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Pharmacology > Autonomics > Flashcards

Autonomics Flashcards

1
Q

Ibuprofen: Brand name

A

Motrin; related naproxen (Aleve)

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2
Q

Ibuprofen: Drug Class (6)

A

Pharmacologic–NSAID

Therapeutic–analgesic, antipyretic, anti-inflammatory, anti-gout, anti-dysmennorhea

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3
Q

Ibuprofen: Pharmacodynamics

A

Exact mechanism unclear, but most likely involves inhibition of prostaglandin synthesis via COX 1 and COX 2 (effects on pain, inflammation, kidney, stomach)

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4
Q

Ibuprofen: Pharmacokinetics (4)

A

F=80%
Extensive metabolism in liver
Some is excreted unchanged in urine
Half-life about 2-4 h

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5
Q

Ibuprofen: Toxicity issues (contraindications, precautions, warnings, ADRs, etc) (3)

A

Avoid in patients “allergic” to aspirin (asthma, nasal polyps, etc)
Use with caution in patients with renal compromise or ulcer disease
Fluid retention in CHF patients

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6
Q

Ibuprofen: Drug interactions (4)

A

Warfarin
Aspirin
Diuretics
Antihypertensives

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7
Q

Ibuprofen: Special considerations

A

Greater potential for toxicity in geriatric patients

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8
Q

Ibuprofen: Dose/route (not necessary to know)

A

OTC 200-400 mg po q4h prn pain; higher doses by prescription only

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9
Q

Norepinephrine: Brand name (2)

A

Noradrenaline, Levophed

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10
Q

Norepinephrine: Drug class (3)

A

Pharmacologic class—direct-acting adrenergic agonist

Therapeutic class —vasopressor, vasoconstrictor

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11
Q

Norepinephrine: Pharmacodynamics (4)

A

Major action is to stimulate peripheral alpha-1 adrenoceptors –> vasoconstriction (resistance arterioles, increase SVR) and venoconstriction (in capacitance vessels, increase preload)

  • -> Increases CO, SVR, and MAP
  • -> Decreases blood flow to vulnerable tissues like skin, muscle, and kidney
  • -> Stimulates beta-1 receptors in the heart, increasing HR and contractility; main effects are vasoconstriction and cardiac stimulation.
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12
Q

Norepinephrine: Pharmacokinetics (6)

A

F ~100%
Given IV only
Metabolized by COMT and MAO, mostly in liver
Metabolites are excreted in urine
Half-life 1-2 minutes (e.g. can be titrated quickly IV)
Can cross the placenta, but not the blood/brain barrier.

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13
Q

Norepinephrine: Toxicity issues (contraindications, precautions, warnings, ADRs, etc) (2)

A

Excessive vasoconstriction in mesenteric vessels, peripheral arterioles causing ischemia, infarction, gangrene
Reflex bradycardia

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14
Q

Norepinephrine: Drug interactions (2)

A

Use cautiously in patients taking an MAO inhibitor such as phenelzine (use lower doses)
Risk of excessive hypertension in patients taking propranolol

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15
Q

Norepinephrine: Special considerations (4)

A

Correct volume depletion with IV fluids BEFORE giving NE infusion
Select infusion site carefully—extravasation is a major problem
Monitor patient and BP continuously in ICU setting
Use cautiously in pediatric and geriatric patients

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16
Q

Norepinephrine: Dose/route (not necessary to know)

A

For adults with acute hypotension and shock (related to low SVR) infuse 2-12 mcg/min

17
Q

Norepinephrine: Monitor (4)

A

BP, HR, infusion site, evidence of extravasation

18
Q

Epinephrine: Brand name

A

Adrenaline, EpiPen

19
Q

Epinephrine: Drug class

A

Pharmacologic class—direct-acting adrenergic agonist
Therapeutic class—vasopressor, cardiac stimulant, bronchodilator, adjunct to local anesthetics, treatment for anaphylaxis

20
Q

Epinephrine: Pharmacodynamics

A

Major action is to stimulate peripheral alpha-1 adrenoceptors, thereby leading to vasoconstriction (resistance arterioles, increase SVR) and venoconstriction (in capacitance vessels, increase preload); beta-1 receptors leading to tachycardia and increased contractility; and beta-2 receptors leading to bronchodilation; these actions are also helpful in severe allergic reactions (e.g. anaphylaxis) by stabilizing mast cells

21
Q

Epinephrine: Pharmacokinetics

A

Can be given iv (immediate), IM (variable), SC (5-15 min), and via inhalation (1-5 min onset), ophthalmic topical; metabolized by COMT and then renally excreted

22
Q

Epinephrine: Toxicity issues (contraindications, precautions, warnings, ADRs, etc)

A

Excessive vasoconstriction, HTN, hemorrhagic stroke, angina, arrhythmias

23
Q

Epinephrine: Drug interactions

A

Risk of excessive hypertension in patients taking propranolol

24
Q

Epinephrine: Special considerations

A 
Utility with local anesthetics; drug of choice in severe
anaphylactic reactions (along with others)
25
Q

Epinephrine: Dose/route (not necessary to know)

A

For anaphylaxis, 0.1-0.5 mg SC or IM; for cardiac arrest, 1-5 mg IV push; for infusion, 1-4 mcg/min

26
Q

Epinephrine: Monitor

A

BP, HR, rhythm, infusion site, evidence of extravasation

Pharmacology (10 decks)

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