Nitroprusside purpose
decreases preload and afterload by vasodilation (mainly afterload)
Dobutamine mechanism of
... [Show More] action
contractility
Dopamine at a low-end dose "renal dose"
0.5-4mcg/kg/min
increases renal and mesentric perfusion
Dopamine at a mid-range dose
4-10mcg/kg/min
increases contractility and heart rate
Dopamine at a high-range dose
greater than 10mcg/kg/min
vasoconstriction and increases BP
Dopamine and Levophed infiltration
leads to tissue necrosis
Dopamine antidote
regitine (phentolamine)
TpA monitor for
bleeding-hemorrhagic CVA
diltiazem (cardizem) works by?
(calcium channel blocker) slows ventricular rate by slowing conduction through the SA and AV node
Diltazem (cardizem) biggest effect on which hemodynamic
hypotension
diltazem is used for patients with
a-fib or a-flutter
amiodarone (Cordarone) is a
antiarrythmic
prolongs the cardiac duration
You MUST use a __________ when using amiodarone infusion
0.22 micron filter
Watch out for ____________ in patients on a amiodarone infusion
hypotension, prolongation of QT interval and bradycardia
amiodarone is used for patients with
a-fib, a-flutter and VT
how much amiodarone is given to a stable VT with a pulse and a unstable pulseless VT/VF?
150mg over 10min for VT with pulse
300mg push; repeat x1 at 150mg
Epinephrine has what effect on the body?
increases HR, BP, and contractility
what is the first line drug for pulseless arrest?
Epinephrine
What rhythms are considered fatal?
V-fib, Vtach (pulseless), and asystole
Epinephrine is also given for?
anaphylaxis and as a vasopressor for hypotension
Heparin is used for? Antidote is?
anticoagulant
Protamine Sulfate
What is the osmotic diuretic of choice to decrease intracranial pressure?
mannitol
How does mannitol work?
pulls fluids into intravascular space to be excreted by the kidneys to reduce intracranial pressure
what insulin is given IV?
What is the peak?
Regular insulin can only be given IV
2-4 hr peak time
Which insulin has a peak of 8-14 hrs?
NPH
Atropine is ineffective in which heart rhythms types?
high degree AV blocks: 2nd degree type2 and 3rd degree
Atropine works by?
increasing heart rate-increasing conduction through SA node
Atropine is given to treat?
symptomatic bradycardia
Dilantin is given to treat
seizure disorders
DO NOT give __________ with dilantin because ________ will happen.
DO NOT give with dextrose containing solutions because it will crystalize
Which corticosteroid is usually given in insufficient adrenal activity or hypersensitivity/inflammation reactions?
Cortisone
If chronically using cortisone be sure to _____ to prevent _____.
If chronically using cortisone be sure to taper the medications to prevent acute adrenal insufficiency
This medication is a cardiac glycoside that increases contractility.
Digoxin
Digoxin increases contractility by
slowing the heart rate which decreases conduction through the AV node
What should be monitored in patients taking Digoxin?
hypotension, bradycardia, and symptoms of toxicity
Signs/Symptoms of Digoxin toxicity
nausea, yellow vision/halo, paroxysmal atrial tachycardia (PAT with block).
True/Flase:
Digoxin WILL NOT cause rapid AV conduction or hypertension
True
what medication is a antiarrhythmic that suppresses automaticity and depolarization?
lidocaine
Lidocaine is used to treat?
ventricular dysrhythmias
lidocaine toxicity sign
mental confusion/change in LOC
Monitor serum levels with _________
Lidocaine
DO NOT give _______ medications to patients with suppressed respirations
Narcotics (morphine, dilaudid)
What changes on a EKG would you expect to see on a patient with a acute MI?
ST elevation
normal QRS:
Prolonged QRS indicates:
<0.12 seconds is normal QRS
prolonged QRS indicates intraventricular conduction defect, typically a bundle branch block
Distinguishing V-fib
fibrillatory waves with no recognizable pattern
Defib the Vfib
Distinguishing V-Tach
atrial rhythm and rate cannot be identified
"Tombstones"
First degree block interpretation
looks like sinus rhythm but the PR is longer than normal. there will be 1 p for every qrs, but the PR interval will be greater than 0.20 sec
Type 1 second degree block interpretation
"Wenckebach"
"Longer, Longer... drop" prolonged PR intervals and the missing QRS
Type 2 second degree block interpretation
PR interval is constant...QRS is missing
"2 small p waves right after each other"
give atropine, dopamine, or epi to increase HR is symptomatic bradycardic
Third degree AV block interpretation
a strip of p-waves laid independently over a strip of QRS complexes. Note that the p wave doesn't conduct the QRS complex that follows it. [Show Less]