Cardiovascular

Cardiovascular System Acronyms and Mnemonics

Angina | Precipitating Factors: 4 E’s
◾E1 | Exertion: physical activity and exercise
◾E2 | Eating
◾E3 | Emotional distress
◾E4 | Extreme temperatures: hot or cold weather
Arterial Occlusion: 4 P’s
◾P1 | Pain
◾P2 | Pulselessness or absent pulse
◾P3 | Pallor
◾P4 | Paresthesia
Blood Pressure Formula: BP = CO x SVR
◾Blood Pressure
◾Cardiac Output
◾Systemic Vascular Resistance
Congestive Heart Failure Treatment: MADD DOG
◾M | Morphine
◾A | Aminophylline
◾D | Digoxin
◾D | Dopamine
◾D | Diuretics
◾O | Oxygen
◾G | Gasses (Arterial blood gasses [ABGs] monitoring)
Cor Pulmonale Signs and Symptoms: Please Read His Text
◾P | Peripheral edema
◾R | Raised JVP
◾H | Hepatomegaly
◾T | Tricuspid incompetence
Coronary Arteries Location: Right CAMP Left ARC (I have a Right to CAMP if you Left
an ARC)
◾Right = Right
◾Coronary
◾Artery
◾Marginal Artery
◾Posterior Interventricular Artery
◾Left = Left
◾Anterior Interventricular Artery
◾Circumflex Artery
Endocarditis: FAME
◾Fever
◾Anemia
◾Murmur = think Endocarditis
Heart Murmur Causes: SPAMS
◾S | Stenosis of a valve
◾P | Partial obstruction
◾A | Aneurysms
◾M | Mitral regurgitation
◾S | Septal defect
Heart Sounds: All People Enjoy the Mall
◾A | Aortic: 2nd right intercostal space
◾P | Pulmonic: 2nd left intercostal space
◾E | Erb’s Point: 3rd left intercostal space
◾T | Tricuspid: 4th left intercostal space
◾M | Mitral or Apex: 5th left intercostal space
Hypertension Care: DIURETIC
◾D | Daily weight
◾I | I/Os
◾U | Urine output*
◾R | Response of blood pressure
◾E | Electrolytes
◾T | Take pulse (tachycardia may occur in response to hypotension)
◾I | Ischemic episodes or TIAs
◾C | Complications: CVA, CAD, CHR, CRF
*Note: Excessive urination may indicate that diuretics dose are too high and lead to
dehydration. Decreased urine output may be associated with impaired renal function.
Declined renal function is often the first non-cardiac sign of a cardiac issue.
Myocardial Infarction Nursing Management: BOOMAR
◾B | Bed rest
◾O | Oxygen therapy
◾O | Opioids: morphine
◾M | Monitoring: vitals, arterial blood gases, cardiac enzymes, and other blood work
◾A | Anticoagulation therapy
◾R | Reduce clot size
Myocardial Infarction Treatment: MONA (or ON AM for the correct order)*
◾M | Morphine
◾O | Oxygen
◾N | Nitroglycerin
◾A | Aspirin
*The correct order of MONA interventions is oxygen, nitroglycerin, aspirin, and then
morphine. This can be remembered by the mnemonic: ON AM (I am ON fire in the AM
as I am a morning person)
Shortness of Breath (SOB) Causes: AAAAPPPP
◾A | Airway obstruction
◾A | Angina
◾A | Anxiety
◾A | Asthma
◾P | Pneumonia
◾P | Pneumothorax
◾P | Pulmonary Edema
◾P | Pulmonary Embolus
Heparin-Induced Thrombocytopenia (HIT) Probability: The 4 T’s*
1. T | Thrombocytopenia present (low platelet count): >50% fall in platelet levels =
Higher probability of it being HIT
2.T | Timing of platelet count fall: Drop occurs during the 5-10 days after heparin use
(most common time period for reaction to occur) or drop occurs rapidly (less than 1 day)
and heparin exposure occurred within past 30 days = Higher probability of it being HIT
3.T | Thrombosis or other sequelae. Proven thrombosis or presence of skin necrosis, or
an acute systemic reaction following administration of a heparin bolus = Higher
probability of it being HIT
4.T | Thrombocytopenia, other causes. No other evident = Higher probability of it being
HIT
*Thrombocytopenia is a low platelet level. There are various etiologies that may be
responsible, but one cause is heparin-induced (AKA: HIT), which is an immune
mediated reaction following drug exposure. The 4 T’s is used to predict the probability
that the thrombocytopenia is associated with heparin use.
