CV Flashcards
WHAT ARE PERIPHERAL EXCITATORY ACTION OF E/NE?
VASOCONSTRICTION OF SMOOTH MUSCLE OF BLOOD VESSELS PERFUSING SKIN.
WHAT ARE SYMPATHOMIMETIC AMINES?
EPI AND NOREPI
WHAT IS PERIPHERAL INHIBITORY ACTION?
RELAX SMOOTH MUSCLES OF THE GUT, BRONCHIOLES, AND BLOOD VESSELS PERFUSING SKELETAL MUSCLES.
E/NE CARDIAC EFFECTS ARE WHAT?
POSITIVE CHRONOTROPIC, DROMOTROPIC, AND IONOTROPIC.
E/NE METABOLIC EFFECTS ARE?
ENHANCES GLYCENOLYSIS AND LIPOLYSIS. WILL RESULT IN INCREASED BLOOD GLUCOSE AND FATTY ACIDS.
NE/E ENDOCRINE ACTIONS?
MODULATE THE SECRETION OF INSULIN.
NE/E EFFECT ON CNS?
INHIBIT APPETITE. INFLUENCE LEVEL OF AROUSAL
WHAT RECEPTORS DOES EPI ACTIVATE?
BOTH ALPHA AND BETA RECEPTORS.
EPI DOSES AND EFFECTS. LOW, MODERATE, HIGH DOSE.
LOW: 1-2 MCG/MIN: STIM BETA 2: MODEST VASODILATION.
MED: 4 MCG/MIN: STIM. BETA 1: INCREASED BP, HR, CO.
HIGH: 10-20 MCG/MIN: STIM. BOTH ALPHA AND BETA CAUSING VASOCONSTRICTION AND DILATION.
EPI CARDIAC ARREST DOSE?
1MG IV Q 3-5 MIN.
EPI TOXIC EFFECTS ARE….?
STRESS SYMPTOMS, CARDIAC ARRHYTHMIAS ESP WHEN COMBINED WITH CERTAIN VA DRUGS LIKE HALOTHANE. PRESSOR EFFECT IN LARGE DOSES CAN CAUSE EXTREME INCREASE IN BP AND CAN CAUSE STROKE, MI ETC.
WHAT RECEPTORS DO NE WORK AT?
ALPHA AND B1. NO B2 SO NO BRONCHODILATION.
WHAT ARE TOXIC EFFECTS OF NE?
SAME AS EPI EXCEPT LESS PRONOUNCED AND FREQUENT. CONTRAINDICATED WITH HALOTHANE, PREGNANCY.
ACLS DOSE OF NE?
.5-30 MCG/MIN TITRATE TO EFFECT.
WHAT IS THE DOSE OF DOPAMINE?
RENAL DOSE: 1-3 MCG/KG/MIN
BETA DOSE: 2-10 MCG/KG/MIN
ALPHA DOSE: > 10MCG/KG/MIN
WHAT RECEPTORS DOES DOBUTAMINE WORK AT AND WHAT IS THE DOSE?
MAINLY B1 RECEPTOR.
2-20 MCG/KG/MIN
INDICATIONS/CONTRAINDICATIONS FOR DOBUTAMINE?
TO INCREASE CO IN PTS WITH CHF, ESP IF HR AND SVR ARE INCREASED.
IE: WANT A GOOD SQUEEZE WITHOUT MUCH ELSE.
CAUTION IN PT WITH A FIB. AND THERE IS AN INCREASED RISK OF SVT/ V ARRYTHMIAS WITH VA. HIGHER DOSES PREDISPOSE PT TO TACHYCARDIA AND DYSRYTHMIAS.
RECEPTOR ISOPROTERENOL WORKS AT?
DOSE?
INDICATIONS/CONTRAINDICATIONS?
ACTS SELECTIVELY ON BETA RECEPTORS…1 AND 2.
END RESULT IS INCREASED CO AND O2 CONSUMPTION. 2-10 MCG/MIN INFUSION…TITRATE TO EFFECT.
USED FOR ASTHMA BRONCHODILATION, INCR HR IN HEART BLOCK, DECR PULM VASC RESISTANCE IN PULM HTN. CONTRAINDICATED IN V TACH, VFIB, HYPOTENSION.
WHAT IS MOA OF EPHEDRINE?
ACTS DIRECTLY ON B1 AND B2. ACTS INDIRECTLY ON ALPHA 1 BY CAUSING NE RELEASE. CAUSES INCREASED BP AND HR. INCREASE IN BP ONLY IF NE STORES ARE INTACT.
DOES EPHEDRINE ELICIT TACHYPHYLAXIS?
YES! IT MAY DEPLETE THE NE STORES IN SYMPATHETIC NERVE ENDINGS.
EPHEDRINE INDICATIONS?
HYPOTENSION DUE TO VASODILATION. GOOD FOR USE IN PREGNANCY AS IT DOES NOT REDUCE PLACENTAL BLOOD FLOW.
EPHEDRINE DOSE?
5-10MG. MAX DOSE IS 60MG.
HOW DOES NEOSYNEPHRINE WORK?
DIRECT ALPHA 1. NO BETA. ALPHA 2 IN HIGHER DOSES. GOOD FOR PT WITH CAD OR ADEQUATE HR.
WHY IS NEO THE DRUG OF CHOICE FOR CAD?
IT INCREASES CORONARY PERFUSION WITHOUT INCREASING HR.
WHAT IS DOSE FOR NEO?
50-100MCG IV BOLUS PERIOP.
INFUSION 10-200 MCG/MIN TITRATED TO EFFECT.
HOW MUCH PHENTOLAMINE WOULD YOU GIVE IF YOUR EPI JUST WENT SUB Q?
5-10 MG PHENTOLAMINE.
WHAT ARE 2 POSSIBLE USES FOR PHENOXYBENZAMINE?
ITS AN ALPHA ANTAGONIST CAUSING VASODILATION. CAN BE USED TO CONTROL BP FOR PHEOCHROMOCYTOMA AND POSSIBLE USE FOR RAYNAUDS.