Cardiac Drugs

Inhibits platelet aggregation

Chestpain associated with MI

81-324 mg PO

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

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

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)

Needed for normal cardiac contractility

• Hyperkalemia
• Magnesium Sulfate Overdose
• Calcium Channel Blocker overdose

500mg - 1g IV

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)

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

Raises the seizure threshold, induce amnesia and sedation

• Seizure activity
• Acute Anxiety
• Sedation prior to cardiovesion

5-10mg IVP

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

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

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

Dilation of arterioles and veins in the periphery. Decreases workload of the heart and decreases myocardial O2 demand

• Ischemic Chest Pain
• CHF

0.4 mg SL

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

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