contraindications

Answer 8

Hypersensitivity
Hypercalcemia
Pt with Dig Toxicity
Extravasation will cause necrosis

Question 9

Clopidogrel(Plavix) - Class, Use, Dose

Answer 9

Class - Antiplatelet
Use - VHR STEMI
Dose - As per VHR Doc

Question 10

Plavix Contraindications

Answer 10

Hypersensitivity
Active Bleed
Liver impairment or jaundice
Hx of Cirrhosis ETOh abuse
Suspected Aortic Dissection

Question 11

Dopamine - Class, Use, Dose

Answer 11

Class - Sympathomimetic
Use - BB/CCB OD, Bradycardia/Heart Block, General Shock Management
Dose - IV/IO 5mcg/kg/min, increase by 5mcg/kg/min to max of 20 mcg/kg/min(titrate to systolic BP of 90)

Question 12

Dopamine - Contraindications

Answer 12

Hypovolemic Shock
Pheochromocytoma
Uncorrected Tachycardia
V-Fib
MAOI therapy within 14 days

Question 13

Enoxaparin - Class, Use, Dose

Answer 13

Class - Anticoagulant
Use - VHR STEMI
Dose - As per VHR Doc

Question 14

Epinephrine (1:10 000) - Class, Use, Dose

Answer 14

Class - Sympathomimetic
Use - Anaphylaxis, Asystole, V-Fib, PEA, P Vtach
Dose - (Cardiac) 1mg IV/IO q 3-5min prn

Question 15

Epinephrine Contraindications

Answer 15

NONE in an Emergency

Question 16

Epinephrine Infusion - Use, Dose

Answer 16

Use - Beta Blocker/ Calcium Channel Blocker OD

Dose - IV/IO start at 2mcg/min, increased 1 mcg/min prn titrated to systolic of 90 and a mazimum of 10 mcg/min

Question 17

Glucagon - Class. Use, Dose

Answer 17

Class - Antihypoglycemic
Use - Anaphylaxis, Beta-Blocker/CCB OD, Hypoglycemia
Dose - (Cardiac) 2mg IV/IO q 5 to max of 4mg

Question 18

Metoprolol - Class, Use, Dose

Answer 18

Class - Beta-Blocker
Use - A-Fib/A-Flutter(Symptomatic - altered, CP, SOB)
Dose - With OLMC 5mg SIVP q5 to a total of 15mg or HR less than 110bpm

Question 19

Morphine - Class, Use, Dose

Answer 19

Class - Narcotic
Use - Pain Management, Headache, Flash Pulmonary Edema, Suspected ACS
Dose - (Cardiac) After 3 sprays Nitro, 2.5mg SIVP/IO q5 to max of 15mg