Cardiac Drugs Quick Sheet!

Just a quick overview for the major cardiac/ACLS drugs as pertaining to adults. This is essentially what my flash cards would pertain! Get your AHA ACLS Manual here!
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Digoxin
- Action
- Positive inotrope – increases the force of cardiac contraction
- Decrease HR
- Allow for more complete emptying of the ventricles, thus increasing CO
- Decrease conduction through the AV node, reduce automaticity of the SA node
- Indications
- Heart failure
- A-fib and A-flutter
- Paroxysmal atrial tachycardia
- Special
Considerations
- Monitor potassium levels
- Count apical for 1 min prior to administration
Atropine
- Action
- An anticholinergic drug and increases the firing of the SA node by blocking the action of the vagus nerve.
- Increases HR
- Indications
- 1st line for symptomatic bradycardia
- Special
Considerations
- Anticholinergic S/E
- Increases myocardial oxygen demand à be careful in presence of myocardial ischemia
Adenosine
- Action
- Antiarrhythmic that decreases conduction through the AV node
- Indications
- Paroxysmal Supraventricular Tachycardia
- Special Considerations
- Commonly causes a few seconds of asystole
- Very short half-life (6-10 seconds)
- Push FAST
- Patient may feel “like they got punched in the chest”

Amiodarone
- Action
- Delay repolarization resulting in prolonged duration of action potential and refractory period
- Class III Potassium Channel Blocker
- Decreases heart rate and contractility
- Indications
- Pulseless V-fib or V-tach
- Oral – Atrial fibrillation
- Special Considerations
- Do NOT use with cardiogenic shock or severe sinus bradycardia – may cause hypotension
Epinephrine
- Action
- Stimulate beta1 receptors – cardiac stimulation
- Increased HR, CO, and contractility
- Indications
- Cardiogenic shock, Anaphylactic shock, Septic shock
- Cardiac arrest, pulseless ventricular tachycardia, ventricular fibrillation, asystole
- Special Considerations
- Raises BP and increases HR; may cause myocardial ischemia, angina
- May contribute to post-resuscitation myocardial dysfunction
Dopamine
- Action
- Positive inotropic
- Increased myocardial contractility, increased automaticity, increased AV conduction, increased HR, CO, BP, MAP
- Indications
- Cardiogenic shock
- 2nd line for symptomatic bradycardia
- Special Considerations
- Correct hypovolemia with volume replacement before using dopamine
- DO NOT mix with Sodium Bicarb
Lidocaine
- Action
- Sodium channel blocker
- Indications
- V-fib, V-tach – with and without pulse
- Special
Considerations
- *REMOVED from ACLS Guidelines*
- Can cause toxicity!
Sources: 2018 ACLS Guidelines (Provider Manual), Medical-Surgical Nursing : Assessment and Management of Clinical Problems, 10th Ed (Lewis)
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