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Big Blue Topics > Cardiac drugs > Flashcards

Cardiac drugs Flashcards

1
Q

nitroprusside: indication

A

-HTN, CHF without ischemia

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2
Q

nitroprusside: side effects

A

hypotension, reflex tachy, cyanide tox, methemoglobinemia

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3
Q

SNP: action

A
  • direct smooth muscle relaxation

- decreases preload and afterload

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4
Q

SNP titration

A
  • up to 10 ug/kg/min
  • don’t give over 1 mg/kg in 2.5 hrs
  • toxic levels of 100 ug/kl occur if more than 1 mg/kg given over 3 hours
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5
Q

cyanide tox

A
  • unexplained metabolic acidosis

- treat with sodium nitrate and thiosulfate

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6
Q

Nitroglycerine: indication

A

Myocardial ischemia, pulmonary HTN, systemic HTN

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7
Q

NG: side effects

A

hypotension, arrhythmia, myocardial ieschemia

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8
Q

NG: action

A
  • direct smooth muscle relaxation
  • reduces preload
    0. 25-5 ug/kg/min,
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9
Q

epinephrine: indications

A

hypotension, LV failure, bronchospasm

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10
Q

epi: side effects

A

HTN, arrhythmias, myocardial ischemia

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11
Q

Dosage effects

A
  • 1-2 ug/min-b2-bronchodilation (0.01-0.05 ug/kg/min)
  • 4 ug/min-stim b1 receptors, LV improves
  • 10-20 ug/min–both and alpha and beta receptors activated
  • renal blood flow decreases, CO and HR increase
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12
Q

Dopamine: indications

A

-hypotension, oliguria

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13
Q

dopamine: side effects

A

HTN, tachycardia, arrhythmia, myocardial ischemia

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14
Q

dopamine: effects

A 
-increase contractility, renal blood flow, GFR
1-30 ug/kg/min-dopaminergic
2-10 beta
>10-alpha
-less arrhythmogenic than epi
-modiest inc in HR
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15
Q

dobutamine: indications

A

-Heart failure

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16
Q

dobutamine: side effects

A

hyper and hypotension, tachycardia, arrhythmia, myocardial ischemia

17
Q

dobutamine action

A
  • selective b1 agonist
  • dose-dependent increases in CO without marked increases in HR and BP
  • acts directly to increase contractility
18
Q

Amrinone: indication

A

-short term CHF

19
Q

amrinone: side effects

A

thrombocytopenia, tachyphylaxis, hypokalemia, GI effects–marked hypotension in hypovolemic pts

20
Q

PDEI

A
  • PDE breaks down cAMP

- PDEI–inc cAMP, improves uptake, storage and release of ca from SR during excitation-contraction coupling

21
Q

-amrinone: action

A
  • inc CI, dec SVR and cardiac filling pressures
  • HR usu unchanged to slightly inc
  • in pts with CHF, does not significantly inc myocardial O2 consumption
  • enhances AV conduction–pts with atrial arrhythmias should be pretreated w/ digitalis
22
Q

milrinone

A
  • bypyridine derivative
  • positive inotropy, vasodilation
  • greater decrease in LV pressure and BP compared to amrinone b/c has enhanced vasodilatory properites
23
Q

chronotropes

A

atropine, isoproternol

24
Q

isoproterenol

A
  • b1 and b2 agonist
  • 3rd degree HB and EMD
  • may decrease SVR and MAP at same time it’s increasing HR, contractility and myocardial O2 consumption
25
Q

SVT rx

A
  • adenosine–6 mg, then 12mg, then 12mg

- verapamil-can be lethal in VT

26
Q

amiodarone

A
  • antidysrhythmic
  • recurrent or refractory V-tach or V-fib
  • inc refractory period, reduce membrane excitability of heart
  • use prior to 3rd or 4th counter shock in cardiac arrest
27
Q

LIdcoaine

A
  • suppresses ventricular arrythmias-PVC, Vtach, Vfib
  • decreases automaticity without causing myocardial depression
  • can block chronotropy and dec sympathetic NS outflow
28
Q

LIdo and defibrillation

A
  • disrupts subsequent defib and cardioversion by increasing current and energy requirements, a process worsened by acidosis
  • asystole has been associated with prophylactic use of lido for rx of cardiac arrest\
29
Q

LIdo dosing

A
  • 1.5-6ug/cc is therapeutic level
  • 1mg/kg bolus, 15-60 ug/kg/min infusion
  • rate of metabolism is dependent on hepatic blood flow and hepatic function
30
Q

Procainamide

A

-suppresses ventircular ectopy when lido is ineffective

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