Tetralogy of Fallot: PROVe
◾P: Pulmonary stenosis (narrowed pulmonary artery)
◾R: Right ventricular hypertrophy (enlarged right ventricle)
◾O: Overriding aorta (malposition of the aorta over both ventricles)
◾V: Ventricular septal defect
◾e*
*The lowercase “e” is intentionally left blank as its purpose it to serve as a filler for the
mnemonic
Ventricular Arrhythmias Drugs: AL
◾A | Amiodorone
◾L | Lidocaine
Critical Care
Critical Care Acronyms and Mnemonics
Advanced Life Support Drugs: LEAN
◾L | Lidocaine
◾E | Epinephrine
◾A | Atropine
◾N | Narcan
Compartment Syndrome Signs and Symptoms: 5 P’s
1.P | Pain
2.P | Pallor
3.P | Pulse declined or absent
4.P | Pressure increased
5.P | Paresthesia
Emergent Syncope: CRAPS (Like the Vegas Gambling Game)
◾C | Cardiac
◾R | Ruptured AAA (abdominal aortic aneurysm, AKA: “Triple A”)
◾A | Aortic stenosis
◾P | Pulmonary embolism (PE)
◾S | Subarachnoid hemorrhage
Shock Characteristics: HYPO-TACHY-TACHY
◾Hypotension
◾Tachycardia (elevated heart rate of 100 bpm or > at rest* in adults)
◾Tachypnea (elevated respiration rate)
The Significance of Tachycardia | Tachycardia is an anticipated finding in an individual
who is exerting his or herself; for example, the heart rate can easily reach 160 while
working out on cardio equipment at the gym. In a clinical setting, tachycardia is typically
used to reference an individual with an elevated pulse while at rest, or not exerting his
or herself physically.
Shock Signs and Symptoms: CHORD ITEM
◾C | Cold, clammy skin
◾H | Hypotension
◾O | Oliguria
◾R | Rapid, shallow breathing
◾D | Drowsiness, confusion
◾I | Irritability
◾T | Tachycardia
◾E | Elevated or reduced central venous pressure
◾M | Multi-organ damage
Shock Differential: CHORD
◾C | Cardiac
◾H | Hypovolemia
◾O | Obstructive (tension pneumothorax, tamponade, PE)
◾R | Respiratory/medical (hypoxia, acidosis, hypothermia, hyperkalemia, OD)
◾D | Distributive (spinal shock, anaphylaxis, sepsis)
Shock Types: SHRIMP CAN
◾S | Septic
◾H | Hemorrhagic
◾R | Respiratory
◾I | Insulin- hypoglycemia from insulin overdose or extreme hyperglycemia – diabetic
ketoacidosis (DKA)
◾M | Metabolic
◾P | Psychogenic
◾C | Cardiogenic
◾A | Anaphylactic
◾N | Neurogenic
Shock Types: RN CHAMPS
◾R | Respiratory
◾N | Neurogenic
◾C | Cardiogenic
◾H | Hemorrhagic
◾A | Anaphylactic
◾M | Metabolic
◾P | Psychogenic
◾S | Septic
Diabetes
Diabetes Acronyms and Mnemonics
Diabetic Ketoacidosis (DKA) Treatment: KING UFC
◾K | K+ (potassium)
◾I | Insulin
◾N | Nasogastric tube: if the patient is comatose
◾G | Glucose: once serum levels drop
◾U | Urea: monitoring
◾F | Fluids: crystalloids
◾C | Creatinine: monitor and catheterize
Exercise Regimen for Patients with Diabetes: FIT
◾F | Frequency: 3 times a week
◾I | Intervals: 30 minutes a day
◾T | Time
Hyperglycemia Versus Hypoglycemia
◾HYPER | Hot N’ dry: Sugar high
◾HYPO | Cold N’ clammy: Need some candy
Hypoglycemia Causes and Characteristics: RE-EXPLAIN
◾RE | REnal failure
◾EX | EXogenous
◾P | Pituitary
◾L | Liver failure
◾A | Alcohol
◾I | Infection
◾N | Neoplasm
Hypoglycemia Signs: TIRED
◾T | Tachycardia
◾I | Irritability
◾R | Restlessness
◾E | Excessive hunger
◾D | Depression and diaphoresis
Mixing 2 Types of Insulin in 1 Syringe: Clear, Cloudy, Cloudy, Clear
