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OCEMS Pharmacology - Drug Guide Questions With Answers Graded A+ Assured Success

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Adenosine ped dose - ️️BASE HOSPITAL ORDER: 0.2mg/kg rapid IVP in a port closest to patient followed by a rapid 5ml NS flush; may repeat with 0.2mg/kg rapid IVP in 2 minutes if tachycardia persists Adenosine side effects - ️️Chest pain/pressure, Hypotension, Transient PAC/PVCs, Transi...

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  • October 10, 2024
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PatrickKaylian
OCEMS Pharmacology - Drug Guide
Adenosine ped dose - ✔️✔️BASE HOSPITAL ORDER: 0.2mg/kg rapid IVP in a port
closest to patient followed by a rapid 5ml NS flush; may repeat with 0.2mg/kg rapid IVP
in 2 minutes if tachycardia persists

Adenosine side effects - ✔️✔️Chest pain/pressure,
Hypotension,
Transient PAC/PVCs,
Transient bradycardia/sinus arrest,
Metallic taste,
Throat tightness,
Facial flushing

Adenosine Classification - ✔️✔️Antiarrhythmic

Adenosine Mech of Action - ✔️✔️Depress automaticity in sinus node and Purkinje
fibers

Slows AV conduction and interrupts reentry pathways thru AV node

Immed onset w/ duration less than 10 sec


Adenosine contraindications - ✔️✔️Known adenosine hypersensitivity, 2nd or 3rd
degree AV block w/o functioning pacemaker

Adenosine dosage form - ✔️✔️3mg/1ml (12mg/4ml prefill)

Adenosine adult dose - ✔️✔️12mg rapid IVP in a port closest to patient followed by
rapid 10ml NS flush; may repeat 12 mg rapid IVP once after 3 minutes if tachycardia >/=
150 persists


Adenosine Precautions/comments - ✔️✔️Start IV in AC vein

Drug is metabolized in 10 seconds

Must flush by injecting the NS flush, running the IV wide open is not an adequate flush

History of "sick sinus" syndrome, 2nd or 3rd degree heart block without pacemaker
**reactive airway disease (asthma/COPD) may have bronchospasm

,Does not convert atrial flutter or fibrillation;

Persantine (Dipyridamole) and Tegretol can cause a heart block-need to use a lower
dose

Due to denervation of heart, use with extreme caution in cardiac transplant recipients -
may have persistent asystole

Theophylline preparations can render adenosine ineffective, may need a higher dose

If SBP <90, s/s of cardiac ischemia or poor perfusion including associated chest pain,
shortness of breath, pulmonary congestion or congestive heart failure, hypotension or
shock, altered skins or decreased capillary refill use cardioversion before drug therapy

Albuterol Classification - ✔️✔️Bronchodilator

Albuterol Mech of Action - ✔️✔️Stimulates beta adrenergic receptors; beta-2 effects
(bronchodilation) dominating over beta-1 effects (inc HR); relaxation of airway smooth
muscle with subsequent bronchodilation

Albuterol Indications - ✔️✔️Asthma/COPD; bronchospasm/wheezing/smoke inhalation;
Crush injury-potassium control

Albuterol Contraindications - ✔️✔️None

Albuterol Dosage form - ✔️✔️3.0 ml (2.5mg) of 0.083% solution unit dose; 90mcg MDI

Albuterol Adult dose - ✔️✔️6ml (5mg) continuous nebulization as tolerated

Albuterol Ped dose - ✔️✔️6ml (5mg) continuous nebulization as tolerated

Albuterol Side Effects - ✔️✔️Palpitations
Tachycardia
Nausea
Nervousness

Amiodarone Classification - ✔️✔️Antiarrhythmic
Potassium channel blocker

Amiodarone Mech of Action - ✔️✔️Blocks alpha and beta adrenergic receptors
(antianginal & sympatholytic)

Slows the sinus rate

Increases the PR & QT intervals

, Decreases peripheral vascular resistance by relaxing smooth muscle (causing
vasodilation, esp in coronary arteries)

Amiodarone Indications - ✔️✔️Unstable wide complex with SBP <90, chest pain,
altered LOC, signs of poor perfusion)

Wide complex tachycardia with pulse if cardioversion is unsuccessful;

V-Fib or Wide complex Tach without a pulse

Amiodarone Contraindications - ✔️✔️Severe sinus node dysfunction

2nd and 3rd degree AV heart block

Sinus bradycardia

Hypersensitivity to amiodarone or iodine

If Lidocaine has already been administered

Amiodarone Dosage form - ✔️✔️50mg in a 1ml solution; prefills and vials

Amiodarone Adult dose - ✔️✔️V-Fib: 300mg IV/IO, may repeat with 150mg once in ~3
minutes (MAX = 450mg)

Unstable Wide Complex Tachycardia With Pulse, if cardioversion unsuccessful: 150mg
slow IV, allow to circulate for 2 minutes may repeat once after ~3 minutes and after 2nd
attempt of cardioversion (MAX = 300mg)

BASE HOSP ORDER: Automatic Implanted Cardiac Defibrillator (AICD) is in place and
discharges >/= 2 firings in 15 minutes: 150mg slow IV (hold if allergic to or presently
taking Amiodarone)

Amiodarone Ped dose - ✔️✔️V-Fib: 5mg/kg IV/IO, may repeat 5mg/kg IV/IO in 5
minutes and 10 minutes

BASE HOSP ORDER: Wide Complex Tachycardia without a pulse

Amiodarone Side Effects - ✔️✔️Worsening of arrhythmias
CHF
Bradycardia
Hypotension
Heart blocks

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