Cardiac Medications

Question 1

Mechanism of action.

Adenosine

Answer 1

Slows conduction through AV node and interrupts re-entrant pathways.

Question 2

Indication:

Adenosine

Answer 2

SVT

Question 3

Adult and pediatric dosage.

Adenosine

Answer 3

• Adult: 6 mg, 12 mg fast IVP
• Pediatric: 0.1mg/kg, 0.2mg/kg

Question 4

Mechanism of action.

Amiodarone

Answer 4

Inhibits Na(+) and K+ channels and delays repolarization.

Question 5

Indication:

Amiodarone

Answer 5

• V-Fib
• V-Tach

Question 6

Adult and pediatric dosage.

Amiodarone

Answer 6

Adult:

• V-tach w/ Pulse: 150mg/10; Infusion 1mg/min w/ conversion
• Pulseless V-tach/V-fib: 300mg, 150mg

Pediatric:

• V-tach w/ Pulse: 5mg/kg/20-60min
• Pulseless V-tach/V-fib: 5mg/kg MAX 300mg; MAX total 15mg/kg

Question 7

Mechanism of action.

Aspirin

Answer 7

Antiaggregate

It stops platelets from clumping together

Question 8

Indication:

Aspirin

Answer 8

chest pain/STEMI

Question 9

Adult and pediatric dosage.

Aspirin

Answer 9

• Adult: 160-325 mg PO
• Pediatric: N/A

Question 10

Mechanism of action.

Atropine

Answer 10

Acetylcholine antagonist

Question 11

Indication:

Atropine

Answer 11

• Bradycardia
• Pediatric RSI
• Organophosphate poisoning

Question 12

Adult and pediatric dosage.

Atropine

Answer 12

• Adult: 1mg Q 3-5 min
• Pediatric: 0.02 mg/kg

Question 13

Mechanism of action.

Calcium Chloride

Answer 13

Increases cardiac contraction.

Inotropic effect

Question 14

Indication:

Calcium Chloride

Answer 14

• Hyperkalemia
• Hypocalcemia
• Calcium channel blocker/beta blocker toxicity

Question 15

Adult and pediatric dosage.

Calcium Chloride

Answer 15

Adult: Hyperkalemia & Toxicity: 500-1000mg

Pediatric: Hyperkalemia & Toxicity: 20mg/kg MAX 1G

Question 16

Mechanism of action.

Diltiazem

Answer 16

calcium channel blocker

Blocks calcium influx during depolarization.

Question 17

Indication:

Diltiazem

Answer 17

Atrial Fibrillation/Flutter

Question 18

Adult and pediatric dosage.

Diltiazem

Answer 18

Adult: 0.25mg/kg; 0.35mg/kg MAX 20mg, 25mg; Infusion: 5-15mg/hr

Pediatric: N/A

Question 19

Mechanism of action.

Dobutamine

Answer 19

Increases myocardial contractility, stroke volume, and cardiac output.

Question 20

Indication:

Dobutamine

Answer 20

Cardiogenic shock, CHF

Question 21

Adult and pediatric dosage.

Dobutamine

Answer 21

Adult & Pediatric: 2-20 mcg/kg/min

Question 22

Mechanism of action:

Dopamine

Answer 22

Increases inotropic and chronotropic effects.

Question 23

Indication:

Dopamine

Answer 23

• Cardiogenic shock
• Septic shock
• Distributive shock
• Bradycardia

Question 24

Adult and pediatric dosage.

Dopamine

Answer 24

Adult & Pediatric: 2-20 mcg/kg/min

Question 25

# Mechanism of action. Epinephrine

Answer 25

* Alpha-1 agonist * Beta-1 agonist * Beta-2 agonist

Question 26

# Indication: Epinephrine ## Footnote *Hint: Cardiac*

Answer 26

* Asystole * PEA * V-fib * Pulseless V-tach * Bradycardia

Question 27

# Adult and pediatric dosage. Epinephrine ## Footnote Hint: cardiac

Answer 27

**Adult**: * Asystole/PEA/Pulseless V-Tach/V-Fib: 1 mg IV/IO * Bradycardia/Hypotension: 2-10 mcg/min **Pediatric**: * Asystole/PEA/Pulseless V-tach/V-Fib: 0.01 mg/kg IV/IO * Bradycardia: 0.01 mg/kg IV/IO * Infusion: 0.1 - 1 mcg/min

Question 28

# Mechanism of action. Furosemide

Answer 28

**Inhibits absorption of chloride and sodium** at proximal and distal tubules and loop of Henle. ## Footnote It can cause an increase in urine output.

