OCEMS Pharmacology - Drug Guide 2023/2024
(Answered) Complete Solution
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 Indications
Narrow complex tachycardia w/ reg rhythm and rate >/= 150 in conscious pt w/
complaint of mild chest discomfort, lightheadedness or diaphoresis AFTER Valsalva
attempt
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 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 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
Amiodarone Precautions/Comments
Heart failure
Cardiogenic shock
Hypersensitivity
Renal failure
(Answered) Complete Solution
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 Indications
Narrow complex tachycardia w/ reg rhythm and rate >/= 150 in conscious pt w/
complaint of mild chest discomfort, lightheadedness or diaphoresis AFTER Valsalva
attempt
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 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 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
Amiodarone Precautions/Comments
Heart failure
Cardiogenic shock
Hypersensitivity
Renal failure
