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303 MEDIMAGE > 10. Drugs used in radiology I: emergency drugs > Flashcards

10. Drugs used in radiology I: emergency drugs Flashcards

1
Q

what are medical emergencies

A

any clinical situation that requires immediate medical attention to prevent harm or loss of life

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2
Q

what are sympathomimetics

A

mimic sympathetic nervous system

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3
Q

what are antiarrhytmics in terms of what they do

A

restore cardiac rhythm

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4
Q

what is the goal in prescribing emergency drugs

A

restore normal physiology

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5
Q

what is normal physiology

A

any physiology that allows you to maintain homeostasis and allows perfusion of vital organs and respiration

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6
Q

what is DRABC

A 
D = remove from danger 
R = check for response 
A = check airways are open 
B = if patient is attempting to breathe
C = circulatory refill, check blood pressure and pulse and see if capillary refill is normal
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7
Q

what are the determinants to blood pressure

A

cardiac output and total peripheral resistance

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8
Q

what is CO determined by

A

stroke volume and heart rate

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9
Q

what is SV determined by

A

venous return/preload

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10
Q

what is the determinants of systemic resistance

A

arteriolar constriction

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11
Q

what 3 aspects of blood pressure does SNS affect

A

Heart rate, arteriolar constriction and veno-constriction,

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12
Q

what does IV fluids affect in terms of blood pressure

A

blood volume -> preload -> stroke volume

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13
Q

what does the autonomic nervous system allow the body to do

A

maintain homeostasis by determining individual end organ homeostasis

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14
Q

what response is determined by the SNS and PSNS

A 
SNS = fight or flight
PSNS = rest and digest
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15
Q

what are the SNS and PSNS in relation to each other in homeostasis

A

SNS and PSNS are in balance

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16
Q

what does SNS do to the heart rate and contraction

A

increases both

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17
Q

how does the SNS impact contraction of the heart

A

arteries constrict as want to move blood from periphery to central compartments for heart to pump more and get better contraction

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18
Q

when SNS is activated, veins constricting do what to the TPR and BP

A

increase total peripheral resistance and BP

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19
Q

what effect does BP and TPR increase due to venous constriction have on perfusion (when SNS is activated)

how is the bronchus involved

A

improves perfusion to end organs and dilation of bronchus to get more air into the lung so more air transfers

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20
Q

what happens to the gut and liver when the SNS is activated

A

Decrease gut and liver and constrict to get blood out of reservoir and vasoconstrict in lungs to get more blood circulating

21
Q

how is the SNS used to manipulate blood pressure and what receptors are involved

A

using drugs that act on adrenoreceptors that are receptors associated with SNS to mimic flight or fight situation

22
Q

in hypotension what does heart rate needed to do

A

Heart rate want to increase and want to increase contractility and reduction of conduction velocity as want heart to repolarise quicker

23
Q

what does veins constriction do to SV

A

increase preload so increases SV

24
Q

what are the 2 types of adrenoreceptors

A

alpha and beta

25
Q

what does alpha 1 adrenoreceptors work on

A

vascular smooth muscle to increase vasoconstriction

26
Q

what does beta adrenoreceptors work on

A

acts on heart for positive ionotropic to increase force of contraction and chronotropic to increase heart rate

27
Q

how do direct catecholamines act

A

direct interact with A and B receptors

28
Q

how do naturally indirect catecholamines act

A

indirect = affect presynaptic preterminal to release adrenaline and noradrenaline to produce effect

29
Q

what are 2 naturally occuring catecholamines

A

adrenaline

noradrenaline

30
Q

what are 2 synthetic catecholamines

A

alpha 1 and B2 antagonists

31
Q

what is metaraminol and how does it work

A

synthetic indirect mixed a and b receptor antagonist, release adrenaline and noradrenaline across synaptic terminal to cross synapse and interact with alpha and beta

32
Q

why do you need to raise the legs or give fluid bolus for someone who has collapsed to the ground

A

Raise legs for someone collapsed to shift blood from legs to central compartment to increase blood volume to increase SV and preload

give fluid bolus rapidly to make heart think its got a lot of blood transfused and act as pump

Increases SV

33
Q

what is the bronchospasm mechanism

A

Only affect one organ with anaphylaxis

Narrowing and constriction of airways

34
Q

what are symptoms of a bronchospasm

A

Cant get air in or out (easier to get air in than out)

Cough wheeze, shortness of breath, severe can have silent chest (no air in or out) and in this case need to help them expel air by pushing on chest mechanically or by using drugs

35
Q

what are the anatomic mechanisms of bronchospasm

A

Airway inflammation and mucous secretion, smooth muscle constriction, swelling of membrane in acute phase

36
Q

what is salbutamol similar to and how do they work

A

Salbutamol is similar to adrenaline structurally and act mainly on Beta 2 receptors so don’t get cardiac effects, works more on smooth muscles of lungs

37
Q

What do anticholinergics do and how do they work

A

Anticholinergic as PSNS relies on acetylcholine as a neurotransmitter and by giving anticholan blocks acetylcholine from work so don’t have PSNS working against us to relax the smooth muscle

38
Q

how do nebulizers work and what do they do

A

Nebulizers deliver drug to site of action - bronchial smooth muscle - relaxes smooth muscle by B2 effect and anticholinergic effect

39
Q

what are the 2 types of medications to treat acute bronchospasm

A

sympathomimetics and anticholanergic

40
Q

For someone who goes through a anaphylatic shock reaction what happens to their blood pressure and why

A

low blood pressure as the trigger goes systemically and all blood vessels don’t know what it is so it has peripheral relaxation, not going to get venous return and SV low so increase HR to compensate - and systemic vascular resistance is going to be low so BP is low as well

41
Q

how does adrenaline treat anaphylatic shocks

A

Give adrenaline as it treats/stabilises mast cell degranulation makes vessels bronchi leaky and peripheral vasodilation

Stops mast cells from producing histamine

42
Q

how is adrenaline administered to treat anaphylactic shocks

A

Bolus of adrenaline into muscle via epipen or injection

Muscles are vascular rich and can repeat administration every 5 min

Can also give intravenous bolus

43
Q

what is a con of using adrenaline to treat anaphylactic shock

A

Problem with adrenaline is that it pushes patient into fight flight, muscles in body get charged metabolically and release hydrogen ions and get acidotic and potassium release so hyperbulemic (not good in long term)

44
Q

what are the 2 types of shockable rhythms

A

ventricular tachycardia and ventricular fibrillation

45
Q

how does amiodarone treat anaphylactic shock

A

antiarrythmic

blocks potassium channels in the heart and slows rate of repolarisation

46
Q

how does amiodarone block potassium channels in the heart and slows rate of repolarisation - 2 ways

A

increases duration of action potential

increases refractory period

47
Q

what is predisone

A

corticosteroid that acts as anti-inflammatory and stabilize mast cells and inflammation that leads to anaphylaxis

48
Q

what is loratidine

A

antihistamine, histamine acts of histamine receptor and loratadine drug blocks receptor so reduces chance of having allergy reaction

303 MEDIMAGE (14 decks)

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