Code drugs Flashcards
What drug is given for SVT? What do we do first?
Adenosine, get the pt to bear down first triggering the vagus nerve
What should you warn your patient about with Adenosine
they’re gonna feel like SHIT, their heart is stopping and restarting
What is the chemical cardioversion drug?
Adenosine
When can I not give adenosine?
For anything that’s not SVT- no heart blocks
Side effects of adenosine?
Chest pain, flushing, brief asystole or bradycardia, ventricular ectopy
Adenosine administration?
6mg IVP bolus over 1-3 seconds followed by a 20ml flush then elevate the extremity.
2nd dose of 12mg can be given in 1-2 mins if needed.
PUT IN A LARGE BORE IV AT THE AC OR HIGHER!!!!
Can give in pregnancy because its in and out of the body quick
Amiodarone: Why do we give it? (what dysrhythmia)?
VF, VT unresponsive to shock/cpr/prressors, recurrent hemodynamically unstable VT
Amiodarone: Whats a major adverse effect? What should the nurse monitor?
- POTENTIATES ARRHYTHMIAS, nurse should monitor for Torsades
- BB warning for Pulmonary and liver toxicities (monitor PFTs and liver enzymes)
- Do not give with other drugs that prolong QT interval (torsades risk)
Amiodarone: How does it work?
Decreases the defib threshold, making the body respond easier to the shock (shock is more effective)
Admiodarone: dosage
1st dose: 300 mg IV push 2nd dose: 150 mg IVP (if needed) always hang on a pump Max dose: 2.2g/24hrs Rapid infusion: 150mg IVPB/10mins (can repeat every 10 mins) Slow infusion: 360 mg/6hrs (1mg/min) Maintenance infusion:540mg/18hrs Change rate after 6 hours!!
Atropine: When do we give it?
Symptomatic (dizziness, hypotension, syncope, diaphoretic) sinus brady 1st line drug, also for organophosphate poisoning in extremely high doses
Atropine:
- How does it work?
- When should we not give it?
- Whats a quick way to remember when to not give?
- anticholinergic drug that blocks the action of the vagus nerve (want HR faster)
- Not for 2nd degree type 2 and 3rd degree heart blocks. Consider epi/dope and external pacing. WONT WORK ON HEART TRANSPLANT PTS (no vagus nerve)
- ” no p waves= dont give the drug with a P in it”
Atropine:
- When should I not give it? Why?
- What happens if the dose is below 0.5 mg?
- Use cautiously in MI/hypoxia (increases myocardial o2 demand), avoid in hyperthermic bradycardia (Slowly warm pt)
- May result in paradoxical slowing of the HR, this is why we never want a dosage below 0.5 mg
Atropine:
- Dosage
- What should we do if atropine administration doesn’t help the bradycardia?
- 0.5mg IV every 3-5 mins as needed. Don’t exceed the total dose of 0.04mg/kg (total 3mg)
- Consider pacing or epi/dope
Dopamine:
- Why do we give it?
- Whats the major side effect?
- 2nd line for symptomatic brady
- use for hypotension (SBP <70) with sxs of shock - Causes tachyarrhythmias while increasing BP and contractility