Term
|
Definition
|
|
Term
|
Definition
| Misc Antidysrhythmic, endogenous nucleoside |
|
|
Term
|
Definition
| Decreases electrical conduction through the AV node with out causing negative inotropic effects |
|
|
Term
|
Definition
| Supraventricular Tachycardia's (SVT/PSVT) |
|
|
Term
|
Definition
| Hypersensitivity, bradycardia, drug induced tachycardia, 2nd and 3rd degree heart blocks, afib, aflutter, vtach,WPW, and afib/aflutter |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| 6mg rapid IV/IO push followed by 20cc saline flush. May be repeated at 12mg rapid IV push followed by 20cc saline flush. |
|
|
Term
|
Definition
| 0.1mg/kg (max of 6mg) Rapid IV push followed by 5-10cc saline flush. May be repeated at 0.2mg/kg (max of 12mg) rapid IV push followed by a 5-10cc Saline flush |
|
|
Term
|
Definition
| dizziness, headache, SOB, hypotension, flushing, palpations, chest pain, nausea/vomiting |
|
|
Term
|
Definition
| Methylxathine classified stimulants (caffeine and theophylline) usage will antagonize adenosine |
|
|
Term
|
Definition
|
|
Term
|
Definition
| Prolongs durations of the action potential and prolongs the refractory period. Also has beta adrenergic receptor and calcium channel blocking activity. Works on both the ventricals and atria. |
|
|
Term
|
Definition
| Vfib, hemodynamically unstable Vtach, treatment for some stable atrial rhythms |
|
|
Term
|
Definition
| CHF, Cardiogenic Shock, bradycardia, 2nd and 3rd degree heart blocks with no pacemaker present, hypersensitivity to Amiodarone and iodine |
|
|
Term
|
Definition
|
|
Term
|
Definition
| Variable but considered 30-45 days |
|
|
Term
|
Definition
Pulseless Vtach/Vfib arrest: 300 mg IV/IO my be repeated at 150mg IV/IO
Vtach with a pulse: 150mg IV drip over 10 minutes up to a max of 2.2g in 24hours. |
|
|
Term
|
Definition
Pulseless Vtach/Vfib arrest: 5mg/kg IV/IO
Vtach with a pulse: 5mg/kg IV drip given over 20-60 minutes with a max of 15mg/kg/day |
|
|
Term
|
Definition
| Bradycardia, hypotension, Headache, CHF, abnormal liver/thyroid function. In rare cases can cause pulmonary fibrosis |
|
|
Term
|
Definition
| anticholinergic, parasympatholytic |
|
|
Term
|
Definition
| Inhibits actions of acetylcholine (mostly at muscarinic receptor sites) causing decreasing salivation and bronchial secretions, increased heart rate, decreased gastric motility |
|
|
Term
| Atropine Sulfate Indications |
|
Definition
| Hemodynamically unstable bradycardia, organophosphate or nerve gas poisoning |
|
|
Term
|
Definition
| Tachycardia, Hypersensitivity, avoid use with hypothermic pts, caution in pts with an active MI and hypoxia |
|
|
Term
|
Definition
|
|
Term
| Atropine Sulfate Duration |
|
Definition
|
|
Term
| Atropine Sulfate Adult Dose |
|
Definition
Bradycardia: 0.5mg IV/IO every 3-5min up to a max total of 3mg or .04mg/kg
Organophosphate poisoning: 1-5 mg IV/IM/IO Repeated 3-5 min until cessation of bronchial secretions |
|
|
Term
| Atropine Sulfate Peds Dose |
|
Definition
Bradycardia NOT responding to EPI - 0.02mg/kg IV/IO (min dose of 0.1mg and max single dose 0.5mg) with a max total of 1mg for a child and 3mg for an adolescent.
