Sodium Bicarb & Cardizem

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Author:
cjl410
ID:
185763
Filename:
Sodium Bicarb & Cardizem
Updated:
2012-11-27 21:04:19
Tags:
Phoenix College Paramedic 2012 2013 Drug Profiles Sodium Bicarb Cardizem
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Phoenix College Paramedic 2012 2013 Drug Profiles - Sodium Bicarb & Cardizem
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  1. What is the generic name for Sodium Bicarbinate?
    sodium bicarbinate 8.4%
  2. What is the brand name for Sodium Bicarbinate?
    Sodium Bicarbinate 8.4%
  3. What is the class for Sodium Bicarbinate?
    Buffer
  4. What is the mechanism of action for Sodium Bicarbinate?
    • Act as a buffering agent
    • Buffer H+ increases pH
  5. What are the indication and field use for Sodium Bicarbinate?
    • Pre-existing metabolic acidosis
    • OD of ASA, cyclic antidepressants
    • Cardiac arrest after other interventions and ventillation is adequate
  6. What is the dosage for Sodium Bicarbinate?
    IV bolus or infusion

    • Adult - 
    • Pre-existing metabolic acidosis
    •   50-100mEq IV per medical control

    • OD of ASA, cyclic antidepressants
    •    contact medical control

    • Cardiac arrest after other interventions and ventilation is adequate
    •    0.5-1mEq/kg repeat with 0.5mEq/kg q 10 minutes after defib, ventilation, intubation and at least one epi
  7. Contraindications for Sodium Bicarbinate?
    Alkalosis
  8. Drug interactions for Sodium Bicarbinate?
    Incompatible with other drug infusions
  9. Side effects for Sodium Bicarbinate?
    • CHF
    • Hypernatremia
    • Edema
    • Metabolic alkalosis
  10. What is the onset of action for Sodium Bicarbinate?
    Seconds
  11. What is the duration of action for Sodium Bicarbinate?
    10 minutes
  12. What is the AZ drug box supply for Sodium Bicarbinate?
    2 x 50mEq in 50cc prefilled syringes
  13. What is the generic name for Cardizem?
    diltiazem
  14. What is the brand name for Cardizem?
    Cardizem
  15. What is the class for Cardizem?
    Calcium Channel Blocker
  16. What is the mechanism of action for Cardizem?
    • Blocks calcium channels in myocardial cell slowing influx of calcium ions
    •    Reduces force of contraction
    •    Slows heart rate
    •    Slows A/V node conduction
    •    Slows ventricular response from A-Fib/A-Flutter

    • Blocks calcium channels in vascular smooth muscle slowing influx of calcium ions
    •    Dilation of coronary arteries
    •    Dilation of peripheral blood vessels
  17. Indication and field use for Cardizem?
    • Rapid ventricular response from A-Fib/A-Flutter
    •    Why?
    •       Slows influx of calcium ions reducing ventricular response

    • SVT refractory to Adenosine
    •    Why?
    •       Slows influx of calcium ions reducing heart rate and AV node conduction
  18. What is the dosage for Cardizem?
    All doses are VERY slow IV push over several minutes with patient supine followed by a maintenance infusion

    Adult

    Cardizem 0.25 mg/kg very slow IV push over 3 minutes.  May repeat in 15 minutes at 0.35mg/kg.  If sucessful

    For infusion, add 50mg to 50cc NS bag or 100mg to 100cc NS bag making 1mg per 1cc
  19. Contraindications for Cardizem?
    • Wolff-Parkinson-White (WPW)
    • Hypotension
    • Any wide QRS tachycardia
    • Cardiogenic shock
    • Concurrent IV beta-blocker use
  20. Drug interactions for Cardizem?
    • Hypotension potentiated by other calcium channel blockers or beta-blockers
    • Hypotension might be reversed by Calcium Chloride & IV fluids
    • Calcium Chloride pretreatment recommended if BP is marginal
  21. Side effects for Cardizem?
    • Cardiogenic shock
    • CHF
    • Hypotension
    • Heart block
    • Headache
    • Asystole
    • Dizziness
    • Bradycadia
    • N/V
  22. Onset of action for Cardizem?
    Immediate
  23. Peak effect for Cardizem?
    2 hours
  24. Duration of action for Cardizem?
    4-6 hours
  25. AZ drug box supply for Cardizem?
    2 x 5cc or 10cc vial of 5mg per 1cc

    (2 x 25mg or 50mg in 5cc or 10cc vial)

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