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Module 7 (Critical Care) > Exam 1 Pharmacology > Flashcards

Exam 1 Pharmacology Flashcards

Adenosine, Amiodarone, Epinephrine, Atropine, Lidocaine, Magnesium, Levetiracetam, Simvastation (70 cards)

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1
Q

Adenosine MOA

A

GIves the heart a break for the SA node to take back control in a normal sinus rhythm

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2
Q

Adenosine med type

A

Antidysrhythmic
- Bring heart back to normal sinus rhythm

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3
Q

Adenosine can treat

A

PSVT (IV adenosine 1st)
Myocardial perfusion stress imaging study (vasodilator)
**chemical cardioversion

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4
Q

Adenosine injection half-life

A

short 10 seconds

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5
Q

What should you let the patient know before giving them adenosine (if able)?

A

chest pressure after giving the medication is common

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6
Q

Adenosine injection

A

antecubital close to heart not on bone prominences

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7
Q

Adenosine IV is given

A

rapid (1-2 secs)
followed by 20 mL flush rapidly
stop cock setup

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8
Q

Adenosine half-life IV

A

2-3 seconds

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9
Q

The nurse give the PSVT patient 6mg of adenosine. After giving it IV, the patient’s rhythm goes asystole, what should the nurse do?

A

continue to monitor as asystole immediately after injection is okay

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10
Q

What equipment should be in the room when receiving adenosine?

A

BP cuff
12 lead
cardiac monitor
defibrillator and AID-ready

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11
Q

What does the nurse need to assess for on an adenosine patient?

A

flushing
dizziness
chest pain
palpation
can faint

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12
Q

Adenosine doses

A

6mg (1st) - 12 mg (2nd)
HCP can continue or go to cardioversion

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13
Q

Adenosine is less effective in patients taking

A

caffeine
theophylline

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14
Q

T/F: Adenosine is safe for pregnant women.

A

True

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15
Q

For a rapid IVP of adenosine, place the patient in what position

A

reverse trendelenburg (mild)

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16
Q

Amiodarone MOA

A

blocks K, Na ions channels and antagonizing alpha and beta-adrenergic receptors(prolonging repolarization)
- slows nerve impulses of the heart and into normal rhythm

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17
Q

Amiodarone used for

A

VFib
VTach unresponsive to shock delivery
CPR
Vasopressor
VTach unstable hemodynamically

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18
Q

Amiodarone drug interactions

A

Beta-blockers
procainamide
iodine
pregnant women
grapefruit juice

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19
Q

Amiodarone do not give to

A

pregnant women or people with iodine allergies

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20
Q

Amiodarone ACLS doses
1 -
2 -

A

1st = 300 mg
2nd = 150 mg

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21
Q

CPR algorithm SHOCKABLE

A

Call help
start CPR (30:2)
attach defibrillator
SHOCKABLE (VTach or VFib)
- Shock
- CPR 2 minutes
- IV/IO access
- SHOCK
- CPR 2 min
- Epinephrine 3-5 minutes
- SHOCK - CPR 2 minutes
- Amiodarone or lidocaine
- Repeat

