rapid atrial arrhythmias, especially atrial flutter and a fib
Digoxin
contraindication
any patients with signs or symptoms of digitalis toxicity
V-fib
Digoxin
precautions
monitor for signs of digitalis toxicicty
patients who have greater sensitivity to the effects of digitalis
calcium should not be administered to patients receiving digitalis
Digoxin
Side effects
Nausea and vomiting
Arrhythmias
Yellow vision
Digoxin
dosage
0.25-0.50 mg
Digoxin
route
IV
Digoxin
ped dose
rarely used in pre-hospital setting
Heparin
Class
Anticoagulant (unfractionated)
Heparin
Action
Direct inhibitor of thrombin
Heparin
Indication
Acute coronary syndrome
Pulmonary
Heparin
Contraindication
known hypersensitivity to the med and /or beef and pork products
Heparin
Precautions
Do not use in patients with active major bleeding or thrombocytopenia
use with caution in elderly or any patient with increased risk of bleeding
Heparin
Side effects
Confusion
Edema
Dizziness
Bleeding complications
Heparin
dosage
Adult dose ( acute stemi and unstable angina): 60 u/kg IV (maxium 4000 units) followed by 12 u/kg/hr (max 1000 u/hr). this is often given with alteplase (rtPA)
Adult dose (NSTEMI and unstable angina): 60-70 U/kg IV (max 5000 U) as intitial bolus followed by a 12-15 U/kg/h infushion
Heparin
route
IV
Heparin
ped dose
50 Units/kg followed by IV infusion
Enoxaparin
Class
Anticoagulant (low molecular-weight heparin)
Enoxaparin
Action
acts as effective anticoagulant
Enoxaparin
Indication
Unstable Angina
Non q-wave MI
Pulmonary embolism
DVT
Enoxaparin
contraindication
sensativity to the med '
heparin
Enoxaparin
precaution
do not use in paitents with major bleeding or a t risk
Enoxaparin
side effects
Confusion
Dizziness
Edema
Bleeding complication
Enoxaparin
Dosage
Stemi: 30 mg IV plus a 1 mg/kg SQ dose followed by 1 mg/kg SQ/SC dose every 12 hours (max 100 mg for the first two doses only)
unstable angiana and NSTEMI: 1 mg/kg admin SQ every 12 hours in conjunction with asprin
Enoxaparin
route
SC
IV
Enoxaparin
ped dose
1 mg/kg
Clopidogrel
class
platelet aggregate inhibitor
Clopidogrel
actions
inhibits platelet aggregation by binding to ADP recepters on the surface of platelets
Clopidogrel
indication
ACS
stroke
PVD
Clopidogrel
contraindication
Bleeding disorder
Peptic ulcer
sensativity to the med
Clopidogrel
precautions
do not use with NSAIDs
Clopidogrel
side effects
bleeding
fever
allergic reaction
myalgias
rash
Clopidogrel
dosage
ACS: 300 mg loading dose folowed by 75 mg dose once daily