Organophosphate Peds <12 yrs old: 0.02-0.05mg/kg IV/IM/IO may be repeated every 20-30 minutes until cessation of bronchial secretions |
|
|
Term
| Atropine Sulfate Side Effects |
|
Definition
| Tachycardia, paradoxical bradycardia if given to slow or too small of dose, mydriasis (dilated pupils), dysrhythmias, headache, N/V, dizziness, flushed, anicholinergic effects (dry mouth/Nose/Skin, blurred vision, urinary retention, constipation) |
|
|
Term
|
Definition
| Effects of atropine may be potentiated by antihistamines, procainamide, quinidine, anti psychotics, antidepressants, and thiazides |
|
|
Term
|
Definition
| Electrolyte, Hypertonic Solution |
|
|
Term
|
Definition
| It is essential element for regulating the excitation threshold of nerves and muscles, normal cardiac, contractility, and blood coagulation |
|
|
Term
| Calcium Chloride Indications |
|
Definition
| Hyperkalemia, hypocalcemia, hypermagnesemia, calcium channel blocker overdose |
|
|
Term
|
Definition
| V-fib during cardiac resuscitation, digitalis toxicity, hypercalcemia |
|
|
Term
|
Definition
|
|
Term
| Calcium Chloride Duration |
|
Definition
| Dost dependent but may last up to 4 hours |
|
|
Term
| Calcium Chloride Adult Dose |
|
Definition
| 500-1000mg slow IV of 10% solution |
|
|
Term
| Calcium Chloride Peds Dose |
|
Definition
| 20 mg/kg slow IV of 10% solution |
|
|
Term
| Calcium Chloride Side Effects |
|
Definition
| Bradycarida, hypotension, Metallic Taste in mouth, local necrosis if giving IM or IV infiltration |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| Inhibits calcium ion influx through slow channels into the cell of myocardial and arterial smooth muscle. Slows SA and AV nodal conduction. Dilates coronary arteries and arterioles thus inhibits coronary artery spasms. |
|
|
Term
|
Definition
| A-fib and A-flutter. Multifocal atrial tachycardias. SVT/PSVT refractory to Adenosine |
|
|
Term
|
Definition
| Hypersensitivity, 2nd and 3rd degree heart block, hypotension, cardiogenic shock, ventricular rhythms, sick sinus syndrome, wolf Parkinson White syndrome |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| 0.25mg/kg IV over 2 min, may be repeated in 15 min at 0.35mg/kg IV over 2 min |
|
|
Term
|
Definition
| Not recommended in the prehospital setting |
|
|
Term
|
Definition
| Headache dizziness, hypotension, 1st and 2nd degree heart block, bradycardia, palpations, CHF, Chest pain, ventricular rhythms |
|
|
Term
|
Definition
| Use caution with renal/liver impaired pts and those taking beta blockers |
|
|
Term
|
Definition
|
|
Term
|
Definition
| Sympathomimetic, vasopressor |
|
|
Term
|
Definition
| Acts primarily on alpha 1 and beta adrenergic receptors. At low doses (2-5mcg/kg/min) may act on dopaminergic receptors causing renal, mesenteric, and cerebral vascular dilation. At moderate doses(5-10mcg/kg/min) dopamine stimulates mostly beta 1 receptors causing increased cardiac contractility and output. At high doses (10-20mcg/kg/min) dopamine has mostly alpha 1 stimulation effects causing peripheral arterial and venous constriction. |
|
|
Term
|
Definition
| Hemodynamically significant hypotension in the absence of hypovolemia such as in cardiogenic shock, neurogenic shock, septic shock. Second line pharmacological treatmeant for bradycardia after atropine |
|
|
Term
|
Definition
| Hypovolemia, trauma, tachy dysrhythmias, V-Fib, pts with pheochromocytoma |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| Dopamine Adults and peds dose |
|
Definition
| 2-20 mcg/kg/min IV drip and titrate to desired effect |
|
|
Term
|
Definition
| Tachycardia, hypertension, anxiety, headache, N/V, Increased myocardial oxy demand, mydriasis, dose related tachydysrhythmias |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| Endogenous catecholamine that directly stimulates both alpha and beta 1 and 2 adrenergic receptors. The effects this will have on the heart include increased contractile force, increased rate, and increased cardiac output. Epinephrine is also a potent vasoconstrictor as well as a bronchodilator. Other effects include slowing of gastric motility, miosis, and pale skin |
|
|
Term
|
Definition
| Anaphylaxis, cardiac arrest, asthma, bradycardia (first line in peds, not adults), shock not caused by hypovolemia, severe hypotension accompanied with bradycardia when pacing and atropine fail. |
|
|
Term
|
Definition
| Hypovolemic shock. Caution should be used in pts with known cardiovascular disease or pts over 45 yo |
|
|
Term
|
Definition
| 1-2 min IV and 5-10 Min SQ |
|
|
Term
|
Definition
|
|
Term
|
Definition
Cardiac Arrest: 1mg 1:10,000 IV/IO every 3-5 min with NO max.
Anaphylaxis/asthma 0.3-0.5 SQ/IM 1:1000 If no response some protcols give 0.3-0.5 mg IV 1:10,000.
