Studydroid is shutting down on January 1st, 2019



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Epninephrine
  • Alpha, Beta1, Beta2
  • ^SVR, ^MAP, ^HR
  • Increased coronary/cerebral blood flow potentially beneficail to cardio-resp arrest
  • V-fib, pulseless V-tach, symtomatic bradycardia
  • 1mg of 1/10000 solution intervals no greater then 3-5 min
Vasopressin - Pitressin
  • Potent vasoconstrictor
  • Effects- ^SVR, ^MAP
  • Increased coronary/cerebral perfusion
  • Dosage- 40U IV, single dose, 1 time
  • Used in place of 1st or 2nd dose of epinephrine
Amiodarone - Cordarone
  • Mech- Delays repolarization, prolongs refractory period
  • Indications- V-fib,pulseless V-tach, recurrent hemodynamically unstable V-tach
  • Dosage- 300 mg IV push. May repeat once at 150 mg in 3-5 min
  • Max 24 hr dose 2.2g IV in 24 hours
Atropine
  • Parasympatholytic
  • Enhances S/A node automaticity, enhances A/V conduction, ^ HR
  • Indications- Symptomatic bradycardia, used for pts w/normal HR who would benefit from higher HR
  • Dosage- .5-1.0 mg IV at 3-5 min intervals till desired effects achieved
Lidocaine - Xylocaine
  • Suppresses V-tach by decreasing automaticity
  • Decreases slope of phase 4 action potential
  • Acts on ischemic myocardial tissue
  • Indications- V-fib, pulseless V-tach, PVC's, V-fib in pts w/MI
  • Precautions- CNS depression
  • Toxic doses may produce convulsions/resp arrest
Magnesium Sulfate
  • Indications- Suspected hypomagnesemia or torsades de pointes
Procainamide - Pronestyl
  • Anti-Rythmic
  • Mech- Suppresses Ventricular arrythmia by decreasing automaticity by decreasing slope of phase 4 of action potential
  • Indications- PVC's, pulseless v-tach, v-fib not controlled by lidocaine
  • Precautions- Hypotension
Sodium Bicarbonate
  • Indications- pre exisiting hyperkalemia, metabolic acidosis, some drug overdoses, prorated code (intubated), return of circulation after long code.
  • Dosage- 1mEg/Kg IV
  • Precautions- Not recommended for routine use in cardiac arrest
Norepinephrine - Levophed
  • Potent vasoconstrictor
  • Mech- Increases permeability of cell ion channels, strong alpha/beta1
  • Cardio effects- ^automaticity due to ^Ca++, ^contractility, ^SVR.
  • Used to increase BP
  • Indications- Hypotension refractory to other sympathomimetics 
Dopamine - Intropin
  • Indications- Hypotension in absence of hypovolemia
  • Low dosage - 1-2 ug/kg/min ^urinary output
  • Med Dosage- 2-10ug/kg/min ^CO w/modest increase in preload & SVR. Bradycardia tx
  • High dosage- >10 ug/kg/min Alpha adrenergic effects predominate

Dobutamine - Dobutrex
  • Mech- Beta 1, Alpha 1 adrenergic, Beta 2 effects antgonize Alpha 1 effects
  • Does not stimulate release of norepinephrine
  • Cardio effects- ^Coronary blood flow, positive inotropic effects
Digoxin or Digitoxin
  • Mech- Decreases automaticity of SA node, dec AV conduction, inc refractory period of AV node
  • Indications- CHF, A-fib, A flutter, SVT if pt hemodynamically stable
Digoxin vs Digitoxin
  • Digoxin- glycoside of choice, eliminated by kidneys
  • Digitoxin- eliminated by liver, used when levels must be very stable, renal or compliane problems
  • Digatalis toxicity- Both drugs, withdraw dig/K excreting dieuretics (Lassix)
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