Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Pharm II, Exam 2 > Cardiac Meds > Flashcards

Cardiac Meds Flashcards

0
Q

Epinephrine

Bronchodilator dose

A

0.1-0.5 mg IM/SQ q10-15 m repeat PRN

8-15 gtts in nebulizer reservoir 4-6x/day onset 1min

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
1
Q

Epinephrine

Cardiac arrest dose

A 
1mg IV q3-5m =standard
2-5mg IV q3-5 = intermediate
1,3,5 MG IV q3m = escalating 
0.1 mg/kg IV q3-5 min high
ETT 2-2.5x higher dose in 10 ml NS/distilled water
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Epinephrine

Anaphylaxis dose

A
  1. 3-0.5 mg IM/SQ q15-20 min repeat PRN

0. 1 mg IV over 5-10 min if hypotension, f/u with 1-10mcq/min gtts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Epinephrine

Refractory hypotension & bradycardia DOSE

A

1-10 mcq/min IV titrated to effect

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Epinephrine what receptors?

A

Alpha & beta agonist

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are alpha effects of epinephrine

A 
Alpha 1: 
-peripheral vasoconstriction, inc PVR
-sphincter contraction bladder
Alpha 2:
-Decrease insulin secretion, inc BS
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are beta effects on epinephrine

A

B1: inc HR, contractility, conductivity- inc BP
B2: dilation of skeletal m, bronchodilator, detrussor relaxation, incr glycogenolysis
B3: increase lypolysis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the toxic effects of epinephrine

A
  • stress related: fear, anxiety, restlessness
  • cardiac arrhythmias esp when used w/halothane
  • pressor effect: lg doses extreme HTN—-MI, stroke, etc
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Norepinephrine (levophed)

What receptors

A

Alpha and Beta1 not B2

Increase in SVR
Vasoconstriction in all vascular beds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Cardiac effects of norepinephrine

A

Baroreceptor mediated reflex BRADYCARDIA

Inc SVR- dec venous return- dec CO

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Effects of levophed on blood vessels

A

A1: vasoconstriction in all vascular beds incr in SVR- dec venous return- dec CO

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Toxic effects of norepinephrine

A

Similar to epinephrine, but less severe

Don’t use with halothane - dysrythmias

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Norepinephrine dose

A

0.5-1mcq/min titrated to desired response
8-30 mcq/min is usual dose
ACLS dose range is 0.5-30mcq/min
O: 1-2 min D: limited.
Elimination: urine 84-96% as inactive metabolite

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Dopamine doses, onset, peak, DOA

A 
1-20 mcq/kg/min
Renal 1-3 mcq/kg/min
Beta    2-10
Alpha   >10 increase PVR, decrease RBF
O: 2-4 min.      P: 2-10 min.         DOA<10 min
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What receptors does dobutamine works on

A

Beta 1 agonist, minimal if any B2 & A agonist effects
Positive inotropic, less chronotropic effects
Direct acting synthetic catecholamine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Dobutamine problematic

A

Pregnant pt: increases uterine vascular resistance thereby decreasing uterine blood flow

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Why we use dobutamine

A
  • increase CO for CHF pt, esp if HR & SVR are increased
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Dobutamine dose

A

2-20 mcq/kg/min
>10mcq/kg/min predisposes to tachycardia & dysrythmias
>20 increases HR>10%, may lead to MI

O: <10

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Toxic effects of dobutamine

A
  • Caution in A-fib pt r/t increased conduction velocity may cause RVR
  • Increases risk of SVT & ventricular arrhythmias with VAs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Which med increases risk for SVT/arrhythmias due to VA?

A

Dobutamine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

How to use dobutamine if SVR is high?

