Aortic Dissection Drugs

Question 1

Labetalol

Answer 1

• β-Blocker
• blocks both β and α receptors
• decreases peripheral vascular resistance w/o significant change to HR or CO
• indicated for arterial HTN
• extensive first-pass metabolism (better IV)
• risk of adverse effects on fetus
• increased progesterone in pregnancy increases labetalol metabolism

Question 2

Esmolol

Answer 2

• β-Blocker
• decreases HR and BP
• Blocks β1>β2
• indicated for rapid HR, arrythmia, and HTN
• risk of anaphylaxis and extravasation
• may cause HYPERkalemia and HYPOtension
• very short half life

Question 3

Nitroprusside

Answer 3

• Breaks down in circulation to release NO
• Leads to increased PKG which vasodilates
• indicated for HTN
• Risk of cyanide toxicity, may need to give sodium thiosulfate to avoid toxicity
• do not use on pt w/ congenital Lebers optic atrophy, or Tobacco ambylopia

Question 4

Nicardipine

Answer 4

• slow CCB (dihydropyridine)
• inhibits calcium influx into heart muscle and vascular smooth muscle w/o changing serum calcium
• indicated for SHORT term treatment of HTN
• DO NOT give to pt w/ advanced aortic stenosis
• can cause hypotension and tachycardia
• do not give with cyclosporine, tacrolimus, or cimetidine
• CYP3A4 SUBSTRATE