Prehospital Emergency Pharmacology Cardiac Drugs Cards

Morphine sulfate

Classification: opiate agonist; schedule C-II
Action: binds with opiod receptors. Depression of vasomotor centers of brain as well as release of histamines. For angina: morphine reduces stimulation of the sympathic nervous system caused by pain/anxiety. R

Aspirin

Classification: Antiplatelet, nonnarcotic analgesic, antipyretic
Action: Prevents formation of chemical "thromboxane A2" which causes platelets to clump and obstruct arteries
Indications: fever, inflammation, angina, MI, cardiac chest pain
Side Effects: A

Nitrous oxide

Classification: inorganic gas, inhaled anesthetic
Action: exact mechanism in not known
Indications: mild to severe pain
Adverse effects: delirium, hypoxia, resp depression, nausea/vomiting
Contraindication: use with caution in head trauma, increased ICP,

Atropine sulphate

Class: Anticholinergic
Action: Competes reversibly with acetylcholine at the site of muscarinic receptors.
Indications: Symptomatic brady, asystole, PEA,
Adverse Effects: Decreased secretions resulting in dry mouth and hot skin temperature.
Contraindicati

Furosemide (Lasix)

Classification: Loop diuretic
Action: inhibits the absorption of the sodium and chloride ions and water in the loop of Henle, as well as the convoluted tubule of the nephron. This results in decreased absorption of water and increased production of urine.

Nitroglycerin

Classification: antianginal agent
Action: relaxes vascular smooth muscle, therby dilating peripheral arteries and veins. Decreases preload and afterload of the heart.
Indication: angina, ischemic chest discomfort, hypertension, myocardial ischemia associa

Digoxin (Lanoxin)

Classification: cardiac glycoside
Action: inhibits sodium-potassium-adenosine triphosphatase membrane pump, resulting in a n increase in calcium inside the heart muscle cell, which causes an increase in the force of contraction of the heart.
Indication: C

Metoprolol

Classification Beta adrenergic antagonist, antianginal, antihypertensive, class II antiarrhythmic
Action: inhibits the strength of the hearts contractions, as well as heart rate. This results in a decrease in cardiac oxygen consumption. Also saturates the

Sodium nitroprusside

Classification: antihypertensive agent
Action: causes direct relaxation of both arteries and veins
Indications: HTN emergencies
Adverse effects: cyanide or thiocyanate toxicity, nausea/vomiting, dizziness, headache, restlessness, abdominal pain, methemogl

Labetolol

Classification: beta adrenergic antagonist, antianginal, antihypertensive
Action: binds with both beta1 and beta2 receptors and alpha1 receptors in vascular smooth muscle. Inhibits the strength of the hearts contractions, as well as heart rate. This resul

Magnesium sulfate

Classification: electrolyte, tocolytic, mineral
Action: required for normal physiologic function.
Indication: torsades de pointes, cardiac arrhythmias associated with hypomagnesemia, eclampsia and seizure prophylaxis in preeclampsia, status asthmaticus
Si

Hydralasine (Apresoline)

Classification: antihypertensive agent, vasodilator
Action: directly dilates the peripheral blood vessels
Indications: hypertension associated with preeclampsia and eclampsia, hypertensive crisis
Adverse effects: headache, angina, flushing, palpitations,

Propranolol

Classification: beta adrenergic antagonist, antianginal, antihypertensive, antiarrhythmic class II
Action: nonselective beta antagonist that binds with both the beta1 and beta2 receptors. Propranolol inhibits the strength of the hearts contractions, as we

Heparin

Classification: anticoagulant
Action: acts on antithrombin III to reduce the ability of the blood to form clots, thus preventing clot deposition in the coronary arteries
Indications: ACS, acute pulmonary embolism, deep vein thrombosis
Adverse effects: ble

Streptokinase (Streptase)

Classification: thrombolytic agent
Action: dissolves thrombi plugs in the coronary arteries and reestablishes blood flow
Indications: ST-segment elevation (greater than or equal to 1mm in two or more contiguous leads), new or presumed new left bundle bran

Alteplase, tissue plasminogen activator (tPA) (Activase)

Classification: thrombolytic agent
Action: dissolves thrombi plugs in the coronary arteries and reestablishes blood flow
Indications: ST-segment elevation (greater than or equal to 1mm in two or more contiguous leads), new or presumed new left bundle bran

Retaplase, Recombinant (Retavase)

