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CV Module > Cardivascular Stimulants > Flashcards

Cardivascular Stimulants Flashcards

1
Q

Which drugs are affected by pre-treatment with Reserpine?

A 
Reduced (mixed acting)
-ephedrine
Abolished (indirect acting)
-Tyramine
-Amphetamine
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2
Q

How does the administration of Epinephrine affect diastolic pressure?

A

It barely affects it and may lower it due to the Beta-2 vasodilatory effect

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3
Q

What are the effects of IV epi?

A

Cardio stimulatory, increase in heart rate and force of contraction, vaso constriction

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4
Q

What is the effect of small dose epi

A

Small dose epi may decrease blood pressure

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5
Q

How does Epi affect the heart rate?

A
  1. Shortened systole which increases CO and O2 consumption
  2. Increased relaxation rate of ventricular muscle
  3. Accelerating SA node slow depolarization rate
  4. Amplitude of AP and maximal rate of depolarization (phase 0) also are increased
  5. Activates latent pace maker cells in SA node
  6. Directly shortens AV node refractory period; opposed by reflex vagal discharge
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6
Q

What is one of the consequences of epi administration?

A

Premature ventricular contractions may occur

-ventricular extrasystoles, tachcardia or even fibrillation may be precipitated

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7
Q

How does Ephedrine Administration affect the renal system?

A
  1. Decreases renal Blood flow
  2. Decreses excretion of Na+, K+, and Cl-
  3. Increases renin secretion (B1 receptors of JGA)
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8
Q

How does Ephedrine administration affect the pulmonary system?

A
  1. Increases pulmonary (arterial and venous) pressures
    - Redistribution of blood from other constricted areas
    - Pulmonary edema precipitated by high conc
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9
Q

What are the side effects of Epinephrine administration?

A
  1. Cerebral hemorrhage especially with non-specific b-blockers
    - Ventricular arrhythmias
    - Angina
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10
Q

What opposes the effects of Norepi on the heart?

A

Vagal stimulation

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11
Q

What is a complication of IV administration of Norepi?

A

Necrosis at infusion site

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12
Q

What drug will oppose the effect of Norepi?

A

Phentolamine

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13
Q

What effect does dopamine have on the kidney at low conc?

A

Increases renal perfusion

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14
Q

What are the Low dose effects of Dopamine .2-2 mcg/kg/min?

A

Predominantly D1 action

  • Vasodilation in renal mesenteric coronary and intracerebral vasculature
  • inproves GFR
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15
Q

What are moderate dose (2-10 mcg/kg/min) effects

A

D1 and B1 activity

  • increase CO (contractility»»>HR) and the D1-induced vasodilation
  • Moderate dose also causes the release of NE from nerve terminals which contributes to its effects in the heart
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16
Q

What are the effects of High dose (10 mcg/kg/min)?

A

Alpha agonism predominates

-increase peripheral vascular resistance and renal vasoconstriction

17
Q

Where does Dobutamine have its effect?

A

Beta-1 agonist that increases CO and in so doing increases urinary output

18
Q

What is the major use of Dobutamine

A

For short term treatment of cardiac decompensation

19
Q

What is interesting about Dobutamine?

A

Ultrashort halflife

20
Q

Where does Isoproterenol have its effects?

A

Beta receptors, it decreases diastolic blood pressure

May cause Palpitations, sinus Tachycardia; and even serious arrhythmias

21
Q

Where does Isoproterenol decrease resistance?

A

In vasculature of skeletal muscle but also in renal and mesenteric vascular beds

22
Q

How is isoproterenol given?

A

Parenteral or by aerosol

23
Q

What is the major use of isoproterenol?

A

Used in emergencies to stimulate HR in patients with bradycardia or heart block particularly in anticipation of inserting an artificial cardiac pacemaker or in patients with ventricular arrhythmia torsades de pointes

24
Q

What is Phenylephrine?

A

Direct acting alpha-adrenergic agonist with virtually no B-adrenergic activity

25
Q

What are the effects of Phenylephrine administration?

A

Systemic Arterial vasoconstriction and reflex decrease in HR and CO

26
Q

What are the indication of Phenylephrine?

A

Control of hypotension associated with regional or spinal anesthesia

27
Q

What are the adverse effects of Phenylephrine?

A

Angina, anxiety, hallucinations or psychosis, hypertension, excitability dizziness insomnia pallor

28
Q

What are the effects of Ephedrine?

A

Mixed acting smpathomimetic

  • direct action on both a and b receptors
  • Enhances release of NE from sympathetic neurons
29
Q

What are the uses of Ephedrine?

A

Used for hypotension and hypotension of analgesia

30
Q

What are some of the side effects of Ephedrine administration?

A
  1. Increased cardia workload leads to Angina
  2. s-TACH
  3. Fatal Arrhythmias including ventricular fibrilation

CV Module (24 decks)

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