◾Clear before cloudy
◾Cloudy before clear
Diagnostics/Labs
Diagnostic and Lab Value Acronyms and Mnemonics
Acid Base: ROME
◾R | Respiratory (acidosis and alkalosis)
◾O | Opposite: pH ↓ & CO2 ↑ = Acidosis; pH ↑ CO2 ↓= Alkalosis
◾M | Metabolic (acidosis and alkalosis)
◾E | Equal: pH ↓ & HCO3 ↓ = Acidosis; pH ↑ & HCO3 ↑= Alkalosis
Calcium: 8.5-10
◾Children’s bones grow strong between ages 8 ½ -10
◾This is a way to remember the range of normal calcium values in the blood serum
CBC (Complete Blood Count) Components: HELPR
◾H | H/H (Hemoglobin/Hematocrit)
◾E | Erythrocytes (RBCs)
◾L | Leukocytes (WBCs)
◾P | Platelets
◾R | R/R* (reticulocytes/RBC indices)#
*Unlike H/H (which stands for hemoglobin/hematocrit), R/R is NOT a term typically used
to describe reticulocytes/RBC indices…it’s just used for the purpose of this mnemonic.
#RBC indices involve components that are used to describe the shape, size, and other
characteristics of the RBCs…They’re important for differentiating the type of anemia.
Potassium: 3.5 -5 POTS
◾Children age 3½ -5 like to play with POTS (example: making mud pies)
◾This is a way to remember the normal range of potassium values
Lab Values from Lowest to Highest: Miss Piggy & Kermit Came Home on Cloud Nine
◾Miss: Magnesium = 1.5-2.5
◾Piggy: Phosphate = 2.5-4.5
◾&
◾Kermit: (K) Potassium = 3.5-5.5
◾Came: Calcium = 8.5-10.5
◾Home: HCO2 = 22-26
◾On: Oxygen Saturation = 95-100%
◾Cloud: Chloride = 95-104
◾Nine: (Na) Sodium = 135-145
Electrolytes
Electrolytes Acronyms and Mnemonics
Hypernatremia Signs and Symptoms: FRIED SALT
◾F | Flush skin and fever (low-grade)
◾R | Restless, irritable, anxious, confused
◾I | Increased blood pressure and fluid retention
◾E | Edema: peripheral and pitting
◾D | Decreased urine output and dry mouth
◾S | Skin flushed
◾A | Agitation
◾L | Low-grade fever
◾T | Thirst
Hypernatremia Causes: MODEL
◾M | Meals (high intake) and medications
◾O | Osmotic diuresis
◾D | Diabetes Insipidus
◾E | Excessive loss of water
◾L | Low intake of water
Hypocalcaemia Signs and Symptoms: CATS
◾C | Convulsions
◾A | Arrhythmias
◾T | Tetany
◾A | Stridor and spasms
Hyperkalemia (High K+) Causes: MACHINE
◾M | Meds: ACE inhibitors, NSAIDS, Diuretics (potassium sparing)
◾A | Acidosis: Metabolic and respiratory
◾C | Cellular destruction: Burns, traumatic injury
◾H | Hypoaldosteronism and hemolysis
◾I | Intake: Excessive dietary consumption (eg: Salt replacements products that contain
potassium)
◾N | Nephrons: Renal failure
◾E | Excretion: Impaired (unable to excrete K+ normally)
Hyperkalemia Signs and Symptoms: MURDER
◾M | Muscle cramps that progress to weakness or even paralysis
◾U | Urine abnormalities: Oliguria or anuria (output less than 30 mL/hour or no output)
◾R | Respiratory distress
◾D | Decreased cardiac contractility
◾E | EKG changes
◾R | Reflexes: Hyperreflexia or areflexia (flaccidity)
Hyperkalemia Treatment: C BIG K DROP
◾C | Calcium
◾B | Bicarbonate
◾I | Insulin
◾G | Glucose
◾K | Kayexalate
◾D | Diuretics and dialysis
Hypokalemia Signs and Symptoms: A SIC WALT
◾A | Alkalosis
◾S | Shallow Respirations
◾I | Irritability
◾C | Confusion and drowsiness
◾W | Weakness and fatigue
◾A | Arrhythmias: tachycardia or bradycardia, irregular rhythm
◾L | Lethargy
