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Baker CPR > CPR Drugs > Flashcards

CPR Drugs Flashcards

1
Q

Adenosine

A

Class V antiarrhythmic. Decreases conduction velocity in AV node and prolongs refractory period. IV adenosine is drug of choice for acute supraventricular tachycardia.

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2
Q

Albuterol

A

Beta-2 adrenergic receptor agonist, used in the control of chronic asthma. Racemic mixture, xopenex is the enantiomerically pure form of the same compound.

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3
Q

Amiodarone

A

Class III K+ channel-blocking antiarrhythmic. Shows class I, II, III, and IV effects. Prolongs action potential and refractory period. Used to manage atrial fibrillation and maintain sinus rhythm.

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4
Q

Amphetamine

A

Releases intracellular stores of catecholamines. Monoamine oxidase inhibitor (MAOI). Stimulates CNS, indirectly stimulates adrenergic system through norepinephrine release. Similar effects to cocaine.

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5
Q

Atenolol

A

Beta-1 selective adrenergic antagonist, cardioselective, does not cause bronchoconstriction. Lowers blood pressure. See metoprolol.

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6
Q

Bertylium

A

Class III antiarrhythmic, blocks K+ channels, also inhibits norepi release. Used to manage ventricular tachycardia and v-fib. Contraindicated in AV-block or digoxin toxicity.

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7
Q

Brimonidin

A

Alpha 2 agonist, reduces cAMP and aqueous humour production, lowers intraocular pressure in glaucoma.

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8
Q

Carvedilol

A

Beta blocker with partial alpha 1 blocking action. Lowers blood pressure, produces peripheral vasodilation. Decreases vascular wall thickening. Prevents cardiovascular mortality in heart failure patients.

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9
Q

Clonidine

A

Alpha 2 agonist, lowers blood pressure and acts on CNS. Inhibition of sympathetic vasomotor centers.

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10
Q

Digoxin

A

Positive inotrope, inhibits Na+/K+ exchange, decreasing Na+/Ca+2 exchange, more free Ca+2 in cell increases contractility. This lowers end diastolic volume, improved circulation and higher ejection fraction lower sympathetic activity and decrease peripheral resistance. This ultimately lowers heart rate and enhances vagal tone and slows conduction velocity through AV node. Cleared by kidneys, dose depends on creatinine clearance. Accumulates in muscle and has large volume of distribution. Decreased serum potassium predisposes to toxicity, may need to supplement K+. Quinidine, verapamil, amiodarone can compete with digoxin for renal clearance and increase toxicity.

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11
Q

Diltiazem

A 
Calcium channel blocker, class IV arrhythmic, used to treat hypertension.  Decreases inflow of Ca+2 that triggers contraction.  Better for atrial than ventricular arrhythmias.  
CAlly was VERy TIred- Calcium: Verapamil, Diltiazem
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12
Q

Dobutamine

A

Beta 1 agonist and catecholamine. Increases cardiac output in CHF. Inotropic support after cardiac surgery. Increases AV conduction.

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13
Q

Dopamine

A

Lower doses activate Beta 1 receptors, positive inotrope. Higher doses activate alpha 1 receptors and causes vasoconstriction. Increases blood flow to the kidneys, can treat shock when kidney function is reduced by sympathetic activity.

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14
Q

Ephedrine

A

Induces release of NE from presynaptic terminals and activate adrenergic receptors. Raises systolic and diastolic blood pressure by vasoconstriction and cardiac stinulation. Produces bronchodilation but less potent than epi or isoproterenol.

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15
Q

Epinephrine

A

Also called adrenaline. Activates all alpha and beta receptors, at lower doses beta activation and vasodilation predominate while at higher doses alpha activation and vasoconstriction arise. Synthesized from tyrosine in the adrenal medulla. Positive inotrope, strengthens heart rate and contractility, raises systolic BP and lowers diastolic BP. Decreases peripheral resistance. Powerful bronchodilator, used in rescue pens for asthma attacks and anaphylactic shock.

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16
Q

Fenoldopam

A

D1 dopamine receptor agonist, partial alpha 2 agonist activity as well. Rapid vasodilator, treats hypertension.

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17
Q

Flecainide

A

Class I-C antiarrhythmic drug, slows Phase 0 depolarization in ventricles, negative inotrope that suppresses contraction and reduces automaticity and contractility. Raises action potential threshold by slowly dissociating from resting sodium channels.

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18
Q

Guanethidine

A

Enters via NET
Blocks the release of stored NE by displacing NE from storage vesicles in presynaptic terminals.
AntiHTN

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19
Q

Ibutilide

A

Class III antiarrhythmic: K+ channel blocker
used in atrial flutter and atrial fibrillation.
Increases AP duration and QT interval

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20
Q

Isoproterenol

A

Direct-acting synthetic catecholamine, beta-1 and beta 2 agonist, no significant alpha activation. Increases heart rate and contractility through beta-1 stimulation, dilates arterioles of skeletal muscles through beta-2 stimulation and decreases peripheral resistance. Strongly increases cardiac output and heart rate, slightly increases systolic pressure, greatly lowers diastolic pressure and peripheral resistance.

