Caution should be used in patients with any of the following:

▪Tuberculosis

▪Immunocompromised

▪Pregnancy

▪Active infection

▪Sarcoidosis

▪Sepsis

▪Peptic ulcer disease

▪Diabetes mellitus

▪Renal or hepatic dysfunction

▪Malignant hypertension

Reference:PJ Mehta’s Practical Medicine

ADENOSINE – ADENOCARD, ADENOSCAN

• MOA;  acts on A1 receptors in AV node causing temporary heart block.
• DOSE ; : 6mg IV RAPID push, may give 12mg IV q 2 minutes if no effect x2
• EMERGENT INDICATIONS; : stable SVT, stable narrow complex tachycardias.
• WARNINGS; : prodysrhythmic, do not give in preexisting 2nd or 3rd degree block, Preg C
• Reference: PJ Mehta’s Practical Medicine .

HEPARIN

• MOA:  binds to antithrombin III thereby potentiating inactivation of thrombin and factors IX, Xa, XI, XII; prevents fibrinogen → fibrin; preferential inactivation of thrombin over other clotting factors
• DOSE: Venous thromboembolism: 80 units/kg IV x 1, then 18 units/kg/hour ACS or Afib: 60 units/kg IV x 1, then 12 units/kg/hr 
• EMERGENT INDICATION:  thromboembolism; ACS (enoxaparin preferred for NSTEMI) 
• WARNINGS:  bleeding (protamine may be given for reversal), dosing errors, Preg C
• Reference:ghoms Textbook Of Oral Medicine