Post cardiac Arrest or for bradycaridia with severe hypotension - IV drip infusion 2-10mcg/min and titrate to effect |
|
|
Term
|
Definition
Cardiac Arrest: 0.01mg/kg 1:10,000 IV/IO max of 1mg every 3-5 min
Anaphylaxis/asthma: 0.01mg/kg 1:1,000 SQ/IM with a max single dose of 0.3mg |
|
|
Term
|
Definition
| Tachycardia, Hypertension, anxiety, cardiac dysrhytmias, tremors, dyspnea |
|
|
Term
|
Definition
| Always use epi 1:1,000 when giving SQ/IM and 1:10,000 when given IV/IO. Due to sever complications associated with Epi IV drip infusion, this is not typically done in the prehospital field |
|
|
Term
|
Definition
|
|
Term
|
Definition
| Lidocane is a sodium channel blocker that acts primarily on the ventricles of the heart during phase 4 diastolic depolarization which decreases automaticity, suppresses PVC's, and increases the vfib threshold |
|
|
Term
|
Definition
| Significant ventricular ectopy with ischemia/MI,pulseless V-tach or V-Fib cardiac arrest, stable V-Tach with a pulse |
|
|
Term
| Lidocaine Contraindications |
|
Definition
| Hypersensitivity, prophylactic use in an acute MI, 2nd or 3rd degree heart block in the absence of a pacemaker, stokes adams syndrome |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| Lidocaine Adult Dose/Route |
|
Definition
| Pulseless cardiac arrest: 1-1.5mg/kg IV/IO bolus may be repeated every 5-10 minutes with a max total of 3mg/kg. Bolus is followed by a maintenance infusion drip of 1-4mg/min post cardiac arrest. PVC's and V-tach with a pulse: 0,5-0.75mg/kg up to 1-1.5 mg/kg IV/IO may be repeated for a max total dose of 3mg/kg |
|
|
Term
| Lidocaine Peds Dose/Route |
|
Definition
1mg/kg IV/IO followed by a maintenance infusion drip of 20-50 mcg/kg/min post cardiac arrest.
PVC's and V-tach with a pulse: 1mg/kg IV/IO |
|
|
Term
|
Definition
| Blurred vision, dizziness, hypotension, bradycardia, seizures, ALOC |
|
|
Term
|
Definition
| Use caution in pts with impaired Liver/renal function and the elderly. May half dose initial dose for pts >70 yo |
|
|
Term
|
Definition
|
|
Term
|
Definition
| electrolyte, anti convulsant |
|
|
Term
|
Definition
| Reduces skeletal muscle contractions and block peripheral neuromuscular transmissions by reducing acteylcholine release at the myoneural junction. |
|
|
Term
| Magnesium Sulfate Indications |
|
Definition
| Seizures due to eclampsia after the seizure activity has stopped, torsades de pointes, unstable vtach due to digitalis toxicity, hypomagnesimia, status asthmaticus not responsive to beta andrenergic drugs |
|
|
Term
|
Definition
| Any heart block or myocardial damage, hypotension |
|
|
Term
|
Definition
|
|
Term
| Magnesium Sulfate Duration |
|
Definition
|
|
Term
| Magnesium Sulfate Adult Dose/route |
|
Definition
Pulseless Arrest( hypomagnesemia and torsades de pointes) and status asthmaticus: 1-2g IV/IO diluted in 10ml D5W. Hypomagnesemia or torsades with a pulse: 1-2g diluted in 100ml D5W given over 5-60min IV.
Eclampsia: 1-4g IV with a max of 30-40g/day |
|
|
Term
| Magnesium Sulfate Peds Dose/route |
|
Definition
| Pulseless arrest or hypomagnesemia/ torsades with a pulse 25-50mg/kg IV/IO (max 2g) given over 10-20min. Status Asthmaticus 25-50mg/kg (Max 2g) IV/IO given over 15-30 min. |
|
|
Term
| Magnesium Sulfate Side effects |
|
Definition
| Hypotension, facial flushing, hyporeflexia (decreased reflexes), bradycardia, respiratory depression, diaphoresis |
|
|
Term
|
Definition
| If overdoes is suspected ( usually by decreased deep tendon reflexes) may give calcium chloride or calcium gluconate to reverse effects. |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| Blocks beta adrenergic receptor sites in the heart, lungs, and blood vessels. The beta 1 blocking action on the heart decreases heart rate, conduction velocity, myocardial contractility, and cardiac output. The beta 2 effects may result in bronchoconstriction. |
|
|
Term
|
Definition
| Supraventricular tachycardias (SVT/PSVT), Atrial Fibrillation, Atrial Flutter, to reduce myocardial ischemia and damage in acute MI/unstable angina |
|
|
Term
| Metoprolol Contraindications |
|
Definition