A

Use with vasodilators to decrease afterload to optimize CO

No vasoconstrictor activities and no effect on SVR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Contraindications for Isoproterenol

A

V-tach, vfib, hypotension, idioventricular rhythm, ischemic heart, cardiac arrest, CAD pt

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

The most potent sympathomimetic at B1 & 2 receptors

A

Isoproterenol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Isoproterenol

receptors & Effects

A
  • B1: Increases HR, contractility, automacitity=inc CO/MRO2 consumption
  • B2: Decreased SVR/MAP due to vasodilation in skeletal muscle
  • B1 & B2 agonist
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
How is Isoproterenol metabolized
Liver by COMT | Rapidly metabolized- needs continuous infusion
25
Dobutamine doses
-2-20 mcq/kg/min >10 predispose pt to tachycardia/dysrhythmias >20 incr HR>10% may lead to MI
26
Which drug can cause tachyphylaxis?
Ephedrine
27
Ephedrine Dose, onset, duration, metabolism, excretion, receptors
``` 5-10 mg prn max=60 mg Onset=<1 mon Duration 5-15 min Metabolism: liver Renal up to 40% unchanged Direct B1 & B2, indirect A1 via NE relase ```
28
Which med is safe for pregnancy
Ephedrine
29
What is the drug of choice for CAD pt, to increase BP
Phenylepherine: Neo-synephrine Direct A1 agonist
30
What is neosynephrine use for
Increase BP Drug of choice for CAD r/t minimal chronotropic effects Prolongs LA effects
31
Phenylepherine dosing Receptors
``` Supplied as 1% solution = 10mg Dilute .1ml=1mg in 10ml for 100mcq/ml Dose: 50-100 mcq IV bolus 2-5 mg IM/SQ ``` Drip 30mg/500ml = 60 mcq/ml Rate 10-200 mcq/min titrated Direct A1 agonist
32
Phentolamine Receptor Use
A1 & A2 blocker | Use: HTN crisis, prevent sloughing after inadvertent extravasation of sympathomimetic drugs
33
What r the effects of Phenolamine on cardiac & blood vessels
Cardiac: increased HR via baroreceptor reflex (also blocked A2=increased NE release) Blood vessels: anti A1= vasodilator, decreases systemic BP
34
Phenoxybenzamine Receptor Use Causes
A1 & A2 blocker Use: control BP for pheochromocytoma, reynaud's ??? Blood vessels: vasodilation, ortho hypotension Slow onset
35
alpha 2 function Pre Post
Pre- inhibition of NE release: negative feedback loop | Post- hyper polarization of CNS cells (dec Mac) platelet aggregation
36
Alpha 1 function Med agonist - Med antagonist -
Vasoconstriction, mydriasis, GI relaxation, GI sphincter contraction Agonist: Phenylephrine Antagonist: Prazosin
37
Beta 1 Function Meds: agonist and antagonist
Post: cardiac= increased conduction, automaticity, contractility Dobutamine Metoprolol
38
Beta 2 Presynaptic Postsynaptic Medications
Pre- NE release Post-vasodilation, bronchodilator, GI/uterine/bladder relaxation, glycogenolysis, lipolysis Terbutaline
39
Norepinephrine should not be used....
Pregnancy, alpha 1-causes contractions
40
What receptors - neosynephrine
Direct A1 agonist | A2 @ High Doses
40
What Alpha antagonists do?
Bind selectively to Alpha receptors interfering w/ability of catecholamines & sympathomimetic agents to elicit alpha responses.
40
What do Beta antagonist exhibit?
Selective affinity for receptors where they competitively inhibit stimulation
41
What activates receptors?
NE, Epi, Dopa or agonist drugs
42
Alpha 1 POST
Vasoconstriction, mydriasis, GI relaxation, contraction of GI/bladder sphincters
43
Alpha 2 POST
Hyper polarization of the CNS cells, decreased MAC, platelet aggregation
44
Alpha 2 PRE
Inhibition of NE release | Negative feedback loop
45
Beta 1 POST
Cardiac-increased conduction, automaticity & contractility
46
Beta 2 POsT
Vasodilation, bronchodilation, GI uterine & bladder relaxation, glycogenolysis, lipolysis
47
Beta 2 PRE
Norepinephrine release
48
Yohimbine