Question 29

# Indication: Furosemide

Answer 29

* CHF * Pulmonary edema * Hypertensive crisis

Question 30

# Adult and pediatric dosage. Furosemide

Answer 30

**Adult**: 0.5 - 1 mg/kg; if no response, double the dose **Pediatric**: 1 mg/kg

Question 31

# Mechanism of action. Labetalol

Answer 31

**Alpha and beta antagonist**, it decreases blood pressure.

Question 32

# Indication: Labetalol

Answer 32

It is used for managing moderate to severe **hypertension**.

Question 33

# Adult and pediatric dosage. Labetalol

Answer 33

**Adult**: 10mg IV; repeat or double Q 10min; Infusion: 2-8 mg/min **Pediatric**: N/A

Question 34

# Mechanism of action. Lidocaine

Answer 34

**Sodium channel blocker**; decreases automaticity.

Question 35

# Indication: Lidocaine

Answer 35

* V-Tach * V-Fib

Question 36

# Adult and pediatric dosage. Lidocaine

Answer 36

**Adult**: * Pulseless V-tach/V-Fib: 1-1.5 mg/kg; repeat .5-.75 mg, MAX 3 mg/kg * Stable V-Tach: 1-1.5 mg/kg; repeat .5-.75 mg/kg Q 5-10min, MAX 3mg/kg * Infusion: 1-4 mg/min **Pediatric**: * Pulseless V-tach/V-Fib: 1 mg/kg, MAX 100mg * Infusion: 20-50 mcg/kg/min

Question 37

# Mechanism of action. Metoprolol

Answer 37

Decreases HR, conduction, contractility, and cardiac output. ## Footnote Selective Beta-1 agonist

Question 38

# Indication: Metoprolol

Answer 38

* PSVT * A-Flutter * A-Fib * Reduces oxygen demand in STEMI patients

Question 39

# Adult and pediatric dosage. Metoprolol

Answer 39

**Adult**: STEMI: 2-4mg NSTEMI/Unstable Angina: 1-5mg **Pediatric**: 0.1 - 0.2 mg/kg, MAX 5mg

Question 40

# Mechanism of action. Nitroglycerine

Answer 40

* Dilates peripheral arteries * Decreases preload and afterload * Vasodilator

Question 41

# Indication: Nitroglycerine

Answer 41

* Acute angina * NSTEMI * STEMI * CHF * Pulmonary edema * Hypertension

Question 42

# Adult and pediatric dosage. Nitroglycerine

Answer 42

**Adult**: * Tablet: 0.4 mg * Spray: 1-2 sprays, MAX 3 sprays * Infusion: 10 mcg/min; increase by 10 mcg/min Q 3-5 min, MAX 200 mcg/min **Pediatric**: N/A

Question 43

# Mechanism of action. Norepinephrine

Answer 43

* Vasopressor * **Alpha and beta agonist** causing peripheral vasoconstriction. ## Footnote Positive inotropic effect and dilates coronary arteries.

Question 44

# Indication: Norepinephrine ## Footnote Hint: cardiac

Answer 44

* cardiogenic shock * significant hypotension

Question 45

# Adult and pediatric dosage. Norepinephrine

Answer 45

**Adult**: 0.1-0.5 mcg/kg/min **Pediatric**: 0.1-0.2 mcg/kg/min

Question 46

# Adult and pediatric dosage. Nitropaste

Answer 46

**Adult**: ½'' to ¾'' (15-30mcg); cover with wrap and secure, MAX 5'' (75mg) **Pediatric**: N/A