Adrenergics And Anti-adrenergics Flashcards
What are the effects of milrinone on the myocardium?
Increased inotropy Increased lusitropy (reduction in LVEDP, increase in CPP, increases SV)
What happens with alpha 2 blockade?
Increased cardiac output
Tachycardia due to beta adrenergic activity
Decreased orthostatic hypotension
Where are alpha 1 receptors found?
Vascular smooth muscle
Where are alpha 2 receptors found
In CNS and peripheral nervous systems (presynaptic)
What happens with alpha 2 stimulation?
Norepinephrine release through negative feedback
When is phenoxybenzamine or Phentolamine used?
Preoperatively for pheochromocytomas
What is the difference between phenoxybenzamine and Phentolamine?
Phentolamine has more alpha 2 blocking activity
Phenoxybenzamine is irreversible and works more on alpha 1
How long is the half life of Phenoxybenzamine
24 hours
What other meds can be used intraoperatively for hypertension in pheochromocytomas?
Esmolol
Magnesium
What triggers the release of vasopressin?
Hypotension
Plasma osmolality
What does the receptor V2 do?
Increases blood volume
What are the effects of vasopressin on the pulmonary and cerebral vasculature?
Vasodilation
What does vasopressin do to VWF?
Increases the circulating Vwf and factor VIII
What is levosimendan?
A type of calcium sensitizing agent and inotrope
Causes calcium-dependent binding of troponin C to increase ventricular contractility
Opens ATP-dependent K channels causing venoarteriolar vasodilation
What is tolvaptan?
V2 receptor antagonist used in SIADH
