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Flashcards in vasoactive drugs Deck (262)
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1
Q

trade name of adenosine

A

Adenocard, Adenocor,

2
Q

dose of adenosine

A
6 mg
over 1-2 seconds
12 mg 
second dose
20 mL flush
3
Q

onset of adenosine

A

rapid

4
Q

DOA adenosine

A

very breif

5
Q

uses of adenosine

A

Paroxysmal SVT including those associated with accessory bypass tracts (WPWS);

not effective for a.fib/flutter, vtach

6
Q

metabolism of adenosine

A

Blood and tissue to inosine\

then to AMP and hypoxanthine

7
Q

elimination of adenosine

A

Erythrocytes and vascular endothelial cells

8
Q

a/e adenosine

A

Arrhythmias,
hypotension,
bronchospasm in patients with asthma

9
Q

contraindications of adenosine

A
Second or third degree AV block, 
sick sinus syndrome, 
symptomatic bradycardia;
 known or suspected bronchoconstriction, 
asthma
10
Q

Atenolol category

A

beta blocker
beta 1 selective
Antianginal,
antihypertensive,

11
Q

atenolol b receptors

A

b 1 selective

12
Q

dose of atenolol

A

HTN PO 25-50 mg

May also be used for angina, a.fib, post-MI, thyrotoxicosis

13
Q

onset of atenolol

A

1 hour

14
Q

peak of atenolol

A

2-4 hours

15
Q

uses of atenolol

A
Tx HTN, 
angina, 
post-MI, 
acute ETOH withdrawal, 
SVT, 
a.fib, 
migraine h/a prophy
16
Q

metabolism of atenolol

A

hepatic

17
Q

elimination of atenolol

A

Feces 50%,

urine 40%

18
Q

major side effects of atenolol

A
Bradycardia, 
hypotension, 
2nd degree AV block, 
bronchospasm,
 wheezing
19
Q

contraindications of atenolol

A
Sinus bradycardia, 
SAnode d/f, 
heart block greater than first degree, 
cardiogenic shock, 
uncompensated heart failure,
 pulmonary edema, 
pregnancy
20
Q

cation with atenolol certain conditions

A
Caution: diabetes, 
myasthenia gravis, 
PVD, 
raynauds, 
pheochromocytoma (use alpha blocker first), 
thyroid disease
21
Q

calcium chloride dosage acute symptomatic

A

Acute symptomatic 200-1000 mg Q1-3 days

Beta blocker OD 20mg/kg over 5-10min followed by infusion 20mg/kg

22
Q

calcium chloride dosage Cardiac arrest with hyperkalemia/magnesemia or hypocalcemia and how fast

A

Cardiac arrest with hyperkalemia/magnesemia or hypocalcemia 500-1000mg over 2-5 min

23
Q

calcium chloride with beta blocker overdose

A

Beta blocker OD 20mg/kg over 5-10min followed by infusion 20mg/kg

24
Q

onset of calcium chloride

A

immediate

25
Q

uses of calcium chloride

A
Treat hypocalcemia, 
emergent tx of severe hypermagnesemia, 
beta blocker OD, 
severe hyperkalemia, 
malignant arrhythmias
26
Q

elimination of calcium chloride

A

feces

27
Q

AE with calcium chloride

A
Acidosis, 
hyperphophatemia,
 hypokalemia, 
hypomagnesemia,
 tissue necrosis,
 hot flash, 
vasodilation
28
Q

absolute contraindication with calcium chloride

A

digoxin overdose

29
Q

calcium chloride forms a precipitate with WHAT and do no give with it then?

A

Do not give with bicarb or phosphate containing solutions to avoid precipitation;

30
Q

what electrolyte imbalance should you give hyperkalemia with

A

Preferred in hyperkalemia with circulatory compromise

31
Q

how do CaCl and Calcium Gluconate compare

A

Amp of 10% CaCl contains three times (3x) more Ca than amp of 10% Ca gluconate

32
Q

dose of calcium gluconate

A

Hypocalcemia ionized Ca 4-5 mg/dL or 1-1.2mmol/L

1000-2000 mg over 2 hrs

33
Q

elimination calcium gluconate

A

feces

34
Q

adverse effects of calcium gluconate

A

Risk for hyperphosphatemia,
hypokalemia,
hypomagnesemisa,
kidney stones

35
Q

contraindications of calcium gluconate

A

v.fib,
hypercalcemia,
concomitant use of IV Ca gluconate and ceftriaxone; caution in pts on digitalis bc hypercalcemia promotes cardiotoxicity

