Antiarrhythmics - Revision history

Mfrdmanager: /* Adenosine (ADENOCARD) / Antiarrhythmic */

2018-03-21T21:06:06Z

‎Adenosine (ADENOCARD) / Antiarrhythmic

Mfrdmanager: /* Amiodarone / Antiarrhythmic */

2018-03-15T11:30:08Z

‎Amiodarone / Antiarrhythmic

Mfrdmanager at 17:19, 10 February 2018

2018-02-10T17:19:13Z

Mfrdmanager: Protected "Antiarrhythmics" ([Edit=Allow only administrators] (indefinite) [Move=Allow only administrators] (indefinite))

2018-02-10T17:18:02Z

Protected "Antiarrhythmics" ([Edit=Allow only administrators] (indefinite) [Move=Allow only administrators] (indefinite))

Mfrdmanager: Created page with "==Section 8 - MEDICATION GUIDELINES== ===8.06 ANTIARRHYTHMICS=== ====Adenosine (ADENOCARD) / Antiarrhythmic==== '''DESCRIPTION/ACTION:''' * It is a natural occurring agent th..."

2018-02-10T17:17:54Z

Created page with "==Section 8 - MEDICATION GUIDELINES== ===8.06 ANTIARRHYTHMICS=== ====Adenosine (ADENOCARD) / Antiarrhythmic==== '''DESCRIPTION/ACTION:''' * It is a natural occurring agent th..."

New page

==Section 8 - MEDICATION GUIDELINES==
===8.06 ANTIARRHYTHMICS===

====Adenosine (ADENOCARD) / Antiarrhythmic====
'''DESCRIPTION/ACTION:'''
* It is a natural occurring agent that can "chemically cardiovert" Paroxysmal Supraventricular Tachycardia (PSVT) to a normal sinus rhythm.
* It has a half-life of 5 seconds and does not cause hypotension like Verapamil.
* Restores normal sinus rhythm by interrupting re-entrant pathways in the AV node.
* Slows conduction time through the AV node.
* Produces coronary artery vasodialation.
'''INDICATIONS:'''
* [[Supraventricular Tachycardia|Narrow complex (PSVT)]] refractory to vagal maneuvers.
'''CONTRAINDICATIONS:'''
* 2nd and 3rd Degree Heart Block, Sick Sinus Syndrome, or known hypersensitivity to the medication.
'''PRECAUTIONS:'''
* It may cause transient arrhythmias.
* It may cause bronchospasm in asthma patients.
* Heart transplant patients may only require a smaller dosage and patients on Theophylline based medications may require larger dosage, contact MEDICAL CONTROL for consult.
'''DOSAGE:'''
* IV 6 mg by rapid IV bolus, if no results repeat 1-2 minutes later as 12 mg rapid IV bolus. Maximum total dose 18 mg.
* Pediatrics - Refer to Handtevy System for patient specific dosage
** Premies - 13 y/o: 0.1 mg/kg (1st dose), 0.2 mg/kg (2nd dose)

====Atropine Sulfate / ANTIMUSCARINICS / ANTIDOTES====
'''DESCRIPTION / ACTION:'''
* It blocks the parasympathetic nervous system and it’s inhibiting effects on heart rate.
* It does not increase the strength of cardiac contraction.
'''INDICATIONS:'''
* [[Supraventricular Bradycardia and AV Blocks|Symptomatic Bradycardia]], [[Asystole]] if clinically indicated (vagally induced), and [[Drug Overdose Poisoning|Organophosphate Poisoning]].
'''CONTRAINDICATIONS:'''
* None in the emergency setting.
'''PRECAUTIONS:'''
* Give no more than 3.0 mg for cardiac-related problems. May cause a decrease in ventricular rate in the presence of 2nd Degree Mobitz II and 3rd Degree Heart Block.
'''DOSAGE''':
* 0.5 mg - 1.0 mg IVP AND refer to appropriate PRACTICE PARAMETER for specific dosage.
* Refer to Handtevy System for pediatric specific dosage.

====Lidocaine 2% (XYLOCAINE) / Antidysrrhythmic====
'''DESCRIPTION:'''
* Lidocaine is an agent that increases the fibrillation threshold thereby reducing the development of ectopy and Ventricular Fibrillation.
'''INDICATIONS:'''
* More than 6 [[Premature Ventricular Contractions (PVC)|unifocal PVCs]] / minute, [[Premature Ventricular Contractions (PVC)|multifocal PVCs]], R on T phenomenon, couplets, runs of PVCs, [[Ventricular Tachycardia with a Palpable Pulse|Ventricular Tachycardia]], and in [[Ventricular Fibrillation Pulseless Ventricular Tachycardia|V-Fib/Pulseless Ventricular Tachycardia]].
* May be used to enhance RSI in head injuries and may be useful in seizures caused by head injuries.
'''CONTRAINDICATIONS:'''
* 2nd degree Mobitz II and 3rd Degree Heart Blocks and bradycardias.
'''PRECAUTIONS:'''
* Side effects include: lowering LOC, confusion, irritability, muscle spasm, seizures, coma and possibly death.
'''DOSAGE:'''
* 0.5 - 1.5 mg / kg AND refer to appropriate PRACTICE PARAMETER for specific dosages.
* Refer to Handtevy System for pediatric specific dosage.

