Cardiology Medication Review

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Questions and Answers

Which medication is most appropriate for increasing blood pressure in a bradycardic patient?

  • Adenosine 6mg rapid IV push
  • Dopamine 5-20 mcg/kg/min (correct)
  • Atropine 0.5mg IV push
  • Magnesium Sulfate 2g IV infusion

What change in heart rate (HR) is most indicative of increased parasympathetic nervous system (PNS) activation?

  • Decreased HR (correct)
  • Increased HR
  • No change in HR
  • Irregular HR patterns

Epinephrine's effects include all of the following EXCEPT:

  • Increased heart rate
  • Increased myocardial contractility
  • Decreased vascular resistance (correct)
  • Bronchodilation

What is the primary treatment for Torsades de Pointes?

<p>Magnesium Sulfate (C)</p> Signup and view all the answers

Which of the following is NOT a characteristic effect of the sympathetic nervous system?

<p>Decreased contractile force (C)</p> Signup and view all the answers

Which of the following is the correct equation for calculating cardiac output (CO)?

<p>CO = SV x HR (A)</p> Signup and view all the answers

Lidocaine exerts its antiarrhythmic effects through which mechanism?

<p>Sodium channel blockade (A)</p> Signup and view all the answers

What is the correct dose of epinephrine for pediatric CPR using epinephrine 1:10,000?

<p>0.01 mg/kg (C)</p> Signup and view all the answers

A medication with a positive inotropic effect will have what impact on the heart's contractions?

<p>Increase in force (A)</p> Signup and view all the answers

To which drug class does verapamil belong?

<p>Calcium channel blocker (B)</p> Signup and view all the answers

What is the initial dose of lidocaine for an adult patient experiencing a life-threatening arrhythmia?

<p>1.5 mg/kg (C)</p> Signup and view all the answers

In the context of cardiac arrest, vasopressin can potentially replace which dose(s) of epinephrine?

<p>Either the first or second dose (C)</p> Signup and view all the answers

What is the typical initial bolus dose of amiodarone, followed by the repeat dose for refractory ventricular arrhythmias ?

<p>300mg, followed by 150mg (C)</p> Signup and view all the answers

What paradoxical effect can occur if atropine is administered too slowly?

<p>Paradoxical bradycardia (B)</p> Signup and view all the answers

Which of the following is NOT a characteristic EKG change associated with procainamide infusion?

<p>QRS complex is narrowed by 50% (A)</p> Signup and view all the answers

Epinephrine exhibits its greatest positive inotropic and chronotropic effects and causes vascular dilation. True or false?

<p>False (B)</p> Signup and view all the answers

Which class of drugs reduces blood pressure primarily by reducing circulatory blood volume via increased excretion through the kidneys?

<p>Diuretics (D)</p> Signup and view all the answers

What is amiodarone's primary mechanism of action on cardiac muscle?

<p>Blocking efflux of potassium (C)</p> Signup and view all the answers

For a patient in cardiac arrest, after initial unsuccessful defibrillation, the subsequent energy level for the second shock should be:

<p>The same as the initial shock (C)</p> Signup and view all the answers

In the treatment of symptomatic bradycardia, when is transcutaneous pacing indicated?

<p>When atropine is ineffective (B)</p> Signup and view all the answers

Flashcards

Dopamine for Bradycardia

Dopamine at 5-20 mcg/kg/min can increase blood pressure in bradycardic patients.

PNS effect on HR

Activation of the parasympathetic nervous system (PNS) leads to a decrease in heart rate.

Epinephrine's Effects

Epinephrine (Epi) increases vascular resistance.

Torsades Treatment

Torsades de Pointes is primarily treated with Magnesium Sulfate.

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Sympathetic Nervous System

The sympathetic nervous system increases contractile force, not decrease it.

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Cardiac Output Equation

CO = SV x HR (Cardiac Output = Stroke Volume x Heart Rate)

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Lidocaine Class

Lidocaine acts as a sodium channel blocker.

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Pediatric CPR Epi Dose

Epinephrine dose for pediatric CPR is 0.01 mg/kg of 1:10,000 epinephrine.

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Positive Inotropic Effect

A medication with a positive inotropic effect will cause an INCREASE in the heart's contraction force.

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Verapamil Drug Class

Verapamil is a calcium channel blocker.

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Initial Lidocaine Dose

Initial lidocaine dose for an adult is 1.5mg/kg.

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Vasopressin in Cardiac Arrest

Vasopressin can replace the first or second dose of epinephrine in cardiac arrest.

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Amiodarone Dosing

The initial dose of amiodarone is 300mg, followed by 150mg as a repeat dose.

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Atropine Administration risks

When atropine is pushed too slowly, it can cause a paradoxical effect (bradycardia).

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Diuretics Mechanism

Diuretics reduce blood pressure by reducing circulatory blood volume in the kidneys.

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Amiodarone MOA

Amiodarone affects the cardiac muscle by blocking the efflux of potassium.

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Study Notes

  • Dopamine at 5-20mg is typically the most appropriate medication to increase blood pressure (BP) in a bradycardiac patient.
  • Decreased heart rate (HR) is a symptom of Parasympathetic Nervous System (PNS) activation.
  • Epinephrine's effects include increased vascular resistance, not decreased.
  • Torsades is primarily treated with Magnesium Sulfate.
  • Decreased contractile force is NOT a characteristic of the Sympathetic Nervous System.
  • Cardiac Output (CO) = Stroke Volume (SV) x Heart Rate (HR).
  • Lidocaine is a sodium channel blocker.
  • The correct dose of epinephrine for pediatric cardiopulmonary resuscitation (CPR) is 0.01mg/kg of epinephrine 1:10,000.
  • A medication with a positive inotropic effect will increase the heart's contraction, not decrease it.
  • Verapamil is a calcium channel blocker.
  • The initial dose of lidocaine for an adult is 1.5mg/kg.
  • Vasopressin can replace either the first or second dose of epinephrine in cardiac arrest.
  • The initial dose of amiodarone is 300mg, followed by a repeat dose of 150mg.
  • Pushing Atropine too slowly can cause a paradoxical effect.
  • QRS complex narrowing is NOT one of the effects of procainamide.
  • Epinephrine has the greatest positive inotropic and chronotropic effect, but causes vasoconstriction, not vasodilation.
  • Diuretics reduce blood pressure (BP) by reducing circulatory blood volume in the kidneys.
  • Amiodarone affects cardiac muscle by blocking the efflux of potassium.

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