◾T | Thready Pulse
◾(Other signs: decreased intestinal mobility, vomiting, and ileus)
Hypokalemia Causes and Characteristics: SUCTION
◾S | Skeletal muscle weakness
◾U | U-wave on EKG
◾C | Constipation
◾T | Toxicity to digoxin
◾I | Irregular and weak pulse
◾O | Otostasis
◾N | Numbness paresthesia
Hypokalemia Signs and Symptoms: 6 L’s
◾L | Lethargy
◾L | Leg cramps
◾L | Limp muscles
◾L | Low, shallow respirations
◾L | Lethal cardiac dysrhythmias
◾L | Lots of urine (polyuria)
Endocrine
Endocrine System Acronyms and Mnemonics
Adrenal Hormones: SSS | Salt, Sugar, Sex
◾S | Sugar: Glucocorticoids = Glucose control, stress and immunity (Memory Trick:
When you’re stressed, you eat too much sugar and you get sick)
◾S | Salt: Mineralocorticoids = Fluid/electrolyte balance and blood pressure regulation
(Memory Trick: You drink mineral water in order to stay hydrated and keep your
electrolytes and blood pressure balanced)
◾S | Sex: Androgens (testosterone and estrogen) = Sex drive/development (Memory
Trick: Androgen + Estrogen = Drives sex, which is how humans are developed)
Acute Pancreatitis Etiology: GET SMASH’D
◾G | Gallstones
◾E | Ethanol
◾T | Trauma
◾S | Steroids
◾M | Mumps
◾A | Autoimmune (PAN)
◾A | Scorpion bites
◾H | Hyperlipidemia
◾D | Drugs… such as azathioprine and diuretics
Cushing’s Disease (Symptoms/Etiology/Patho): CUSHING
◾C: Central obesity and moon face
◾U: Urinary levels of free cortisol and glucose increased
◾S: Suppressed immunity, skin changes (skin thin, striae)
◾H: Hypercortisolism, hyperglycemia, hypercholesterolemia, hypernatremia,
hypertension, hirsutism
◾I: Infections. Iatrogenic cause = Excessive use of corticosteroids
◾N: Non-iatrogenic cause = Neoplasms (benign pituitary or adrenal tumor that secretes
cortisol)
◾G: Gynecomastia, glucose intolerance, growth delay, growth of hair
Cushing’s Disease Signs/Symptoms: CUSHING
◾C: Central obesity/moon face
◾U: Urine high in cortisol and glucose
◾S: Skin changes
◾H: Hyperglycemia, hypernatremia, hypertension, hirsutism
◾I: Infections
◾N: Neoplasm observed in MRI (on the adrenal or pituitary gland)
◾G: Gynecomastia
Antifibrinolytics
Antifibrinolytics are used in menorrhagia and bleeding tendency due to various causes.
Their application may be beneficial in patients with hyperfibrinolysis because they arrest
bleeding rapidly if the other components of the haemostatic system are not severely
affected. This may help to avoid the use of blood products such as fresh frozen
plasma (FFP) with its associated risks of infections or anaphylactic reactions.
These drugs block the binding sites of the enzymes or plasminogen respectively and
thus stop plasmin formation.
Warfarin Sodium (Coumadin)
Coumadin is a prescription medicine used to treat blood clots and to lower the chance
of blood clots forming in your body. Blood clots can cause a stroke, heart attack, or
other serious conditions if they form in the legs or lungs.
To help warfarin (Coumadin) work effectively, it is important to keep your vitamin K
intake as consistent as possible. Sudden increases in vitamin K intake may decrease
the effect of warfarin (Coumadin). On the other hand, greatly lowering your vitamin K
intake could increase the effect of warfarin (Coumadin).
Heparin
Heparin is an anticoagulant (blood thinner) that prevents the formation of blood
clots. Heparin is used to treat and prevent blood clots in the veins, arteries, or lung.
Heparin is also used before surgery to reduce the risk of blood clots.
Heparin – Coumadin (Responding Lab Tests)
Partial thromboplastin time (PTT) and activated partial thromboplastin time (aPTT) are
used to test for the same functions; however, in aPTT, an activator is added that speeds
up the clotting time and results in a narrower reference range. The aPTT is considered
a more sensitive version of the PTT and is used to monitor the patient’s response to
heparin therapy.
The reference range of the aPTT is 30-40 seconds. The reference range of the PTT is
60-70 seconds. Critical values that should prompt a clinical alert are as follows: aPTT:
More than 70 seconds (signifies spontaneous bleeding) PTT: More than 100 seconds
(signifies spontaneous bleeding)
Albumin
Albumin helps move many small molecules through the blood, including bilirubin,
calcium, progesterone, and medications. It plays an important role in keeping the fluid
from the blood from leaking out into the tissues.
Albumin is used in the treatment of shock, burns or low blood protein to temporarily
correct or prevent a blood volume deficiency.
Iron Supplements
Iron supplements are dietary supplements containing iron that can be prescribed by a
doctor for a medical reason, or purchased from a vitamin shop, drug store etc. They are
primarily used to treat anemia or other iron deficiencies.
The patient may notice that his/her stools become black. This is completely harmless,
but patients must be warned about this to avoid unnecessary concern. When iron
supplements are given in a liquid form, teeth may reversibly discolor (this can be
avoided through the use of a straw). Intramuscular injection can be painful, and brown
discoloration may be noticed.
Clopidogrel (Plavix)
Clopidogrel is used to prevent heart attacks and strokes in persons with heart disease
(recent heart attack), recent stroke, or blood circulation disease (peripheral vascular
disease). It is also used with aspirin to treat new/worsening chest pain (new heart
attack, unstable angina) and to keep blood vessels open and prevent blood clots after
certain procedures (such as cardiac stent). It works by blocking certain blood cells
called platelets and prevents them from forming harmful blood clots. This “anti-platelet”
effect helps keep blood flowing smoothly in your body.
It might take longer than normal to stop bleeding if you cut yourself while taking
clopidogrel.
Epoetin Alfa (Procrit)
Epoetin alfa injection is used to treat anemia (a lower than normal number of red blood
cells) in people with chronic kidney failure (condition in which the kidneys slowly and
permanently stop working over a period of time). Epoetin alfa injection is also used to
treat anemia caused by chemotherapy in people with certain types of cancer or caused
by zidovudine (AZT, Retrovir, in Trizivir, in Combivir), a medication used to treat human
immunodeficiency virus (HIV). Epoetin alfa injection is also used before and after certain
types of surgery to decrease the chance that blood transfusions (transfer of one
person’s blood to another person’s body) will be needed because of blood loss during
surgery.
Epoetin alfa is in a class of medications called erythropoiesis-stimulating agents (ESAs).
It works by causing the bone marrow (soft tissue inside the bones where blood is made)
to make more red blood cells.
Thrombolytics
Thrombolytic medications are approved for the immediate treatment of stroke and heart
attack. The most commonly used drug for thrombolytic therapy is tissue plasminogen
activator (tPA), but other drugs can do the same thing.
Thrombolytics work by dissolving a major clot quickly. This helps restart blood flow to
the heart and helps prevent damage to the heart muscle. Thrombolytics can stop a
heart attack that would otherwise be deadly.
ACE Inhibitors
Angiotensin-converting enzyme (ACE) inhibitors help relax blood vessels. ACE
inhibitors prevent an enzyme in your body from producing angiotensin II, a substance in
your body that affects your cardiovascular system by narrowing your blood vessels and
releasing hormones that can raise your blood pressure. This narrowing can cause high
blood pressure and force your heart to work harder.
ACE inhibitors are used for controlling high blood pressure, treating heart failure,
preventing strokes, and preventing kidney damage in people with hypertension or
diabetes. They also improve survival after heart attacks.
ACE Inhibitors 2
ACE inhibitors are used to treat heart disease. These medicines make your heart work
less hard by lowering your blood pressure. This keeps some kinds of heart disease from
getting worse. Most people who have heart failure take these medicines.
