Transradial Cardiac Catheterization Medication

Updated: Jan 24, 2014
  • Author: David H Adler, MD, FACC; Chief Editor: Eric H Yang, MD  more...
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Medication

Medication Summary

The goals of pharmacotherapy are to minimize pain, to reduce morbidity, and to prevent complications.

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Local Anesthetics, Amides

Class Summary

Local anesthetics are used for local pain relief.

Lidocaine (Xylocaine)

Lidocaine 1%-2% may be used. Lidocaine is an amide local anesthetic used in 1%-2% concentration. The 1% preparation contains 10 mg of lidocaine for each 1 mL of solution; the 2% preparation contains 20 mg of lidocaine for each 1 mL of solution. Lidocaine inhibits depolarization of type C sensory neurons by blocking sodium channels.

Bupivacaine (Marcaine)

Bupivacaine decreases permeability to sodium ions in neuronal membranes. This results in the inhibition of depolarization, blocking the transmission of nerve impulses.

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Calcium Channel Blockers

Class Summary

Calcium channel blockers are used to prevent radial artery spasm.

Diltiazem (Cardizem, Dilacor XR, Diltzac, Matzim LA)

During depolarization, diltiazem inhibits calcium ions from entering slow channels and voltage-sensitive areas of vascular smooth muscle and myocardium.

Verapamil (Verelan, Calan)

Verapamil inhibits calcium ions from entering slow channels and voltage-sensitive areas of vascular smooth muscle and myocardium.

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Vasodilators

Class Summary

Vasodilators dilate the mesenteric arterial system. They thereby reverse reactive arterial vasospasms.

Nitroglycerin (Nitro-Dur, Nitro-Bid, Nitrolingual, Nitrostat)

Nitroglycerin produces a vasodilator effect on the peripheral veins and arteries.

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Anticoagulants, Hematologic

Heparin

Heparin may be used if thrombocytopenia is not present. Heparin augments activity of antithrombin III and prevents conversion of fibrinogen to fibrin. It does not actively lyse but is able to inhibit further thrombogenesis. It prevents recurrence of a clot after spontaneous fibrinolysis.

Bivalirudin (Angiomax)

Bivalirudin inhibits coagulant effects by preventing thrombin-mediated cleavage of fibrinogen to fibrin.

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