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Drug Quiz 8 Flashcards

(53 cards)

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1
Q 
Dopamine HCL (Intropin)
Drug Classification
A

Sympathomymetic

Sympathetic Agonist

Cathecholamine

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2
Q

Dopamine HCL (Intropin) MOA 1/2

A

A1 AGONIST—> 2nd Messenger release of Calcium in VSMC—> PERIPHERAL VASOCONSTRICTION—> increased SVR
—>increased BP

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3
Q

Dopamine HCL (Intropin) MOA 2/2

A

B1 AGONIST—> Increased Intracellular Ca2+ in cardiac cells—> POSITIVE inotropy, chronotropy, and dromotropy.

the mechanism for this drug is dose-dependent.

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4
Q

Dopamine HCL (Intropin) Pharmacokinetics

A

OoA: <5min.
PE: 5-8min.
DoE: <10min.
HL: 2min.

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5
Q

Dopamine HCL (Intropin) Indications/Field use

A

Cardiogenic shock

Symptomatic Bradycardia

Septic shock following fluid resuscitation

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6
Q

Dopamine HCL (Intropin) Contraindications

A

UNCORRECTED HYPOVOLEMIA

If profoundly hypotensive, may give IV fluids concurrently

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7
Q

Dopamine HCL (Intropin) side effects/adverse reactions

A 
Tachycardia 
Dysrhythmias (A-fib, PVC’s)
Chest Pain
Dyspnea
Nervousness
Headache 
N/V
Extravasation necrosis
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8
Q

Dopamine HCL Dose Adult (low dose)

Shock/Bradycardia

A

ADULT: 2-5 ug/kg/min IV,IO infusion

Low dose) increases blood flow to mesentery and renal (GUT

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9
Q

Dopamine HCL Dose Adult (Medium Dose)

Shock/Bradycardia

A

ADULT: 5-10 ug/kg/min. IV, IO infusion

Stimulates Beta effects

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10
Q

Dopamine HCL Adult Dose (High Dose)

Shock/Bradycardia

A

ADULT: 10-20 ug/kg/min. IV, IO infusion

Stimulates Alpha effects

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11
Q

Dopamine HCL Dose Pedi

Shock/Bradycardia

A

PEDI: 2-20 ug/kg/min IV,IO infusion

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12
Q

Dopamine HCL (Intropin) Precautions

A

Must be kept out of direct sunlight

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13
Q

Dopamine HCL (Intropin) Drug-Drug Interactions

A

None

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14
Q

Norepinephrine (Levophed)

Drug classification

A

Sympathomimetic
Sympathetic agonist
Catecholamine

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15
Q

Norepinephrine (Levophed) MOA 1/2

A

PrimaryA1 Agonist—> 2nd Messenger release of Calcium in VSMC—> PERIPHERAL VASOCONSTRICTION—> increased SVR
—>increased BP

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16
Q

Norepinephrine (Levophed) MOA 2/2

A

Secondary B1 Agonist—> Increased intracellular Ca2+ in cardiac cells—> positive inotropy, chronotropy, dromotropy.

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17
Q

Norepinephrine (Levophed) Pharmacokinetics

A

OoA: <1 min.
PE: <2 min.
DoE: 1-2 min.
H-L: 3 min.

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18
Q

Norepinephrine (Levophed) Indications/Field Use

A

Cardiogenic Shock
Septic shock following fluid resuscitation
Neurogenic Shock

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19
Q

Norepinephrine (Levophed) Contraindications

A

Hypovolemia

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20
Q

Norepinephrine (Levophed) Side Effects/Adverse Reactions

A 
Reflex Bradycardia 
Dysrhythmias 
Dizziness 
Headache 
Anxiety 
Tremulousness
N/V
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21
Q

Norepinephrine (Levophed) Adult Dose

A

1-30 mcg/min IV, IO infusion—titrate to BPsystolic >90 mmHg

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22
Q

Norepinephrine (Levophed) Pediatric Dose

Study These Flashcards
A

0.1-2 mcg/kg/min IV, IO infusion—titrate to normotensive systolic BP

23
Q

Norepinephrine (Levophed) Precautions

Study These Flashcards
A

Can cause tissue necrosis w/extravasation
Caution with coronary artery disease
Leads to increased myocardial oxygen demand

24
Q

Norepinephrine (Levophed) Drug-Drug interactions

Study These Flashcards
A

MAOI and TCA may potentiate cardiovascular effects.

