Antiarrhythmic

2nd or 3rd degree heart block

sick sinus syndrome

Hypersensitivity to adenosine

Onset: 30 seconds

Duration: 10 seconds

SVT

&

Monomorphic wide-complex tachycardia

Onset: within 5 min

Duration: 3-4 hrs

Onset: 2-3 minutes

Duration: days to weeks

Inhibition of platelet aggregation and platelelt synthesis.

Reduction of risk of death in patients with history of MI or unstable angina. 

Onset: 30-60 minutes

Duration: 4-6 hrs

Blocks acetylcholine receprots, decresseas vagal tone resulting in increased HR and AV conduction.

Dilates bronchioles and decreases respiratory tract secretions.

Decreases gastrointestinal secretions and motility. 

Symptomatic bradycardia

Organophosphate poisoning

Pre-intubation for patients < 5 yo

Nerve agent exposure

Neonates

Wont work in heart transplants.

Onset: 2-5 minutes

Duration: 20 minutes

Hyperkalemia

Hypokalemia 

Hyperagnesmia 

Digitalis Toxicity 

Hypercalcemia 

Digitalis Toxicity 

Hypercalcemia 

Induce cardiac dysrhythmias

IM administration may cause tissue necrosis 

Dry mouth, headache, anxiety, thirst, metal taste, vomiting/diarrhea.  

Onset: Immediate

Duration: 30 min - 2 hrs

Onset: 30-60 seconds

Duration: Dependent on level of hypolgycemia 

Systolic < 100

Coma, shock, head injury, drug abuse. 

Hypotension 

Tachycardia

Respiratory depression

confusion 

nausea

Onset: IV-1-5 min    IM 15-20

Duration: 15- 60 min 

Reverses muscle spasms associated with dystonic ractions.

Competes with histamines at receptor sites. 

Allergic reactions

Muscle spasms with dystonic reactions 

Glaucoma

Acute asthma 

COPD

Hypotension

Drowsiness

tachycardia

bradycarida

dry mouth

Urinary retention 

Hypotension

Drowsiness

tachycardia

bradycarida

dry mouth

Urinary retention 

Onset: IV/IO - 1-5 min     IM/PO 15 min

Duration : 3-4 hrs

Acts on Alpha and Beta receptors of SNS.

Increased HR (chronotrphy)

Increase Cardiac contractile force (inotropy)

Increased electrical activity within myocardium. 

Increased BP

Increased Automaticity 

Hypertension

undiluted 1:1 ml IVP

Hypertension-tachycardia

increased myocardial O2 demand 

Potentially increase MI. 

Onset: Immediate IVP & 5-10 for SQ/IM

Duration: 5- 10

Tachy and bradycarida

hyper or hypotension

laryngospasm 

hypo/hyperventilation

apnea

nausea/vomiting

myoclonic skeletal muscle movements 

Onset: within a minute

Duration: 3-10

Reduces pain pathways

Depresses CNS by interacting with receptors 

Hypertension/Hypotension 

BP< 100 

Increased ICP

Nausea/vomiting

AMS

Hypotension/bradycardia

respiratory depression. 

Respiratory difficulty due to thoracic rigidity. 

Onset: immediate

Duraiton 1-2 hrs 

Hypovolemia 

Dehydration

Electrolyte depletion

Anuria 

Hypotension

ECG changes

Chest pain

Hypokalemia

Hypenatremia

Hyperglycemia 

Onset: 15-20

Duration: 4-6 hrs

Elevates blood glucose taking from liver

Increased cardiac output

Hypoglycemia

Beta blocker OD

Allergic reaction 

Nausea/Vomiting

Headache

Onset: 1-3 IVP

5-20 Im

Duration: 15-20 IV

15-30 IM

Asthma & Bronchsoapsm associated with COPD

Bronchospasm with chronic bronchitis

Onset: 15-30 min peak in 1-2 hrs 

Duration: 4-8 hrs

Acts on limbic System 

Blocks transmission of impullses with pain perception. 

Short acting amnesia withou muscle relaxation

Stroke

Increased intracranial pressure

Severe Hypertension

Cardiac Decompensation

Hypersensitivity

Hypertension

Increased HR

Hypotension 

Hypersalvation

Hallucinations, delusions, explicit dreams

Onset: with 30 sec

Duration: 5-10 min

Anti-inflammatory 

nonnarcotic pain reliever 

Bleeding Disorders 

Renal Failure

Active peptic ulcer disease

allergies to aspirin 

Anaphlaxis from hypersensitivity 

Edema 

Sedation

Bleeding disorders

Rash

Nausea

Headache

Onset: with 10 min

Duration: 6-8 hrs 

Actions of Lidocaine?

