chapter 21 - vasopressors and inotropes

Question 1

what are inotropes?

Answer 1

drugs that either increase or decrease heart contractility.
positive inotropes increase it.
negative inotropes decrease it.

Question 2

what is a Chronotropic agent?

Answer 2

drug that will increase or decrease heart rate

Question 3

give examples of catecholamines

5 examples

Answer 3

Norepinephrine
Isoproterenol
Dopamine
Phenylephrine
Vasopressin

Question 4

what drugs can be used to treat torsades?

3 drugs

Answer 4

isuprel (isoproteronol), magnesium, or procainamide

Procainamide is the indicated treatment.

Question 5

what effects does isoproteronol have?

Answer 5

has beta 1 positive inotropic and chronotropic effects and beta 2 vasodilation and bronchodialation.

Question 6

what can you say about the effects of dopamine?

Answer 6

it is dose dependant.
lower doses can increase blood flow to the kidneys but not raise contractility too high.
higher doses are the reverse

Question 7

what should you be aware of before giving dopamine to a patient.

Answer 7

It increases afterload and O2 demand in the heart.

Question 8

Why is dopamine not a first choice drug for sepsis patients?

what drug is the better choice?

Answer 8

sepsis patients have trouble oxygenating their body.

dopamine increases heart O2 demand and makes this self defeating

Question 9

what are some adverse effects of dopamine?

4 effects

Answer 9

Tachyarrhythmias, ectopic beat, palpitations, decreased perfusion

Question 10

what are the effects of Phenylephrine?

Answer 10

purely an α-agonist

it causes vasoconstriction at most vascular beds and causes a rise in systolic BP

Question 11

what does Phenylephrine have the potential to cause?

Answer 11

it can cause reflex bradycardia from aortic constriction.

Question 12

when would you use vasopressin?

Answer 12

when a patient is hypotensive due to fluid loss because this drug is an antidiuretic drug.

Question 13

what is an adverse effect to vasopressin?

Answer 13

may decrease splanchnic blood flow. which blood flow to the digestive system.

Question 14

what is dobutamine used for?

Answer 14

short term treatment of heart failure secondary to decreased heart contractility.

Question 15

Dobutamine is a right isomer to what drug?

Answer 15

dopamine

Question 16

What are the effects of the isomer of dobutamine?

Answer 16

Positive inotropic and chronotropic effects and vasodilation

Question 17

what is digoxin used for and what are its effects?

Answer 17

management of chronic heart failure and inhibits vagus nerve and slows HR.
Blocks AV node and prolongs refractory period

Question 18

Give an example of a class I - A Antiarrhythmic drug?

Answer 18

Procainamide

Question 19

What are 2 things that can cause irritations to the heart muscle?

Answer 19

Hypoxemia and Acidosis

Question 20

Give an example of a Class I-B Antiarrhythmic drug?

Answer 20

Lidocaine

Question 21

What might you use to treat a patient who has coughing reflex due to an ET tube placement?

Answer 21

Lidocaine dropped into ET tube to soothe out the Carina.

Question 22

what is Lidocaine used to treat?

Answer 22

VENTRICULAR Arrhythmia
Soothes irritated portions of the heart and relaxes the heart.
But too much can slow the heart down too much.

Question 23

Beta Blockers have what effect on the heart?

Answer 23

They are negative inotropes. they decrease contractility

Question 24

what do can you use to treat patients with supraventricular tachycardia?

Answer 24

Adenosine.

Which stops the heart and due to 12 second half life, the heart should restart right away.

Question 25

What is an alternative route of administration after IV?

Answer 25

intraosseous and ET Tube

Question 26

WHat arethe durgs that can be adminstered through the ET tube?

Answer 26

``` Narcan/Naloxone Atropine Vasopressin Epinephrine Lidocane ```

Question 27

What is a first line therapy for hypotensive episodes?

Answer 27

Fluids

Question 28

Class I-A anti-arrhythythmics drugs are associated with what cardiac actions?

Answer 28

Pro arrhythmic properties like QT-interval prolongation

Question 29

Procainamide belongs to what class of Antiarrhythmic drugs?

Answer 29

CLASS I-A

Question 30

Class I-B anti-arrhythythmics drugs are associated with treating what cardiac conditions?

Answer 30

Ventricular arrhythmias

Question 31

Lidocaine belongs to what class of Antiarrhythmic drugs?

Answer 31

CLASS I-B

Question 32

CLASS I-C Antiarrhythmic drugs are commonly used to treat what?

Answer 32

Supra ventricular tachycardia (SVT) But they can also have activity against ventricular arrhythmias as well

Question 33

CLASS II Antiarrhythmic agents contain what kind of drugs? What conditions do they treat?

Answer 33

Beta blockers Management of hypertension and post-myocardial infarction

Question 34

Propranolol and metoprolol belong what what class of Antiarrhythmic drugs?

Answer 34

Beta blockers Trick is they all end in "lol"

Question 35

Beta blockers are commonly used for what type of effects on the heart?

Answer 35

Negative Dromotropic and negative chronotropic properties

Question 36

What class of Antiarrhythmic drugs belong to CLASS IV?

Answer 36

Calcium channel blockers

Question 37

Calcium channel blockers manage what?

Answer 37

SVT and ventricular rate control for AF

Question 38

Verapamil and diltiazem belong to what class of drugs?

Answer 38

CLASS IV - calcium channel blockers

Question 39

Adenosine is used to treat what?

Answer 39

SVT