36
Q

what must you NOT give calcium gluconate with? and what would happen if you did

A

Do not give with bicarb or phosphate containing solutions to avoid precipitation

37
Q

trade name of clonadine

A

catapres

38
Q

category of clonadine

A

Alpha2 adrenergic agonist;

antihypertensive

39
Q

dose of clonadine PO

A

PO 0.1mg BID

TD 0.1mg/24hr patch

40
Q

dose of clonadine for pain epidural

A

Pain epidural: 30 mcg/hr titrate MAX >40mcg/

41
Q

onset of PO clonidine

A

PO 0.5-1hr

TD 2-3 days

42
Q

peak of PO clonidine

A

6-10 hours

43
Q

uses of clonidine

A

Tx HTN,
ADHD,
cancer pain,
neuropathic pain,

44
Q

metabolism of clonidine

A

hepatic

45
Q

elimination of clonidine

A

urine

46
Q

major adverse effects of clonidine

A

Bradycardia/tachycardia,

hypotension

47
Q

contraindications with clonadine

A
Epidural administration: 
infection at site; 
concurrent anticoagulation, 
bleeding diathesis,
 administration above C4 dermatome; 
caution with drugs with SA/AV nodal blocking properties
48
Q

how do alpha 2:1

A

Alpha2:Alpha1
220:1

49
Q

trade name of digoxin

A

digitalis

50
Q

category of digoxin

A

Antiarrhythmic;

cardiac glycoside

51
Q

dose of digoxin with SVT

A

SVT: 0.5-1mg give ½ of total digitalizing dose as the initial dose than ¼ of the TDD in each of the 2 subsequent doses at 6-8 hr interval

52
Q

onset of digoxin IV

A

5-60 min IV

53
Q

onset of digoxin PO

A

PO 1-2 hrs

54
Q

DOA digoxin

A

DOA 3-4 days

55
Q

uses of digoxin

A

Sequential sugar hydrolysis in the stomach or
reduction of lactone ring by intestinal bacteria
A-fib with RVR
A-flutter
*NO LONGER THE FIRST CHOICE WITH these- BB or Ca channel blockers are best

56
Q

metabolism of digoxin

A

urine

57
Q

major adverse effects of digoxin

A
Junctional rhythm, 
heart block,
 PR prolongation, 
Vtach/vfib, 
Noncardiac side effects: 
GI—anorexia, N/V, and abd pain: CNS—visual disturbances, headache, drowsiness, confusion vision changes (yellow/blurred vision),
58
Q

contraindications of digoxin

A

Hypersensitivity; vfib

59
Q

what can lead to cardiac toxicity?

A
Cardiac arrhythmia (toxicity) can be precipitated by hypokalemia, 
hypomagnesemia, 
hypoxia,
 hypercalcemia, 
hypernatremia,
 renal failure
60
Q

class of anti arrhythmic of diltiazem

A

Class IV

61
Q

category of diltiazem

A

anti-arrythmic

calcium channel blocker

62
Q

dose of diltiazem and use

if it is repeated what is the dose?

A

Afib/flutter: 0.25 mg/kg over 2 min bolus (~20mg); may repeat after 15 min at 0.35 mg/kg over 2 min (~25mg);

63
Q

infusion dose of diltiazem

A

cont inf 10 mg/hr

may increase rate in 5mg/hr increments up to 15mg/hr

64
Q

onset of diltiazem

A

3 minutes

65
Q

peak of diltiazem

A

2-5 minutes

66
Q

DOA diltiazem

A

1-3 hours

67
Q

use of diltiazem

A

control of rapid rate in a-fib a-flutter

68
Q

metabolism of diltiazem

A

hepatic

69
Q

elimination of diltiazem

A

urine

70
Q

adverse effects of diltiazem

A

Hypotension,
av block,
elevated ast/alt,
stevens-johnson syndrome

71
Q

contraindications with diltiazem

A
Sick sinus syndrome,
 2nd or 3rd degree block, 
severe hypotension, 
cardiogenic shock, 
concomitant administration with IV beta blocker, 
WPWS, 
vtach
72
Q

trade name of esmolol

A

Brevibloc

73
Q

classification of esmolol

A

B-1 selective beta blocker

74
Q

intubation dose of esmolol

A

Intubation 1-2mg/kg

75
Q

HTN dose of esmolol w/tachycardia

bolus (mg/kg)

