Questions and Answers
Which of the following medications are used for bradycardia? (Select all that apply)
What is the classification of Atropine Sulfate?
Parasympatholytic (Anticholinergic)
What is the mechanism of action of Atropine Sulfate?
Inhibits parasympathetic stimulation by blocking acetylcholine receptors.
List one indication for using Atropine Sulfate.
Signup and view all the answers
Atropine Sulfate has no absolute contraindications.
Signup and view all the answers
One side effect of Atropine Sulfate can be ______.
Signup and view all the answers
What is the dosage for Atropine Sulfate in adults with bradycardia?
Signup and view all the answers
What is the classification of Dopamine?
Signup and view all the answers
What are the effects of low dose Dopamine?
Signup and view all the answers
One indication for Dopamine is ______.
Signup and view all the answers
Dopamine can cause tachydysrhythmias.
Signup and view all the answers
What are some side effects of Epinephrine HCL?
Signup and view all the answers
What is the onset of action for Epinephrine HCL when administered IVP/IO?
Signup and view all the answers
What is the pediatric dosage for Epinephrine HCL in cardiac arrest?
Signup and view all the answers
Study Notes
Bradycardia Medications
- Medications include Atropine Sulfate, Dopamine, Epinephrine HCL, and Isoproterenol HCL.
Atropine Sulfate
- Classification: Parasympatholytic (Anticholinergic)
-
Mechanism of Action:
- Blocks acetylcholine receptors, inhibiting parasympathetic stimulation.
- Decreases vagal tone, which may increase heart rate and AV conduction.
- Dilates bronchioles and reduces respiratory secretions.
- Suppresses sweating, lacrimation, and salivation.
-
Indications:
- Used for symptomatic bradycardia, organophosphate poisoning, and prior to RSI in pediatrics.
- Contraindications: No absolute contraindications noted.
-
Side Effects:
- Cardiovascular: Tachycardia, ventricular tachycardia/fibrillation, atrial fibrillation.
- Neurological: Seizures, dizziness, irritability, hallucinations.
- Respiratory: Mucus plugs.
- Other: Increased intraocular pressure, worsened glaucoma, blurred vision.
-
Precautions:
- May cause paradoxical bradycardia if underdosed or administered too slowly.
- Not recommended for asymptomatic bradycardia due to potential myocardial infarction risk.
- Can exacerbate AV blocks.
- Interactions: Potentiated by tricyclic antidepressants, antihistamines, and procainamide.
- Routes of Administration: IVP, IO, IM.
- Onset and Duration: Onset is 2-5 minutes; duration lasts 20 minutes.
-
Adult Dosages:
- Bradycardia: 0.5 mg IVP/IO, may repeat every 3-5 minutes, max 3 mg.
- Pesticides: 2 mg IVP/IO/IM, may repeat every 5 minutes until asymptomatic.
-
Pediatric Dosages:
- RSI: 0.01-0.02 mg/kg IVP/IO (min 0.1 mg, max 0.5 mg).
- Cardiac: 0.02 mg/kg IVP/IO (min 0.1 mg, max 0.5 mg).
- Pesticides: 0.02-0.05 mg/kg IVP/IO/IM (administer based on age criteria).
- Notes: Signs of atropinization include blind as a bat, mad as a hatter, red as a beet, dry as a bone, hot as hell.
Dopamine (Intropin)
- Classification: Sympathomimetic, catecholamine, vasopressor.
-
Mechanisms of Action:
- Low Dose (1-5 mcg/kg/min): Dilates renal and mesenteric arteries, increasing urine output.
- Moderate Dose (5-10 mcg/kg/min): Increases inotropy without raising chronotropy.
- High Dose (10-20 mcg/kg/min): Causes vasoconstriction (alpha) and raises inotropy and chronotropy (beta 1).
- Indications: Used in cardiogenic shock, distributive shock after fluids, significant hypotension, and symptomatic bradycardia as a second-line agent.
- Contraindications: Hypovolemia, tachydysrhythmias, hyperthermia.
-
Side Effects:
- Cardiovascular: Tachycardia, hypertension/hypotension, chest pain, ventricular irritability.
- Respiratory: Dyspnea.
-
Precautions:
- Use the largest vein possible; ensure IV patency to avoid necrotic complications.
- Start a second IV for additional medications, avoid interruption of dopamine infusion.
- Interactions: Flushing with Sodium Bicarbonate and caution with antidepressants and phenytoin.
- Routes: IVPB.
- Onset and Duration: Onset is 5 minutes; duration of effects is 3-5 minutes.
-
Dosages:
- Low dose: 1-5 mcg/kg/min IVPB.
- Moderate dose: 5-10 mcg/kg/min IVPB.
- High dose: 10-20 mcg/kg/min IVPB.
-
Notes:
- Flow rate determines receptor site stimulation; frequent vital sign monitoring is necessary.
- Infusion may need to slow but not stopped once blood pressure is achieved.
Epinephrine HCL (Adrenalin)
- Classification: Sympathomimetic, catecholamine, vasopressor.
-
Mechanism of Action:
- Increases cardiac output and blood pressure by enhancing inotropy, chronotropy, and dromotropy (beta1).
- Vasoconstriction raises systolic blood pressure (alpha).
- Dilation of bronchioles improves respiratory function (beta2).
- Enhances coronary perfusion during CPR by raising aortic diastolic pressure.
- Indications: Effective in cardiac arrest, asthma, allergic reactions, symptomatic bradycardia in pediatrics, and beta blocker overdose in pediatrics.
- Contraindications: Hypovolemia and hypertension.
-
Side Effects:
- Cardiovascular: Tachycardia, hypertension, palpitations, chest pain, ventricular fibrillation.
- Neurological: Tremors, seizures.
- Respiratory: Paradoxical bronchospasms with excessive inhaler use.
-
Precautions:
- Administer slowly to conscious patients to prevent hearing loss.
- Monitor blood pressure and ECG closely post-administration, especially in older patients.
- Interactions: Sodium Bicarbonate can inactivate Epinephrine; flush tubing before and after administration.
- Routes of Administration: IVP, IO, IVPB, IM, SQ.
-
Onset and Duration:
- Onset is 1-2 minutes IVP/IO and 5-10 minutes SQ.
- Duration lasts 3-5 minutes IVP/IO; 20 minutes SQ.
-
Adult Dosages:
- Cardiac Arrest: 1 mg (1:10,000) IVP/IO every 3-5 minutes.
- Asthma/Allergic Reaction: 0.3-0.5 mg (1:1,000) SQ/IM every 20 minutes (x2).
- Anaphylaxis: 0.1-0.5 mg (1:10,000) slow IVP/IO (over 1-5 minutes), repeat every 3-5 minutes.
- Vasopressor: 1-4 mcg/min IVPB.
-
Pediatric Dosages:
- Cardiac Arrest: 0.01 mg/kg (1:10,000) IVP/IO, repeat every 3-5 minutes.
- Asthma/Allergic Reaction: 0.01 mg/kg (1:1,000) IM/SQ, max single dose 0.3 mg, repeat every 20 minutes (x2).
- Anaphylaxis with Shock: 0.01 mg/kg slow IVP/IO (over 1 minute), max single dose 0.1 mg, repeat every 3-5 minutes.
Studying That Suits You
Use AI to generate personalized quizzes and flashcards to suit your learning preferences.
Description
Test your knowledge on medications used for treating bradycardia, including their classifications and mechanisms of action. This quiz covers essential drugs like Atropine Sulfate and their impact on heart function.