E-CART MEDICATIONS

1. ADENOSINE
-First line of treatment in
unstable supraventricular
tachycardia (SVT).

-The first dose of

adenosine should be 6
mg administered rapidly
over 1-3 seconds
followed by a 20 ml NS
bolus. If the patient’s
rhythm does not convert
out of SVT within 1 to 2
minutes, a second 12 mg
dose may be given.

Two Effects of Adenosine:

a. Negative Chronotropic: it slows down the heart rate.
b. Negative Dromotropic: decreased conductivity of ventricles.

2. AMIODARONE
-This medication is used to treat
certain types of serious (possibly
fatal) irregular heartbeat (such as
persistent ventricular
fibrillation/tachycardia).

-It is used to restore

normal heart rhythm and maintain a
regular, steady heartbeat.

-works primarily by blocking potassium rectifier currents that are responsible for the
repolarization of the heart during phase 3 of the cardiac action potential.

-This potassium channel-blocking effect results in increased action potential duration and a
prolonged effective refractory period in cardiac myocytes.

3. ASPIRIN
 -is a medication used for pain, fever, and inflammation. It is also a blood thinner. Besides having
these medical uses, it has a variety of non-medical uses. Adding aspirin to a vase of flowers
helps the flowers to last longer, or applying a facemask with aspirin in it will help improve your
complexion.

-Anti Platelet.

-Anticoagulant: slows down process of clotting

-Antiplatelets: prevents platelet in clumping to each other.

4. ATROPINE SULFATE
- is the first-line therapy
(Class IIa) for symptomatic
bradycardia in the absence of
reversible causes.

-1 mg every 3 to 5 minutes (3
mg max), repeat until desired
heart rate is obtained, most
effective for sinus and AV
nodal disease.

-Use with caution in patients

with coronary heart disease,
acute myocardial ischemia,
congestive heart failure,
tachycardia, or hypertension
as the increased cardiac
demand and possible further worsening of tachycardia and hypertension can prove detrimental to
patient outcomes.

5. CALCIUM GLUCONATE
-Calcium protects the myocardium from
the deleterious effects of hyperkalemia.
Beta-adrenergic agents, insulin, and
loop diuretics stimulate cellular uptake of
potassium, lowering the serum
potassium level.

-Used for emergency treatment of

 Hyperkalemia
 Hypocalcemia
 Hypermagnesemia
6. DIGOXIN(LANOXIN)

-increases the strength and

efficiency of heart
contractions, and is useful in
the treatment of heart
failure and control the rate
and rhythm of the heart.

-Digoxin also slows electrical

conduction between the atria
and the ventricles of the heart
and is useful in treating
abnormally rapid atrial
rhythms such as atrial
fibrillation, atrial flutter, and
atrial tachycardia.

7. DIPHENHYDRAMINE
-An anti-cholinergic agent that is used to
treat severe anaphylactic reactions.

-may also be used to suppress irregular

muscle movements and restlessness.

8. DOBUTAMINE
-To increase cardiac output in short-term
treatment for cardiac decompensation
caused by depressed contractility.
 -stimulates beta1-adrenergic receptors to increase
myocardial contractility and stroke volume,
resulting in increased cardiac output
(a positive inotropic effect in patients with
normal hearts or in heart failure).

-At therapeutic doses, dobutamine decreases

peripheral resistance (afterload),
reduces ventricular filling pressure (preload),
and may facilitate AV node conduction.

-Systolic blood pressure and pulse pressure may

remain unchanged or increased from increased cardiac output.

-Increased myocardial contractility

results in increased coronary blood flow and
myocardial oxygen consumption.

9. DOPAMINE
- a medication most commonly used in the
treatment of very low blood pressure,
a slow heart rate that is causing symptoms,
and, if epinephrine is not available,
cardiac arrest.

-It increases cardiac output by also increasing

the cardiac rate.

A notable difference between Dopamine

and Dobutamine is:

Dobutamine increases cardiac output

without or minimal increase in cardiac
rate.

Dopamine increases cardiac output in

expense of increasing the cardiac rate.
Therefore contraindicated to patient’s
with Aortic Stenosis, elevated cardiac
rate, blood clots, and cardiac congestion.

10. EPINEPHRINE
-A hormone secreted by adrenal glands that
stimulates the “fight-or-flight” response.
 -Acts as a Sympathomimetic Agent(imitate
the actions of Sympathetic Nervous System)

-Also use as adjunct treatment to

severe anaphylactic reaction.

ACLS Indications:
 Vasoconstriction
Causes direct vasoconstriction thus improving perfusion pressure to brain and heart.

 Cardiac Output
-Acts a sympathomimetic agent, improving cardiac out by:
1. Increasing Heart Rate
2. Increasing cardiac contractility.
3. Increases conductivity on the AV nodes.

*Epinephrine should be used with caution in patients suffering from myocardial infarction
since epinephrine increases heart rate and raises blood pressure. This increase in HR and BP can
increase myocardial oxygen demand and worsen ischemia.

11. FUROSEMIDE
-a medication used to treat fluid build-up due
to heart failure, liver scarring, or kidney
disease. It may also be used for the
treatment of high blood pressure.

-used to prevent cellular absorption of Na-K-

Cl so that may be excreted through fluids.
This treatment is used to prevent excess
water and electrolyte retention which may
lead to congestion.

-Also used in cases of hypoalbuminemia in

patients with CKD, it is used together with
Albumin infusion in promote diuresis.
12. HALOPERIDOL
-is used in the treatment of schizophrenia, tics
in Tourette syndrome, mania in bipolar disorder,
nausea and vomiting, delirium, agitation,
acute psychosis, and hallucinations in alcohol
withdrawal.

- It helps calm muscles down leading to weakness

and possible sleepiness which is helpful
especially for those individuals who are most
likely to harm themselves.

13. HYDROCORTISONE
-Medication counterpart of the hormone Cortisol.

-Uses include conditions such as

 -adrenocortical insufficiency
 -adrenogenital syndrome,
 -high blood calcium,
 -thyroiditis,
 -rheumatoid arthritis,
 -dermatitis,
 -asthma and COPD.

- It is used as an immunosuppressive drug,

given by injection in the treatment of severe allergic
reactions such as anaphylaxis and angioedema.

-In place of prednisolone in patients needing steroid

treatment but unable to take oral medication

-Perioperatively in patients on long-term steroid

treatment to prevent an adrenal crisis.

14. ISOSORBIDE DINITRATE

 - is a nitrate that dilates (widens) blood vessels(both arteries and veins), making it easier for
blood to flow through them and easier for the heart to pump.

-Only the sublingual tablet should be used to treat an angina attack that has already
begun.

-Watched out for patients who have low blood pressure. Because ISDN causes vasodilation, it
may lead to further decrease in blood pressure.

15. LIDOCAINE
-one of several ACLS drugs used to treat cardiac arrest from ventricular tachycardia (VT) and
Ventricular Fibrillation (VF).

-considered a second-line antiarrhythmic drug and should be administered in VF/VT cases

where amiodarone is either unavailable or ineffective.

-When used to treat cardiac arrest from VT/VF, the initial dose should be 1-1.5 mg/kg IV/IO.

16. MAGNESIUM SULFATE

- An effective treatment for intractable
ventricular tachycardia and
ventricular fibrillation for patients
with hypomagnesemia.

-It was also effective in ventricular

tachycardia characterized by 'torsades
de pointes' and in massive digoxin
intoxication.

-Parenteral magnesium sulfate

administration, 10-15 ml of 20%
 MgSO4 in 1 min and 500 ml of 2% MgSO4 in 5 h in patients without renal failure was found to
be safe and effective.

17. METOCLOPRAMIDE
-It is commonly used to treat and
prevent nausea and vomiting, to
help with emptying of the stomach in
people with delayed stomach
emptying, and to help
with gastroesophageal reflux
disease.

-The antiemetic action of

metoclopramide is due to its
antagonist activity at D2 receptors in
the chemoreceptor trigger zone in
the central nervous system — this
action prevents nausea and
vomiting triggered by most stimuli.

-Metoclopramide increases peristalsis of the duodenum and jejunum, increases tone and
amplitude of gastric contractions, and relaxes the pyloric sphincter and duodenal bulb, while
simultaneously increasing lower esophageal sphincter tone.

18. METHYLPREDNISOLONE
- is a corticosteroid medication
used to suppress the immune
system and
decrease inflammation.

-Conditions in which it is used

include skin diseases, rheumatic
disorders,
allergies, asthma, croup, COPD,
certain cancers, multiple
sclerosis, and as add-on therapy
for tuberculosis.

- Glucocorticoids can inhibit

leukocyte infiltration at the site of
 inflammation, interfere with mediators of inflammatory response, and suppress humoral immune
responses.

