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Q5 ACLS > Meds > Flashcards

Meds Flashcards

(45 cards)

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1
Q

α does what?

A

Vasoconstrictor (SNS: Vascular bed))

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2
Q

β1 does what?

A

↑ HR (SNS: heart)
Speeds conduction
↑ contraction force

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3
Q

PNS does what?

A

↓ HR and conduction speed

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4
Q

Inotrope is?

Causes of + inotrope effect?

Causes of - inotrope effect?

A

Contractility

+ = digoxin, dopamine, epi

  • = verapamil (CCB), acidosis, hypoxemia
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5
Q

Chronotrope is?

Causes of + chronotrope effect?

Causes of - chronotrope effect?

A

Rate

+ = epi, atropine (antichol)

  • = adenosine (antiarrhy), diltiazem (CCB)
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6
Q

Dromotrope is?

A

Speed of AV conduction

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7
Q

Primary goal of tx is to optimize what first?

A

Rate/rhythm in diastole

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8
Q

Affecting Stroke Volume: Preload (volume)?

Afterload (resistance)?

Contractility (pump)?

A

NS

Norepi

Dopamine

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9
Q

Synchronized Countershock used for?

Used when?

Measured in?

A

Stop impulse during relative refractory (T’s)

Tachy: when pt has pulse but doesn’t respond to pharm

Joules

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10
Q

External Pacemaker used for?

Used when?

Measured in?

A

Take place of dysfxn’l pacemakers

To capture vents and get a QRS

Milliamps

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11
Q

Amiodarone class?

Action?

A

Antidysrhy multi-channel blocker

Blocks Na+, K+, Ca2+, α and β

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12
Q

Amiodarone used for what type of pts?

Why?

A

STABLE pts with normal QTI

Amio can make Long QTI’s become Torsades
Unstable pt’s need quick intervention, amio has 10 min lead

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13
Q

Amiodarone indications?

A 
Vent rhythms (all wide, ugly, bizarre)
Rate control of Af and AF
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14
Q

Amiodarone: Initial dose?

Repeat dose?

Special instructions?

A

150 mg

150 mg

Run minimum of 10 min @ 15mg/min

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15
Q

Amiodarone precautions?

A 
May cause:
Vasodilation and hypoTN
Torsades
Neg inotrope
Prolong QTI

t1/2 = 40 days

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16
Q

Lidocaine class?

Action?

A

Antidysrhy, weak Na+ channel block

Affects vents:
Blocks re-entry
↓ automaticity
↑ Vfib threshold

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17
Q

Lidocaine indications?

A

PULSELESS VT and Vfib
Stable VT
WCT
Control PVCs in infarct w/o brady

  • Only works on re-entry caused Vtach
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18
Q

Lidocaine: Initial dose?

Repeat dose?

Special Instructions?

A

1 to 1.5 mg/kg

1/2 initial dose

None

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19
Q

Lidocaine precautions?

Study These Flashcards
A

Toxicity w/ CNS signs

20
Q

Loss of cardiac compensation is?

Sxs? (7)

Study These Flashcards
A

Vtach takes over regardless of meds

↓BP
ST/T ∆s
Chest pain
Nausea
Diaphoresis
∆ in LOC
SOB
21
Q

Next step in loss of compensation?

22
Q

Electrical Intervention in Vtach: Mode?

Initial joules?

Study These Flashcards
A

(Pt still has pulse)
Synchronized countershock

100 j

23
Q

Monomorphic Vtach Mgmt: Pharm?

Electrical?

Study These Flashcards
A

Amiodarone 150 mg or
Lidocaine 1 mg/kg

Sedate
Synch @ 100j

24
Q

Wide Complex Tachy (WCT) is?

Study These Flashcards
A

Same as Vtach but of uncertain origin

No normals on the ECG to compare to

25
WCT mgmt: Pharm?
Same as Vtach + P Adenosine
26
Adenosine used for WCT if pt meets all 4 criteria?
1) Stable (BP >90) 2) Rhythm undifferentiated (no normal to compare) 3) Rhythm regular 4) Monomorphic QRS's
27
Racing heart indicates rhythm from where?
Supervents
28
Narrow Complex Tachy (NCT) with regular rhythm caused by? (4)
Re-entry SVT Jxn'l tachy Arial flutter Ectopic atrial tachy
29
NCT w/ reg rhythm tx? (3)
DOC = Adenosine* (if works, re-entry was cause) CCB (if works, jxn'l was cause) β-block *must have HR > 160, narrow QRS and reg rhy to use, otherwise use a blocker
30
NCT w/ irregular rhythm caused by? (3)
Atrial fib Atrial flutter MAT (wandering)
31
NCT w/ irregular rhythm tx? (2)
CCB | β-block
32
Adenosine class? Action?
Antidys ``` Effects on supravent tissue: Interrupts RE-ENTRY ↓ SA and AV node ↓ conduction thru AV ↓ HR ``` t1/2 = 5 seconds
33
Adenosine indications? (2) Doesn't help? (2)
NCT (SVT) Stable, reg mono WCT AF or Af
34
Adenosine: Initial dose? Repeat dose? Special inst?
6mg 12mg x 2 Deliver in < 3 sec Follow w/ flush
35
NCT electrical mode? Initial joules?
(Pt w/ s&s of decomp) Sedate Synchronized 50 j
36
Cut off for needing O2?
<94% need O2
37
Brady tx?
Atropine if: 1) HR <60 2) Pt symptomatic
38
Atropine class?
Parasympatholytic
39
Atropine action?
Indirect ↑ HR (inhibits PNS) ↑ AV conduction Doesn't fix problem, just buys time Doesn't work if issue is in tissue w/ low PNS innervation
40
Atropine indication?
Brady
41
Atropine dosing: Initial? Repeat? Special instructions?
0. 5 mg 0. 5 to 1 mg None
42
Electrical for brady? Starting setting?
External pacemaker (TCP) Lowest milliamps w/ 80 bpm rate
43
Brady tx if pharm and electric don't work?
Dopamine | 2 to 10 ug/kg/min
44
Brady w/ 2° Type II or 3° first line tx?
TCP
45
Nitro should NOT be used when? (5)
``` SBP < 90 SBP drop >30 HR 100 Recent Phosphodiaesterase Inhib use Inf wall or RV MI ```

Q5 ACLS (8 decks)

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