A

HTN/tachycardia 80mg initial bolus (1mg/kg) over 30 sec

76
Q

infusion dose of esmolol

A

& infusion

followed by 150 mcg/kg/min infusion max 300 mcg/kg/min

77
Q

onset of esmolol

A

2-10 minutes

78
Q

peak of esmolol

A

10-30 minutes

79
Q

DOA esmolol

A

unknown

80
Q

metabolism of esmolol

A

In RBCs by blood cell esterases

81
Q

excretion of esmolol

A

urine

82
Q

uses of esmolol

A

Treatment of SVT and Afib/flutter;

tx of intraoperative and postoperative tachycardia and or HTN

83
Q

major adverse effects of esmolol

A
Hypotension, 
bradycardia, 
bronchospasm, 
CHF, 
pulmonary edema
84
Q

contraindications with esmolol

A

Sinus bradycardia,
heart block greater than 1st degree,
cardiogenic shock,
uncompensated cardiac

85
Q

fenlodopam categoty

A

dopamine 1 agonist

arteriol vasodilation

86
Q

fanlodopam trade name

A

corlopam

87
Q

fenlodopam dose

A

0.03-0.1mcg/kg/min may increase by 0.05-0.1mcg/kg/min Q15min

88
Q

max dose of fenlodopam

A

max 1.6 mcg/kg/min

89
Q

onset of fenlodopam

A

10 minutes

90
Q

duration of action of fenlodopam

A

1 hour

91
Q

metabolism of fenlodopam

A

hepatic

92
Q

excretion of fenlodopam

A

Urine 90%. 10% feces

93
Q

uses of fenlodopam

A

Severe HTN

94
Q

A/E fenlodopam

A
Hypotension, 
flushing,
 dizziness,
 h/a,
 nausea, 
hypokalemia, 
increases HR
95
Q

caution with fenlodopam

A

Use with caution in patients with glaucoma as it increases IOP

96
Q

trade name of hydralazine

A

apresoline

97
Q

category of hydralazine

A

Direct vasodilator;

phenothalazine derivative

98
Q

dose of hydralazine

A

10-20 mg Q 4-5 hrs PRN

99
Q

onset of hydralazine

A

5-10 minutes

100
Q

peak of hydralazine

A

1-4 hours

101
Q

DOA hydralazine

A

15-30 minutes

102
Q

metabolism of hydralazine

A

hepatic

103
Q

elimination of hydralazine

A

urine

104
Q

use of hydralazine

A

HTN

105
Q

adverse effects of hydralazine

A
Tachycardia, 
increased ICP, 
lupus like syndrome, 
pancytopenia,
 peripheral neuropathy,
 skin
106
Q

contraindications of hydralazine

A

Mitral valve rheumatic heart disease

107
Q

Amrinone trade name

A

Inocor

108
Q

Amrinone category

A

Phosphodiesterase enzyme inhibitor

109
Q

dose amrinon

A

0.75 mg/kg IV bolus over 2-3 min

followed by maintenance of 5-10 mcg/kg/min

110
Q

maintenance dose of amrinon

A

IV bolus

followed by maintenance of 5-10 mcg/kg/min

111
Q

onset of amrinon

A

2-5 minutes

112
Q

peak of amrinon

A

30 min to 2 hrs

113
Q

DOA amrinon

A

10 min

114
Q

metabolism of amrinon

A

hepatic

115
Q

elimination of amrinon

A

urine

116
Q

use of amrinon

A

Short term therapy in pts with intractable heart failure

117
Q

major adverse effects of amrinon

A
Arrhythmias,
hypotension,
n/v,
thrombocytopenia, 
hepatotoxicity
118
Q

amrinon contraindications

A

Hypersensitivity, patients with severe aortic or pulmonic valvular disease

119
Q

category of labetalol

A

Blocks alpha,
beta1,
beta 2

120
Q

labetalol receptors PO B1:B2

A

1:3

121
Q

labetalol recepotrs IV B1: B2

A

1:17

122
Q

dose of labetalol

A

20 mg IV over 2 min; may administer 40-80 mg at 10 min

123
Q

max dose of labetalol

A

300 mg

124
Q

infusion dose of labetalol

A

2 mg/min

125
Q

onset of labetalol

A

2-5 minutes

126
Q

peak of labetalol

A

5-15 min

127
Q

DOA of labetalol

A

2-18 hours

128
Q

metabolism of labetalol

A

hepatic

129
Q

elimination of labetalol

A

urine

130
Q

major adverse effects of labetalol

A
Hypotension,
bronchospasm, 
ventricular arrhythmias, 
hyperkalemia, 
hepatotoxicity
131
Q

contraindications of labetalol

A
Severe bradycardia,
 heart block,
 asthma,
 non compensated heart failure,
 cardiogenic shock
132
Q

trade name of labetalol

A

Normodyne

133
Q

category of lisinopril

A

Inhibitor of ACE

134
Q

dose of lisinopril

A

CHF 2.5-5mg PO initially up to 20-40 mg

HTN PO 10 mg to 40 mg

135
Q

onset of lisinopril

A

1 hour

136
Q

peak of lisinopril

A

6 hours

137
Q

DOA of lisinopril

A

24 hours

138
Q

elimination of lispinopril

A

urine

139
Q

uses of lisinopril

A

Acute MI, CHF, HTN

140
Q

major adverse effects of lisinopril

A

Hypotension,
dizziness,
increased BUN/creatinine,
angioedema

141
Q

contraindications of lisinopril

A
cardiogenic shock
Lisinopril
Inhibitor of ACE
CHF 2.5-5mg PO initially up to 20-40 mg
HTN PO 10 mg to 40 mg
1hr
6hrs
24hrs
Urine
Acute MI, CHF, HTN
Hypotension, dizziness, increased BUN/creatinine, angioedema
Hypersensitivity, angioedema; concomitant use with aliskiren in pts with DM
142
Q

trade name of metoprolol

A

lopressor

143
Q

category of metoprolol

A

beta 1 selective

144
Q

dose of metoprolol for afib

A

A.fib IV 2.5-5mg Q2-5min;

145
Q

dose of metoprolol HTN

A

HTN 1.25-5mg A6-12 hrs IV

MI 5mg Q5min up to 3 doses

146
Q

peak of metoprolol

A

20 minutes

147
Q

DOA of metoprolol

A

5-8 hours

148
Q

metabolism of metoprolol

A

hepatic

149
Q

excretion of metoprolol

A

urine

150
Q

uses of metoprolol

A

angina
HTN
MI

151
Q

major adverse effects of metoprolol

A

Bradycardia, heart block, hypotension, pulmonary edema, bronchospasm

152
Q

contraindications of metoprolol

A
Hypersensitivity, 
sinus brady,
 heart block,
 cardiogenic shock, 
overt heart failure, 
sick sinus syndrome, 
PAD
153
Q

category of milrinone

A

Selective phosphodiesterase inhibitor

154
Q

milrinone trade name

A

milrinone lactate

155
Q

dose of milrinone

A

Loading 50 mcg/kg over 10 min

follow by maint inf 0.375-0.75mcg/kg/min

156
Q

maintenance dose of milrinone

A

follow by maint inf 0.375-0.75mcg/kg/min

157
Q

onset of milrinone

A

5-15 minutes

158
Q

metabolism of milrinone

A

hepatic

159
Q

excretion of milrinone

A

urine

160
Q

treatment uses of milrinone

A

Tx heart failure; inotropic therapy

161
Q

adverse effects of milrinone

A
Ventricular arrhythmia,
thrombocytopenia, 
angina, 
hypotension,
h/a, 
hyperthermia
162
Q

contraindications of milrinone

A

Hypersensitivity;

caution in pts w/ renal insufficiency and aortic/pulmonic valvular disease

163
Q

category of nicardipine

A

calcium channel blocker

164
Q

trade name of nicardipine

A

cardene

165
Q

dose of nicardipine

A

IV 5mg/hr initially;

166
Q

max of nicardipine

A

max 15mg/hr

167
Q

onset of nicardipine

A

10 minutes

168
Q

DOA of nicardipine

A

8 hours

169
Q

metabolism of nicardipine

A

hepatic

170
Q

excretion of nicardipine

A

urine

171
Q

uses of nicardipine

A

Chronic stable angina, HTN

172
Q

major adverse side effects of nicardpine

A

Flushing,
hypotension
, edema,
exacerbation angina pectoris

173
Q

contraindications with nicardipine

A

Hypersensitivity;
advanced aortic stenosis
caution- may increase angina or MI, use with beta blockers may worsen HF

174
Q

category of nitroglycerine

A

Nitrate/antianginalVenodilator

175
Q

how does nitroglycerine affect vessels?