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22
Q

What is the ratio of CPR and breaths

A

30:2

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23
Q

CPR Quality
- depth
- rate
- allow for

A

2 inches
100-120 bpm
chest recoil

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24
Q

If you are the person giving CPR, count

A

out loud

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25
CPR Algorithm NONSHOCKABLE
Call help start CPR (30:2) attach defibrillator NONSHOCKABLE (Asystole/PEA) - **Epinephrine ASAP** - CPR 2 minutes - Epinephrine 3-5 minutes Repeat until causes reversed
26
Biphasic Shock
120-200 J
27
Monophasic Shock
360 J
28
Epinephrine dosages in CPR
1 mg every 3-5 minutes
29
Amiodarone dosages in CPR
1st = 300 mg Bolus 2nd = 150 mg
30
Lidocaine dosages in CPR
1st = 1-1.5 mg/kg 2nd = 0.5-0.75 mg/kg
31
When an advanced airway has been placed then the ratio is moved to
1 breath every 6 seconds (10 bpm) with continuous chest compression
32
Reversible Causes of Asystole/PEA
Hs and Ts - Hypovolemia - Hypoxia - Hydrogen ions (acidosis) - Hypo/Hyperkalemia - Hypoglycemia - Hypothermia - Tension Pneumothorax - Tamponade, cardiac - Toxins - Thrombosis, pulmonary - Thrombosis, coronary
33
Maximum amiodarone dose over 24 hours
2.2 g
34
Rapid infusion of amiodarone may lead to
hypotension
35
Epinephrine is given for
Cardiac arrest: VFib, pulseless VTach, asystole, PEA Symptomatic bradycardia Severe hypotension Severe allergic reaction
36
Epinephrine is given every ________ in a code
3-5 minutes
37
Epinephrine raises
BP and HR - causing Myocardial ischemia, angina, increased O2 demand
38
T/F: Epinephrine improves survival post-resuscitation.
False, high doses do not guarantee neurological outcome
39
Epinephrine dosage
1 mg in 10 mL NS every 3-5 minutes in a Code
40
Epinephrine side effects
Tachycardia HTN HA anxiety palpations sweat N/V weakness tremors
41
Atropine Sulfate MOA
increases the heart rate and improves the atrioventricular conduction by blocking the parasympathetic influences on the heart.
42
Atropine is used for
symptomatic bradycardia - not in AV Heart Blocks PEA/asystole Organophosphate poisoning
43
Atropine caution with
myocardial ischemia hypoxia increase O2 demand **not for hypothermia bradycardia**
44
Atropine dosages for bradycardia
0.5 mg IV every 3-5 minutes
45
Atropine dosages for organophosphate poisoning
2-4mg (Disaster Mgmt)
46
Atropine should not exceed
0.04mg/kg (total 3mg)
47
Dopamine
2nd line drug to symptomatic bradycardia (after atropine) - hypotension (SBP < 70-100) with s/s of shock
48
Dopamine caution with
cardiogenic shock with CHF
49
Dopamine should not be mixed with
sodium bicarbonate
50
Dopamine may cause
tachyarrhythmias excessive vasoconstriction
51
What should be used before atropine with hypovolemia
volume replacement
52
What can be substituted for atropine in a code
Lidocaine
53
Lidocaine is used in
VFib pVTach stable polymorphic VTach QT prolongation if torades suspected
54
Lidocaine can be given during a code only if
doctor says to give
55
Lidocaine is contraindicated if
reduce dose due to impaired liver function
56
Dosage for Lidocaine
1-1.5 mg/kg every 5-10 minutes max 3 doses
57
Magnesium Sulfate is given for
Torsades de Pointes suspect hypomagnesium
58
Mag occassionally has what with rapid infusion
BP falling
59
Use Mag cautiously if
renal failure
60
What do you need before giving Mag even in a code?
Mag level
61
Endotracheal tube drugs if IV is not available or started
Lidocaine Epinephrine Atropine Narcan
62
Levetiracetam is given for
controlling seizures tx epilepsy
63
Levetiracetam can have an increased risk of side effects with
Carbamazepine Ginkgo
64
Levetiracetam SIDE EFFECTS
aggression, delusions anxiety, depression personality change chills cough cry tachypnea with dizziness dry mouth N/V/D INSOMNIA/sleepiness
65
Levetiracetam adverse effects
unusual thoughts and behaviors - dizzy, drowsy,
66
Levetiracetam monitoring
renal dysfunction
67
Simvastatin
Tx cholestrol and high triglyceride levels - help prevent clogged blood vessels
68
Simvastatin adverse effects
rhabdomyolysis (paralytic) - muscle breakdown and kidney damage - tea/red colored urine - dysrhythmias muscle pain tenderness weakness cramps
69
Simvastatin patients should avoid drinking
grapefruit juice
70
Simvastatin is given
At night ( Flushing )

Module 7 (Critical Care) (22 decks)

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