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21
Q

Labetalol

A

Beta blocker with partial alpha 1 blocking action. Lowers blood pressure, produces peripheral vasodilation. La-BETA-lol is a BETA blocker.

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22
Q

Lidocaine

A

Class I-B antiarrhythmic drug, rapidly associates and dissociates from sodium channels. Shortens phase 0 depolarization, useful in ventricular arrythmia but does not slow conduction and doesn’t help with atrial or AV node problems. No negative inotropic effect.

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23
Q

Midodrine

A

Metabolized into its active form functions as an alpha-1 agonist, increases vascular tone and raises blood pressure. No positive inotropic activity.

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24
Q

Norepinephrine

A

Direct-acting catecholamine, most stimulates alpha adrenergic receptors when given in therapeutic doses. Raises systolic and diastolic blood pressure, constricts all blood vessels to greatly increase peripheral resistance, and induces reflex bradycardia. When atropine is given beforehand to block the vagus nerve, NE causes tachycardia. Used to raise blood pressure to treat shock and hypovolemia.

25
Q

Oxymetazoline

A

Direct-acting alpha-1 and alpha-2 receptor agonist, used mostly in the nose and eyes as a vasoconstrictor.

26
Q

Phenoxybenzamine

A

Irreversible alpha-1 and alpha-2 antagonist, covalently bonds to the receptors requiring synthesis of new receptors. Prevents vasoconstriction by sympathetic alpha-1 stimulation, lowers blood pressure, induces reflex tachycardia. Also increases cardiac output, unsuccessful in maintaining low blood pressure in hypertension. Because it blocks alpha receptors, only the beta-agonist activity of epi is seen, thus epi given with phenoxybenzamine will cause vasodilation and decrease blood pressure.

27
Q

Phentolamine

A

Competitively blocks alpha-1 and alpha-2 receptors, causes postural hypotension (hypotension upon standing) and epi reversal.

28
Q

Phenylphrine

A

Direct-acting synthetic alpha-1 agonist. Vasoconstrictor, raises systolic and diastolic blood pressures. Induces reflex bradycardia given parenterally. Used as a nasal decongestant and to terminate supraventricular tachycardia.

29
Q

Pindolol

A

Beta blocker that is also a weak beta 1 and beta 2 agonist. Stimulate beta receptors weakly while inhibiting stimulation by the endogenous catecholamines, epi and norepi. Diminished effect on cardiac rate and output compared to other beta blockers.

30
Q

Prazosin

A

Selective competitive inhibitor of alpha-1 receptors, actually useful in treating hypertension unlike phenoxybenzamine. Decreases peripheral resistance and lowers arterial blood pressure by relaxing arterial and venous muscle. Used to treat congestive heart failure. Prazosin, tamsulosin, and terazosin all do the same thing. PTT- Prazo, Tamsu, Terazo.

31
Q

Procainamide

A

Class IA antiarrythmic drug, similar action to quinidine, binds to open and inactive Na+ channels, preventing sodium influx and depolarization. Decreases slope of phase 4.

32
Q

Propanolol

A

Nonselective beta-blocker, negative inotrope that lowers cardiac output. Depresses sinoatrial and AV node activity. Causes bronchoconstriction, reflex peripheral vasoconstriction, increased Na+ retention. Lowers hepatic blood flow. Blocks the actions of isoproterenol.

33
Q

Sotalol

A

Class III antiarrhythmic, potent nonselective beta blocker. Blocks rapid outward K+ current, prolongs repolarization and the duration of the action potential, lengthening effective refractory period. With SO-ta-LOL, the refractory period is SO LONG.

34
Q

Tamsulosin

A

Selective competitive inhibitor of alpha-1 receptors, actually useful in treating hypertension unlike phenoxybenzamine. Decreases peripheral resistance and lowers arterial blood pressure by relaxing arterial and venous muscle. Prazosin, tamsulosin, and terazosin all do the same thing. PTT- Prazo, Tamsu, Terazo.

35
Q

Terazosin

A

Selective competitive inhibitor of alpha-1 receptors, actually useful in treating hypertension unlike phenoxybenzamine. Decreases peripheral resistance and lowers arterial blood pressure by relaxing arterial and venous muscle. Prazosin, tamsulosin, and terazosin all do the same thing. PTT- Prazo, Tamsu, Terazo.

36
Q

Verapamil

A

Class IV antiarrhythmic drug, decrease inward Ca+2 current, decrease rate of phase 4 depolarization. Bind to open, depolarized channels, therefore have greater effect on faster-beating heart. Better against atrial rather than ventricular fibrillation. CAlly was VERy TIred- Calcium: Verapamil, Diltiazem

37
Q

Acetylcholine

A

Muscarinic and nicotinic ACh receptor agonist (obviously). No therapeutic importance because of rapid inactivation and diffuse effects. Decreases heart rate and cardiac output, lowers blood pressure, sometimes used to produce miosis during eye surgery.