====Diltiazem (CARDIZEM) / Calcium Channel Blocker====
'''DESCRIPTION:'''
* Slows conduction through the SA / AV node, Causes vasodilation.
'''INDICATIONS:'''
* [[Atrial Fibrillation Atrial Flutter|ATRIAL FIBRILLATION, ATRIAL FLUTTER]]. PRACTICE PARAMETER (4.03)
'''CONTRAINDICATIONS:'''
* HYPOTENSION, wide complex tachycardia, conduction system disturbances.
'''PRECAUTIONS:'''
* CHF, Hypotension, renal disease.
'''DOSAGE:'''
* 0.25 mg/kg IV bolus over 2 minutes AND refer to appropriate PRACTICE PARAMETERS for specific dosages.

====Amiodarone / Antiarrhythmic====
'''DESCRIPTION:'''
* Class III antidysrhythmic that prolongs the cardiac action potential and repolarization phase of the cardiac cycle. It shows beta-blocker and potassium channel blocker properties thus reducing dysrhythmias. It has complex drug effects on sodium and potassium.
'''INDICATIONS:'''
* [[Ventricular Fibrillation Pulseless Ventricular Tachycardia|Ventricular Fibrillation]], [[Ventricular Fibrillation Pulseless Ventricular Tachycardia|Pulseless V-Tach]] (4.08), [[Ventricular Tachycardia with a Palpable Pulse|V-Tach with a pulse]] (4.09).
'''CONTRAINDICATIONS:'''
* Sinus bradycardia, AV blocks.
'''PRECAUTIONS:'''
* Not recommended for pregnant or nursing mothers.
* Multiple drug interactions – interacts with digoxin, warfarin, phenytoin.
* When given concurrently with simvastatin (cholesterol drugs) it increases the risk for rhabdomyolysis and renal failure.
'''DOSAGE:'''
* Adult
** VF/VT – 300 mg IVP, IO. May repeat once with 150 mg IVP, IO if dysrhythmia is not suppressed with initial dose.
** VT with a pulse – 150 mg diluted in 50 ml (Buretrol) over 10 minutes.
* Pediatric - Refer to Handtevy System for pediatric specific dosage.
** VF/VT - 5 mg/kg, can repeat dose in 5 mg/kg doses to max of 15 mg/kg total dose.

[[Category:Medication Guidelines|0806]]

← Older revision		Revision as of 11:30, 15 March 2018
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−	~~====Amiodarone / Antiarrhythmic====~~	+
−	~~'''DESCRIPTION:'''~~
−	* Class III antidysrhythmic that prolongs the cardiac action potential and repolarization phase of the cardiac cycle. It shows beta-blocker and potassium channel blocker properties thus reducing dysrhythmias. It has complex drug effects on sodium and potassium.
−	~~'''INDICATIONS:'''~~
−	* [[Ventricular Fibrillation Pulseless Ventricular Tachycardia\|Ventricular Fibrillation]], [[Ventricular Fibrillation Pulseless Ventricular Tachycardia\|Pulseless V-Tach]] (4.08), [[Ventricular Tachycardia with a Palpable Pulse\|V-Tach with a pulse]] (4.09).
−	~~'''CONTRAINDICATIONS:'''~~
−	* Sinus bradycardia, AV blocks.
−	~~'''PRECAUTIONS:'''~~
−	* Not recommended for pregnant or nursing mothers.
−	* Multiple drug interactions – interacts with digoxin, warfarin, phenytoin.
−	* When given concurrently with simvastatin (cholesterol drugs) it increases the risk for rhabdomyolysis and renal failure.
−	~~'''DOSAGE:'''~~
−	* Adult
−	** VF/VT – 300 mg IVP, IO. May repeat once with 150 mg IVP, IO if dysrhythmia is not suppressed with initial dose.
−	** VT with a pulse – 150 mg diluted in 50 ml (Buretrol) over 10 minutes.
−	* Pediatric - Refer to Handtevy System for pediatric specific dosage.
−	** VF/VT - 5 mg/kg, can repeat dose in 5 mg/kg doses to max of 15 mg/kg total dose.

	[[Category:Medication Guidelines\|0806]]		[[Category:Medication Guidelines\|0806]]

← Older revision		Revision as of 17:19, 10 February 2018
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		+	__NOTOC__
	==Section 8 - MEDICATION GUIDELINES==		==Section 8 - MEDICATION GUIDELINES==
	===8.06 ANTIARRHYTHMICS===		===8.06 ANTIARRHYTHMICS===

@@ Line 19: / Line 19: @@
 * Heart transplant patients may only require a smaller dosage and patients on Theophylline based medications may require larger dosage, contact MEDICAL CONTROL for consult.
 '''DOSAGE:'''
-* IV 6 mg by rapid IV bolus, if no results repeat 1-2 minutes later as 12 mg rapid IV bolus. Maximum total dose 18 mg.
+* IV 12 mg by rapid IV bolus, if no results repeat 1-2 minutes later as 12 mg rapid IV bolus. Maximum total dose 24 mg.
 * Pediatrics - Refer to Handtevy System for patient specific dosage
 ** Premies - 13 y/o: 0.1 mg/kg (1st dose), 0.2 mg/kg (2nd dose)
 ====Atropine Sulfate / ANTIMUSCARINICS / ANTIDOTES====

← Older revision	Revision as of 17:18, 10 February 2018
(No difference)