Sunday, November 11, 2012

More Cardiac Drugs

The following three drugs help with patients who are suffering from a cardiac-related emergency.


Epi 1:10,000

Class:  Sympathomimetic
MOA:  Alpha 1, Beta 1, Beat 2 stimulation
Indications:  Cardiac Arrest; Anaphylaxis; Bradycardia
Contraindications:  None in emergency setting
Side Effects:  Palpitations; Anxiety; N&V
Onset/Duration:  Immediate / 10 min
Route:  IV, IO, IM Drip, ET
Considerations:  Pregnancy Class “C” drug
       Cardiac Arrest:  1mg IVP every 3-5 min       Anaphylaxis: 0.3-0.5 mg IVP       Bradycardia: 2-10 mcg/kg  PEDS
        Cardiac Arrest:  0.01 mg/kg IVP every 3-5 minSupplied: 1mg/ 10mL


Adenosine (Adenocard)

Class:  Antiarrhythmic
MOA:  Works by interrupting re-entry pathways trough the AV nodes, slowing AV conduction causing refractory period to prolong.
Indications:  SVT
Contraindications:  Allergy
Side Effects:  Bradycardia; Asystole; Facial Flushing; CP; Light-headedness
Onset/Duration:  Immediate / 12 seconds
Route:  IV
Considerations:  Elevate arm, rapid IVP in most central site followed by 20 mL flush.
                           Be careful in patients who have Wolf Parkinson's White (WPW)
        Adult:  6mg --> 12mg (only if ineffective after 2 min)
        PEDS:  0.1 mg/kg (MAX 6mg), if ineffective, then 0.2 mgkg (MAX 12 mg)
Supplied:  6mg/ 1mL ampules


Amiodarone (Cordarone)
Class:  Antiarrhythmic (Potassium Channel Blocker)
MOA:  Blocks the potassium channels, in doing so it delays the hearts ability to repolarize. This will   prolong the QT interval on the ECG/EKG.
Indications:  VTACH with a Pulse; VTACH without a Pulse; VFIB
Contraindications:  Allergy; Bradycardia; AV Blocks
Side Effects:  Allergic reaction; Bradycardia; AV Blocks
Onset/Duration:  Immediate / 40 days (half life)
Route:  IV; IO
Considerations:   Get 12-lead before, to determine VTACH
       VTACH + Pulse:  150mg IV given over 10 minutes
       VTACH – Pulse:  300mg IVP à (after 5 min) 150mg IVP
       VFIB:  300mg IVP à (after 5 min) 150mg IVP
       VTACH + Pulse:  5mg/kg IV given over 20 minutes
       VTACH – Pulse:  5mg/kg IVP
       VFIB:  5mg/kg IVP
Supplied:  150mg vials & 150mg/ 3mL

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