25
Phenylephrine (Neo-Synephrine) Drug classification
Sympathomimetic | Sympathetic agonist
26
Phenylephrine (Neo-Synephrine) MOA
A1 Agonist—> 2nd messenger release of Ca2+ in VSMC—> peripheral vasoconstriction—>increased SVR —>Increased BP
27
Phenylephrine (Neo-Synephrine) Pharmacokinetics
OoA: Immediate PE: <1 min DoE: 15-20 min HL: 2 min
28
Phenylephrine (Neo-Synephrine) Indications/Field use
Septic Shock following fluid resuscitation | Neurogenic Shock
29
Phenylephrine (Neo-Synephrine) Contraindications
Cardiogenic Shock
30
Phenylephrine (Neo-Synephrine) Side Effects/Adverse Reactions
``` Dysrhythmias Hypertension Tremulousness Nausea Vomiting ```
31
Phenylephrine (Neo-Synephrine) Dose
ADULT: 100-180 mcg/min IV IO infusion until BP> 90 mmHg PEDI: 0.1-0.5 mcg/kg/min
32
Phenylephrine (Neo-Synephrine) Precautions
Can cause tissue necrosis with extravasation.
33
Phenylephrine (Neo-Synephrine) Drug-Drug interactions.
Deactivated by alkaline solutions | Caution in patients with digitalis toxicity, may aggravate tachydysrhythmias
34
Calcium Chloride Drug classification
Mineral | Electrolyte
35
Calcium Chloride MOA 1/2
*HYPERKALEMIA* Raises action potential threshold for cardiac contracting cells to compensate for elevated resting potential and hyperexcitability—> reduces likelihood of dysrhythmias.
36
Calcium Chloride MOA 2/2
*Ca2+ channel blocker OD* Replacement of elemental Ca2+—> dissociates rapidly to Ca2+ and CL- ions—> increase extracellular Ca2+ concentration to overcome calcium channel blockade —> positive inotropy and chronotropy / peripheral vasoconstriction.
37
Calcium Chloride Pharmacokinetics
OoA: Immediate PE: Unknown DoE: Varies HL: N/A
38
Calcium chloride Indications/field use
>Moderate/Severe HYPERKALEMIA (crush syndrome, dialysis pt, rhabdomyolysis) >Ca2+ channel blocker toxicity >Abdominal muscle spasm from Brown Recluse Spider, or Man of WarJellyfish. >Cardiac arrest (Suspected HYPERKALEMIA).
39
Calcium Chloride contraindications
Hypercalcemia | Pt taking Digoxin
40
Calcium Chloride Side Effects/ Adverse Reactions
``` Bradycardia Dysrhythmias Syncope Nausea Vomiting Cardiac Arrest ```
41
Calcium Chloride Dose
DOSE for hyperkalemia/ OD/ CA/ Abd Spasm ADULT: 1 g slow IV, IO over 5 minutes PEDI: 20 mg/kg slow IV, IO
42
Calcium Chloride Precautions
>Can cause tissue necrosis at injection site, ensure patent IV line. >Moderate/severe hyperkalemia is characterized by wide QRS on ECG.
43
Calcium Chloride Drug-Drug Interactions
>Forms precipitate with NaHCO3, flush tubing between administration. >Digitalis toxicity when administered to patient currently taking digitalis/Digoxin—inhibits Ca2+ channels causing “stone heart”.
44
Calcium Gluconate Drug Class
Mineral | Electrolyte
45
Calcium Gluconate MOA 1/2
*HYPERKALEMIA* Raises action potential threshold for cardiac contracting cells to compensate for elevated resting potential and hyperexcitability—> reduces likelihood of dysrhythmias.
46
Calcium Gluconate MOA 2/2
*Ca2+ channel blocker OD* Replacement of elemental Ca2+—> dissociates rapidly to Ca2+ and gluconate ions—> increase extracellular Ca2+ concentration to overcome calcium channel blockade —> positive inotropy and chronotropy / peripheral vasoconstriction.
47
Calcium Gluconate Pharmacokinetics
OoA: Immediate PE: Unknown DoE: Varies HL: N/A
48
Calcium Gluconate Indications/Field Use
>Moderate/Severe HYPERKALEMIA (crush syndrome, dialysis pt, rhabdomyolysis) >Ca2+ channel blocker toxicity >Abdominal muscle spasm from Brown Recluse Spider, or Man of WarJellyfish. >Cardiac arrest (Suspected HYPERKALEMIA).
49
Calcium Gluconate Contraindications
Hypercalcemia | Patient taking Digoxin
50
Calcium Gluconate Side Effects/ Adverse Reactions
``` Bradycardia Dysrhythmias Syncope Nausea Vomiting Cardiac Arrest ```
51
Calcium Gluconate Dose
DOSE for hyperkalemia/ OD/ CA/ Abd Spasm ADULT: 2 g slow IV, IO over 5 minutes PEDI: 60 mg/kg slow IV, IO over 5 minutes
52
Calcium Gluconate Precautions
>Can cause tissue necrosis at injection site, ensure patent IV line. >Moderate/severe hyperkalemia is characterized by wide QRS on ECG.
53
Calcium Gluconate Drug-Drug Interactions
>Forms precipitate with NaHCO3, flush tubing between administration. >Digitalis toxicity when administered to patient currently taking digitalis/Digoxin—inhibits Ca2+ channels causing “stone heart”.

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