What are Adenosine's Indication(s) and contraindication(s)?
Indication: Supraventricular tachycardia
Contraindications: Second or third degree block, Sick sinus syndrome
Sick sinus syndrome is the name for a group of arhythmias, in which the sinus node doesn't work properly. This includes sinus arrest, sinus node exit block, sinus bradycardia, and other types of bradycardia.
What are the seven side effects of Adenosine?
- 1: Arrhythmias
- 2: Chest pain
- 3: Shortness of breath
- 4: Facial flushing
- 5: Head Ache
- 6: Dizziness
- 7: Nausea
1) What arrhythimas are usually associated with Adenosine administration?
2) What is the dosage for Adenosine?
1) PVCs, PACs, Bradycardia, tachycardia, AV Block, or Asystole
- 2) A: 6mg rapid IV push (1-2 sec) flushed rapidly with 20ccs NS
- B: If no response observed within 1-2 min. repeat at 12 mg rapid IV push (1-2 seconds) flushed with 20ccs NS
What is Adenosines pediatric dose?
0.2mg/kg rapid IV push (repeat same dose if SVT persists)
Patients taking _______________ are less sensitive to Adenosine and may require larger doses.
Per our protocols, these patients are more sensitive to Adenosine and usually require lower doses.
Cardiac transplant patients
What is Albuterols pharmacology and actions?
It is a sympathomimetic that is relatively selective for Beta 2 adrenergic receptors. It is an effective bronchodilator with relatively few cardiovascular effects. The duration of action may be between 4-6 hours.
What are Albuterols indications:
- 1: Asthma
- 2: Bronchospasm (COPD, emphysema)
- 2: Bronchospasm assiciated with anaphylaxis
What are the 4 listed precautions to Albuterol administration?
1: Discontinue if patient develops chset pain or arrhytmias
2: Administer with caution to patients with CAD or hypertension
3: Administer with caution to patients with hyperthyroidism, diabetes, or seizures
4: May result in paradoxial bronchospasm - discontinue immediately
What are the listed side effects to Albuterol administration?
Anxiety, Palpitations/tachycardia, dizziness, nausea/vomiting, tremors
What is the adult dosage for Albuterol
Adult=2.5mg with 3cc NS via nebulizer (may repeat x3)
What is Albuterols pediatric dosage?
Pediatric < 14kg=1.25mg c/ 3cc NS via Neb
What is Amiodarones pharmacology and actions?
Amiodarone is a class IIb antidysrhythmic agent used to treat ventricular dysrhythmias unresponsive to other antidysrhythmics. Amiodarone prolongs the action potential duration in all cardiac tissues
What are Amiodarones indications?
V-tach, V-fib, A-Fib
What are the listed precautions for Amiodarone?
Use with caution in patients with latent or manifes heart faliure (failure can be worsened by this drug)
What are the side effects to Amiodarone administration?
- Hypotension, Bradycardia, Increased ventricular beats
- Prolonged PR intervals, QRS complex, and QT intervals
- Monitor for signs of pulmonary toxicity such as dyspnea and cough
What is Amiodarones dosage for V-Tach(with pulse) or A-Fib?
150mg over 10 mins (may repeat as needed per OLMC)
Maintenance dose 1mg/min for 6 hours then 0.5mg/min
What is Amiodarones dosage for cardiac arrest (persistent)?
Persistent VF/VT after several shocks = 300mg IV, repeat with 150mg in 3-5min max dose 2.2g over 24 hours
This is question 4.
a)This is answer 4
What is the pharmacology and actions of Aspirin?
Aspirin is a non-steroidal anti-inflammatory analgesic and inhibits platelet aggregation
Chest pain of suspected cardiac nature
- 1: History of active GI bleed or indications of GI bleed
- 2: Hypersensitivity
- 3: Patient who have taken at least 160mg ASA in the last 12 hrs
324mg PO (81mg x 4)
Atropine pharmacology and actions:
Atropine is a parasympatholytic drug that enhances both sinus node automaticity and atriobentricular conduction via its direct vagolytic action.