38
Q

Bethanechol

A

Direct muscarinic receptor stimulator, used to stimulate the bladder.

39
Q

Carbachol

A

Muscarinic and nicotinic receptor agonist. Induces miosis and decreases intraocular pressure, used to treat glaucoma.

40
Q

Pilocarpine

A

Muscarinic receptor agonist, induces miosis, stimulates salivation (used to treat xerostomia in Sjogren’s syndrome). Can reverse mydriasis caused by atropine.

41
Q

Edrophonium

A

Short-acting acetylcholinesterase inhibitor (AChEI), reversibly binds to active site of AChE enzyme. Brand-name Tensilon, used in the Tensilon Test to diagnose myasthenia gravis.

42
Q

Physostigmine

A

Substrate for AChE, reversible inactivates it. Thus potentiates cholinergic activity everywhere in the body. Contracts visceral smooth muscle, causes miosis, hypotension, and bradycardia. Antidote to atropine overdose.

43
Q

Neostigmine

A

Reversibly binds to and inhibits AChE, like physostigmine. Stimulates bladder and GI tract and symptomatically treats myasthenia gravis.

44
Q

Donepezil

A

Anticholinesterase that increases ACh concentration in the CNS to slow, but unfortunately not stop, the progression of Alzheimer’s.

45
Q

Atropine

A

Antimuscarinic agent that binds to muscarinic receptors and prevents ACh from binding. Causes persistent mydriasis of the pupil. Antispasmodic that reduces GI tract activity. Inhibits sweating and salivary secretion. Slows heart rate at low doses and raises it at high doses.

46
Q

Scopolamine

A

Muscarinic blocker, effective anti-motion sickness drug that also blocks short-term memory. Produces sedation and sometimes euphoria, can be abused.

47
Q

Tiotropium

A

Muscarinic blocker that treats bronchospasms, inhaled once daily. Treats COPD.

48
Q

Ipratropium

A

Muscarinic blocker that treats bronchospasms, inhaled several times daily. Treats COPD.

49
Q

Nicotine

A

No therapeutic benefit (except in smoking cessation therapy) and deleterious to health. Depolarizes and stimulates autonomic ganglia at low doses, blockades them at higher doses. Highly addictive.

50
Q

Cocaine

A

Blocks reuptake of monoamines (norepinephrine, dopamine, serotonin) into presynaptic terminals. Prolongation of dopaminergic stimulation produces euphoria, highly addictive. Continued usage depletes dopamine :( Potentiates action of norepinephrine and produces flight-or-flight reflex. Death can result from overdose or hyperthermia because cutaneous dilation and sweating are impaired.

51
Q

Metoprolol

A

Beta-1 selective adrenergic antagonist (beta blocker, class II antiarrhythmic), cardioselective, does not cause bronchoconstriction. Lowers blood pressure. See atenolol.

52
Q

Class IA antiarrhythmic method of action

A

Slow the rate of rise of the action potential (decrease Phase 4 slope). Slow conduction, prolong the action potential, increase effective ventricular refractory period. Concomitant class III activity (inhibition of K+ channels). Slow phase 0, prolong the action potential. Quinidine, procainamide.

53
Q

Class IB antiarrhythmic method of action

A

Na+ channel blockers that rapidly associate and dissociate from sodium channels. Useful in treating ventricular arrhythmias. Shorten phase 3 repolarization, decrease duration of the action potential. Lidocaine, mexiletine.

54
Q

Class IC antiarrhythmic method of action

A

Bind slowly to Na+ channels. Markedly depress rate of rise of the membrane action potential, slow phase 0 depolarization, slow conduction, little effect on duration of the action potential or the ventricular refractory period. Flecainide.

55
Q

Class II antiarrhythmic method of action

A

Beta-1 adrenergic receptor antagonists. Diminish phase 4 depolarization. Decrease automaticity, heart rate, and contractility, and prolong AV conduction. Used for tachyarrhythmias from sympathetic stimulation, atrial flutter, atrial fibrillation, and AV-nodal reentrant tachycardia. Propanolol (non-selective beta antagonist), metoprolol (beta-1 selective antagonist), atenolol (also beta-1 selective).

56
Q

Class III antiarrhythmic method of action

A

Potassium-channel blockers, diminish the outward K+ flow that repolarizes cardiac cells. Prolongs the duration of the action potential and prolongs phase 3 repolarization. Amiodarone, bertylium, sotalol.

57
Q

Class IV antiarrhythmic method of action

A

Calcium channel blockers, decrease Ca+2 influx and decrease rate of phase 4 depolarization, inhibit action potential in SA and AV nodes. Major effects on vascular smooth muscle and the heart. Verapamil, diltiazem. CALly is VERy TIred.

58
Q

What are the two antiarrhythmic drugs that do not fall into one of the four standard classes of antiarrhythmics? (Also called Class V antiarrhythmic drugs).

A

Adenosine and digoxin.

Baker CPR (1 decks)

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