A

Nitroglycerine forms free nitric oxide which activates guanylate cyclase to increase cGMP smooth muscle relaxant

176
Q

dose of nitroglycerine

A

IV 5mcg/min up to 400mcg/min

177
Q

max dose of nitroglycerine

A

400 mcg/min

178
Q

onset of nitroglycerine

A

immediate

179
Q

peak of nitroglycerine

A

immediate

180
Q

use of nitroglycerine

A

Tx or prevention angina pectoris,
acute decompensated heart failure,
perioperative HTN

181
Q

metabolism of nitroglycerine

A

Hepatic;

nonhepatic via RBC and vascular walls

182
Q

elimination of nitroglycerine

A

urine

183
Q

major adverse side effects of nitroglycerine

A

hypotension
tachycardia
flushing
dizziness

184
Q

what conditions can you not give nitroglycerine with?

A

, constrictive pericarditis,
pericardial tamponade,
restrictive cardiomyopathy,
SUBLINGUAL- early MI, increased ICP, severe anemia

185
Q

hypersensitivity to certain things are contraindicated with nitro

A

Hypersensitivity to organic nitrates or components,

hypersensitivity to corn,

186
Q

what medications can you not give nitroglycerine with?

A

concurrent use of phosphodiesterase inhibitors,

concurrent use with riociguat

187
Q

trade name of nitroprusside

A

nipride

nitropress

188
Q

category of nitroprusside

A

direct acting ventilator and arteriol dilator

189
Q

how does nitroprusside work?

A

Direct acting venous and arteriolar smooth muscle relaxer; releases NO spontaneously

190
Q

dose of nitroprusside

A

0.3-0.5 mcg/kg/min

191
Q

max dose of nitroprusside

A

max 10 mcg/kg/min

192
Q

onset of nitroprusside

A

less than 2 minutes

193
Q

DOA nitroprusside

A

1-10 minutes

194
Q

uses of nitroprusside

A

HTN, acute decompensated HR

195
Q

metabolism of nitroprusside

A

Combines with hgb to form

cyanide and cyanmethemoglobin

196
Q

excretion of nitroprusside

A

urine

197
Q

major adverse effects of nitroprusside

A

Hypotension,
flushing,

cyanide toxicity when max dose is used for long periods (even >10 min), increased ICP

198
Q

contraindications with nitroprusside

A

Compensatory HTN (aortic coarctation, av shunt),
controlled hypotension in pts with inadequate cerebral circulation/moribund pts ,
high output HF with reduced SVR,
congenital optic atrophy or tobacco amblyopia

199
Q

phenoxybenzamine trade name

A

dibenzyline

200
Q

MOA/category of phenoxybenzamine

A

alpha 1 blocker

201
Q

dose of phenoxybenzamine

A

PO 10 mg up to 20-40 mg BID or TID

202
Q

oset phenoxybenzamine

A

several hours

203
Q

DOA phenoxybenzamine

A

3 days

204
Q

excretion of phenoxybenzamine

A

urine/bile

205
Q

uses of phenoxybenzamine

A

Symptomatic pheochromocytoma, (tx sweating)
micturition problems associated with neurogenic bladder, outlet obstruction,
treatment of hypertensive crisis caused by sympathomimetic amines

206
Q

major adverse side effects phenoxybenzamine

A

hypotension

tachycardia

207
Q

contraindications of phenoxybenzamine

A

hypersensitivity

shock

208
Q

phentolamine category

A

nonselective alpha blocker

209
Q

dose of phentolamine extravasation NE

A

5-10 mg in 10-15 mL NS

210
Q

HTN w/pheo dose of phentolamine

A

5mg 1-2 hrs before surgery; 5mg during surgery;

211
Q

HTN crisis with phentolamine dose

A

HTN crisis 1-5 mg bolus up to 15 mg max

212
Q

max dose of phentolamine

A

1-5 mg

213
Q

onset of phentolamine

A

1-2 min

214
Q

DOA phentolamine

A

10-30 minutes

215
Q

metabolism of phentolamine

A

hepatic

216
Q

excretion of phentolamine

A

urine

217
Q

uses of phentolamine

A

Diagnosis of pheo;
management of extravasation of sympathomimetic vasopressors,
tx hypertensive crisis

