week 4 pam 103

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kevinkuczma
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261216
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week 4 pam 103
Updated:
2014-02-10 13:23:46
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pam drugs
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pam drugs
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  1. Propranolol (Inderal)
    class
    Sympathetic blocker
  2. Propranolol (Inderal)
    action
    Nonselectively blocks Beta-adrenergic receptors
  3. Propranolol (Inderal)
    Indication
    • Stable, narrow-complex tachycardia
    • Rate control in atrial fibrillation or atrial flutter
  4. Propranolol (Inderal)
    contraindication
    • Asthma and COPD
    • CHF
    • PTs dependent on sympathetic agonists
  5. Propranolol (Inderal)
    Precautions
    • Should not be given concurrently with Verapamil
    • Atropine and transcutaneous pacing should be readily available
  6. Propranolol (Inderal)
    side effects
    • Bradycardia
    • Heart blocks
    • CHF
    • Bronchospasm
  7. Propranolol (Inderal)
    adult dose
    IV: 1-3mg diluted in 10-30cc of D5W given slowly
  8. Propranolol (Inderal)
    route
    Slow IV bolus
  9. Propranolol (Inderal)
    Ped dose
    0.01mg/kg
  10. Sotalol HCL (Betapace, Sotacor)
    Class
    Antiarrhythmic (Class II) and Nonselective Beta-adrenergic blocking agent
  11. Sotalol HCL (Betapace, Sotacor)
    Action
    • Blocks stimulation of Beta-1 (Myocardial) and Beta-2 (Pulmonary, vascular, and uterine) adrenergic receptor sites
    • Suppression of arrhythmias
  12. Sotalol HCL (Betapace, Sotacor)
    Indications
    Hemodynamically-stable monomorphic ventricular tachycardia
  13. Sotalol HCL (Betapace, Sotacor)
    Contraindications
    • Uncompensated CHF
    • Pulmonary edema
    • Cardiogenic shock
    • Bradycardia 
    • heart block
  14. Sotalol HCL (Betapace, Sotacor)
    Precautions
    • Renal impairment
    • Hepatic impairment
  15. Sotalol HCL (Betapace, Sotacor)
    Side effects
    • Fatigue
    • Weakness
    • Anxiety
    • Dizziness
    • Drowsiness
    • Insomnia
    • Memory loss
    • Mental depression
    • Mental status changes
    • Nervousness
    • Nightmares
  16. Sotalol HCL (Betapace, Sotacor)
    Adult Dose
    IV: 1.5mg/kg over 5 minutes (slow infusion preferred)
  17. Sotalol HCL (Betapace, Sotacor)
    route
    • IV
    • PO
  18. Sotalol HCL (Betapace, Sotacor)
    ped dose
    not indicated
  19. Metoprolol (Lopressor)
    Class
    • Sympathetic blocker (Beta-2 selective)
    • Antiarrhythmic (Class II)
  20. Metoprolol (Lopressor) 
    Action
    Selectively blocks Beta-2 adrenergic receptors (cardioprotective)
  21. Metoprolol (Lopressor) 
    Indication
    • Suspected or definite acute MI in hemodynamically stable PTs
    • Stable, narrow-complex tachycardias if rhythm remains uncontrolled or unconverted by adenosine or vagal maneuvers or if SVT is recurrent
    • Control ventricular rate in PTs with atrial fibrillation or flutter
    • Certain forms of polymorphic VT (associated with acute ischemia, familial Long QT syndrome, catecholaminergic)
  22. Metoprolol (Lopressor) 
    Contraindication
    • HR <45BPM
    • Systolic BP<100mmHg
    • Heart block
    • Shock
    • History of asthma
  23. Metoprolol (Lopressor) 
    Precautions
    • BP, HR, and EKG should be monitored constantly
    • Atropine and transcutaneous pacing should be available.
  24. Metoprolol (Lopressor) 
    Side Effects
    • Bradycardia
    • Heartblock
    • CHF
    • Depression
    • Bronchospasm
  25. Metoprolol (Lopressor) 
    Adult dose
    • Initial bolus of 5mg slow IVP
    • May repeat 5 mg bolus in 5 minutes if vitals are stable
    • May repeat 5mg bolus in 10 minutes if vitals are stable
  26. Metoprolol (Lopressor) 
    Route
    Slow IV bolus
  27. Metoprolol (Lopressor) 
    Ped dose
    Safety in children has not been established
  28. Labetalol (Trandate, Normodyne) 
    Class
    Sympathetic blocker
  29. Labetalol (Trandate, Normodyne) 
    Action
    Selectively blocks Alpha-1 receptors and nonselectively blocks Beta receptors.
  30. Labetalol (Trandate, Normodyne) 
    Indication
    Hypertensive emergency
  31. Labetalol (Trandate, Normodyne) 
    contraindication
    • Bronchial asthma
    • CHF
    • Heartblock
    • Bradycardia
    • Cardiogenic shock
  32. Labetalol (Trandate, Normodyne) 
    Precautions
    • BP, HR, and EKG should be monitored constantly
    • Atropine should be available
  33. Labetalol (Trandate, Normodyne) 
    Side effects
    • Bradycardia
    • Heartblock
    • CHF
    • Bronchospasm
    • Postural hypotension
  34. Labetalol (Trandate, Normodyne) 
    Adult dose
    • 20mg slow IV infusion over 2 minutes
    • doses of 40mg can be repeated in 10 minutes until desired supine BP is obtained or until 300mg had been given
    • 200mg placed in 500cc D5W to deliver at 2mg/min
  35. Labetalol (Trandate, Normodyne) 
    route
    IV infusion or slow IV bolus as described earlier
  36. Labetalol (Trandate, Normodyne) 
    ped dose
    Safety in children has not been established

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