Alpha 2 pre blocker More NE, erectile dysfunction, veterinary medicine to reverse certain sedatives
49
Propranolol Dose Contraindicated Receptors
.5-3 mg IV 20-80 mg PO for migraines Not for asthma pt B1 & B2 Blocker
50
Esmolol = brevibloc | Use
Prevent HTN from ECT, response to laryngoscopy
51
How is brevibloc hydrolyzed?
In the blood by plasma esterase
52
Brevibloc Receptors Doses
Beta 1, in high doses beta 2 100-200 mg IV 2 min prior to intubation .5-1mg/kg load + 50-300 mcq/kg/min -----HTN .5 mg/kg load + 50-200 mcq/kg/min--------SVT
53
Labetalol | Receptor
B1 & B2 > A1 blocker Beta > Alpha = 3:1 PO, 7:1 IV, not A2= negative feedback is intact: NE stimulation intact
54
Labetalol | Dose
-5-20mg IV initially, increased to 40-80 mg q10 min up to 300 mg Infusion .5-2 mg/min ---- not common
55
What meds r used for pheochromocytoma
Prazosin A1 blocker | Phenoxybenzamine A1 & A2 blocker
56
What is the MOA for Ace inhibitors
Block conversion of angiotensin I to angiotensin II via competitive inhibition of Ace
57
When would you use ACE inhibitors
1st line therapy for HTN, CHF, mitral regurg
58
How is renin secreted
Juxtaglomerular apparatus of the kidney in response to glomerular hypo perfusion or a reduced salt intake Or release in response to stimulation from the SNS
59
Conversions renin to
Angiotensin I--- rapidly in converted to Angiotensin II in lungs by ACE
60
What is Angiotensin II?
Potent vasoconstrictor and thus causes rise in BP | Stimulates release of aldosterone from the adrenal gland--- inc BP
61
What is HTN related to
Interection between ANS & renin angiotensin system | Na, circulating volume, & some hormones
62
What local vasoactive agents do endothelial cells have?
Vasodilator ---------nitric oxide | Vasoconstrictor ----peptide endothelin
63
What is atrial natriuretic peptide
-Hormone secreted from atria of the heartiness response to increased volume -acts like natural diuretic, Defect may cause fluid retention & HTN
64
What is Ouabian?
Steroid like substance | Interfere with cell Na & Ca transport---vasocontstriction
65
When is elevated SBP and DBP more important
SBP after age >50 years old | DBP before <50 years old
66
Secondary HTN
55 y.o. Artherosclerosis renal artery stenosis, sudden onset: TIA MI Episodic: high thyroid, obesity,
67
Grade 2 secondary HTN
Unresponsive to meds
68
What diuretic has a high ceiling effect | MOA
Lasix Act on ascending loop of Henley Inhibits Na, K, Cl reabsorption, all 3 go out with urine Most effective diuretic drugs
69
S/s of lasix
Hypokalemia Ototoxicity reversible: tinnitus, ear pain, vertigo, hearing impairment Dehydration Hypotension ASA has irreversible ototoxicity
70
Lasix drug interaction
Digoxin- ventricular dysrythmias low K Ototoxic drugs: Aminoglycosides Lithium not metabolized element,
71
What drugs work in the distal convoluted tubule
Thiazide & related diuretics
72
Function of thiazide Ceiling effect Contra
Increase renal excretion of Na, Cl, K, and H20 Low ceiling diuretic Caution in sulfa allergy
73
Which drug causes hyperuricemia
Thiazide Hypokalemia Hyperlipidemia Conta: Sulfa allergy
74
What drug/diuretic can be used for DI
``` Thiazide Clinical use: Essential HTN Edema DI ```
75
Where in the kidney do K sparing diuretics work
Distal tubule where Na is normally reabsorbed in exchange for K
76
What r two types of K sparing diuretics?
Epithelial Na channel blockers | Aldosterone receptor antagonist: blocks action of aldosterone
77
Adverse effects of potassium sparing diuretics
Hyperkalemia | Endocrine effects: male boobs, menstrual irregularities
78
Which drug has NO receptors?
Osmotic diuretics
79
What diuretic - glaucoma
Carbonic anhydrase inhibitor
80
What drugs can cause ototixicity
Lasix & mannitol
81
What drugs increases lithium level
Thiazides & Ace inhibitors

Pharm II, Exam 2 (1 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions