Cardiac Meds Special Considerations Flashcards

Special Considerations:

• Short half-life limits side effects in most patients.
• Pregnancy Safety: Category C.

Special Considerations:

• Administer cautiously in patients with Heart Failure or poor systolic function.
• Pregnancy Safety: Category C

Special Considerations:

• Not recommended in pediatric population.
• Pregnancy Safety: Category D.

Special Considerations:

• Moderate doses dilate pupils.
• Pregnancy Safety: Category C.

Special Considerations:

• For pediatrics: if calcium gluconate is unavailable, 1-2 ml of 10% calcium chloride solution, diluted with IV fluid, may be substituted.
• Pregnancy Safety: Category C.

Special Considerations:

• Use in caution in patients with renal or hepatic dysfunction.
• Pregnancy Safety: Category C.

Special Considerations:
Effects are dose-dependent;

• Dopaminergic response: 2 - 4mcg/kg/min: dilates vessels in kidneys; increased urine output.
• Beta-adrenergic response: 4 - 10mcg/kg/min: Increased chronotropy and inotropy.
• Adrenergic response: 10 - 20mcg/kg/min: Primarily alpha stimulant/vasoconstriction.
• >20mcg/kg/min: reversal of renal effects/override alpha effects.
• Always monitor drip rate.
• Avoid extravagation injury.
• Pregnancy Safety: not established.

Special Considerations:

• Pregnancy Safety: Category C.

Special Considerations:

• Pregnancy Safety: Category C.

Special Considerations:

• Ototoxicity and deafness can occur.
• Pregnancy Safety: Category C.

Special Considerations:

• Reduce maintenance infusions by 50% if patient is over 70 years of age, has liver disease, or is in CHF or shock.
• A 75-100 mg bolus maintains levels for only 20 minutes.
• If bradycardia occurs with PVCs, always treat the bradycardia with atropine.
• Exceedingly high doses can result in coma or death.
• Pregnancy Safety: Category B.

Special Considerations:

• IV calcium gluconate or calcium chloride should be available as antagonist if needed.
• Use with caution in patients with renal failure.
• Being used for acute MI patients in some systems under Medical Direction.
• Pregnancy Safety: Recommended that drug not be given in the 2 hours before delivery, if possible.

Special Considerations:

• Not recommended in pediatric population. The safety and effectiveness have not been established in children.
• Pregnancy Safety: Category C (manufacturer); D (2nd and 3rd trimesters - expert analysis).

Special Considerations:

• Safety in neonate not established.
• Use with caution in geriatric population and those with COPD, asthma.
• Naloxone should be readily available as antidote.
• Pregnancy Safety: Category C.
  **Rapidly crosses the placenta.

Special Considerations:

• Hypotension more common in geriatric population.
• Decomposes if exposed to light or heat.
• Must be kept in airtight containers.
• Active ingredient may have a stinging effect when administered SL.
• Pregnancy Safety: Category C.

Special Considerations:

• Infuse through a large, stable vein to avoid extravasation and tissue necrosis.
• Drug or poison induced hypotension may require higher doses to achieve adequate perfusion.
• Pregnancy Safety: Category C.
  **Use cautiously during pregnancy and while breastfeeding. May cause fetal anoxia when used in pregnancy.

Special Considerations:

• Be familiar with liter flow and each type of delivery device used.
• Supports possibility of combustion.

Special Considerations:

• Must ventilate patient after administration.
  Intracellular acidosis may be worsened by production of carbon dioxide.
• May worsen CHF.
• Pregnancy Safety: Category C.