| Hemodynamically unstable pts, CHF, decreased cardiac output, cardiogenic shock. Relative Contras with 2nd or 3rd degree heart blocks, asthma, RAD, severe bradycardia, and SBP <100 |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| 5 mg slow IV at 5 minute intervals and may repeat up to 15 mg max |
|
|
Term
|
Definition
| not recommended in prehospital setting |
|
|
Term
|
Definition
| Bradycardia, Hypotension, AV conduction delays, palpitations |
|
|
Term
|
Definition
| If given in conjuction with calcium channel blockers, such as verapamil and cardizem, may cause severe hypotension. Caution with pt's with liver/renal dysfunction |
|
|
Term
|
Definition
|
|
Term
|
Definition
| Suppresses phase 4 depolarization in normal ventricular muscle and purkinje fibers, reducing the automaticity of ectopic pacemakers. Suppress reentry dysrhythmias by slowing intraventricular conduction. |
|
|
Term
|
Definition
| Stable V-tach, Reentry SVT not controlled by adenosine/ vagal maneuvers, A-Fib with a rapid rate with WPW syndrome |
|
|
Term
| Procainamide Contraindactions |
|
Definition
| 2nd and 3rd degree heart blocks without a functioning artificial pacemaker in place, digitalis toxicity, torsades de pointes, tricyclic antidepressant overdose |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| 20-50 mg/min slow infusion drip with a total dose of 17mg/min. Maintainence drip post cardiac arrest of 1 gm in 250 ml d5w or ns infuse at 1-4mg/min |
|
|
Term
|
Definition
| Loading Dose 15mg/kg IV/IO and infuse over 30-60 minutes |
|
|
Term
| Procainamide Side Effects |
|
Definition
| hypotension, bradycardia, reflex tachycardia, AV block, widening QRS complex, prolonged PR or QT interval, PVC's, vfib/vtach/asystole, seizures, CNS depression |
|
|
Term
|
Definition
| Stop use immediately for the following: reached max dose of 17mg/kg, QRS widens >50%, dysrhythmia resolves, and pt become hypotensive. |
|
|
Term
|
Definition
| PH buffer, Alkalizing agent, electrolyte supplement |
|
|
Term
| Sodium Bicarbonate Action |
|
Definition
| Sodium Bicarbonate is a short acting, potent acid buffer. The bicarbonate (HC03) binds to hydrogen Ions (H+) to make carbonic acid (H2C03). This is broken down in the lungs and exhaled as water H20 and carbon dioxide C02. As a plasma hydrogen ion concentration decreases causing blood ph to rise |
|
|
Term
| Sodium Bicarbonate Indications |
|
Definition
| Tricyclic antidepressant (TCA) overdose, management of metabolic acidosis, prolonged cardiac arrest down time, known preexisting hyperkalemia, DKA, alkalinization treatment for specific intoxications/rhabdomyolysis |
|
|
Term
| Sodium Bicarbonate Contraindications |
|
Definition
| Hypokalemia, suspected metabolic or respiratory alkalosis, hypernatremia, pts with chloride loss due to vomiting or GI suction, severe pulmonary edema. |
|
|
Term
|
Definition
|
|
Term
| Sodium Bicarbonate Duration |
|
Definition
|
|
Term
| Sodium Bicarbonate Adult Dose |
|
Definition
|
|
Term
| Sodium Bicarbonate Peds Dose |
|
Definition
| Same as adult but infuse slowly and only if ventilations are adequate |
|
|
Term
| Sodium Bicarbonate Side Effects |
|
Definition
| Metabolic alkalosis, seizures |
|
|
Term
|
Definition
| Should not be given at the same time as other electrolytes, be sure to flush IV thoroughly or use separate IV sites. Not recommended for and ineffective in hypercarbic acidosis such as seen in cardiac arrest and CPR without intubation |
|
|
Term
|
Definition
|
|
Term
|
Definition
| Furosemide is a potent diuretic that inhibits reabsorbtion of sodium and cholride in the proximal tubule and loop on Henle. IV doses can also reduce cardiac preload by increasing venous capacitance |
|
|
Term
|
Definition
| Pulmonary Edema (CHF) with SBP >90, hypertensive emergencies, Hyperkalemia |
|
|
Term
|
Definition
| Anuria, hypersensitivity, hypovolemia, hypokalemia |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| 0.5-1 mg/kg IV over 1-2 min. If no response double dose to 2 mg/kg over 1-2 min. Most services allow a max total of 40-80 mg IV |
|
|
Term
|
Definition
| 1 mg/kg/dose IV over 1-2 min with a total max of 6 mg/kg |
|
|
Term
|
Definition
| Tinitus (if given to quickly), Hypotension, Hypokalemia, hyponatremia, hypocalcemia, hyperglycemia |
|
|
Term
|
Definition
| Must give slowly or may cause permanent hearing problems |
|
|
