1. opiates include
    • morphine
    • fentanyl
    • demerol
  2. morphine dose

    not used in cath lab, used on floor
    mostly used in ambulance & ER
    great analgesic
    decreases pain, HR
    dilates blood vessels so it decreases BP
    • 4-10 mg on floor
    • 2-5 mg in cath lab
    • onset 5-30 min
  3. fentanyl

    mostly used in cath lab for pain
    don't have BP effects like morphine does
    works quicker, stays shorter in blood stream
    • 25mcg-50mcg
    • redose 1/2 the 1st dosage every 5-10 min
  4. demerol

    not used in cath lab
    triggers n/v
    not as strong as morphine
  5. Benzodiazepines include:

    the mostly used in cath lab
    • valium
    • versed
  6. valium
    used for anxiety
    given on floor as pre-op
    increases respiratory depression
    5-10 mg IV
  7. versed

    used for anxiety
    mostly used in cath lab
    hits hard, wears off quickly
    0.5-1.5 mg

    1mg usually 1st dose given
  8. Vasodilators mostly used in cath lab include:
    • nitroglycerine
    • nitroprusside
  9. nitorglycerine

    drops BP ALOT!!
    increases blood flow to heart by dilating blood vessels
    good for controlling spasms
    easily triggers migraines
    • sublingual/spray/tablet: 150-600mcg
    • IV: 5-20mcg titrate low to high, BP below 110 stop nitro.
    • IC: 200-400mcg for spasms
  10. nitroprusside

    extremely potent and powerful
    given to relax vessels that spasm closed
    onset very fast
    watch doses can turn into cyanide
    • IV: 0.3-10mg/min
    • IC: 200-400mcg/dose
  11. Beta Blockers used mostly in cath lab include:
    Specific: metropolol(lopressor)

    • Non-specific: propanolol
    • lobatalol
  12. Specific beta blockers---metropolol(lopressor)

    decrease HR, decreasing contractility there fore decreasing BP
    given to pt w/ fast HR and high BP
    5mg bolus via IV every 5 min
  13. Non-specific beta blockers

    given to pt with fast HR and low to normal BP
    propanolol: 1-3 mg IV every 5 min

    lobatolol: 20 mg IV over 2 min
  14. Calcium Channel Blockers includes

    used to control HR and contractility
    not given for MI's
    decrease HR and decrease vasotone therefore decreasing contractility
    • diltiazem
    • verapamil
  15. diltiazem

    may decrease HR
    causes blood vessels to dilate some and decreases BP
    for really high BP
    • IV: 0.25mg/kg over 2 min
    • IV drip: 0.5mg/hr
  16. Verapamil

    decreases HR
    decreases vaso constriction
    decreases contractility

    No Flow phenomenon: no flow occurance
    • IV: 2.5-10mg max dose 20mg
    • IC: 50-200mcg
  17. Antithrombins used in cath lab include
    • heparin
    • low molecular wt heparins: enoxaprin
    • angiomax
  18. heparin

    used for angioplasty
    reversal is protamine
    • 25 units/kg for diagnostic procedures
    • 50 units/kg for interventional procedures
  19. protamine reversal for heparin
    1 mg of protamine for every 100 units of heparin
  20. enoxaprin(lovenox)

    low wt molecular heparin
    most commonly used
    may cause HITS
    bleeding complications for diabetics

    • not good for diabetics
    • good for MI's
    • injection into IM/SQ
  21. Bivalirudin(angiomax)

    low wt molecular heparin

    doesn't cause HITS as much
    Given to Diabetics
    • 0.75mg//kg IV bolus
    • 1.75 mg/kg/hr IV drip
  22. antiplatelets used in cath lab include
    • aspirin
    • super aspirin: ticlid
    • plavix
  23. aspirin

    decreases ability for platelets to activate
    doesn't break up previously formed clots but further keeps platelets from sticking together

    can cause ulcers
  24. super asprin--ticlid

    used on acute/urgent/ER patients
    limits hardness of clots
    keeps platelets from sticking together,
    put on right before angioplasty
    or right after stent
    • before procedure: 500mg
    • after procedure: 250mg b.i.d for 2-6 weeks
  25. clipidogrel---Plavix

    used most in cath lab, most common
    • before procedure: 300mg
    • after procedure: 75mg per day for 6 months or longer, depends on type of stent used
  26. anticoagulations used most in cath lab
    • IIbIIIa
    • reopro
    • integrellin
    • aggrestat
  27. reopro


    attachs to platelet so clotting doesnt take effect
    used for stents and MI's

  28. integrellin

    • attached to platelet
    • last for 2 hr
    • hold equipment for 2 hrs
  29. Emetics used in cath lab include
    • phenergan
    • zofran
  30. phenergan

    for n/v
    has sedative effect
    monitor vital signs
    25-50 mg
  31. zofran

    mostly used in cath lab
    has no sedative effects
    4mg IV
  32. Benadryl

    for allergy reaction
    has sedative effects
  33. opiate reversal
    • narcan
    • 0.2-0.4mg
  34. benozo reversal

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