CVICU Drugs Packet from the unit Flashcards
What four drugs will you see on the unit that increase contractility?
dobutamine
dopamine
milrinone
digitalis
what do dobutamine, dopamine, milrinone, and digitalis have in common?
they all increase contractility
Which 4 type of drugs reduce preload?
Nitrates
ACE inhibitors
Angiotensin II Receptor Blockers (ARBs)
Morphine
which vasoconstrictors will you commonly see on the unit?
neosynephrine
lveophed
epinephrine
vasopressin
dopamine
When does dopamine act as a vasoconstrictor?
when used in HIGH doses
what arterial dilators will you commonly see on the unit?
calcium channel blockers
antihypertensives
ace inhibitors
arbs
milrinone
nipride
how do arterial dilators decrease blood pressure?
by reducing after load
what happens when you stimulate alpha receptors?
vascular smooth muscle contraction
what happens when you block alpha receptors?
decrease in blood pressure, relaxation of vascular smooth muscles
what happens when you stimulate beta receptors?
increase in heart rate and bronchodilation
Which drug acts on beta receptors to bronchodilator?
albuterol
what happens when you block beta receptors?
decrease in HR
mild bronchoconstriction
mild decrease in BP
which drugs should you use caution in patients with COPD and why?
beta receptor blockers because of bronchoconstriction
what are 3 examples of drugs that release catecholamines?
epi, norepi, dopamine
catecholamines are released as part of the…
fight or flight response
where are catecholamines produced in the body?
primarily the adrenal medulla
what does the release of catecholamines do to the body?
increase cardiac output
increase in blood pressure
increase in heart rate
increase in blood sugar
catecholamines are a type of…
neurotransmitter
where are alpha 1 receptors located in the body?
vascular smooth muscle
what are alpha receptors responsible for?
they determine both arteriolar resistance and venous capacitance, and thus BP
what is venous capacitance?
volume of blood contained in the venous system at a given pressure
where are alpha 2 receptors located?
in the brain and the periphery
what is amiodarone?
class III anti arrhythmic
how does amiodarone work?
inhibits potassium ion fluxes during phase II and III of the action potential
Amiodarone delays polarization by…
prolonging the QT interval and the refractory period in cardiac tissue
when is amiodarone used?
pulseless v tach or v fib
stable or unstable arterial/ventricular arrhythmias
to convert and manage a fib
amiodarone works as a powerful vaso__
dilator
what must you use when hanging amiodarone?
inline filter
how is an amiodarone drip infused?
loading dose of 150mg over 10 minutes
then
maintenance drip of 1mg/min over 6 hrs
then
0.5mg/min over 18 hrs
what should be done if a patient is on an amiodarone drip and has breakthrough arrhythmias?
give supplemental loading dose of 150 mg over 10 mins
how is amiodarone given for lethal v tach or v fib?
300 mg IVP
what are 4 serious adverse reactions of amiodarone?
thyroid dysfunction
vision loss
interstitial pneumonitis
bradycardia
what is an important ingredient of amiodarone?
it is by weight, 37% iodine
excess iodine intake may precipitate…
hyper/hypothyroidism
goiter
thyroid autoimmunity
what are 3 beta blockers commonly used in the Cvicu?
metoprolol, atenolol, propanolol
what is the mechanism of action of beta blockers?
competitively inhibits catecholamines from binding to beta receptors
what are 2 main functions of beta blockers?
reduce myocardial oxygen demand and increase coronary artery perfusion
how do beta blockers reduce myocardial oxygen demand and increase coronary artery perfusion?
by decreasing heart rate and contractility, and reducing left ventricular wall stress by prolonging diastole
