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Drips Flashcards

1
Q

Heparin Mechanism of action and classification?

A

Classification: Anticoagulant
Mechanism of Action: reversibly binds to and activates antithrombin III (ATIII), resulting in the inactivation of Factor IIa (thrombin) and Factor Xa.

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2
Q

Heparin half-life?

A

1.5hrs

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3
Q

Heparin route and onset?

A

IV: immediate
Sub-Q: 20-60 mins

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4
Q

What lab is needed prior to the administration of subq heparin and what is the normal value?

A

Platelet
Norm: 150-450K

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5
Q

What is HIT and when does it occur?

A
  • An immune mediated response where clots begin to form within blood vessels using available platelets
  • Usually 4-12 days after start of heparin therapy
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6
Q

Nicardipine brand name?

A

Cardene

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7
Q

Cardene class and MOA?

A

Classification: CCB (anti-hypertensive)
Mechanism of Action: inhibits the influx of extracellular calcium across the myocardial and vascular smooth muscle cell membranes.

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8
Q

Nicardipine:
Onset, duration and half-life?

A

Onset: 10 mins
Duration: < 8hrs
Half-Life: 2-4 hrs

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9
Q

Cardene AE?

A

low BP
reflex tachycardia
HA
N/V

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10
Q

Nicardipine contra-indications?

A
  • Low bp and EF < 55%
  • Liver disease (drug is metabolized by the liver)
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11
Q

Cardene dose range?

A

5-15 mg/hr

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12
Q

Diltiazem brandname?

A

Cardizem

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13
Q

Cardizem class and MOA?

A

Classification: CCB (anti-hypertensive)
Mechanism of Action: inhibits the influx of extracellular calcium across the myocardial and vascular smooth muscle cell membranes.

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14
Q

Diltiazem:
Onset, duration and half-life?

A

Onset: 3 min
Duration:
- Bolus: 1-3 hrs
- Continuous: 0.5-10 hrs
Half-Life: 3-5 hrs

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15
Q

Indications of IV Diltiazem?

A

ventricular rate control in A-Fib/Flutter, conversion of SVT

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16
Q

Indications of oral Diltiazem?

A

HTN, spasm prevention during radial artery graft harvesting, migraines, angina

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17
Q

Cardizem dosing?

A

Initial bolus: 0.25mg/kg over 2 mins
Infusion Rate: 5-15 mg/hr

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18
Q

Dobutamine brandname?

A

Dobutrex

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19
Q

Dobutrex class and MOA?

A

Classification: Direct Beta 1 agonist
MOA: increase cardiac contractility and stroke volume, mild positive chronotropic effects (↑HR)

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20
Q

Dobutamine:
onset, peak, duration, and half-life

A

Onset: 1-10 min
Peaks:10-20 min
Duration: minutes
Half-Life: 2 min

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21
Q

Dobutrex dose range?

A

2.5-20- mcg/kg/min

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22
Q

Dobutamine AE?

A

Tachycardia, H/A, tremors, anxiety ventricular arrythmias, hypokalemia, can trigger A-Fib

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23
Q

Dopamine class and MOA?

A
  • Classification: A1 & B1 Agonist
  • MOA: has positive inotropic and chronotropic effects
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24
Q

Dopamine indications?