They also are used to treat diabetes and kidney problems. This can help keep your
kidneys from getting worse.
Adrenergic Antagonists (Alpha-Blockers)
Alpha-blockers are medicines that are mainly used to treat hypertension (high blood
pressure), and problems with passing urine in men who have enlargement of the
prostate gland. If you have hypertension – alpha-blockers are usually prescribed after
most other medicines have been tried. If you have problems passing urine (because of
an enlarged prostate), the decision to start alpha-blockers depends on how much you
are bothered by the symptoms. Side-effects are uncommon (slight drowsiness,
headaches, and dizziness). They are more likely to occur in the first two weeks of
treatment, and usually go away on their own.
Although side-effects are uncommon, they occur in some people. Side-effects are more
likely to occur in the first two weeks of treatment, and usually go away on their own. The
most common side-effects are slight drowsiness, headaches and dizziness. If you are
prescribed an alpha-blocker, read the leaflet that comes with the medicine packet for a
full list of possible side-effects and cautions.
Adrenergic Antagonists (Beta-Blockers)
Beta-blockers are medicines that are used to treat various conditions including angina,
high blood pressure, some abnormal heart rhythms, heart failure, myocardial infarction
(heart attack), anxiety, overactive thyroid symptoms, glaucoma and migraine.
Most people who take beta-blockers have no side-effects, or only minor ones. However,
because of their action in various parts of the body, some people have unwanted side-
effects such as the heart rate can go too slowly, Tiredness, depression, impotence.
Antiarrhythmics
Antiarrhythmic agents are pharmaceuticals used to combat cardiac arrhythmias. An
arrhythmia is an abnormality of the rate or rhythm of the heartbeat, such as atrial
fibrillation, atrial flutter, ventricular fibrillation and ventricular tachycardia.
These drugs only control abnormal heart rhythms, not cure them.
Antihypertensives
Antihypertensive therapy seeks to prevent the complications of high blood pressure,
such as stroke and myocardial infarction.
Although beta blockers lower blood pressure, they do not have a positive benefit on
endpoints as some other antihypertensives.
Antihypertensives 2
There are many classes of antihypertensives, which lower blood pressure by different
means; among the most important and most widely used are the thiazide diuretics,
the ACE inhibitors, the calcium channel blockers, the beta blockers, and the angiotensin
II receptor antagonists or ARBs.
Among the most important and most widely used antihypertensive drugs are the
thiazide diuretics, the ACE inhibitors, the calcium channel blockers, the beta blockers,
and the angiotensin II receptor antagonists or ARBs.
Beta-1 and Beta-2 Blockers
When referring to beta 1 and beta 2 blockers, It is not the blockers that are 1 and 2, but
the receptors they are blocking. There are actually three types of beta receptors. Beta 1
receptors are found in the heart and brain. Beta 2 receptors are found in the
gastrointestinal tract, uterus, vascular smooth muscles, lungs, and skeletal muscles.
Beta 3 receptors are found in fat cells.
Cardioselective beta blockers (beta1- selective blockers) have a clinical advantage in
that they mainly affect the heart, which predominantly has beta1 receptors. The effect of
broncho-constriction is less with beta1 selective blockers, as the bronchial muscle has
more beta2 receptors, however the danger of broncho-constriction cannot be totally
ignored, as they are not totally selective.
Beta Blockers
Beta blockers, also known as beta-adrenergic blocking agents, are a class of drugs that
works by blocking the neurotransmitters norepinephrine and epinephrine from binding to
receptors. There are three known types of beta receptors, known as beta 1 (β1),
beta2 (β2) and beta3 (β3).
When the neurotransmitters are prevented from binding to the receptors, it in turn
causes the effects of adrenaline (epinephrine) to be blocked. This action allows the
heart to relax and beat more slowly thereby reducing the amount of blood that the heart
must pump. Over time, this action improves the pumping mechanism of the heart.
Calcium Antagonists
Calcium antagonist-based regimen is superior to other regimens in preventing stroke,
equivalent in preventing ischemic heart disease, and inferior in preventing congestive
heart failure. Calcium antagonists are also safe and effective as first-line or add-on
therapy in diabetic hypertensive patients. Heart rate-lowering calcium antagonists
(verapamil, diltiazem) may have an edge over the dihydropyridines in post-myocardial
infarction patients and in diabetic nephropathy. Thus, calcium antagonists may be safely
used in the management of hypertension and angina pectoris.