-The anti-inflammatory actions of corticosteroids are thought to involve phospholipase A2

inhibitory proteins, lipocortins, which control the biosynthesis of potent mediators of inflammation such
as prostaglandins and leukotrienes.

19. NOREPINEPHRINE
-used mainly as a sympathomimetic
drug to treat people in vasodilatory
shock states such as septic
shock and neurogenic shock, while
showing fewer adverse side-effects
compared to dopamine treatment.

-It stimulates α1 and α2 adrenergic

receptors to cause blood vessel
contraction, thus increases peripheral
vascular resistance and resulted in
increased blood pressure.

20. PARACETAMOL
-commonly used for pain
management for moderate
to severe pain.

-Initial treatment for fever

ranging from 38.5C and
above or for those patients
who are unable to take
medications by mouth.
21. PHENYTOIN
-is an anti-seizure medication. It is useful for the prevention of tonic-clonic seizures and focal
seizures, but not absence seizures.

-Not used in treatment of pure

absence seizures due to risk for
increasing frequency of seizures.
However, it can be used in
combination with other
anticonvulsants during combined
absence and tonic-clonic seizures.

-Avoid giving intramuscular

formulation unless necessary due to
skin cell death and local tissue
destruction.

-IV use is contraindicated in patients

with sinus bradycardia, SA block,
second- or third-degree AV
block, Stokes-Adams syndrome, or
have known hypersensitivity to
phenytoin or any ingredient in the
respective formulation or to
other hydantoins.

22. POTASSIUM CHLORIDE

-is used in the treatment of hypokalemia as
an electrolyte replenisher.

-Some cardiac surgery procedures cannot be

carried out on the beating heart. For these
procedures, the surgical team will bypass the heart
with a heart-lung machine and inject potassium
chloride into the heart muscle to stop the heartbeat.

-Overdoses cause hyperkalemia, which can lead

to paresthesia, cardiac conduction
blocks, fibrillation, arrhythmias, and sclerosis.

23. Hyoscine-N-Butylbromide(HNBB)
 -is an antispasmodic drug indicated for the treatment of abdominal pain associated with cramps
induced by gastrointestinal (GI) spasms.

-Its anticholinergic action exerts a smooth-

muscle relaxing/spasmolytic effect.

-Hyoscine butylbromide is barely absorbed and

detectable in the blood and does not penetrate
the blood-brain barrier, and is, therefore,
generally well tolerated.

-Hyoscine butylbromide appears to be a

valuable treatment option for patients with
symptoms of abdominal pain or discomfort
associated with cramping.

24. VERAPAMIL
-is used to treat hypertension (high blood
pressure), angina (chest pain), and
certain heart rhythm disorders.

-is a calcium channel blocker. It works by

relaxing the muscles of your heart and
blood vessels.

-You should not use verapamil if you

have a serious heart condition such as
"sick sinus syndrome" or "AV block"
(unless you have a pacemaker),
severe heart failure, Wolff-Parkinson-
White, Lown-Ganong-Levine syndrome,
or slow heartbeats that have caused you
to faint.
25. SODIUM BICARBONATE
-Intravenous sodium bicarbonate is indicated in the
treatment of metabolic acidosis, such as can occur in
severe kidney disease, diabetic
ketoacidosis, circulatory insufficiency, extracorporeal
circulation of blood, in hemolysis requiring
alkalinization of the urine to avoid nephrotoxicity of
blood pigments, and certain drug intoxications, such
as by barbiturate overdose, salicylate
poisoning, tricyclic antidepressant
overdose or methanol poisoning.

-For this purpose it is generally only used when

the pH is less than 7.1 and when the underlying cause
is either diarrhea, vomiting, or the kidneys.

-Non-life-threatening: 2-5 mEq/kg IV infusion over 4-8 hr depending on the severity of acidosis as
judged by the lowering of total CO2 content, clinical condition and pH
 -Severe (except hypercarbic acidosis): 90-180 mEq/L (~7.5-15 g) at a rate of 1-1.5 L (first hour);
adjust for further management as needed

26. LEVIRACETAM
-Levetiracetam is effective for treatment of
generalized tonic-clonic epilepsy.

-Common side effects include sleepiness,

dizziness, feeling tired, and aggression.

- Severe side effects may

include psychosis, suicide, and allergic
reactions such as Stevens-Johnson
syndrome and anaphylaxis.

- It is unclear if use is safe

during pregnancy but it appears okay
when breastfeeding.