A
  • HF
  • shock after fluid replacement fails
  • renal failure
  • low CO when SVR is low and BP is marginal
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25
Dopamine AE?
H/A, HTN, angina, tachycardia, ectopy, myocardial ischemia, > increased of arrhythmias at moderate dose, tissue necrosis can occur with extravasation
26
Dopamine low dose range and effect?
- 0.5-3 mcg/kg/mL (low dose) - dilation of afferent/efferent renal arterioles (increased blood flow and UO)
27
Dopamine mod dose range and effect?
- 3-10 mcg/kg/min, - increased renal flow and CO, contractility and HR (primarily B1 = pos inotropic effect)
28
Dopamine high dose range and effect?
- > 10 mcg/kg/min - inc renal flow, peripheral vasoconstriction & pos inotropic effects
29
Epinephrine dose range?
0.02-3 mcg/kg/min
30
Epinephrine concentration(s)?
4, 8, 16mg/250mL D5W (1:1,000)
31
Dopamine: onset, duration and half-life?
Onset: 5 min Duration: <10 min Half-Life: 2 min
32
Epinephrine: onset, duration and half-life?
Onset: immediate Duration: 5-10 mins Half-Life: 2 mins
33
Esmolol brandname?
Brevibloc
34
Esmolol class and MOA?
- Class: Mostly B1, B2 at high doses & Type II Anti-arrhythmic
35
Esmolol dose range?
50-200 mcg/kg/min
36
Esmolol: onset, duration and half-life?
Onset: 2-10 min Duration: 10-30 min Half-Life: 9 min
37
Esmolol indications?
HTN, Sinus tachy, SVT, Afib, A-Flutter
38
Esmolol Contra-Indication?
- cardiogenic shock - pulmonary HTN - IV admin of CCB - uncompensated HF - 2nd/3rd degree heart block (except if Pt has a PM)
39
Fentanyl brandname?
Sublimaze
40
Fentanyl MOA?
opioid that inhibits ascending pain pathways, increasing the pain threshold
41
Fentanyl: onset, duration and half-life?
Onset: immediate Duration: 30-60 min Half-Life: 2-4 hrs
42
Fentanyl Dose Range:
200 mcg/kg/min (max)
43
Fentanyl Contraindication?
(caution)↓HR or respiration, renal/hepatic/resp disease, head injuries, altered LOC increased ICP, MAOI use within 14days, elderly
44
Fentanyl AE?
- drowsy, N/V Rare – confusion, blurred vision, chills orthostatic ↓BP, constipation - risk for paralytic ileus
45
Labetalol class and MOA?
- Classification: Alpha1 and non-selective Beta Adrenergic Blocker (Antihypertensive) - Mechanism of Action: slows sinus HR and decreases peripheral resistance
46
PO Labetolol: onset, duration and half-life?
Onset: 0.5-2hrs Duration: PO: 8-12 hrs Half-Life: 6-8 hrs
47
IV Labetolol: onset, duration and half-life?
Onset: 2-5 hrs Duration: 2-4 hrs Half-Life: 6-8 hrs
48
Labetolol contraindications?
asthma, cardiogenic shock uncompensated HF, 2nd/3rd degree heart block (except w/ PM)
49
Labetolol AE?
drowsy, dizzy, excessive fatigue, dyspnea, peripheral edema, depression, anxiety, constipation, diarrhea, abd discomfort
50
How must labetolol be d/c and why?
need to taper to discontinue, abrupt withdrawal may cause: - myocardial ischemia - CP - diaphoresis - palpitations - H/A - tremors which may mask symptoms of acute hypoglycemia.
51
Nitroglycerin dose range?
5-200 mcg/min
52
Nitroglycerin: onset, duration and half-life?
Onset: 2-5 min Duration: 10-20 min Half-Life: 1-4 mins
53
Norepinephrine brandname?
Levophed
54
Levophed class and MOA?
Class: adrenergic agonist Mechanism of Action: - A1 & A2: peripheral vasoconstriction - B1: ↑CO (+ inotropic effect), coronary vasodilation, ↑HR
55
Norepinephrine concentration(s)?
4, 8, 16 mg/250mL D5W
56
Norepinephrine: onset, duration and half-life?
Onset: rapid acting Duration: 1-2 mins Half-Life: 3 mins
57
Phenylephrine class and MOA?
Class: Alpha 1 Agonist Mechanism of Action: ↑SVR & diastolic pressure
58
Phenylephrine dose range?
0.5-9 mcg/kg/min
59
Phenylephrine : onset, duration and half-life?
Onset: immediate Duration: 15-20 min Half-Life: 5 mins
60
Phenylephrine indications?
shock and low BP
61
Considerations for administration of phenylephrine?
may cause necrosis if infiltrates, KIDNEYS (↓blood flow, high pressure), use caution in patients with arterial grafts
62
Phenylephrine AE?
Common: ↓CO, HTN, reflex bradycardia, anxiety, metabolic acidosis, ↓urine Rare: arrhythmia
63
Precedex class and MOA?
Class: Selective A2 Agonist Mechanism of Action: inhibits NE release = sedation
64
Precedex dose ranges?
0.1-0.7 mcg/kg/hr
65
Precedex concentration(s)?
200mg/50mL or 400mg/100mL
66
Precedex contraindications?
AV block
67
Precedex: onset, duration and half-life?
Onset: 5-10 min Duration: 1-2 hrs Half-Life: 6 min
68
Precedex AE?
↓BP, HR, resp depression, N, constipation, thirst/dry mouth
69
Primacor brandname?
Milrinone
70
Milrinone class and MOA?
Classification: phosphodiesterase III Inhibitor Mechanism of Action: moderate inotrope and potent vasodilator (A/V)
71
Milrinone dose range?
0.25-0.75 mcg/kg/min
72
Primacor (milrinone): onset, duration and half-life?
Onset: 5-15 min Duration: Half-Life: 2.5 hrs w/ normal renal funct
73
Primacor (milrinone) indications?
acute HF, inotropic support following cardiac surgery, pts waiting for transplant
74
Primacor AE?
↓BP, ventricular arrhythmias, H/A, angina, hypokalemia, thrombocytopenia
75
Propofol brandname?
(Diprivan)
76
Propofol class and MOA?
Classification: short acting sedative Mechanism of Action: GABA agonist
77
Propofol dose range?
1 - 50 mcg/kg/mL (max)
78
Propofol: onset, duration, and half-life?
Onset: 60 secs Duration: 3-10 min Half-Life: 40 mins
79
Propofol AE?
apnea, low BP, resp/myocardial depression
80
Vasopressin is also called?
ADH
81
Vasopressin physiologic effect?
water conservation and increase in BP
82
Vasopressin dose range for shock?
0.04 units/min fixed rate
83
Vasopressin dose range for GI bleed?
0.2-0.4 units/min
84
Vasopressin dose for cardiac arrest?
40 unit IV bolus
85
Vasopressin: onset, duration, and half-life?
Onset: unknown Duration: 30-60 mins Half-Life: 10-20 mins
86
Vasopressin indications?
Diabetes Insipidus, GI bleed, cardiac arrest, shock states
87
Vasopressin AE?
- Myocardial ischemia at high doses - H20 intoxication (confusion, drowsy, H/A, weight gain, seizures, coma) - abd cramps d/t vasoconstriction within the intestinal/gastric mucosa
88
Versed class and MOA?
Classification: benzodiazepine Mechanism of Action: GABA agonist
89
Versed aka?
midazolam
90
Versed dose range?
1-6 mg/hr
91
Versed: onset, duration, and half-life?
Onset: 3-5 mins Duration: 2 hrs Half-Life: 2-6 hrs
92
Versed AE?
respiratory depression, hiccups, low BP, drowsy, H/A

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