In several comparative studies in hypertensive patients, treatment with calcium
antagonists was equally effective as treatment with diuretics, beta-blockers, or
angiotensin-converting enzyme inhibitors.
Cordarone (Amiodarone)
Amiodarone belongs to the family of medications known as antiarrhythmics. It is used to
treat certain types of abnormal heart rhythms (arrhythmias). It works by changing how
electrical impulses affect the heart muscle and by making the heart beat more regularly.
The effects of this medication may be noted as early as 3 days after starting treatment,
but it is usually 1 to 3 weeks before beneficial effects are seen.
Digitalis
Digitalis medication works directly on the heart muscle to strengthen and regulate the
heartbeat. It is used to treat certain heart conditions.
Diarrhea, loss of appetite, drowsiness, headache, muscle weakness, and fatigue may
occur as the body adjusts to the medication.
Drugs for Bradycardia and Low Blood Pressure
Use IDEA to treat bradycardia and hypotension.
I – Isoproterenol, D – Dopamine, E – Epinephrine, A – Atropine
Emergency Drugs
Remember LEAN for emergency drugs.
L – Lidocaine, E – Epinephrine, A – Atropine, N – Narcan
Lidocaine Toxicity
Overdosage with lidocaine can be a result of excessive administration via topical or
parenteral routes, accidental oral ingestion of topical preparations by children,
accidental intravenous (rather than subcutaneous, intrathecal or paracervical) injection
or prolonged use of subcutaneous infiltration anesthesia during cosmetic surgical
procedures. These occurrences have often led to severe toxicity or death in both
children and adults.
Lidocaine easily crosses from the blood to the brain, so, if an overdose has occurred,
the following symptoms will probably show up first: headache, tinnitus (ringing in the
ears), facial twitches, lightheadedness, a metallic taste, and numbness of the lips and
tongue. In higher doses, there may also be seizures, unconsciousness, apnea, and CV
collapse. At the highest doses, heart failure occurs.
Focinopril (Monopril)
Fosinopril is an angiotensin converting enzyme (ACE) inhibitor used for the treatment
of hypertension and some types of chronic heart failure. Fosinopril is the only
phosphinate-containing ACE inhibitor marketed. It is marketed by Bristol-Myers
Squibb under the trade name Monopril.
Monopril works by decreasing certain chemicals that tighten the blood vessels, so blood
flows more smoothly and the heart can pump blood more efficiently.
Nitroglycerin
Nitroglycerin spray and tablets are used to treat episodes of angina (chest pain) in
people who have coronary artery disease (narrowing of the blood vessels that supply
blood to the heart). The spray and tablets may also be taken just before activities that
may cause episodes of angina in order to prevent the angina from occurring.
Nitroglycerin extended-release (long-acting) capsules are used to prevent episodes of
angina in people who have coronary artery disease. The extended-release capsules
can only be used to prevent angina attacks; they cannot be used to treat an attack once
it has begun. Nitroglycerin is in a class of medications called vasodilators.
Nitroglycerin works by relaxing the blood vessels so the heart does not need to work as
hard and therefore does not need as much oxygen.
Spironolactone (Aldactone)
Spironolactone is a potassium-sparing diuretic (water pill) that prevents your body from
absorbing too much salt and keeps your potassium levels from getting too low.
Spironolactone also treats fluid retention (edema) in people with congestive heart
failure, cirrhosis of the liver, or a kidney disorder called nephrotic syndrome. This
medication is also used to treat or prevent hypokalemia (low potassium levels in the
blood).
Bumetanide Bumex
Bumetanide is a potent diuretic (water pill) that causes a profound increase in urine
output (diuresis) by preventing the kidney from retaining fluid. Specifically, it blocks the
reabsorption of sodium and fluid from the kidney’s tubules. It is in a class of diuretics
called “loop” diuretics which also includes furosemide (Lasix) and torsemide (Demadex).
Bumetanide is a very potent medication. Using too much of this drug can lead to serious
water and salt/mineral loss.
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