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Aspirin
Inhibits platelet aggregation
Chestpain associated with MI
81-324 mg PO
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Amiodarone
Prolongs the duration of the action potential and refractory period. Slows the sinus rate, increases PR and QT intervals.
Treatment of persistant VF/pulseless VT. Can also be used in hemodynamically stable VT, SVT, & A-Fib
- VF or Pulseless VT: 300 mg IVP, may repeat in 4 min with 150 mg
- RVR: 150 mg IVP over 10 min
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Atropine
Blocked vagal effects result in positive chronotropy and positive dromotrophy
- Hemodynamically significant Bradycardia
- Asystole
- Slow PEA
- Bradydysrhythmias: 0.5 mg IVP q 4 min to a max of 0.04 mg/kg
- Asystole / Slow PEA: 1.0 mg IVP q 4 min
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Adenosine
Slows conduction through AV node, interrupt reentry pathways through AV node
Conversion of reentry PSVT to sinus rhythm when vagal maneuvers are unsuccessful
- 6 mg IVP
- 12 mg IVP
- 12 mg IVP
- (all doses are followed by a 20cc saline flush)
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Calcium Chloride
Needed for normal cardiac contractility
- Hyperkalemia
- Magnesium Sulfate Overdose
- Calcium Channel Blocker overdose
500mg - 1g IV
-
Dopamine
Act primarily on Alpha1 and Beta1, increasing systemic vascular resistance and exerting a positive inotropic effect
hypotension in the absence of hypovolemia
- Alpha response: 10-20 mcg/kg/min
- Beta response: 2-20 mcg/kg/min
- (titrate to desired BP)
-
Diltiazem
Prolongs AV node refractory period
- A-Fib with RVR
- A-Flutter with RVR
- PSVT
- 0.25 mg/kg IVP
- may be repeated at 0.35 mg/kg
-
Diazepam
Raises the seizure threshold, induce amnesia and sedation
- Seizure activity
- Acute Anxiety
- Sedation prior to cardiovesion
5-10mg IVP
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Epinephrine
Stimulates Alpha1, Beta1, and Beta2 adrenergic receptors. Can be used in all forms of cardiac arrest.
- Profound symptomatic bradycardia
- Cardiac arrest
- Bradycardia: 2-10 mcg/min drip
- Cardiac Arrest: 1mg IVP q 4 min
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Magnesium Sulfate
Reduces Striated muscle contractions
- Seizures of eclampsia
- Asthma unresponsive to conventional therapy
- Torsades de Pointes
- Torsades: 2 g IVP
- Asthma: 2 g IVP
- Seizure: 4 g IV
-
Metoprolol
Beta blocking agent
- PSVT
- A-Flutter with RVR
- A-Fib with RVR
5 mg slow IV at 5 min intervals to a total of 15mg
-
Nitroglycerine
Dilation of arterioles and veins in the periphery. Decreases workload of the heart and decreases myocardial O2 demand
0.4 mg SL
-
Lidocaine
Stabilizes cell membranes, depresses action potential, raises Ventricular Fibrillation threshold
Acute Ventricular Dysrhythmias
- V-Fib / pulseless VT: 1.5 mg/kg IVP repeat at half dose in 4 min. 1-4mg/min matintenance infusion
- Stable VT / malignant PVC's: 1-1.5mg/kg IVP repeat at half dose after 5-10 min. 1-4mg/min if pulse returns to normal
-
Procainamide
Depresses action potential, slows conduction velocity, may depress myocardial contractility
recurrent VF, pulseless VT, Stable VT
- With pulse: 100 mg IV every 5 min until dysrhythmia is terminated, QRS widens by more than 50%, hypotension occures, or 17mg/kg has been reached
- Without pulse: 250 mg IV every 5 min until dysrhythmia is terminated or 17mg/kg has been reached
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