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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.
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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
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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
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What is Adenosines pediatric dose?
0.2mg/kg rapid IV push (repeat same dose if SVT persists)
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Patients taking _______________ are less sensitive to Adenosine and may require larger doses.
Theophylline
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Per our protocols, these patients are more sensitive to Adenosine and usually require lower doses.
Cardiac transplant patients
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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.
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What are Albuterols indications:
- 1: Asthma
- 2: Bronchospasm (COPD, emphysema)
- 2: Bronchospasm assiciated with anaphylaxis
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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
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What are the listed side effects to Albuterol administration?
Anxiety, Palpitations/tachycardia, dizziness, nausea/vomiting, tremors
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What is the adult dosage for Albuterol
Adult=2.5mg with 3cc NS via nebulizer (may repeat x3)
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What is Albuterols pediatric dosage?
Pediatric < 14kg=1.25mg c/ 3cc NS via Neb
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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
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What are Amiodarones indications?
V-tach, V-fib, A-Fib
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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)
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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
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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
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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
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This is question 4.
a)This is answer 4
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What is the pharmacology and actions of Aspirin?
Aspirin is a non-steroidal anti-inflammatory analgesic and inhibits platelet aggregation
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Aspirin Indications:
Chest pain of suspected cardiac nature
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Aspirin Contraindications:
- 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
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Aspirin Dosage:
324mg PO (81mg x 4)
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Atropine pharmacology and actions:
Atropine is a parasympatholytic drug that enhances both sinus node automaticity and atriobentricular conduction via its direct vagolytic action.
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