B2 Flashcards
Damorphine?
An analgesic
Mu-opioid agonist
MoA: Heroin, targets 4 endogenous neurotransmitters (beta-endorphin, dynorphin, leu-enkephalin, and met-enkephalin). Heroin reduces (and sometimes stops) production of the endogenous opioids. Endorphins are regularly released in the brain and nerves, attenuating pain.
What is a healthy oxygen SAT?
96%
Low blood oxygen levels be treated with pure oxygen or air/oxygen mixtures via a mask, nasal cannula, or tracheal intubation.
What does adrenergic antagonists compete with?
Sympathomimetic neurotransmitters such as catecholamines for binding at beta(1)-adrenergic receptors in the heart and vascular smooth muscle. This results in a reduction in resting heart rate, cardiac output, systolic and diastolic blood pressure, and reflex orthostatic hypotension
Atenolol
Beta-adrenergic antagonist.
MoA: Atenolol has similar properties to propranolol, but does not have a negative inotropic effect. Higher doses of Atenolol also competitively block beta(2)-adrenergic responses in the bronchial and vascular smooth muscles.
What is propranolol?
A widely used non-cardioselective beta-adrenergic antagonist.
Can be used for acute myocardial infarction, arrhythmias, angina pectoris, hypertension, hypertensive emergencies, hyperthyroidism, migraine, pheochromocytoma, menopause, and anxiety
Use: Rarely used other than in migraine, cirrhosis of the liver with portal hypertension, and in thyrotoxicosis
Bendroflumethiazide
Sodium chloride cotransporter inhibitor
Thiazide diuretic
MoA:
o It inhibits the Na-Cl cotransporter, blocking active chloride reabsorption in the early distal tubule. This results in an increase in the excretion of sodium, chloride, and water.
o It inhibits sodium ion transport across the renal tubular epithelium through binding to the thiazide sensitive sodium-chloride transporter. This results in an increase in potassium excretion via the sodium-potassium exchange mechanism.
What is amiodarone?
Antianginal and antiarrhythmic agent.
Amiodarone is a Vaughan-Williams Class III antiarrhythmic agent.
MoA: Prolonging the myocardial cell-action potential (phase 3) duration and refractory period and it acts as a noncompetitive a- and b-adrenergic inhibitor.
Warfarin
Anticoagulant
MoA: Inhibition of vitamin K reductase, reducing levels of the reduced form of vitamin K. As vitamin K is required for the production of coagulation factors II, VII, IX, and X and anticoagulant proteins C and S, these levels also drop. Depression of three of the four vitamin K-dependent coagulation factors (factors II, VII, and X) results in decreased prothrombin levels, decreased thrombin generation and reduced ability to form a clot
Use: Prevention and treatment of thromboembolic disease including venous thrombosis, thromboembolism, and pulmonary embolism as well as for the prevention of ischaemic stroke in patients with AF. Warfarin can cross the placental barrier during pregnancy resulting in foetal bleeding, spontaneous abortion, and neonatal death
Ramipril, Lisinopril, Enalapril, and Captopril
Competitive inhibitor of angiotensin-converting enzyme (ACE)
Norepinephrine
Norepinephrine is a precursor of epinephrine secreted by the adrenal medulla.
MoA: Norepinephrine is the principal transmitter of most postganglionic sympathetic fibres and of the diffuse projection system in the brain arising from the locus ceruleus.
Norepinephrine functions as a peripheral vasoconstrictor by acting on both alpha-1 and a-2 adrenergic receptors. It is also an inotropic stimulator of the heart and dilator of coronary arteries as a result of it’s activity at the beta-adrenergic receptors
Use: Only given in ICU as infusion for cardiovascular support
Verapamil
Class IV anti-arrhythmia agent
MoA: Verapamil inhibits voltage-dependent calcium channels. In the heart it blocks the L-type calcium channels causing a reduction in ionotropy and chronotropy, reducing heart rate and blood pressure.
Use: Verapamil is still used (not commonly) but it can only be given via IV. Diltiazem more common as a non-dihydropyridine Calcium Channel Blocker, but this is not available via IV (although it is in the USA).
