Cardiac Medications

Question 1

INOTROPES

Answer 1

affect contractility, digoxin

Question 2

CHRONOTROPES

Answer 2

affect heart rate

Question 3

DROMOTROPES

Answer 3

affect the speed of impulse conduction through the heart.

Question 4

Positive Inotropes

Answer 4

A positive inotrope increases contractility

e.g. Dopamine, Epinephrine, Digoxin, Primacor, Ambrinone, Dobutamine

Question 5

Negative Inotropes

Answer 5

A negative inotrope decreases contractility

e.g. Atenolol, Diltiazem

Question 6

Positive Chronotropes

Answer 6

A positive chronotrope increases heart rate by causing the SA node to fire faster
e.g. Atropine, Epinephrine

Question 7

Negative Chronotropes

Answer 7

A negative chronotrope decreases heart rate

e.g. Digoxin, Atenolol, Amiodarone

Question 8

Positive Domotropes

Answer 8

A positive dromotrope increases the speed of impulse conduction through the heart
e.g. Epinephrine, Dopamine

Question 9

Negative Domotropes

Answer 9

A negative dromotrope decreases the speed of impulse conduction through the heart
e.g. Digoxin, Atenolol

Question 10

Digoxin

Answer 10

Digoxin slows heart rate and conduction but increases contractility so it is a:
Negative chronotrope
Negative dromotrope
Positive inotrope

Question 11

Epinephrine

Answer 11

Epinephrine speeds up heart rate, conduction and contractility so it is a:
Positive chronotrope
Positive dromotrope
Positive inotrope

Question 12

Norepinephrine

Answer 12

This is an alpha AGONIST.
Has small positive effect on B1 receptors

What will this drip do to preload and afterload? Increases afterload because it constricts

Has no effect on heart rate or conduction speed.

Good when we need to increase BP without causing/worsening tachycardia

Question 13

Epinephrine

Answer 13

This is an alpha, B1 and B2 AGONIST.
What does this do to preload and afterload?

It is also a positive chronotrope, dromotrope and inotrope.

Can increase myocardial O2 demands which may be detrimental

Question 14

Dopamine Drips

Answer 14

Naturally occurring substance in our brains.
Positive inotrope, positive chronotrope, positive dromotrope, positive dopaminergic.

Dopamine is prescribed as micrograms/kg/minute
It has different effects at different doses.

1-3 mcg/kg/min You will hear this called “renal dose Dopamine” because it stimulates the dopaminergic receptors in the kidney to dilate the renal arteries and hopefully, increase urine output.

4-10 mcg/kg/min cardiac effects seen. Heart rate speeds up, conduction and contractility are significantly increased—-cardiac output improves.
Very good when contractility is the problem but sometimes, the tachycardia can cause problems (remember coronary filling?)