218
Q

adverse effects of phentolamine

A
Tachycardia, 
bradycardia, 
HTN, 
h/a, 
pain at injection site
219
Q

contraindications of phentolamine

A

hypersensitivity

220
Q

prazosin category/moa

A

Competitive inhibitor of postsynaptic alpha receptors leading to vasodilation of veins and arterioles and decrease in total peripheral resistance and BP

221
Q

dose of prazosin

A

HTN PO 1mg 2-3x/day; max 20 mg

222
Q

onset of prazosin

A

2 hours

223
Q

peak of prazosin

A

2-4 hours

224
Q

DOA prazosin

A

10-24 hours

225
Q

metabolism of prazosin

A

hepatic

226
Q

elimination of prazosin

A

feces

urine

227
Q

major adverse s/e prazosin

A
Palpitation, 
dizziness, 
h/a, weakness, 
nausea, 
angina, 
floppy iris syndrome, 
orthostatic hypotension
228
Q

contraindications of prazosin

A

hypersensitivity

229
Q

propranolol category

A

Nonselective beta blocker B1&2

230
Q

dose of propranolol

A

20-80 mg PO

IV 1-3 mg/dose

231
Q

onset of propranolol

A

1-2 hours

232
Q

peak of propranolol

A

1-4 hours

233
Q

DOA propranolol

A

6-12 hours

234
Q

metabolism propranolol

A

hepatic

235
Q

excretion propranolol

A

urine

236
Q

uses of propranolol

A
Management HTN,
 angina,
 pheo,
 tremor, 
supraventricular arrhythmias
237
Q

major adverse effects of propranolol

A
Bradycardia, 
CHF,
 hypotension,
 fatigue, 
hyperglycemia, 
hyperkalemia, 
bronchospasm
238
Q

contraindications propranolol

A
Hypersensitivity, 
uncompensated HF, 
sick sinus syndrome, 
bradycardia, 
cardiogenic shock, 
asthma
239
Q

trade name of propranolol

A

propranolol

240
Q

moa/ category propranolol

A

beta 1 & 2 blocker

241
Q

dose of timolol

A

10 mg BID

242
Q

onset of timolol

A

15-45 minutes

243
Q

peak of timolol

A

0.5- 2.5 hours

244
Q

DOA timolol

A

4 hours

245
Q

metabolism timolol

A

hepatic

246
Q

excretion timolol

A

urine

247
Q

uses of timolol

A

Tx HTN angina, prophy migraine

248
Q

adverse effects of timolol

A
Bradycardia, 
fatigue, 
bronchospasm, 
hyperglycemia, 
hyperkalemia, 
pulm edema, 
CHF
249
Q

contraindications with timolol

A
Hypersensitivity, 
sinus brady, 
sinus node d/f, 
heart block, 
cardiogenic shock, 
uncompensated cardiac failure, 
bronchospastic disease
250
Q

category of verapamil

A

calcium channel blocker

251
Q

dose of verapamil po

A

80-120 mg PO

252
Q

dose of verapamil IV

A

IV 0.075-0.15mg/kg over 2 min and then 0.005mg/kg/min continuous infusion

253
Q

po onset verapamil

A

PO 1-2 hrs

254
Q

IV onset verapamil

A

IV 1-5 min

255
Q

peak of verapamil

A

Immediate release 1-2 hrs

256
Q

DOA verapamil PO

A

PO 6-8 hrs

257
Q

DOA verapamil IV

A

IV 10-20 min

258
Q

metabolism verapamil

A

hepatic

259
Q

excretion verapamil

A

urine

260
Q

uses verapamil

A

SVT, afib/flutter, HTN, angina

261
Q

major A/E verapamil

A
Gingival hyperplasia, 
hypotension, 
conduction block, 
increased hepatic enzymes, 
arrhythmia, 
decreased neuromuscular transmission
262
Q

contraindications verapamil

A
Hypersensitivity, 
severe LV D/Hypotension, 
cardiogenic, 
sick sinus syndrome, 
heart block, 
afib/flutter, 
WPWs, 
concurrent sue IV beta blocker