Classification: thrombolytic agent
Action: dissolves thrombi plugs in the coronary arteries and reestablishes blood flow
Indications: ST-segment elevation (greater than or equal to 1mm in two or more contiguous leads), new or presumed new left bundle bran

Epinephrine

Classification: Adrenergic agent, inotropic
Action: Binds strongly with both alpha and beta receptors, producing increased blood pressure, increased heart rate, bronchodilation.
Indication: Bronchospasm, allergic and anaphylactic reactions, restoration of

Dobutamine

Classification: Adrenergic Agent
Action: Acts primarily as an agonist at beta1 adrenergic receptors with minor beta 2 and alpha1 effects. Consequently, dobutamine increases myocardial contractility and stroke volume with minor chronotropic effects, result

Dopamine (Inotropin)

Classification: Adrenergic agonist, inotropic, vasopressor
Action: Simulates alpha and beta adrenergic receptors. At moderate doses (2-10mcg/kg/min), dopamine stimulates beta 1 receptors, resulting in inotropy and increased cardiac output while maintainin

Noepinephrine (Levophed)

Classification: Adrenergic agonist, inotropic, vasopressor
Action: Norepinephrine is an alpha1,alpha2,and beta1 agonist. Alpha-mediated peripheral vasoconstriction is the predominant clinical result of administration, resulting in increasing blood pressur

Vasopressin

Class: Nonadrenergic vasoconstrictor
Action: Vasopressin
Class: Nonadrenergic vasoconstrictor
Action: Vasopressin can cause vasoconstriction independent of adrenergic receptors or neural innervations.
Indication: Adult shock refractory VF or pulse less VT

Adenosine (Adenocard)

Class: Antiarrhythmic
Action: slows the conduction of electrical impulses at the AV node
Indication: Stable reentry SVT. Does not convert AF, atrial flutter, or VT
Adverse: commonly mild and short-lived. Include sense of impending doom, complications of f

Amiodarone (Cordarone)

Class: Antiarrhythmic, class III
Action: acts directly to the myocardium to delay the repolarization and incase the duration of the action potential
Indication: ventricular arrhythmias, second-line agent for atrial arrhythmias
Adverse: Burning at the IV s

Diltiazem (Cardizem)

Class: calcium channel blocker, class IV antiarrhythmic
Action: blocks calcium from moving into cardiac muscle cell which prolongs the conduction of electrical impulses through the AV node
Indication: Ventricular rate control in rapid AF
Adverse: flushing

Lidocaine (Xylocaine)

Class: antiarrhythmic, class IB
Action: blocks sodium channels, increasing the recovery period after repolarization, suppresses automaticity in the his-purkinje system and depolarizes in the ventricles
Indication: ventricular arrhythmias, when amiodarone

Procainamide (Pronestyl)

Class: antiarrhythmic, class IA
Action: blocks influx of sodium through membrane pores, consequently suppresses atrial and ventricular arrhythmias by slowing conduction in mayocardial tissue
Indication: alternative to amiodarone for stable monomorphic VT

Sodium Bicarbonate

Class: Electrolyte replacement
Action: Counter acts existing acidosis.
Indications: Acidosis, drug intoxications (e.g., barbiturates, salicylates, methyl alcohol).
Adverse effects: Metabolic alkalosis, hypernatremia, injection site reaction, sodium and fl

Calcium chloride

Class:
-Electrolyte Modifier
Action:
-Essential for transmission of nerve impulses that initiate contraction of cardiac muscle
Indication:
-Hyperkalemia
-Hypocalcemia
-Calcium Channel Blocker OD
Contraindication:
-Hypercalcemia
-Digitalis Toxicity
Precaut

Nifedipine (Procardia, Adalat)

Class:
Calcium Channel Blocker
Indication:
exertional angina, unstable angina, coronary spasms, HTN, pre-eclampsia, Raynaud's phenomenon
Adverse effects:
increased angina, (rare) MI, palpitations, peripheral edema, flushing, constipation, heartburn, dizzi

Enoxaparin (Lovenox)

Drug: Generic: Enoxaparin (Trade: Lovenox)
Classification: Pharmacotherapeutic: Low molecular weight heparin. Clinical: anticoagulant.
Action: Potentiates action of antithrombin III, inactivates coagulation factor Xa. Therapeutic effect: Produces anticoag

Neseritide (Natercor)

Class:
Natriuretic peptide
Indication:
used for treatment of acutely decompensated CHF in pt's who have dyspnea at rest or with minimal activity
Contraindication:
should not be administered to people with known hypersensitivity to the drug. should not be