Cardiac arrest from V-tach or V-Fib 

Monomorphic VT

Widecomplex Tachy

Head injured pt

pain management for post intraosseous insertion

post cardioversion or defrbillation

2nd or 3rd degree heart block

Junctional Bradycardia

Ventricular ectopy

Idionventricular or escape rthythms

Lightheadedness 

Bradycardia

Confusion

Hypotension

Seizures

Onset: 45-90 sec

Duration: 10 -20 minutes

Sedative

Anticonvulsant

Amnestic 

Status Epilepticus 

Sedation prior to pacing/cardioversion/painful procedures

Pre-treatment for DSI

Agitated/Combative pts

Coma

Altered Mental

Severe hypotension

Shock

Respiratory insufficiency 

Respitory Depression

Tachy/bradycardia

Hypotension

Sedation

Ataxia

Confusion

Blurred vision

Onset: 5 min

Duration: 6-8 hrs 

Controles Ventricular response rate

Increases movement of potassium into the cells

Blocks the release of acetylcholine 

V-Fib, Pusleless V-Tach

V-tach with pulse

Post cardioversion

Torsades

Seizures due to exlampsia 

Sinus bradycardia

Hypermagnesmia 

Contraindications of Magnesium sulfate? 

Hypotension/Hypertension

Dysrhthmias 

Facial Flushing

Diaphoresis

Depressed reflexes 

Bradycardia 

Hypotension/Hypertension

Dysrhthmias 

Facial Flushing

Diaphoresis

Depressed reflexes 

Bradycardia 

Hypotension/Hypertension

Dysrhthmias 

Facial Flushing

Diaphoresis

Depressed reflexes 

Bradycardia 

Onset: Immediate 

Duration: 3-4 hrs

Suppresses acute and chronic inflammation

Vascular smooth muscle relaxation

May alter airway hyperactivity 

Anaphylaxis

Persistent Asthma

Unresponsive bronchospasm

Headache

Hypertension

Sodium & water Retention

Hypokalemia

Alkalosis 

Onset: 1-2 hrs

Duration: 8-24 hrs

GI obstruciton, bleeding or perforation

Hypersensitivty 

Confusion

Depression

Drowsiness

Cardiac conduction disturbances

Fatigue

Hypotension

Hypertension

Onset: 1-3 min

Duration: 1-2 hrs

Suspected MI

Unstable Angina

 Hr higher thatn 100

BP Systolic >160 or Diastolic> 100 

Suspected Cocaine use

Hemodynamically unstale pt

Bradycardia

Already on beta blocker

Onset: 1-2 minutes

Duration: 3-4 hrs 

Short acting Bensodiazepine

CNS depressant

Reduces Anxiety

Depresses CNS function

Induces Amnesia

Seizures

agitation in intubated pt

induction for DSi

Excited Delirium 

Hypotension

Shock

Coma

Alchohol Intoxication

Depressed Vitals Signs

Hypersensitivity 

Hypotension

Respiratory Depression or arrest

Fluctuations in vital signs

Hiccups/cough

Headache

Nausea/Vomiting

Onset: 3-5 minutes

Duration: 2-6 

Inhibits ascending pain pathways

Depresses CNS by interacting with brain receptors

Pain releiver

Opens up vessels

Decreases preload/afterload

Moderate-Severe Pain

Pain due to pacing

chest pain

Pts with altered consciousness

Pain unkown

Pts risk of respiratory depression

Head injury

Hypovolemia 

Blood pressure <100

Multi-system trauma 

Repiratory Depression 

Hypotension

Seizures

Bradycardia

Altered mental status

Onset: Immediate 

Duration: 3-5 hrs

Narcotic Use

Coma unknown origin

decreased level of consciousness 

Cation with narcotic dependant pts

Void use in meperidine-induced seizures

Onset: within 2 minutes

Duration: 20-30 minutes

Decreases workload of the heart 

lowers myocardial O2 demand

Ischemic Chest pain

Pulmonary Edema

CHF

AMI

Volume Depletion

Hypotension

Head injury

Symptomatic Brady/tacycardia

Right Ventricular Infraction

Cerebral hemorrhage

Recent use of Cialis,Levitra, or Viagra

Aortic Stenosis

Headache

Tachycardia

Hypotension

Nausea/Vomiting

Postural Syncope

Diaphoresis

Flushing

Onset: 1-3 minutes

Duration: 30-60 minutes

Tachycardia

Hypotension

Syncope 

Onset: 5-10 min

Duration: half-life is 4 hrs

Competes for cholinergic receptors at the end-plate

Paralytic agent 

Hypersensitivity 

Known neuromuscular disease 

Onset: 0.5-2 mint

Duration: 30 min

Cardiopulmonary arrest

Overdose on Tricyclic antidepressants 

Onset: Immediate

Duration: 30-60 min

Inability to control airway

Intraocular injuries

Hyperkalemia 

Hypotension

Respiratory Depression

Bradycardia

Initial muscle fasciculation

Excessive Salvation

Onest: Less than 1 min

Duration: 3-10 min

Short term relief for eye pain or irritation 

Pts comfort before eye irrigation 

Burning or stinging sensation

Irritation

Onest: within 30 sec

Duration: 10-15 minutes