Adenosine
Class: Endogenous Nucleotide
MOA: Slows conduction time through the AV node; can interrupt re-reentrant pathways; slows heart rate; acts directly on sinus pacemaker cells.
First drug of choice for PVST
Amiodarone (Cordarone)
Class: Antidysrhythmic
MOA: Prolongation of Action Potential: non-competitive alpha and beta sympathetic blocking effects; Calcium channel blocking effects.
Aspirin (ASA)
Class: Platelet inhibitor, anti-inflammatory agent.
MOA: Prostaglandin inhibition (makes platelets less sticky).
Atropine sulfate
Class: Anticholinergic agent
MOA:
Increases conduction through the AV node.
Increases HR in life-threatening bradydysrythmias.
Parasympatholytic: inhibits action of acetylcholine at postganglionic parasympathetic neuroeffector sites.
Calcium chloride/Calcium Gluconate
Class: Electrolyte.
MOA:
Increases cardiac contractile state (positive inotropic effect).
May enhance ventricular automaticity.
Helps stabilize the cell membrane.
Diltiazem (Cardizem)
Class: Calcium channel blocker
MOA:
Blocks influx of calcium ions into cardiac muscle.
Arterial and venous vasodilation.
Reduces preload and afterload.
Reduces myocardial oxygen demand.
Dopamine (Intropin)
Class: Sympathomimetic, inotropic agent.
MOA: Immediate metabolic precursor to norepinephrine. Increases systemic vascular resistance, dilate renal and splanchnic vasculature. Increases myocardial contractility and stroke volume.
Epinephrine
Class: Sympathomimetic
MOA:
Direct acting alpha and beta agonist.
Alpha: bronchial, cutaneous, renal and visceral arteriolar vasoconstriction.
Beta 1: positive inotropic and chronotropic actions, increases automaticity.
Beta 2: bronchial smooth muscle relaxation and dilation of skeletal vasculature.
Blocks histamine release.
Fentanyl citrate (Sublimaze)
Class: Potent Narcotic Analgesic
MOA: Binds to opioid receptors.
*a 100 mcg dose is approximately equivalent in analgesic activity to 10 mg of morphine.
Furosemide (Lasix)
Class: Loop diuretic.
MOA: Inhibits electrolyte reabsorption and promotes excretion of sodium, potassium, chloride.
Lidocaine (Xylocaine)
Class: Antidysrhythmic
MOA: Decreases automaticity by slowing the rate of spontaneous Phase 4 depolarization.
Magnesium sulfate
Class: Electrolyte
MOA: Reduces striated muscle contractions and blocks peripheral neuromuscular transmission by reducing acetylcholinesterase release at the myoneural junction; manages seizures in toxemia of pregnancy; induces uterine relaxation; can cause bronchodilation after beta agonist and anticholinergics have been used.
Metoprolol (Lopressor/Toprol XL)
Class: Beta Blocker
MOA: Selective inhibitor of Beta 1 adrenergic receptors; completely blocks Beta 1 receptors, with little or no effect on Beta 2 receptors at doses < 100 mg
Morphine sulfate
Class: Opioid analgesic.
MOA:
Alleviates pain through CNS actions.
Suppresses fear and anxiety centers in brain.
Depresses brain stem respiratory centers.
Decreases preload and afterload, decreasing myocardial oxygen demand.
*schedule II drug
Nitroglycerin (Nitrolingual/NitroQuick/Nitro-Dur)
Class: Vasodilator
MOA:
Smooth muscle relaxant acting on vascular, bronchial, uterine, and intestinal smooth muscle.
Dilation of arterioles and veins in the periphery, reduces preload and afterload, decreases the workload of the heart and, thereby, myocardial oxygen demand.
Norepinephrine
Class: Vasopressor
MOA: Potent alpha-agonist resulting in intense peripheral vasoconstriction, positive chronotropic and increased inotropic effect with increased cardiac output. Alpha adrenergic activity resulting in peripheral vasoconstriction and beta-adrenergic activity leading to inotropic stimulation of the heart and coronary artery vasodilation.
Oxygen
Class: Naturally occurring atmospheric gas
MOA: Reverses hypoxemia
Sodium Bicarbonate
Class: Buffer, alkalinizer
MOA: Reacts with hydrogen ions to form water and carbon dioxide thereby acting as a buffer for metabolic acidosis.